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Welcome to HerHairLossHelp.com!

women's hair loss treatment and cosmetic solutions information

Welcome to HerHairLossHelp.com! As a woman, losing hair or having thinning hair can be a devastating and often confusing experience. A number of women suffer hair loss whether it be through androgenetic alopecia, alopecia areata, universalis, telogen effluvium, etc. With all the possible triggers for our hair loss physically and emotionally, sometimes it feels as if it is a constant battle within to stay sane. However, you are NOT alone!

Her HairLoss Help was made by women with alopecia for women with alopecia, and is one of the longest running women’s hair loss support community just for women.

Please be sure to register as a member of our online community. Go to our online discussion forum to get information, treatments available, support during your quest to find answers, and chat with women who suffer from hair loss from all over the world. Ask a question and most likely you will be overwhelmed by the honest and straightforward answers you will receive. These women are warm and welcoming and sometimes a little looney… We currently have 70,000+ articles concerning hair loss and how women cope with it each day.

We are so glad you are here!

“Brave, Bald and Beautiful”

Have you seen this recent segment on The Doctors? Absolutely exquisite!

Will My Hair Ever Grow Back?

women's hair loss treatment and cosmetic solutions information

There is every chance that your hair will regrow, but it may also fall out again. No one can predict when it might regrow or fall out. The course of the disease varies from person to person. Some people lose just a few patches of hair, then the hair regrows, and the condition never recurs. Other people continue to lose and regrow hair for many years. A few lose all the hair on their head; some lose all the hair on their head, face, and body. Even in those who lose all their hair, the possibility for full regrowth remains. In some, the initial hair regrowth is white, with a gradual return of the original hair color. In most, the regrown hair is ultimately the same color and texture as the original hair.

Some studies suggest that the percent of patients who develop extensive disease (alopecia areata to either totalis or universalis) is anywhere from 16.7% to 19%. Recurrences are possible even after a 20 year remission. However, the prognosis is worse for those that have experienced loss of hair for over a year.

How Will Alopecia Universalis Affect My Life?

Her Hair Loss Help has an outstanding Discussion Forum specifically for women with alopecia and other forms of hair lossThis is a common question, particularly for children, teens, and young adults who are beginning to form lifelong goals and who may live with the effects of alopecia universalis for many years. The comforting news is that alopecia universalis is not a painful disease and does not make people feel sick physically. It is not contagious, and people who have the disease are generally healthy otherwise. It does not reduce life expectancy and it should not interfere with the ability to achieve such life goals as going to school, working, marrying, raising a family, playing sports, and exercising.

The emotional aspects of living with hair loss, however, can be challenging. Many people cope by learning as much as they can about the disease; speaking with others who are facing the same problem; and, if necessary, seeking counseling to help build a positive self-image. HerHairLossHelp.com offers a wonderful Online Community of women who suffer from alopecia and other hair loss afflictions that can help women who suffer from hair loss cope with their everyday activities. Having a community of women, who are all going through various stages of hair loss, offers other women an empathetic person to turn to when dealing with emotional difficulties because of their hair loss. Visit the HerHairLossHelp.com Forum to learn more!

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Life doesn't end with alopecia - Many women are successful in combating the self esteem issues of not having hair

Angelica Galindez was diagnosed with alopecia when she was 12 years old. But now, seven years later, the 19-year-old from San Francisco is the picture of confidence. She proved that on Saturday when she ditched her wig to compete in the Miss Philippines Earth USA beauty pageant and took home one of six victory crowns.  Read more at Huffington Post

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Hypothyroidism and Thyroid Hair Loss in Women

Claire, one of our lovely forum members, put together this incredibly informative post on hypothyroidism, TSH levels and doctors…

Just a little background. I was diagnosed with Hypothyroid in June of 2005. After over a year of fighting with doctors I finally reached a TSH level below 3.0 in August of 2006.

I am not a doctor, nor a health professional. I’ve read, experimented, and suffered through this thyroid maze. As I would say if you came to me with someone else information, please take everything I say about my treatment with a grain of salt. What works for me may not work for you, but I feel it’s important to give you an idea of what can be done.

