I’m a dermatologist and am more interested in telogen effluvium these days because I have it bad–and this time it’s not because I just had a baby. I’m learning more about the gut-skin-hair connection and am suspicious that it has to do with the bacterial flora in your gut. You can learn more about changing your gut flora at BodyEcology.com. Her book is intense but I’ve decided to give it a try after recommending it and seeing it work so well with acne patients.
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*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Alopecia areata is an autoimmune disease, where a person's immune system attacks the body, in this case, the hair follicles. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be greater. On rare occasions, the person loses all of the hair on his or her head (alopecia areata totalis) or entire body (alopecia areata universalis).
Family history will often tell the doctor what type of alopecia a person has. Occasionally, a punch biopsy may be necessary to determine the type of hair loss. Looking at plucked hairs under a microscope can help to tell the difference between alopecia areata and androgenic alopecia. Other tests might be done to check for autoimmune diseases like lupus that can accompany alopecia.
The general medical consensus around laser treatments — caps and combs alike — is that low-level laser light therapy stimulates the cells within the hair follicle. These devices may also increase cell metabolism to promote thicker and more durable hair shafts, something that neither minoxidil or finasteride can do. To use the HairMax Ultima, all you have to do is glide the device over your scalp slowly. Treatments should take about eight minutes, and you should do it three days per week for the best results.
In answer to which doctor should I see for my hair loss, my opinion is that you should probably see both. Most doctors don’t know enough about hair loss as it is, so seeing doctors in different specialties may actually help you get a better, more accurate diagnosis. I am sure there are various conditions of hair loss that might be better served by seeing one more than the other. Perhaps a dermatologist would be better suited in determining if the cause was an infectious skin condition such as ringworm or scaring alopecia, and an endocrinologist may be better at diagnosing hormone related hair loss. The truth is, any doctor whether it is an endocrinologist, dermatologist, or general practitioner with a strong interest and knowledge in hair loss can make a proper diagnosis and work with you on the the treatment they think will produce the best results. The operative words here are “interest and knowledge.”

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.


Alopecia areata is a disease that attacks your hair follicles (the part of your skin that makes hair). In most cases, hair falls out in small, round patches about the size of a quarter. This causes only a few bare patches. Some people may lose more hair. In only a few people, the disease causes total loss of hair on the head or loss of all body hair.
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.

in between all these years, i also tried some homeopathic methods. i read dr. andrew weil’s book on health and used to take 2000mg of alpha-linolenic acid either by evening primrose oil, grapeseed oil or borage oil. it didn’t regrow my hair but i do feel that it helped stall it. only problem is that after a year or so it stopped working for me, but it may help some of you out. there’s a connection, according to dr. weil, between alpha-linolenic acid and hair. i’ve also used homemade rosemary water and washed my hair with it, but it only helps with making me smell like the bush it comes from.
My name is Leslie and IO was recently diagnosed with pcos. My hair has been falling out for about two years! I am African American and I have always had thick healthy hair now you can see my scalp. I started using a product called regrow and my bald spots are filling in but my hair is still thinning! I was fortunate enought to have a child in 2003 I have been trying to have another child for 3 years with no luck can somebody help me with my thinnig hair and infertility……..I don’t even feel like a woman anymore.
As the name suggests, androgenetic alopecia involves the action of the hormones called androgens, which are essential for normal male sexual development and have other important functions in both sexes, including sex drive and regulation of hair growth. The condition may be inherited and involve several different genes. It can also result from an underlying endocrine condition, such as overproduction of androgen or an androgen-secreting tumor on the ovary, pituitary, or adrenal gland. In either case, the alopecia is likely related to increased androgen activity. But unlike androgenetic alopecia in men, in women the precise role of androgens is harder to determine. On the chance that an androgen-secreting tumor is involved, it's important to measure androgen levels in women with clear female pattern hair loss.
I am 43 and I have been thinning/losing my hair for the past four years. It is so upsetting. I know very few people who can relate…until I came across this site. Has anyone tried apple cider vinegar? I read that it can help with hair loss, but I am skeptical, as all of the remedies I’ve tried thus far have been disappointing. I try to put my hair loss situation in perspective, but I’m not always successful. Best wishes to all of the women on this site. I hope hair restoration is around the corner for all of us.
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.
As much as 30 percent of women will experience some sort of hair thinning, usually first noticed with age as a skinnier ponytail or a little more visible scalp peeking out. Thick hair screams “youth,” which makes thinning a tough pill to swallow. But there are many ways you can help slow down thinning and hair loss, from eating the right foods to cutting back on stress, even strategically styling your locks. Here, seven ways to stave off hair loss and keep your ‘do looking young and healthy for longer. 
In contrast to trichotillomania, traction alopecia involves unintentional hair loss secondary to grooming styles. It often occurs in persons who wear tight braids (especially “cornrows”) that lead to high tension and breakage in the outermost hairs (Figure 10). Traction alopecia also occurs commonly in female athletes who pull their hair tightly in ponytails. The hair loss usually occurs in the frontal and temporal areas but depends on the hairstyle used. Treatment involves a change in styling techniques. Other hair-growth promoters may be needed in end-stage disease, in which the hair loss can be permanent even if further trauma is avoided.1
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.
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.
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.

