Duke’s dermatologists diagnose and treat hair disorders, such as hair loss (alopecia), excessive hairiness (hirsutism), and abnormal hair growth (hypertrichosis). We understand that abnormal hair growth can be distressing and affect your self confidence. We work closely with you to diagnose the cause of your condition, and develop a personalized treatment plan that meets your medical needs, improves your condition, and helps you regain a positive self-image.
Several types of hair shaft abnormalities can lead to hair loss. These conditions cause strands of hair to thin and weaken, making them vulnerable to breaking. The hair loss doesn’t occur in the follicle but as a result of a break somewhere along the hair shaft, which is the visible part of a hair strand. This can result in overall thinning, as well as in many small, brittle hairs.

Duke’s dermatologists diagnose and treat hair disorders, such as hair loss (alopecia), excessive hairiness (hirsutism), and abnormal hair growth (hypertrichosis). We understand that abnormal hair growth can be distressing and affect your self confidence. We work closely with you to diagnose the cause of your condition, and develop a personalized treatment plan that meets your medical needs, improves your condition, and helps you regain a positive self-image.

Age-onset thinning, or “miniaturization,” refers to a progressive decrease of the hair shaft’s diameter and length. This happens at least in part because of androgens like dihydrotestosterone (or DHT), a derivative of the male hormone testosterone that causes hair follicles to literally shrink in diameter. This type of hair thinning is referred to as androgenic alopecia, and it occurs in an equal pattern all over the scalp. However, pregnancy, ovarian cysts, medications, emotional or physical shock, and birth control pills can all affect hormone levels, making it complicated to pinpoint the reason for hair loss. For example, polycystic ovarian disease can exacerbate androgens and manifest as thinning, in which case you could treat the condition and fix hair loss. Get your hormone levels checked to see if an underlying health issue is the root cause.


Iron supplements. Iron deficiency could be a cause of hair loss in some women . Your doctor may test your blood iron level, particularly if you're a vegetarian, have a history of anemia, or have heavy menstrual bleeding. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation.
Minoxidil (Rogaine). This is an over-the-counter (nonprescription) medication approved for men and women. It comes as a liquid or foam that you rub into your scalp daily. Wash your hands after application. At first it may cause you to shed hair as hair follicles. New hair may be shorter and thinner than previous hair. At least six months of treatment is required to prevent further hair loss and to start hair regrowth. You need to keep applying the medication to retain benefits.
The characteristic finding of alopecia areata is one or more well-circumscribed areas of otherwise normal, hairless skin in hair-bearing areas. Occasionally, it may be necessary to biopsy the scalp to confirm the diagnosis. Other findings that may be helpful are the appearance of short hairs that presumably represent fractured hairs, short thin hairs, and gray hair growing in a bald area. Other causes of hair loss are generally excluded from the consideration by history and clinical evaluation.
Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person through nasal secretions or droplets. Symptoms and signs of leprosy include numbness, loss of temperature sensation, painless ulcers, eye damage, loss of digits, and facial disfigurement. Leprosy is treated with antibiotics and the dosage and length of time of administration depends upon which form of leprosy the patient has.
When alopecia areata is associated with celiac disease, treatment with a gluten-free diet allows for complete and permanent regrowth of scalp and other body hair in many people, but in others there are remissions and recurrences.[15] This improvement is probably due to the normalization of the immune response as a result of gluten withdrawal from the diet.[15]

Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known.
Greetings ladies, I am so happy I found this website. I have a 19 year old daughter who has been experiencing hair loss for the past 5 years. Throughout high school, she wore hair weave to camouflage what was going on. She is now a sophomore in college and wants to wear her natural hair. It is frustrating her because we don’t know why its happening. Does anybody know of a good endocrinologist in Chicago? Do you think treatments varies depending on ethnicity? She is African American.
Hi there.. I to am experiencing hair loss.. lots of it.. Doesn’t even feel like hair.. and my scalp hurts.. almost like a throbbing.. I have leukemia and have had since 2005 but doesn’t appear to present a problem. I’ve had trouble a couple of times in the past few years due to stress (lost a sister in a car wreck) but my hair got healthy again. This time around there has been no stress.. I was low in B12 (261), however, I’ve been getting shots and its up to 450. They’ve ruled out thyroid.. Any ideas what else it could be and how I should move forward in figuring it out? I’m very anxious.. I’ve always had long very thick coarse hair but always healthy.. now it looks limp and always feels dirty..
Finasteride inhibits 5α-reductase type 2, resulting in a significant decrease in dihydrotestosterone (DHT) levels.6 Studies have shown that, compared with placebo, 1 mg per day of finasteride slows hair loss and increases hair growth in men.6,7,9 Dosages as low as 0.2 mg per day result in decreased scalp and serum DHT levels in men, although the DHT levels may not correlate clinically with changes in hair loss.10
Age-onset thinning, or “miniaturization,” refers to a progressive decrease of the hair shaft’s diameter and length. This happens at least in part because of androgens like dihydrotestosterone (or DHT), a derivative of the male hormone testosterone that causes hair follicles to literally shrink in diameter. This type of hair thinning is referred to as androgenic alopecia, and it occurs in an equal pattern all over the scalp. However, pregnancy, ovarian cysts, medications, emotional or physical shock, and birth control pills can all affect hormone levels, making it complicated to pinpoint the reason for hair loss. For example, polycystic ovarian disease can exacerbate androgens and manifest as thinning, in which case you could treat the condition and fix hair loss. Get your hormone levels checked to see if an underlying health issue is the root cause.
CURRENT REGIMEN: 6 weeks ago I purchased Hair Essentials… and am seeing some fine hair growth. Weight loss & exercise can also heighten follicular dormancy. (Have lost 90 lbs. in the last year.) Important to maintain 50-60mg/daily protein levels, as well as routine multi-vitamin, higher levels of B-Complex, D and Calcium levels while dieting… heavily impacts hair, nails & skin. Am researching possible relationship between gastrointestinal health and hair loss.
Alopecia areata is thought to be a systemic autoimmune disorder in which the body attacks its own anagen hair follicles and suppresses or stops hair growth.[9] For example, T cell lymphocytes cluster around affected follicles, causing inflammation and subsequent hair loss. It has been suggested that hair follicle in a normal state are kept secure from the immune system, a phenomenon called immune privilege. A breech in this immune privilege state is considered as the cause of alopecia areata.[12] A few cases of babies being born with congenital alopecia areata have been reported.[13]
What is a Dermatologist? A certification by the Board of Dermatology; practitioners treat pediatric and adult patients with disorders of the skin, mouth, hair and nails as well as a number of sexually transmitted diseases. They also have expertise in the care of normal skin, the prevention of skin diseases and cancers, and in the management of cosmetic disorders of the skin such as hair loss and scars.
Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.
Hi: I am 61 yrs old. ( Although my hair has been thinning gradually I am all of a sudden shocked about how much of it is gone. I don’t loose a lot–between 10-15 a day probably but I see small areas without any hair grow where I usede have hair sa. I am sure that I am not growing any hair anymore. I have not seen any doctors about it yet but from reading about it I know my hair loss/thinning is due to many medications I have been using that I need to use; antidepressant/tyroid/cholesterol but most mportantly glaucoma medication which my doctor has increased the dosage due to the aggresive nature of it. Of course I am gong to talk to him as well as my family physician. But readign what ting has been very helpful. I will post my findings when I know more. Thanks everyone
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.
So far, I’ve only been on the Propecia for about three weeks. I don’t notice any side-effects thus far. I am taking 2.5 mg of Proscar, to be exact. I feel good and have not noticed any difference in my hair. I continue to lose about 20 hairs when I shower and brush it each day. That may not sound like a lot but I have already lost so much of my hair, that I think that represents more hair loss than it sounds. At least it is stable for now…I thank GOD that it is not getting worse. I DO have re-growth but it is fine and “wispy” as you said. It is not the same as the rest of my “normal” hair but hey, at least some of it is growing back in. Slowly and finer. That seems to support the AGA diagnosis. The thing that really drives me crazy is that I still don’t know WHY the TE started in the first place. The TE unmasked the AGA, but why the damn TE and what from here? Anyway….I digress and obsses!   

Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known.
It is perfectly normal for people to shed 50 to 100 hairs per day. This generally doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time that hair is shedding. However, hair loss occurs when this hair growth cycle and shedding is disrupted or when the hair follicle becomes destroyed and replaced with scar tissue. Female pattern hair loss (androgenetic alopecia) is the most common form of hair loss in women. This occurs gradually and is caused by genetics (from either side of the family), age, and the action of a specific male hormone, dihydrotestosterone (DHT). This hormone is found in lesser amounts in women and it preys on the hair follicles, preventing them from receiving vital nutrients for proper hair follicle growth, leading to the hairs shrinking, and resulting in a shorter lifespan. Interestingly, DHT does not need to be elevated to generate hair loss. Estrogen, when lowered as commonly seen in menopause, creates a change in the ratio of male to female hormones, giving an edge to these male hormones. Compounded with the sensitivity of DHT to the hair follicles, heredity can affect the age at which a woman begins to lose her hair, as well as the rate of hair loss and the extent of baldness. 
"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."
Androgenic alopecia, also known as "male pattern baldness" and “female pattern baldness,” can strike younger as well as older people. It's genetic, so having a family history can predict if you might inherit it. In both men and women, it's linked to having an excess of male hormones (androgens) around the hair follicles, which can block hair growth. Women are more likely to develop androgenic alopecia after menopause, when they have fewer female hormones.
Low-level laser light brushes, combs and other devices which are FDA-cleared for both men and women are available without a prescription. Although it’s not clear how the devices work, it’s thought to “stimulate the hair follicles’ energy cells to be more active,” Francis said. They’re also foolproof, telling you when and how far to move the device and they even automatically shut off.
The best fix by far for replacing lost hair is a transplant. Back in the day, docs used plugs that resembled cornrows (definitely not natural looking). Today, guys have more options. You can go for “the strip method” where a doctor surgically removes a strip of hair from the back of your head, dissects every hair graft under a microscope, and then plants the individual grafts onto hair-thin areas of your scalp with tiny incisions.
The characteristic finding of alopecia areata is one or more well-circumscribed areas of otherwise normal, hairless skin in hair-bearing areas. Occasionally, it may be necessary to biopsy the scalp to confirm the diagnosis. Other findings that may be helpful are the appearance of short hairs that presumably represent fractured hairs, short thin hairs, and gray hair growing in a bald area. Other causes of hair loss are generally excluded from the consideration by history and clinical evaluation.
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.
Alopecia areata affects people of all ages including young children. It produces circular patches of hair loss that appear overnight. More patches appear over time and eventually about 5% of people affected lose every hair on their body. This includes eyebrows, eyelashes and even nose hairs. In some people, hair grows back, either in the same place or on a previously unaffected part of the scalp or body.
Your doctor might also suggest the prescription pill finasteride, sold under the brand name Propecia and also in generic versions. Although the drug is not federally approved for use in female patients, some doctors have observed good results in postmenopausal women. But women who are planning to have children should not take this drug because it can cause birth defects.
I’m 28 and suffer from patches of hair loss. recently it has become so bad that i can no longer leave my hair down. it is really distressing for me, especially as I have recently met a guy and I’m not sure whether I should tell him about it or not. Currently when I meet him, I back brush my hair and try my hardest to cover the gaps; this ultimately means i am making things worse for my hair! I dont know what to do

Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
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!
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.
Iron supplements. Iron deficiency could be a cause of hair loss in some women . Your doctor may test your blood iron level, particularly if you're a vegetarian, have a history of anemia, or have heavy menstrual bleeding. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation.

The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.

Mistakenly thought of as a male disease, around 40% percent of women will suffer from some form of hair loss by the age of 50. A woman’s hair is an important part of her aesthetic make-up. It represents her style and taste, and frames her face while accentuating her best features. Unfortunately, most physicians don’t have answers or solutions for women who begin to lose their hair.  Plano, TX hair restoration surgeon, Dr. Joseph Yaker, understands that this can be extremely catastrophic to a woman’s self-confidence, body image and quality of life. Clinical studies have shown that psychiatric disorders such as depression and anxiety are more common in people with hair loss, especially women.

×