The reason I had so much trouble with doctors is that many of them have been out of med school longer than the newest findings.

As of 2012 the AACE (American Association of Clinical Endocrinologists) published new findings on the correct thyroid levels in most individuals. No longer is the range between .5 and 5.0 but a smaller range of .3 to 3.0

AACE guidelines for correct thyroid levels in women to help find solutions to hair lossThe full AACE Guidelines can be viewed by clicking this link.

What does this mean? That many many doctors are under treating their patients. Even more frightening is that there are doctors who have not been updated on thyroid function for an even longer period of time and think that a TSH level under 10 is appropriate. Luckily those doctors are few and far between. What this teaches us is that educating oneself on ones health matters is most important. We assume that doctors are knowledgable about all health matters. The truth is, scientists and specialists come to new findings every year and general practitioners are the last to know. Doctors are well educated on health matters, unfortunately, they are well educated within the time frame in which they went to medical school. This leaves several years of updated information that they have not had access too. Even more frightening is that many of them dismiss new findings if such information is brought to them by a patient.

Synthroid tablets are a common treatment option for women who suffer from thyroid problems and hair lossIf you are hypothyroid and still suffering with symptoms and your doctor is telling you that your thyroid is functioning normally it is time to start taking control of your situation.

First, obtain a copy of your most recent lab work. Find out what your thyroid levels really are. Second approach your doctor about what issues you are having. If he is unwilling to listen, then you have a couple of options.
A. you can take in a copy of the AACE’s newest research {http://online.liebertpub.com/doi/abs/10.1089/thy.2012.0205?journalCode=thy}, a copy of a checklist of your symptoms {http://thyroid.about.com/cs/hypothyroidism/a/checklist.htm}

If you have any other symptoms that seem abnormal to you, but are not listed, please list them as well. Recently, I’ve discovered that overnight leg cramps is also a symptom of hypothyroid.

B. you can switch doctors.

You may have to do B. anyway, if your doctor is unwilling to work with you. The best thing you can do is request to be sent to an endocrinologist. If your doctor is unwilling to refer you, you are not without hope. Most insurance companies have patient outreach programs. Obtain a copy of your records, including blood tests (you have the RIGHT, by law to get copies of your medical records), a copy of the AACE’s findings, a list of ongoing symptoms and a letter requesting referral to see a specialist. It is possible to go over your doctor’s head in order to do this. You can also switch doctors and request this of your newest doctor. Be warned, even some endocrinologists go by an older TSH scale. If you find this to be so, request a second opinion.

Most important, do not think that the doctor knows more than you. You, and only you truly knows how you feel. Do not worry about offending your doctor. As it is, your doctor doesn’t seem to worry about offending you. You are the boss in this situation. He works for you, if he is unwilling to do his job, then you’ve every right to hire someone else.

Once you find someone willing to work with you ( and if you already have, thank your lucky stars) do not expect your symptoms to alleviate as soon as you start a new dosage. Do not expect your symptoms to alleviate as soon as you reach a healthy TSH level. It’s going to take some time for your body to begin to heal itself. However, you will notice some changes within weeks.

Anatomy image of the thyroid gland courtesy of UpToDate.com

Anatomy image of the thyroid gland courtesy of UpToDate.com

The Thyroid also changes with time. As you begin to reach a healthier TSH level things may plateau and you may have to adjust your meds as needed. It’s not uncommon to reach a healthy TSH level and a few weeks later begin to feel bad. It’s important that within the first year of reaching a healthy TSH goal to be checked every 3 months. After that it’s important to be tested twice a year. Some doctors say only once a year is enough, this is not true. Thyroid levels change with temperature changes. One of the best ideas is to check your thyroid levels a few weeks into the first cold snap of winter and within the first few weeks of summer heat. Many thyroid patients find they need to adjust their dose with the extreme temperatures of both seasons. Cold weather slows thyroid function, hot weather tends to call for less thyroid supplement.