Also, re: the Proscar, I think that it may already be helping some as I think my shedding may be tapering off a bit more. I am losing a few less hairs Per day now. Maybe? I don’t know, but I am trying to stay positive!! I have no real regrowth. Just wisps, extremely fine hair, almost hard to see. Kind of transparent. I am not expecting miracles, but trust me…. THe moment I feel I have any true results to share with you girls, I will definitely be posting them! There aren’t many success stories out here. We need more. I guess people don’t come out here as much if they are experiencing good things w their hair?
Ann, I’m so sorry to hear about your home. That breaks my heart for you. I wish you the best in recovery of your home and blessings on your finances. But I do have to say I think that only losing 20 sounds like a dream! I absolutely know that my TE was triggered by PPD in hair dye. I only wish that I would have figured it out sooner. I was forewarned with itching for a year, no dandruff flaking or anything just itching and that was my body trying to heal itself against the allergy and the all hell broke lose on my head! Please keep me posted propecia; I wouldn’t even look for any improvement for 6 months though. But please be here when you do see it! Have a blessed day!

Hello all, it feels so good to know that I am not alone in this hair battle. I started noticing hair thinning at around 16 (I had ‘horse hair’ before (thick and strong) as my mom would call it). I chalked it up to the crash diet I did at 15 where I lost about 30lbs in about 2 months…since then my hair has gotten thinner and weaker over the years. I just turned 26 and this had been the worst year for my hair. I got married in Aug and some would say it could be the stress from that event but I say NO to that. I’ve had extensive blood work done…iron, testosterone, etc etc blah blah blah…EVERYTHING came back NORMAL! It seems as if nothing can help me! This last derm I saw today just told me to stick to rogaine, and when I asked about Provillus (these pills I heard about) he said he never heard of it and to try it and let him know! I have cried so much this year! I can’t even part my hair in the middle anymore because it’s so thin..and washing it? omg that’s an emotional rollercoaster on it’s own…my scalp is always so oily and the rogain is making it worst! and so ITCHY! AND FLAKY! What can I do now? who should I see? What makes this even more bizzare is that my acne now is worst than it ever was! I was skinny with lots of hair and clear skin in HS and now? It seems I can’t lose the 15lbs I’ve packed on and this acne stuff isn’t making it better! My husband isn’t much help because he doesn’t get it..I don’t know what else to do, someone please help me.
Hair is made up of the hair follicle (a pocket in the skin that anchors each hair) and the shaft (the visible fiber above the scalp). In the hair bulb, located at the base of the follicle, cells divide and grow to produce the hair shaft, which is made from a protein called keratin. Papilla that surround the bulb contain tiny blood vessels that nourish the hair follicles and deliver hormones to regulate the growth and structure of the hair. 

