As mentioned above, an autoimmune response is commonly associated with hair loss related to alopecia areata. Patients who have this condition see their body’s immune system attack their hair follicles. The patient’s hair follicles become very small and hair growth begins to stop.  A major symptom of alopecia areata is patchy hair loss, according to the American Academy of Dermatology, which says patients often first notice the problem when they see clumps of hair on their pillow or in the shower.
when i was 24, went to so. america to visit family. they hadn’t seen me since my last visit, which was when i was 17. there was a guy who i had liked and hung out with when i spent my 17th summer there and was excited to see him once again, “as an adult”. i think it was the second day or so of hanging out with him when he says to me: “hey, i noticed you’re losing your hair”. i was beyond embarrassed at that moment and all i could muster out was, “yeah, i know”. thanks for pointing it out there buddy. next came anger mixed with that embarrassment. i felt, and still feel, that people stare at my head and notice my thinning hair when they are talking to me. when i came back to the states a few weeks later, the first thing i did was make an appt with my pcp. she referred me to an endocrinologist who found my testosterone level slightly elevated. it was in the 70 range. i didn’t have masculinization going on so she told me she didn’t want to put me on medication and to return if i noticed in increase or changes in symptoms.
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. 

I’ve lost count of the types and number of doctors that I have seen over the years, and the amount of time and money that has gone down the drain along with my hair. Used Rogain and only got the little fluffy hair that fell out when topical was stopped. Eight years ago I paid $5k for a transplant… and the transplanted hairs slid right out (NOW I know that it’s not recommended to transplant in summer because perspiration and vasodilation squeezes the transplanted hair out of the scalp).

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.


Side effects and concerns: Minoxidil is safe, but it can have unpleasant side effects even apart from the alcohol-related skin irritation. Sometimes the new hair differs in color and texture from surrounding hair. Another risk is hypertrichosis — excessive hair growth in the wrong places, such as the cheeks or forehead. (This problem is more likely with the stronger 5% solution.)

"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."
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. 
If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
A biopsy is rarely needed to make the diagnosis or aid in the management of alopecia areata. Histologic findings include peribulbar lymphocytic infiltrate ("swarm of bees"). Occasionally, in inactive alopecia areata, no inflammatory infiltrates are found. Other helpful findings include pigment incontinence in the hair bulb and follicular stelae, and a shift in the anagen-to-telogen ratio towards telogen.[citation needed]
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

Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.

The tricheologist advised me to take four (4) fish oil -1000 (blackmores brand) – this also helped sooth the scalp can reduced the itchiness down further. Using the B Complex and the fish oil daily I also saw more hair growth over the period of eight months and am continuing on this regime. I try aim at 300 minutes of walking a week and drinking water. I don’t drink soft drinks nor have sweets and try to avoid processed food.
Medications are available that encourage regrowth of hair. These medications, such as topical minoxidil* and oral finasteride, are not appropriate for everyone with hair loss. Hair growth medications work to varying degrees in different people, and only trigger complete regrowth in a minority of individuals. They work best for people who have smaller amounts of hair loss. Hair loss returns if you stop taking the medication. Finasteride is not appropriate for women who may become pregnant, as it can cause severe birth defects. Spironolactone, although not approved by Health Canada for this purpose, is a medication that may help women who are losing hair due to excess testosterone. Biotin is a vitamin that makes hair and nails stronger and is often used as an adjuvant therapy.