It is also not uncommon for a short period of time in which you have a few of the sensations associated with HypERthyroid upon starting a new dosage. I’ve found the best way to avoid this is to titer up. My doctor is willing to work with me on this. This consists of me cutting pills and slowly adding till I reach my newest dosage level. Thyroid hormone takes time to build within the system. This is why titering up works in many cases. This is also why you do not retest your thyroid till 6-8 weeks after beginning a new dose. If you decide to titer up, do not retest till the 6-8 week mark after you reach your INTENDED dosage. My pm box is always open if you have additional questions about this. It is important to discuss this with your doctor as well. Do not raise your dosage above what he recommends till you’ve had your TSH checked. Then be sure to inform him of anything you intend to do, so that you may have another test lined up.

There is no magic number. Not when it comes to TSH, not when it comes to dosage. The ideal setting is for you and your doctor to work together by using both blood work and how you feel.

When taking thyroid medications it’s important to understand a couple of things. First, any food or vitamins taken with the thyroid med will change the absorption rate of the hormone. Your best bet is to take the thyroid med first thing in the morning and an hour before and after eating. So, no food for an hour on either side of taking your med. Even more important is delaying the taking of vitamins. Especially iron and calcium. Both of those can have an effect on the way your body absorbs the thyroid hormone. It is best to take your vitamins either in the middle of the day (2-3 hours) after your hormone or at night (6-8 hours) before.

If you are the type that has to eat first thing in the morning then know that you must follow the pattern every day. If you eat less than an hour after taking your thyroid hormone then it is important to follow this habit daily. It is also important to stick to a similar breakfast food. For instance if you drink milk, it will have an effect on how your body absorbs the hormone, so it’s important to have dairy at the same time, every day as to keep the hormone absorption similar.

Hair Loss in Women

Her Hair Loss Help has an outstanding Discussion Forum specifically for women with alopecia and other forms of hair lossWomen experience hair loss because of a number of reasons, such as pregnancy, stress, genetics or an illness. Another cause is Alopecia Areata, an autoimmune disorder which results in hair loss.

Women going through any type of hair loss becomes distraught about their changing appearance. Some are comfortable leading their life as someone without hair, but many seek out hair replacement studios to give them back what they have lost.

Unless you yourself have been through sudden and unexpected hair loss, it is nearly impossible to fully understand the emotions that a person must be experiencing. The process going from someone with hair, to someone losing their hair, to someone seeking hair replacement, is a sensitive and personal journey.

Lace Front Wigs

Most store bought wigs are made by machine or largely made by machine, but hand finished. When a wig is hand made, a pattern of your own head has to be taken and from this, a foundation is made. There are different weights and colours of bases available, but the best is a strong, yet sheer lace, which when lightly stretched against the skin, becomes almost invisible.

A lace fronted wig, will usually be custom made and individual human hairs will be painstakingly knotted in to the tiny holes in the lace, creating a natural looking head of hair. The main advantage to a lace-fronted wig is it enables the wearer to have a natural looking hairline. It is also possible to have any style you may desire and lace wigs tend to be significantly lighter, cooler, better fitting and more comfortable than store wigs.

Information about wigs, extensions and other cosmetic options for ladies with hair loss

I would say that 9/10 actors, actresses, models, etc who are wearing additional hair in magazines, on stage or on film, will be wearing lace front wigs or hair pieces.

It is possible to buy lace fronted wigs in stores around the world and I have to say, these bare no resemblance to the type favoured by celebrities. Your average celeb will have paid to use to finest wigmaker, who will have sourced finest European hair, used their expertise to make the foundation fit perfectly, knotted this hair in, in such a way, it looks and acts like real hair and will have chosen lace, which matches that persons’ skin colouring. The wig will then be styled by and maintained by an expert (wig dresser) and the lace replaced as soon as it becomes worn. In real life, the only way, to replicate this look is to have a lace fronted piece made for you – Ladies who have bought ‘off the peg’ lace fronts are usually very disappointed

For Theatre/dancers, the lace is usually left an inch from the hairline, to support the wig, improve fit and help it to last longer in heavy use. Make-up is applied to blend in any areas, which may show. For film/TV (and in real life) it is necessary to cut more of the lace back so it cannot be seen up close, but a fringe (bangs) also helps conceal any lace.