Because of its psychologic nature, the mainstays of treatment are counseling, behavior modification techniques, and hypnosis. Selective serotonin reuptake inhibitors and other medications for depression or obsessive-compulsive disorder may be used in some cases, although no medications are FDA-approved for treatment of trichotillomania.17 If a more moth-eaten appearance of hair loss is present and no evidence of hair-pulling behavior can be elicited, syphilis should be suspected.
Today, one of the most common problems that could degrade one's beauty is hair loss. Most individuals usually shed 50 to 100 hairs every day. This loss, usually does not cause noticeable thinning of scalp hair, as new hair simultaneously grows along. Hair loss occurs when this cycle of growth of hair and shedding of hair is disrupted or when the hair follicle is destroyed and replaced with scar tissue. There are a lot of causes of hair loss. Usually hair loss could be heredity or because of family history, can be due to hormonal changes, because of certain medications and also because of some medical conditions or diseases. Several conditions or diseases leads to hair loss. If you are one of those who suffer from loss of hair then you would probably love to read this article which explains about the diseases that cause hair loss.
Blow dryers, flat irons, and other devices: Frequent use of a blow dryer tends to damage hair. The high heat from a blow dryer can boil the water in the hair shaft leaving the hair brittle and prone to breakage. Dermatologists recommend that you allow your hair to air dry. Then style your hair when it is dry. Dermatologists also recommend limiting the use of flat irons (these straighten hair by using high heat) and curling irons.
Hair loss caused by folliculitis decalvans, an inflammatory disorder that leads to the destruction of hair follicles, is often accompanied by redness, swelling, and lesions on the scalp that may be itchy or contain pus, known as pustules. This type of hair loss is not reversible, but dermatologists can offer medication to control symptoms and, in some instances, stop the progression of hair loss.
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
Minoxidil should be applied twice daily, and one year of use is recommended before assessing its efficacy.6,7 Women also may benefit from adjunctive treatments such as estrogen (hormone replacement or oral contraceptives) or spironolactone (Aldactone). In men, minoxidil may work better in areas with higher concentrations of miniaturized hairs, and its efficacy may be increased by the synergistic use of once-daily tretinoin (Retin-A) applied at separate times during the day.6,8 Minoxidil does not work on completely bald areas and has relatively few side effects; a dosage of 2 mL per day of a 2-percent solution costs about $10.00 to $12.50 per month.
I am 43 and I have been thinning/losing my hair for the past four years. It is so upsetting. I know very few people who can relate…until I came across this site. Has anyone tried apple cider vinegar? I read that it can help with hair loss, but I am skeptical, as all of the remedies I’ve tried thus far have been disappointing. I try to put my hair loss situation in perspective, but I’m not always successful. Best wishes to all of the women on this site. I hope hair restoration is around the corner for all of us.
I’m seventeen and my hair has been gradually thinning for 7 years now. I’ve met some pretty unhelpful doctors who just prescribe me iron pills, always it’s the iron pills. I just wish i could have hair like i used to and thinking about it makes me feel really bad and just kills my self-esteem at times. But what i’ve learned is that there are alot of tough things to go through in a person’s life and instead of complaining 24/7 about what i don’t have, I’ve learned to appreciate the things that i do. Im not saying i wouldn’t be the happiest person in the world of by some miracle my hair decided it wanted to grow back again..that would be awesome! But i know i would give up every hair on my body for the things that i do have, like friends and family and my comfortable life and my freedom. Hair is really really important but i know things that are way more important to me. I hope all of you will keep that in mind too! I wish you all the best of luck so keep trying!!!!!
Alopecia areata is an autoimmune disease, where a person's immune system attacks the body, in this case, the hair follicles. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be greater. On rare occasions, the person loses all of the hair on his or her head (alopecia areata totalis) or entire body (alopecia areata universalis).
I am so so grateful and want to thank everyone who has contributed to this forum. I am 52 years old, and in June of this year my Obgyn said it was time for me to get off Birth control pills , as I was getting too old and the estrogen levels would be dangerous at this time. I had been on BCP since the age of 18 with a break from the age of 35-38, and always been under the impression that BC pills might cause hair loss, but was totally unaware that when you came off them that the real deal happened. He just casually said, don’t take them and we will see if you are in menopause. Well I did and 2 months later (mid Aug..) I went straight into menopause, hot flashes all day, night sweats, etc., Then came the shedding, TE, as I am to understand. By mid-September the texture of my hair felt strange and the hair on the right side/back of my hair thinned out considerably, and I was developing a bald patch. Having always had very thin hair that I was always self conscious about (I had to wear a wig as a child, as I had monilethrix an inherited hair disease, which went into remission, but the hair loss caused terrible self esteem issues throughout my teenage years.), I cried my eyes out, then went on a quest to find out who to see. Derm, another ObGyn or endocrinologist? From everything that I had read, everyone went to countless doctors to find a cure. Having dealt with my HMO over the years to get a quality specialist in different areas, I knew I would be bald by the time I found the right doctor. Then I came across this forum, like Hope in Aug, I have spent countless hours on the internet in search of a solution. Thanks to her post and Toni on 7/14/08 and Shelleo, I found my answer. I called Dr. Redmond, in New York, and prayed that I could get an appointment right away. My prayers were answered, and I have an appointment this coming Monday 10/28!! I will be getting his book I the next day or so, as recommended, and truly feel, from what I have read, if anyone can help me, he is the one. Thank you for sharing your stories. I will make sure to check back, so I can, too, possibly help someone else.
I want to say that all of you are very courageous and sharing. I appreciate everything I have read here. Thankfully, I am starting out in a slightly better position – I still have a fair amount of hair left. I started with a HUGE amount of hair. For the last 6 – 12 months, I have been losing handfulls of hair in the shower every morning, then some more when I comb it out, then a bit more when I put styling product in it, then just a bit more during the day. The shower is the huge hit, though. I’m 37 and on a ton of medication – synthroid, neurontin (an amitryptiline derivative), anti-depressants, and a host of pain medications for a degenerative back problem. I brought my hair loss up to a doc around the time it started, since I was already on synthroid, he re-tested my levels, and said everything was fine. My hair structure has always been on the thin side, but there was just so damn much it didn’t matter – now there is a lot less. What used to take upwards of 20 minutes to dry with a dryer, now takes 5. I’ve been worried about it for quite a while, and didn’t know what to do. I started my on-line research today with hair extensions and stumbled on this site. I am encouraged that I’m starting my search for an answer relatively early in my hair loss journey. I have some great advice and questions to go in to see my doc about. If anyone has any recommendations for the Boise, ID area for a dermatologist and endocrinologist, I would really appreciate it.
Ann, I’m so sorry to hear about your home. That breaks my heart for you. I wish you the best in recovery of your home and blessings on your finances. But I do have to say I think that only losing 20 sounds like a dream! I absolutely know that my TE was triggered by PPD in hair dye. I only wish that I would have figured it out sooner. I was forewarned with itching for a year, no dandruff flaking or anything just itching and that was my body trying to heal itself against the allergy and the all hell broke lose on my head! Please keep me posted propecia; I wouldn’t even look for any improvement for 6 months though. But please be here when you do see it! Have a blessed day!
“There’s people selling pills and creams and lotions and whatever else, and sometimes you can’t even trust what ingredients they have in there,” he warned us when we spoke to him over the phone. Key takeaway: The hair loss industry is crazy dishonest, so we eliminated any treatments (especially homeopathic methods) that aren’t based in concrete, peer-reviewed science.
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
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.
Finasteride has relatively few side effects, and a dosage of 1 mg per day costs about $49.50 per month. Women who could be pregnant should not handle finasteride, because it may cause birth defects in a male fetus. Finasteride has not proved effective in the treatment of female AGA and is not FDA-approved for use in women.11 [Evidence level A: randomized controlled trial] Continued use is required to maintain benefits.
I wanted to say I have been to both a GYN here and a hair loss dermatogist here in Lake Mary FL, with no results, so I am still looking for another derm that knows something about hair dye allergys. I have had my hormones tested, the dr said that my estro was high, but she expected that since their is no period. I am only 45 , I used to have very thick coarse hair. Had a bad eposide of itching, then hair lost last year. I told the derm that I suspected the hair color. They did not seem intested, said that hair loss comes with age. I have now had another spell, of bad rashing. It is the hair dye. From my reseach it can have PPD, in it almost all do. Check the web for PPD allergy. As you color you can become more and more subseptable to it. My hair stylist always commented on the hair loss. I think that hormones changing can effect it also. You can become allergic to this chemical at any time. It is hard to connect the dots. Dr.’s don’t seem interested. Natualist, I tried accupunture and non homotherphy, no noticable difference.. I have tried Jason hair shampoo, not much luck with that either. BUT look for PPD/free hair colors…and test before using, that will save some hair from falling. So far I have found a Wella, Yo Colors, Reflex, Nauture Pat It usually happens a week later, not right after coloring FYI…What does work is Botin….. 

