In the field of aesthetic medicine and cosmetic surgery, Dr. Williams advances the philosophy and disciplines of prevention, longevity and anti-aging medicine. He is a Diplomate of the American Board of Hair Restoration Surgery, Fellow of the International Society of Hair Restoration Surgery, and a board certified primary care physician. He is and member of the American Academy of Cosmetic Physicians, and a Fellow and active member with numerous leadership committees with the International Society of Hair Restoration Surgery. Dr. Williams is the founder and principle physician and surgeon at the Irvine Institute of Medicine and Cosmetic Surgery-Orange County Hair Restoration. Finally, he is a contributor to U.S. News & World Report medical blog.


Re-growing hair: It is likely that the hair will grow back even without treatment. It may fall out again, though. Most patients lose their hair more than once before the disease goes away for good. Even people who lose all the hair on their scalp and body can have their hair grow back. When hair loss is widespread (lots of hair loss on the scalp and/or body), there is a greater chance that the hair will not re-grow.
Hi, I’m 25 years old, and started having hair loss at 15. It started and has continued to thin around my hairline only on one side, to the point that one side is receded and extremely thin. About a year and a half ago, my overall scalp started thinning as well. It’s been about a year since I’ve dyed my hair and I rarely ever put hairspray or any other chemical in my hair. I try to just wash it and let it air dry in fear that anything I do will make more hair fall out. I haven’t been to a doctor at all so far because I’ve never had health insurance. I’m about to have insurance next month and will be looking for a doctor to go to ASAP. I’ve been trying to look online and see what information I can find about what’s happening with me, but I dont’ see anything about a similar case to mine. I used to have long, thick hair and could do anything with it, and now it’s short and thin, and I can never style it at all, and my receding hairline on my right side has me so self conscious. I live in Baton Rouge, Louisiana, does anyone have any suggestions to my situation or a reputable doctor in this area?
In addition to diagnosing and treating any underlying disorder, treatments for alopecia areata include immunomodulating agents and biologic response modifiers (Table 5).6 Although topical and oral corticosteroids have been used, the treatment of choice in patients older than 10 years with patchy alopecia areata affecting less than 50 percent of the scalp is intralesional corticosteroid injections (Figure 8).6
My scalp is pain-free but has on occasion flared again but 1/100 of the original pain. My scalp still needs frequent shampooing (I could go weeks without it before) to keep the dermatitis at bay. My hair and scalp are still fairly dry and brittle despite aloe for moisture, avocado oil to moisturize and seal in moisture and Behentrimonium Methosulfate to close cuticles, provide slip and halt hair snapping, BUT the breakage is 90% better. I’m still too afraid to go back to humectants though I know they’re amazing as moisture-retainers for dehydrated hair. I have spots of completely missing hair towards my hairline that hasn’t and will probably never regrow but I’m focusing on nursing everything else back to health. 

In May I was diagnosed with rhuematoid arthritis and was put on arava, which is known to cause hair loss. After four months I noticed I was losing a bit more hair than normal so the rhuematologist added Enbrel, which I inject once a week. After a month on both my hair really started to fall out and thin. The nurse practitioner (who thinks she’s an MD) told me to stop the Arava and not to stress about it. Yeah, right! I went back to my gyne who ran lab work and found my testosterone level to be 235, way high! I had an MRI of my adrenal glands and my ovaries since these two produce testosterone. I also had an ultrasound of my ovaries. All exams were normal.
When healthy hair is pulled out, at most a few should come out, and ripped hair should not be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata, hair will tend to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy.[11]
Consider consultation with a dermatologist who has an interest in hair loss disorders. They can, admittedly, be difficult to find. Looks like you are about 3 hours away from a noted hair loss expert, Dr. Elise Olsen at Duke University. If it is very important to you, it may be worthwhile for you to travel. Hair loss cannot be appropriately diagnosed without a face-to-face consultation.
Some of the skin disorders like lupus and sarcoidosis can cause hair loss. In case of lupus, the hair tends to get brittle and may fall out in patches. Lupus hairs or short, broken hairs usually appear above the forehead. Hair loss is not permanent in general here. Some individuals with lupus also develop a form of lupus known as discoid or cutaneous lupus that affects the skin. Scars that sometimes develop on the skin of the scalp may lead to hair loss.