Wigs that have ‘lace fronts’ often require re-fronting. The wig itself (if not bonded) should last for many years if well looked after, but may require a new front every 6mths – 12mths if worn every day. I regularly work on wigs which are older than I am and still look like new because of the care they receive.

sally_miniSally Turney
Resident Wig Expert

HerHairLossHelp.com

 

What is androgenetic alopecia (AGA)?

Hair loss can be very concerning to womenHereditary balding or thinning is the most common cause of hair loss. The tendency can be inherited from either the mother’s or father’s side of the family. Women with this trait develop thinning hair, but do not become completely bald. The condition is called androgenetic alopecia and it can start in the teens, twenties, or thirties. There is no cure, although medical treatments are available that may help some people.

Hereditary hair loss, or androgenetic alopecia, is marked by a progressive miniaturization of hair follicles, causing a shortening of the hair’s growth cycle. As the growth phase shortens, the hair becomes thinner and shorter. Eventually there is no growth at all. Because hereditary hair loss is gradual, the sooner treatment is started, the better the chances of results.

Blood Tests to Have Done First for Diagnosing Hair Loss Causes

These are simple blood tests that you should have done if you think that your hair loss may be caused by a chemical deficiencyIt’s easy to get lost in the maze of tests and blood panels that your doctor should require to diagnose the cause of your hair loss. Here is a complete list of blood tests to talk to your physician or dermatologist about at the beginning of your hair loss journey, along with it’s corresponding recommended normal range/level.

Many dermatologists will recommend Rogaine (minoxidil) immediately without spending time reviewing bloodwork and ordering blood panels. It’s okay to remain assertive with your doctor and request a full series of blood tests to rule out any underlying conditions that could be causing your hair loss. Often times, a simple hormonal imbalance or vitamin deficiency can be discovered early with a blood test and you will be well on your way to restoring your hair.

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Vitamin Deficiency:

Simple blood tests to be ordered if you think your hair loss may be caused by a lack of nutrients in your diet.

CBC:
This test will show if you are anemic. Even mild anemia can often cause hair shedding. Look for lower than norm values for Red Cell Count, Hemoglobin.

RBC (Red Blood Count): normal levels: 4.2 to 5.4 mil cell/mcL
WBC (White Blood Count): normal levels: 4500 to 10000 cells/mcL
Hematocrit: normal levels: 36.1 to 44.3%
Hemoglobin: normal levels: 12.1 to 15.1 gm/dl
MCV: normal levels: 80 to 95 femtoliter
MCH: normal levels: 27 to 31 pg/cell
MCHC: normal levels: 32 to 36 gm/dL

Vitamin B12 and B6:
The lack of these vitamins can cause hairloss.
B6: optimum level: 2 to 26 ng/ml
B12: optimum level: 200 to 900 pg/ml

Zinc:
The lack of zinc is a known cause of hairloss. Be careful though, too much of zinc could cause hairloss as well. :?

Iron:
Serum Iron: optimum level: 60 to 170 mcg/dl
Serum Ferritin: optimum level: 12 to 150 ng/ml
TIBC (Total Iron Binding Capacity): optimum level: 240 to 450 mcg/dl

A lot of hairloss specialists believe that one needs a level of ferritin higher than 40 in order to maintain hair and ferritin above 70 to regrow lost hair. There’s also a lot of opposing points of view, however in general it’s probably a good idea to get your ferritin stores at a proper level. One thing to notice is that TIBC above the norm (above 400) means the lack of iron in the iron stores. TIBC above 400 often corresponds to lower serum ferritin numbers. As ferritin increases, TIBC should drop.

ESR:
ESR: optimum level: >20mm/hr
There’s an article stating that if your ESR is less than 10 you need to considerably increase your serum ferritin level to stop/reverse hairloss.

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Electrolyte Panel:

Blood tests that you should have done prior to and during the administration of anti-androgenic medications such as spirolactone. These tests can also aid in diagnosing adrenal problems.

