The topical sensitizers, diphencyprone or squaric acid dibutylester, have been used in those suffering from recalcitrant alopecia areata or those with more than 50% hair loss. The goal of treatment is to create an allergic contact dermatitis of the scalp. This alteration in the immune response occasionally is accompanied by hair regrowth. The efficacy of the topical sensitizers has been demonstrated in both young children and adults, but it probably works less than half the time. Recent success using oral janus kinase inhibitors, including tofacitinib, ruxolitinib, and baricitinib, have been shown to be efficacious in severe, extensive alopecia areata in adults, but long-term therapy has potential side effects. The durability of response to these medications is variable, and most patients experience recurrence of hair loss after discontinuation. Perhaps topical therapy with these types of drugs may be available in the near future.
According to the International Society of Hair Restoration Surgery, since 2004, the number of female surgical hair restoration patients worldwide increased 24 percent. Modern surgical hair restoration procedures such as Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) allow surgeons to take hair from the back of the head (genetically permanent hair zone) and transplant it to the areas where balding has occurred. The reason why the hair does not fall out once transplanted in its new location is because those hair follicles take on the same characteristics as the hair in the area where it originated, the genetically permanent zone. Both approaches result in lasting outcomes. In order to know if you are a candidate, Dr. Yaker will go over your medical history and examine your hair and scalp. He will determine if you have ample, good quality hair in the permanent hair zone in order to be able to relocate those hair follicles to the areas of hair loss.
I’m 42 and I noticed my front top and sides thinning about a year ago – a lot coming out when brushing after washing. I went to the doctor who happened to be African-American (I’m caucasion) and she actually asked me if I wore “corn rows” a lot! Needless to say, she was worthless and just prescribed me something for dandruff, which I do not have! I went to an endocrinologist to see if my thyroid or menopause was the problem – tests turned out honky dorie! Now I can see through the top of my head when the sun shines on it (scar-y) and I’m having to cover over the temple areas with sweeps of hair from the other side (interesting, the right side is much thinner). I will say that I’ve gone through hell and back with a mentally ill young adult but if it was stress, wouldn’t it have come out quicker than just in the last year (I’ve been dealing with his illness for 7 years now)?? I’ve heard that sometimes it takes 2 or 3 blood tests and doctors to finally see that one has thyroid problems. Is this the experience of others, and would I be throwing my money away by seeing my general practitioner?
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.

Hi, I am now 25, I have been losing my hair for the past 6 years. I did find an excellent Dermatologist in Orlando, FL Dr. Crotty who helped me alot in this whole process. He started me on a regimen of 3,000 mmg of Biotin daily. I also did Kenalog shots (which is a steroid). He did localized injections in the scalp and also in the hip. I also was prescribed Olux E Complex foam to put in my hair twice daily. I had to stop using the Kenalog b/c I thought I was getting headaches from it ( IT WAS NOT THE KENALOG – (TMJ/Migraines). This three regimen combo produce amazing results for me, within months. Unfortunately, my hair has now started coming out in the front and on the right side but I changed my insurance and cannot find a in network doctor that will treat the Alopecia. I am very tempted to just Pay OOP for Dr. C. So anyone living in the Orlando area suffering from this condition please contact his office. They are the most caring individuals ever also. I love them!!!!!
Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.
Current evidence suggests that alopecia areata is caused by an abnormality in the immune system that damages hair follicles. This particular abnormality leads to autoimmunity, a misguided immune system that tends to attack its own body. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune lymphocytes penetrating into the hair bulb of the hair follicles. Alopecia areata is occasionally associated with other autoimmune conditions such as thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. The diagnosis or treatment of these diseases is unlikely to affect the course of alopecia areata. Sometimes, alopecia areata occurs within family members, suggesting a role of genes.
In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."
Try and find a doctor that seems to care about women’s hair loss, and understands the emotional devastation it causes. I don’t want my doctor to dismiss my hair loss, and I don’t want him/her to tell me it’s no big deal. It is a big deal and if your doctor makes you feel uncomfortable in any way, they he/she is not for you. If possible try and speak with the doctor by phone (believe it or not some doctors will talk to you on the phone first) and if the rules of the office don’t permit this then try and ask as many questions to the receptionist, such as, does Dr. X see a lot of women for hair loss? Does he order blood work? What does he usually prescribe for treatment? The reality of that last question is that their is no “usual treatment” every woman is different and hopefully the receptionist tells you something to that effect. I don’t want to see a doctor that prescribes Rogaine as his/her first line of defense even before making a proper diagnosis with blood work or any other necessary tests. I firmly believe you should not be walking out with a bottle of Rogaine the first day of your appointment. Sure the doctor can probably be able to tell if your hair is experiencing miniaturization, but what about the blood work to determine the causes? Rogaine may be the right treatment for you, but I’d like to know why.