There is no cure for the condition.[2] Efforts may be used to try to speed hair regrowth such as cortisone injections.[1][2] Sunscreen, head coverings to protect from cold and sun, and glasses if the eyelashes are missing is recommended.[2] In some cases the hair regrows and the condition does not reoccur.[2] In others hair loss and regrowth occurs over years.[2] Among those in whom all body hair is lost less than 10% recover.[5]
About 2 years ago my hair started thinning. I thought it was because I was in college and stressed. At that point I started going what is known as “CG” in the curly hair world. I no longer color, flat iron, use sulfates and I rarely blow-dry and use silicones. I use shampoos and conditioners with beneficial ingredients, not fillers. After 1.5 years on this Curly Girl routine, I experienced some relief and noticed my hair getting thicker. That lasted a couple months and now I’m back to losing a ton of hair. One day I counted 160 hairs…that was on a decent day. I’m sure I’ve lost 2x that amount before. My hair is noticeably thinner, drier, and it knots. It NEVER use to knot. I think my hair has become finer too, but I’m not positive. It just feels more fragile. 

A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.
^ Martinez-Mir A, Zlotogorski A, Gordon D, Petukhova L, Mo J, Gilliam TC, Londono D, Haynes C, Ott J, Hordinsky M, Nanova K, Norris D, Price V, Duvic M, Christiano AM (February 2007). "Genomewide scan for linkage reveals evidence of several susceptibility loci for alopecia areata". American Journal of Human Genetics. 80 (2): 316–28. doi:10.1086/511442. PMC 1785354. PMID 17236136. 

Starting in my very early 20s i noticed the beginnings of my hair loss and started asking doctors about it with no hope/no answers until my 27.5 year. A local dermatologist “heard” something about the spironolactone/yaz combo and was willing to try it out -along with biotin, rogaine and omegas. I believe she helped the quality of my skin and hair, but did not help the fact that my hair continued to disappear.
I am so sorry you’ve been so down. I’ve had some other troubles lately that have been bringing me down so the hair loss almost seems so much less important right now. I may lose my home to foreclosure in the next month so I’m focused right now on getting that resolved and trying to stay out of foreclosure. Then I can go back to focusing on my hair again! ha!

My daughter is 17 and has had significant hair loss over the past 4 years. It has really made her self conscience and depressed. We have been to dermatologists that have done scalp biopsies , natural doctors for herbs, etc. Does anyone know of a really good dermatologist that specializes in hair loss and is knowledgable about immune disorders? We live in St Louis, but are willing to travel for help.


Hello all. First, I would like to say that this site is absolutely amazing. I have never felt so touched in my life. I too suffer from hair loss. I cannot really say what the cause is because I have never been properly diagnosed–still searching for answers. I have been to many doctors and have had many blood tests only to get back normal results (which I guess is good) but how can this be? What really amazes me is when I discuss may hair loss with my doctor, whom ever it may be that day –Endo., Derm., GP., they never seem to really want to help or maybe they just don’t know. I have spent so much money on so many different doctors and it is as if they all go by the same book. Where does one go to seek answers? It really is a sad situation. I believe that all the doctors that I go to must be going through the same type of training and education. Maybe I need to go to a doctor that just got out of med school and hope and pray that he/she learned something new instead of the norm–Purchase Men’s Rogaine….Jeez.


I am 30 and am trying Rogaine and spironolactone but only stopped the loss and I want to try Propecia. I know about the side effects for a male fetus, but I have chosen myself that I do not ever want to create a child out of my body. I will adopt or foster, but have intense lockeophobia. I even agreed to sign a legal document saying such, but my doctor would still not prescribe me propecia unless I had had a hysterectomy. He said it was for safety reasons, but as far as I understand it the only safety issue would be to such a fetus that will not exist. So I am confused about his reservations.

I got really sick at the age 40, 2 years after my second child was born,I started losing weight,I went from 54kg down to 47kg,my skin was splitting on the backs of my legs,both my hands,I had blisters up my arms ,on the tops of my feet,migraines that would have me vomiting none stop for ten hours,then only to sleep for 2 days to recover,no doctors were interested,I saw 8 and they all wanted me on anxiety medication because I was going through a break up that was there answer to the way I was feeling.No one wanted to listen to me.Almost feeling like
Furthermore, Penn dermatopathologists developed an even more advanced method called the HoVert technique for diagnosing hair loss and other disorders from a scalp biopsy. The technique uses a unique horizontal and vertical testing approach that provides a greater amount of information to the referring dermatologist than standard industry longitudinal scalp biopsies.
A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.

I would just like to spare anyone else In Los Angeles thinking about going to see the dermatologist who supposedly specializes in hair lossat UCLA (Dr Strick or something like that I think is his name) He is the most insensitive and uncaring Dr. I have ever met. After waiting close to 2 hours after my scheduled appt to see him. He gave me some xeroxed copy of an article on T E that was out of Glamour or Cosmopolitan or some Fashion magazine like that. He asked no questions. I wasnt even there for 10minutes but when I showed him a big bag of hair which I saved, that had fallen out in the past several weeks. He just very insensitively told me it was T E and it would grow back-basically like just get over it, then he gave me the bums rush out the door.


Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives?
Trying to figure out exactly what is causing your hair loss is going to require a little detective work on the part of your physician. Several lab tests are going to need to be done. I’ll make sure to make another post this week about the standard lab tests that should be ordered to start the process. Hopefully you don’t have to bring the list to the doctors office, he/she should know already. I get concerned when women have to bring a list of tests that should be ordered to their doctor. My feeling is that if they don’t know what to order then how are they going to be able to accurately read the results. But… a good doctor is a good doctor, and if you have one that really cares and takes a strong interest in your hair loss with a willingness to work with you in finding the cause then great.
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
I am 20 and have been losing hair since I was 17. It is such a confidence killer. I really do miss my beautiful thick and black hair. Now my hair is thin and a bit gray as well. I only think of it sometimes…but I used to be so depressed i can barely get out of bed. Whenever I am talking to someone, I always wonder if they are looking at my hair. I am currently using Rogaine for Women…it worked one summer when I was following the regimen religiously. However, I am so bad with routines, so now I try to remember to put it on my scalp morning and night. I recently also started to take Shen Min Hir Nutrients…not sure if it works yet. Does anyone have any advice? I really want to get a hair biopsy but I don’t know how. The places I called offered scalp analysis to prepare for hair transplants…which is not something that I am considering. I also saw 2 derms, one didn’t know what was wrong and only offered Rogaine as a solution, and the other said it is androgenic alopecia. I think I might have hormonal problems, but really not that sure. My scalp is always oily and so is my skin. Before my hairloss, I had really itchy scalp. Now it’s still oily but I wash it every other day. I also dye my hair to hide the gray. Sometimes I just feel so ugly and depressed in thinking about my hair. Beautiful hair is the only thing that I want back.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.
My current solution is this : I have bought clip in hair extensions from Sally’s Beauty Supply store (about 100$) I actually just trim them myself and dye the hair left on my head and the extensions using an ammonia free hair dye (L’oreal or Garnier) in order for them to blend. I use a lot of root lifter and fill in the balding spots with Toppik (dark brown) and top it off with a shine spray. I’m telling you, most people have NO clue of my problem. I feel this is the best way to feel like a woman as I continue on this quest to solve my hair loss problem. I’d be happy to tell more of you about the regimine … high maintenance yes, but you know what, we all have to do what we need to do.

I am mostly afraid that my boyfriend will leave me now, because he found out last night, and he said he doesn’t mind it. He told me that his great grandma had the same thing. He loves me, or so he says, and acts like he does anyway, but I don’t want to lose him. I know I have had a hard time living with this, and since a friend of mine told him before I was ready to tell him, I’m afraid he thinks I’m keeping secrets, but I’m not keeping them. That’s my only one. I was just wondering if anyone else had this same thing happen to them and how they dealt with it. I am aware that this is not a relationship site, but the problem is the hair loss may scare him away. It is not something that can just be ignored, and I just wanted to know if anyone else out there knows how I feel.
In cases of severe hair loss, limited success has been achieved by using the corticosteroid medications clobetasol or fluocinonide, corticosteroid injections, or cream. Application of corticosteroid creams to the affected skin is less effective and takes longer to produce results. Steroid injections are commonly used in sites where the areas of hair loss on the head are small or especially where eyebrow hair has been lost. Whether they are effective is uncertain.[citation needed] Some other medications that have been used are minoxidil, Elocon (mometasone) ointment (steroid cream), irritants (anthralin or topical coal tar), and topical immunotherapy ciclosporin, sometimes in different combinations. Topical corticosteroids frequently fail to enter the skin deeply enough to affect the hair bulbs, which are the treatment target,[7] and small lesions typically also regrow spontaneously. Oral corticosteroids may decrease the hair loss, but only for the period during which they are taken, and these medications can cause serious side effects.[7] No one treatment is effective in all cases, and some individuals may show no response to any treatment.[23] Few treatments have been well evaluated. A 2008 meta-analysis of oral and topical corticosteroids, topical ciclosporin, photodynamic therapy, and topical minoxidil showed no benefit of hair growth compared with placebo, especially with regard to long-term benefits.[24]
Each hair develops from a follicle — a narrow pocket in the skin — and goes through three phases of growth. Anagen (A), the active growth phase, lasts two to seven years. Catagen (), the transition phase, lasts about two weeks. During this phase, the hair shaft moves upward toward the skin's surface, and the dermal papilla (the structure that nourishes cells that give rise to hair) begins to separate from the follicle. Telogen (C), the resting phase, lasts around three months and culminates in the shedding of the hair shaft.
I was searching the internet and came across this wonderful site. I really appreciate you posting this article. I have always had a small bald patch on one side of my head. My mom told me it had always been there so I didn’t worry about it. Recently it has been getting larger and the hair around it is getting lighter. On the other side my hair is thinning and the color and texture is changing. It also seems to be falling out. I have excessive hair loss on a regular basis. I am only 24 years old and I can’t stand that my hair is falling out. I went to the dermatologist and he gave my injections but they didn’t work. He said I have alopecia areata and that the other side was a normal receding hairline. (He barely even looked at it) He then told me after the injections weren’t working to try Rogaine. I think it might be helpful to see an endrocrinologist as I have also been having problems with anemia. Again, thank you so much for the information you have provided.
Thank you so much ladies, I am grateful I was able to find this website. Can anyone suggest a Doctor in the South Florida Area ( West Palm Beach, Ft. Lauderdale, Hollywood or Miami)? I have seem countless of Doctors in the past 20 years; felt like none really cared or took an honest interest. The last Doctor I visited didn’t even bother to see me in person, she just called me on the phone and told me nothing can be done, use Rogaine if you want, she said. Needless to say my condition is serious. After this I am at the point of giving up but if I could find a Doctor that really cares I am willing to try again. Any advise is welcome. Thanks again.
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Triamcinolone acetonide (Kenalog), 0.1 mL diluted in sterile saline to 10 mg per mL, is injected intradermally at multiple sites within the area to a maximum dosage of 2 mL per visit.6 The main side effect, atrophy, can be minimized by not injecting too superficially and by limiting the volume per site and the frequency of injection (no more often than every four to six weeks).6 Because spontaneous resolution often occurs in patients with alopecia areata, assessing treatment response can be difficult. Intralesional steroids should be discontinued after six months if no improvement has been noted.
One day in my mid 20s I got feed up with my at that point frizzy hair. I took a close look at individual hairs. I almost had a heart attack. Again this thought:”NOT NORMAL!!” I had tons of KINKY, ROUGH, even ZEBRA-STRIPED hair!! Much resembling pubic hair. The striped hairs were few, but they were literally striped in the darkest shade of brown I have & white!
Women also may experience AGA, often with thinning in the central and frontal scalp area but usually without frontal–temporal recession (Figure 3). A history and physical examination aimed at detecting conditions of hyperandrogenism, such as hirsutism, ovarian abnormalities, menstrual irregularities, acne, and infertility are indicated. Laboratory tests are of little value in women with AGA who do not have characteristics of hyperandrogenism.5
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that." 