Sodium: normal levels: 15 to 250 mEq/L/day
Chloride: normal levels: 20 to 25 mEq/day
Potassium: normal levels: 25 to 120 mEq/L/day
CO2: normal levels: 20 to 29 mEq/L

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Thyroid Panel:

Rapid hair loss can be the worst symptom of a thyroid problem

Your thyroid gland is one of the largest endocrine glands in your body. [Image courtesy of SutterHealth.org]

Blood tests that are recommended to diagnose hyperthyroid, hypothyroid and other thyroid related problems.
TSH and T3/T4:
Thyroid conditions often cause hairloss as well. The best TSH value is between 1 and 2. Values above 3 are still considered normal by many labs (the upper level of normal is 5) however it usually indicates an overactive thyroid and should prompt for future evaluation.

TSH (Thyroid Stimulating Hormone): optimum level: .3 to 3.0 mlU/L
** if you are on thyroid medication already, your optimum level SHOULD be between .5 and 2.0 mlU/L
Total T3: optimum level: 100 to 200 ng/dL
Free T3: optimum level: 2.3 to 4.2
Total T4 (Total Thyroxin): optimum level: 4.5 to 12.5 mcg/dL
Free T4 (Free Thyroxin): optimum level: .7 to 2.0

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Auto Immune Testing:

These tests can also aid your physician in giving you a definitive answer as to what is causing your hair loss. They show the possibility of lupus, hashimoto’s, sjoren’s, alopecia areata and other autoimmune disorders.

ANA and Anti-DNA

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Adrenal Function Panel:

These are tests you should have done to rule out adrenal deficiencies which can cause hair loss as well as fatigue, joint and scalp pain.

Cortisol AM:
Cortisol is a stress hormone. Even though there’s no direct link to hairloss, a high cortisol value means the body is under a lot of stress and the adrenal gland is working overtime. This situation shows the ‘fight or flight’ reaction of the body as a result of which a lot of hormonal functions are interrupted. Stress significantly decreases the benefits of ALL the hormones. Moreover, high cortisol values can indicate a possibility of
adrenal tumor.

Cortisol: normal 8am levels: 6 to 23 mcg/dl

Serotonin:
Serotonin: normal levels: 101 to 283 ng/ml

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Hormone Panel:

Visit our online discussion forum to read more topics on hormone imbalances and how it affects hair loss in womenThese are ESSENTIAL blood tests to have done if you believe that you may be experiencing hair loss due to hormonal imbalances.

Estradiol:
For premenopausal woman the lowest estradiol value should be shown on the test taken on the 3rd day of her cycle (the week of her period). Values between 80-90 are preferable, values below 50 show estrogen deficiency. For the rest of the cycle the optimal range is 100-200 (closer to 200 the better). Younger women can produce significantly higher levels of this hormone.

Estradiol: normal levels:
**** Premenopause: 20 to 400 pg/ml
**** Postmenopause: 5 to 25 pg/ml

Total Testosterone:
If the value is above 50, it could potentially cause the situation of adrogen sensitivity, but the more important number is the one for free testosterone.

Total Testosterone: normal levels: 20 to 80 ng/dl

SHBG (Sex Hormone Binding Globulin):
Values around 90 are desirable. Values above 100 are considered too high. High values of SHBG decrease the availability of all the hormones in the body. Higher levels of estradiol are needed to raise SHBG.

Luteinizing Hormone (LH):
Luteininzing Hormone: normal levels: 5 to 20 IU/L

Prolactin:
Prolactin: normal levels: 0 to 20 ng/ml

Free Testosterone:
Values above 1-1.5 are considered on the higher end of normal range. Values closer to 0.5-0.6 are more desirable. Free Testosterone is the result of Total Testosterone divided by SHBG.

Progesterone:
Value above 5 means that woman is ovulating.