A biopsy is rarely needed to make the diagnosis or aid in the management of alopecia areata. Histologic findings include peribulbar lymphocytic infiltrate ("swarm of bees"). Occasionally, in inactive alopecia areata, no inflammatory infiltrates are found. Other helpful findings include pigment incontinence in the hair bulb and follicular stelae, and a shift in the anagen-to-telogen ratio towards telogen.[citation needed]


Though we think our hair is super important, our bodies consider it nonessential (read: we don’t need it to stay conscious). Other bodily functions, like breathing, are more pressing and get first access to the nutrients in our diet. Our hair gets the leftovers. Protein is your hair's best friend, so reach for healthy protein such as eggs and fish and avoid fasting or yoyo dieting. These can deprive your body of these essential building blocks for a healthy scalp and hair. Wild salmon, tuna and trout are packed with omega-3 fatty acids that help provide moisture and prevent dry and brittle hair. Foods rich in B vitamins also help keep hair follicles healthy, decreasing the risk for hair loss. Fruits and vegetables, and beans and lean meat sources, such as chicken or turkey breast, are all great sources for vitamin B.
I have had hair loss for the past several years. I have seen both endocrinologists and dermatologists. I had one derm who was good, but I unfortunately moved. She put me on minoxidil 5% and spironolactone. I am now seeing and endo but he has me on Synthroid and I was very interested to read on this site that it can actually be a cause of hair loss! If anyone can recommend a doctor in Chicago i would appreciate it. I see there are 2 other people asking for recommendations but I haven’t seen responses to them. Thanks!
Once male-pattern baldness starts, it’s not going to stop until every last hair on your head has shrunk or shed, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, assures me that “you have to lose half your hair before the human eye can tell.” (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.)
I’m going to see an endocrinologist, a trichologist, a hematologist and a gastroenterologist and maybe this Dr. Redmond. I’m done with ‘hair loss experts’ pushing cosmetic surgery and trying the all around approach. My insurance is crap, but….Anyway, thanks all for your stories and knowing I’m not alone in hair loss and the fight against disinterested medical establishment. xxx
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.
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]