The main symptom of alopecia areata is hair loss. Hair usually falls out in small patches on the scalp. These patches are often several centimeters or less. Hair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of the body. Some people lose hair in a few places. Others lose it in a lot of spots.

I had embolization and an angiogram for an AVM on my jaw. I was told there would be some hair loss because of the radiation (The size of a quarter). Well I have lost all but 1/3 of my hair left …not the area of a quarter! Has anyone ever had this happen? My doctor says the hair should grow back, but it has been three months and it is still coming out and no new growth. I don’t know what to do! Any suggestion? As with many women my hair was a part of my identity. I am not bragging but people remember me as the girl with all the hair. I realize we are more than our hair, but it makes me so sad!

I am 31 years old and I been loosing my hair (in the front) for 3 years now. I have seen different 4 different gynecologists and the one I have now she took blood work and other tests and the when all the tests came back everything was fine. I am trying to find a dermologist in my area that accepts my insurance. I just want to know what caused the hair loss and what can be done. It is embarrassing to even go out, when I do go out I make sure that I have a hat on. ????????
The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
I just began reading this post this evening. My hair loss began when I was 18, currently 29. No bald spots, but it just keeps getting thinner and thinner and thinner. I have been to many doctors as well. Every PCP and family doctor have been of no help. After four dermatologists I have given up on that as well. I went to Hans Wiemann (in the St. Louis area) that offers laser treatments and hair transplants. The whole appointment was such a sales pitch that I was so aggravated and felt worse by the time I left. I have also tried an herbalist, chinese medicine, and a nutritionist/chiropractor. I try not to think about it, I really do, but let’s face it, that’s about impossible. I know my problem is NOT genetic, everyone in my family has a full head of hair. I’m healthy in terms of exercise and diet, I don’t take any medications, smoke, or drink. None of the doctors have ever found anything with blood work or urine samples. If anyone can suggest a doctor, specialist, anyone that can help in the St. Louis or Chicago area, PLEASE do let me know.
Most people naturally shed about 50 to 100 hairs a day, but sometimes men and women can shed much more, leading to thinning hair, hair loss, and over time, baldness. The causes of this hair loss can be a result of hormones, underlying medical conditions, and even certain medications like antidepressants, high-blood pressure medications, and NSAIDS (non-steroidal anti-inflammatory medications). Sometimes, hair loss is purely genetic and can run in families.
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