Progesterone: normal levels:
**** Pre-ovulation: >1 ng/ml
**** Midcycle: 5 to 20 ng/ml
**** Postmenopausal: >1 ng/ml

Follicle Stimulating Hormone (FSH):
Hormone that regulates production of female hormones. Levels above 15 indicate menopause. Levels of 3 and below usually indicate BCP use. Higher levels of FSH indicate decrease of estradiol production, while lower
levels indicate higher level of estradiol production.

FSH: normal levels:
**** Follicular: 3.5 to 12.5 IU/L
**** Midcycle: 4.7 to 21.5 IU/L
**** Postmenopausal: 25.8 to 134.8 IU/L

DHEA and DHEAS: Some doctors report finding that a high percentage of patients with autoimmune disorders are also deficient in DHEA, and should be tested.

DHEA: normal level for women by age:
18 to 29 years: 62 to 615 ug/dL
30 to 39 years: 52 to 400 ug/dL
40 to 49 years: 44 to 352 ug/dL
50 to 59 years: 39 to 183 ug/dL
60+ years: 11 to 150 ug/dL

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Illustration of glucose molecular structure

Diabetes is a common cause of hair loss due to the build-up of blood sugar in the body when it is not controlled.

Fasting Blood Glucose (also known as a Fasting Blood Sugar): Blood test done after fasting for 8 to 10 hours
Normal glucose tolerance: From 70 to 99 mg/dL (3.9 to 5.5 mmol/L)
Impaired fasting glucose (pre-diabetes): From 100 to 125 mg/dL (5.6 to 6.9 mmol/L)
Diabetes: 126 mg/dL (7.0 mmol/L) and above on more than one testing occasion

Glucose Tolerance Test (OGTT or GTT): Blood test done two hours after a 75-gram glucose drink
[levels below are NOT for gestational diabetes GTT testing]
Normal glucose tolerance: Less than 140 mg/dL (7.8 mmol/L)
Impaired glucose tolerance (pre-diabetes): From 140 to 200 mg/dL (7.8 to 11.1 mmol/L)
Diabetes: Over 200 mg/dL (11.1 mmol/L) on more than one testing occasion

Fasting Insulin: normal levels: 5 to 20 mcU/mL

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Tests that your Dermatologist should do:

** Pull Test
** Scalp Biopsy

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How Can I Cope With the Effects of Alopecia?

Living with hair loss can be hard, especially in a culture that views hair as a sign of youth and good health. Even so, most people with alopecia areata are well-adjusted, contented people living full lives.

The key to coping is valuing yourself for who you are, not for how much hair you have or don’t have. Many people learning to cope with alopecia universalis find it helpful to talk with other people who are dealing with the same problems. More than four million people nationwide have this disease at some point in their lives, so you are not alone. We have a number of women who live with alopecia universalis on a daily basis in our Online Community who can help through message boards and support groups. You can also find others with the disease, the National Alopecia Areata Foundation (NAAF) can help through its pen pal program, message boards, annual conference, and support groups that meet in various locations nationwide.

Wigs and hair extensions are available to help achieve a full head of hair even when you have lost all your hairAnother way to cope with the disease is to minimize its effects on your appearance. If you have total hair loss, a wig or hairpiece can look natural and stylish. For small patches of hair loss, a hair-colored powder, cream, or crayon applied to the scalp can make hair loss less obvious by eliminating the contrast between the hair and the scalp. Skillfully applied eyebrow pencil can mask missing eyebrows.

For women, attractive scarves can hide patchy hair loss; jewelry and clothing can distract attention from patchy hair; and proper makeup can camouflage the effects of lost facial hair. If you would like to learn more about camouflaging the cosmetic aspects of alopecia universalis, visit our online forum for information about your cosmetic options.

Sally’s Not-So-Quick Guide To The Wonderful World Of Wigs

Dear Friends,
I have put this not-so-quick-guide together, to try and steer you through the endless maze of where to start when you are looking to buy a wig. I hope you find it useful,
Sally Turney
Resident Wig Expert, HerHairLossHelp.com

Where to start…
There are so many choices aren’t there? It can be an incredibly daunting experience to buy your first wig. I think the very first question you need to ask is:

Do I really need a wig?
Most people think because I work with wigs, that I must think they are the answer to everybody’s prayers, but the advice I would give to my mother, sister or best friend, is not to go in to one unless you really need to. There is nothing worse than being rushed in to making a decision and I believe it is essential you take the time to do your homework and be fully informed about ALL the options before committing to a wig.

