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Archive for the ‘hair loss’ Category

Hair Loss - Why Me? Notes from a San Francisco Bay Area Dermatologist

Tuesday, October 13th, 2009

For the majority of the population, hair loss is a fact of life.  And even though most people will experience it at some point, it still makes us feel self-conscious and distressed.

Hair loss that runs in families is known as androgenetic alopecia (”andro” referring to androgen hormones, and “alopecia” referring to baldness) or as male and female pattern baldness.  Commonly, 50 percent of people by age fifty have some degree of this type of hair loss.  It has been linked with the mother’s side of the family, but new research shows that early male-pattern baldness can be passed down from the father’s side as well.  People with hereditary hair loss produce too much of an enzyme that converts testosterone to dihydrotestosterone (DHT), a hormone that causes hair follicles to shrink and eventually shut down.

Women tend to have diffuse thinning, especially in the crown and front of their scalp.  One way to tell if you are losing hair is to check your part.  Is it wider and can you see more scalp than before?  Women notice an increase in hair loss after menopause, but premenopausal women may notice it as well.  It also may occur in women even with normal androgen levels.

Hair loss can also be triggered by other factors too like thyroid disease, fungal infection, anemia, iron or other nutritional deficiency, excessive vitamin A intake, crash dieting, severe infections, traumatic illness, certain medications, general anesthesia in surgery, cancer treatments and emotional distress.  Women also experience hair loss due to hormonal changes during pregnancy.

Patchy hair loss and bald spots are caused by a condition known as alopecia areata, which is often attributed to an auto-immune issue.  Hair styles, tight braids and chemical hair products like bleaches and relaxers can also contribute to hair loss.  In those cases hair will generally grow back once the underlying cause is corrected.

There are two drugs that are FDA approved for common hair loss.  One is minoxidil (brand name Rogaine), a topical solution applied directly to the scalp, which can be purchased over the counter.  It has been shown to slow hair loss and encourage hair regrowth in some people.  It must be used consistently for many months to see results.  This medication should be used with caution in people with heart and kidney disease and should not be used by pregnant or nursing women.

The second drug is called finasteride (brand name Propecia) and is a prescription pill taken once a day indefinitely.  This medication is approved for men only and blocks the hormone that shrinks hair follicles.  In most studies about 80 percent of men who take Propecia slow or stop hair loss on the top of the head and about 60 percent regrow some hair.  However, it is important to take this medication as soon as you notice any hair loss.  Taking it once most of your hair is already gone, will not be effective.  Men with liver disease should avoid finasteride unless approved by your doctor.  It can also make it harder for your doctor to detect prostate cancer so be sure to tell your doctor before having a PSA test.

Don’t believe miracle treatments!  Only minoxidil and finasteride have been shown in good, reliable studies to significantly help hair loss.  If you are experiencing any loss don’t delay treatment - contact your doctor and he or she can help determine the cause and best treatment.  The sooner your start, the better chance you have of keeping the hair you’ve got!

 

In Denial About Hair Loss?

Wednesday, May 20th, 2009

When looking in the mirror, people often deny or intentionally overlook the fact that the part in their hair is widening, bald spots are appearing or their hair is becoming so thin that they can see the scalp right through it! Denial, however, will not change the facts. If you are noticing these changes, you are not alone. Losing hair is something most people experience at some point in their lifetime. In fact, 50 percent of women by the age of 50 have lost at least 50 percent of their hair. By age 35, two thirds of American men will experience some degree of appreciable hair loss, and by age of 50, approximately 85 percent of men have significantly thinning hair. Let’s face it, hair loss can be unsettling, but taking steps to address the issue sooner than later can make all the difference.

Treatments are available to slow down hair loss and possibly stimulate new hair growth in both women and men. The oral medication, Propecia is the only once-a-day pill approved by the FDA for the treatment of certain types of male pattern hair loss in men.  Propecia reduces DHT (dihydrotestosterone), a substance in the body that can shrink the hair follicle until it no longer produces visible hair. Propecia is safe and effective with few potential side effects. It is important for men to begin taking this medication as soon as they notice more than average hair loss (it is normal to lose an average of 100 hairs per day) as Propecia is designed to help you keep the hair you have. For some men this may be as early as in their twenties. It has been clinically proven to stop hair loss in most men and stimulated new growth in nearly 50 percent of those cases. Propecia is available by prescription only.

For both men and women, Rogaine topical treatment is available without a prescription. Rogaine contains topical minoxidil, the only FDA-approved ingredient clinically proven to regrow hair. Minoxidil reinvigorates shrunken hair follicles to increase their size and helps to regrow thicker hair over time. Rogaine must be used daily and for at least 6 months for appreciable results.

If the hair loss is seriously advanced and oral or topical treatments would be ineffective, surgical procedures like hair transplants, scalp reductions, and scalp flaps might be considered.

While a majority of hair loss is hereditary, it may also be a signal of illness or disease, or a reaction to improper diet, medications, stress and hormones. The way you style or care for your hair may also cause hair thinning, breakage or balding. Avoid purchasing supplements, shampoos, conditioners or other formulations designed to help hair loss without consulting your dermatologist first.  Many products are clinically unproven and ineffective.  You may end up spending a lot of money without seeing any results. Visiting a dermatologist is the first step in determining what type of hair loss you are experiencing and plotting the appropriate course of treatment.

Starting treatment early will lead to greater success in keeping your hair, so don’t delay! For more information on the causes of hair loss visit the American Academy of Dermatology website.

 

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