"Dr. Yaker is ABSOLUTELY AMAZING! He is innovative, highly professional, incredibly skilled and extremely passionate about hair restoration. His bedside manner is one of complete dedication and compassion with genuine care for his patients and their needs. He strives for excellence in everything he does, and it's evidenced by his loyal client following and their satisfaction with their incredible outcomes. I'd recommend him to anyone & everyone interested in hair restoration or transplantation."
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).
The pattern of hair loss, especially whether it is focal or diffuse, also may be helpful (Figure 1). The hair-pull test gives a rough estimate of how much hair is being lost.2,4  It is done by grasping a small portion of hair and gently applying traction while sliding the fingers along the hair shafts. Usually one to two hairs are removed with this technique. The hairs are then examined under a microscope (Table 2).
Harklinikken (“hair clinic” in Danish) inspires great loyalty. Four out of five users come as referrals from satisfied customers, said Lars Skjoth, the company’s founder and chief scientist. The results are certainly compelling. After four months of daily application — that is, working the tea-colored tonic into the hair section by section, then letting it sit on the scalp for six hours — most users regain at least 30 percent of lost density, and some as much as 60 percent, according to company figures.
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.
Speaking of a new style: Don’t choose one that’s so high maintenance that it needs to be heat styled daily—the damage you’ll do with too much hot tool usage can leave strands damaged and fried, and breaking before it can grow to a certain length. Plus, thinner hair tends to break easier, so you want to avoid any extra damage-inducing practices at all costs. Make a conscious effort, too, to brush more gently, and use a moisturizing and reparative hair mask to hydrate hair and nourish the scalp—where hair gets most of its strength.
You ARE the same inside, but you are also different… you’ve been through a lot and it is so difficult to to stay strong through this experience. I won’t even go into the hair stuff, because it sounds to me that this is not what your post is about. You need to get some really solid support and find something other than your hair to focus on. You need an awesome hair system…and support system. From there, I hope and pray for you, that you will be able to find happiness and balance in your life again. You are a glorious human…don’t doubt that for a moment!
It may take some time to find the right dosage of thyroid hormone to get your thyroid under control. If you're uncomfortable with the look of your hair while treatment is underway, there are options to consider. Wearing a hair piece or wig or getting a new hairstyle can help camouflage hair loss as you wait for the results of thyroid treatment to begin. Ask your doctor if it makes sense to try a topical medication that helps spur hair growth like mixoxidil (Rogaine).
Finally people who understands what I am going through …I am in a desperate search for doctors in the Miami/Boca Raton, Florida area. Can anyone help? I dont know yet what has been causing my hair loss…I had been loosing some hair throighout the years, and sometimes it gets lees severe but lately has just gotten worse and there is no stopping it seems. I had mt Tyroid checked by PCP a coulpe months ago and my iron level also looked normal …getting desperate. Would appreciate some help.
Well, after breaking down and crying in the beauty salon today I came home to try to find why my hair is falling out so rapidly. I am currently seeing an endocrinologist in Houston for hypothyroidism and he wants to put me on Aldactone (Spiro) but I tried it for one week and got dizzy and am afraid to try it again. I am also fearful to get on medication and have to live on it the rest of my life. From what I’ve read, once you get on something and stop you lose the hair all over again. Has anyone ever been on Aldactone (Spiro), regained hair and got off with no problems? Does anyone know of anyone in the Houston area that treats hair loss? I’m almost certain mine is due to thyroid issues as I can’t seem to get stabilized but I’ve been shedding for almost a year and now it’s falling out in handfuls. My hair dresser, shampooer and the rest of the salon staff tried to comfort me today but I filled their sink with hair when they washed it. I don’t know what to do! I’ve been to 2 dermatologist who suggest Rogaine, this endocrinologist who suggests Aldactone…what to do? Anyone have any ideas? Thanks!
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]
How many of us are out there… feeling alone and pretending to not be ashamed. As a child, I had so much hair that my mother used a thinning shears on my locks. In high school I had a glorious mane, cut into a ‘Gypsy’… what great pictures. By my mid-20’s I had to cut my hair short because it was so thin that it wouldn’t hold a style. Was diagnosed with PCOS and told that this syndrome, combined with heredity, caused my hair loss.
For the first time in my life also, I have been experiencing a lot of scalp pain. I think it is because this time, it is not slow and diffuse like it was in my teenage years, at the onset of PCOS. Quitting the pill after 5 years of dependency meant a major hormonal shock to the system which provoked both a mix of both Telogen Effluvium (shock loss), and Androgenic Alopecia (the testosterone from the PCOS back in full form, killing hair follicles).
*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.
It’s really great reading this website. No one in my life truly understands what hair loss does to a woman emotionally. I completely thought I was blowing it out of proportion when I first became obsessed with my hair loss when I was 19. I am 24 now and have lost a little bit more hair but it is not immediately noticeable. I also appreciate that people share my sentiments about how unwilling doctors are to help us with this problem- they do not care about helping us solve the problem- only throw solutions at us for us to figure it out on our own–mostly to figure out they don’t work! I am going to try to see an endocrinologist and hope he/she can help. Although I have lost a lot of hair, I still have enough to cover my scalp left so I may not be able to talk, but I think what we think people see and what they actually see is completely different. I know we’re all beautiful women and I just try to think of hair loss as preparing me for getting old! (at which time I’m sure to have a crisis as well). Well, I will continue reading this site for hope and support. Thank you!
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.
A board certified Dermatologist is best trained to diagnose and manage diseases of the hair. It would be best to select such a doctor who has a special interest in hair loss. If you are considering a surgical treatment, I would recommend selecting a physician who only does hair transplant and nothing else. This type of physician has the most experience to give you the best possible results. 

A board certified Dermatologist is best trained to diagnose and manage diseases of the hair. It would be best to select such a doctor who has a special interest in hair loss. If you are considering a surgical treatment, I would recommend selecting a physician who only does hair transplant and nothing else. This type of physician has the most experience to give you the best possible results. 
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
Before men or women invest in hair restoration, consultation and workup by a board-certified dermatologist experienced should be performed first to rule out other medical conditions that may trigger hair thinning and second to maximize medical therapy. Full medical therapy as prescribed and outlined by a board-certified dermatologist must continue in order to protect one's investment in hair transplant such as NeoGraft hair restoration.
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