My hair was healthy. No split ends and thick and tame – I could not break it. The healthy condition of my hair may be the reason that I didn’t loose all of it. My hair loss was due to a “HAIR DESTROYER” causing chemical damage, burning my scalp and my hair ( I think she used a product banned in Australia). I had bald spots on my crown the size of 50 cent pieces and the rest of my hair was singed. I lost my hair gloss, I was left with hair that was as thin a rice paper and breaking everywhere. I had severe itching on my scalp for two years. Not pleasant. I cursed her every day and still do. I bought myself a pair of hairdressing scissors and cut as much hair off as I could; and chipped into it everywhere. I do this every two weeks. Hence I will never go to a hair dresser again and have not colored my hair since December 2012 – I asked for Brown on Brown 10 vol – how could an idiot of a hair destroyer (dresser) get it so wrong.

Too much stress is bad for health and beauty, but did you know there’s a known connection between stress and hair loss, too? Constant stress can cause cortisol levels to spike, which can contribute to increased hair shedding. To relieve stress and its damaging effects on your hair, try meditation, regular exercise, keeping a regular sleep schedule, or any other activity that helps you decompress.
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."
"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."
If you do decide to start treatment to save your hair, a good place to start is with minoxidil, more commonly known as Rogaine. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to Dr. Amy McMichael, professor and chair of Wake Forest Baptist Medical Center’s Department of Dermatology, it is effective “if used as recommended, with evidence of improvement seen around six to nine months.” Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula with 5 percent concentration.
I am scared to find out whether I have PCOS…I was hoping to find out about my insulin as I sensed a major blood sugar problem for years, but I took the news surprisingly poorly. I’m more stressed than before and am terribly depressed. The doctor, by the way, had zero to say about it all. Nothing. His words “Ask your gynocologist, I am just a lowly MD.” [gasp]
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