Thank you for all your post. My daughter had extremely thick hair about eight years ago. It was so thick you could barely put it in a scrunchie. Her hair has been continuously thinning to the point that you can see through it. All the women in my family on both sides have extremely thick hair. We live in the north east and have seen several GP and a Dermatologist who act like there is nothing wrong. I work in the medical field and when I hear this I get so mad because I feel like they want to just brush of like no big deal. It is a big deal to all women no matter what ages. I have written done some of the post advise and will continue to look for an endocrinologist for her. Please keep me postes on any new developements.
Androgenetic alopecia (AGA), or male-pattern baldness, is hair thinning in an “M”-shaped pattern; hair loss occurs on the temples and crown of the head with sparing of the sides and back5 (Figure 2). This pattern reflects the distribution of androgen-sensitive follicles in most people.6 Starting at puberty, androgens shorten the anagen phase and promote follicular miniaturization, leading to vellus-like hair formation and gradual hair thinning.6
Finasteride inhibits an enzyme that converts testosterone to DHT, or dihydrotestosterone, the hormone that causes hair loss in men, and unlike minoxidil, this drug can actually help hair grow back, as well as prevent further loss. All you have to do is take one pill a day, and according to Dr. Evan Rieder, dermatologist in the Ronald O. Perelman Department of Dermatology at NYU Langone Health, two-thirds of men taking this treatment will see improvements in hair density over time.
Hi everyone! First off I just wana say this is a great site and thank all of you for sharing your experiences with hair loss. I too am having a huge problem with this. I’m 21 years old, and it’s been going on since about October of last year. Since then it has gotten much worse. I’m so scared to wash my hair, because every time I do, 100 or more hairs fall out. I’m also having the sore scalp feeling like somebody is pulling at it. It’s horrible. I’v had long, fine, but thick and straight hair forever. It’s always been very healthy. But now it jsut looks awful. I plan to see a doctor soon, but not looking forward to it. I guess I’m just really depressed about this right now. Last night I cried myself to sleep. It’s the first time that’s happened since this has started. I’v tried to stay strong, but holding it in hasn’t helped. So anyway, I’m looking into wigs, but I really need some help finding a natural human hair wig that is affordable. If anyone knows of a place or site, please let me know. I’m so sorry that all of you are having this problem and I feel your pain.
Other medical conditions — most commonly telogen effluvium and seborrheic dermatitis — can also cause hair loss, but most people can trace their follicular woes back to androgenetic alopecia, so we focused our search there. We started with more than 200 products, including all-natural solutions and high-tech gadgets, while skipping treatments that focus only on volumizing or thickening hair. We also limited our scope to the scalp, and left out specialty products designed only for eyebrows or beards.
I too have been having bad hair loss. I am 25 years old and since the birth of my second child 2 1/2 years ago, it has not stopped. It is normal for it to fall out for a few months after child birth so I wasn’t too worried at first. After about 6 months it started to slow down then all of a sudden started up again. And has been falling out ever since. I am really thin in the front and around the temples and just recently, has become really unhealthy. It breaks and is very course. I have been to 3 derms. and 2 PCP’s. All my lab work has always come back normal. And they just tell me to use Rogain. The past 6 months I have been trying to get pregnant again and haven’t been able to. I got pregnant with my last 2 very easy and feel that my hair loss and not being able to get pregnant are intertwined. I also have gained about 15 pounds. I don’t want to use the Rogain because I am trying to get pregnant and don’t know the effects it will have if I did get pregnant. I don’t know what to do next. I am in the Phoenix area so if anyone know of any good docs around here please let me know.
Try and find a doctor that seems to care about women’s hair loss, and understands the emotional devastation it causes. I don’t want my doctor to dismiss my hair loss, and I don’t want him/her to tell me it’s no big deal. It is a big deal and if your doctor makes you feel uncomfortable in any way, they he/she is not for you. If possible try and speak with the doctor by phone (believe it or not some doctors will talk to you on the phone first) and if the rules of the office don’t permit this then try and ask as many questions to the receptionist, such as, does Dr. X see a lot of women for hair loss? Does he order blood work? What does he usually prescribe for treatment? The reality of that last question is that their is no “usual treatment” every woman is different and hopefully the receptionist tells you something to that effect. I don’t want to see a doctor that prescribes Rogaine as his/her first line of defense even before making a proper diagnosis with blood work or any other necessary tests. I firmly believe you should not be walking out with a bottle of Rogaine the first day of your appointment. Sure the doctor can probably be able to tell if your hair is experiencing miniaturization, but what about the blood work to determine the causes? Rogaine may be the right treatment for you, but I’d like to know why.
If you find yourself snacking at night before bed, it may be because you're bored or anxious — not truly hungry — and eating makes you feel better. Try eating a healthy dinner a bit later in the evening. If your stomach is truly growling before bed, try a protein-based snack like a hard-boiled egg or a slice of cheese. A few spoonfuls of yogurt or some fruit is another good option. 
I am on Arava and my hair has become extremely coarse, frizzy, and tight tight curls in the back. The sides of my hair are pure frizz and the top is straight, with frizz. It used to be smooth and so easy to manage. Now it takes so long and it looks awful. Anyone find the same thing and anything that helps? I have tried so very many hair products, so has my beautician. She says it is like I have 3 completely different textures on my head.
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
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