I have seen many women wearing full wigs, who could in fact have been better suited to ¾ pieces or even less, but they didn’t know they were available. I recently saw a lady who had been wearing a topper for 5 years, which she was renting at enormous expense and she didn’t need it at all. She had been told she needed it by a girl in a very successful salon (who in my opinion was more more interested in her commission than doing right by someone), but in fact all she needed was some light cosmetic coverage. There are many options.

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Cosmetic Options
This should be your first port of call and probably will be. There are so many great volumising products on the market – shampoos, mousses, serums, lotions – don’t be frightened to experiment and keep a written record of things you like/don’t like and any observations you make about the effect of the products on your hair/scalp. Try concealers like Couvre, dermamatch, Fullmore and Toppik – they all make the hairs appear denser and stop light reflecting off a bare scalp. Cosmetic options often take skill and practice to perfect, but many people find them enormously useful.

Extensions
For many people, this is the next step. Again, I would urge anyone who is contemplating extensions to really do their homework and be very selective in whom they go to. The whole subject of extensions is one that I tend to shy away from, because I have seen more harm than good come of them, but I do accept, for many women, who have got the balance right, they are a life line. If the extensions are too heavy or left for too long, they can cause traction Alopecia, which is a trend now amongst celebrities who are wearing long, heavy extensions and almost permanently. They can also be very expensive, as you not only pay for the initial setting up, but regular refreshings and these are sometimes required as often as every fortnight.

Hats With Hair
It is possible to buy a hat, which comes with synthetic hair. Sometimes this is sewn in, sometimes this is attached with Velcro and you can put it in to other hats. A great idea for when you need to pop something on super quick – to answer the door for instance. I particularly like the hats with hair, for children. They are relatively cheap to purchase and there are lots of shops that sell them on line.

Hair Pieces & Add ons
Unfortunately for many women, a full wig is their first step, instead of a last resort, which I would prefer it to be. Girls, don’t rush it, please look at all the other options first.

There are many hairpieces available to purchase and these are also known as toppers, units, systems, enhancers, wiglets, falls, add ons, etc. They vary greatly in price and quality, starting from low-end pieces, which you could buy on market stalls, thro to custom made pieces from the finest wig makers. So you are looking at spending anywhere from £1 to £1000.

Pieces are attached in a variety of ways, from glue, to clips to bands to Velcro to grips to being weaved in…the list of possibilities is endless.

Synthetic pieces tend to be more popular because they are significantly cheaper and easier to cope with in how you care for them. They are easy to buy – you can cut them down if required and do a bit of D.I.Y on them and you won’t go far wrong. The down side is that they are heavier and hotter and as they are made of an artificial medium, they will never be perfect.

Human hair pieces are a different ball game, better fitting (when they are custom/hand made) lighter, shinier, easier to handle, but price wise they are coming in at a premium and need more care, but the quality…again…depends on the hair you buy!!! Ugh, this subject is so complicated!!

When Is Human Hair Not Human Hair?
When it has had all its ‘human’ qualities removed. This is a process of removing the cuticle, which truly PAINS me to say, has become incredibly popular over the last decade. The result is hair you can (Wha Hey!) sleep in and swim in and that is light, but won’t tangle. It will also look dead and flat (it has no cuticle to reflect shine) and will need silicones etc to make it look like the hair it was once!

Hair Integrations
These are similar to hairpieces, but have a section of elastic webbing, which, once the little piece is in place, you would then slide your own hair through the spaces in between to ‘integrate’ with the piece. Sometimes you can do this at home, but it is big business for salons, producing these systems and either sewing or micro linking these in – there are lots of different ways it can be done. In my experience, integrations look superb at first, but for the wearer they are uncomfortable, it can be hard to wash hair properly, regular salon visits will be required and as you will be wearing it 24/7, you will find it will wear out quickly. Traction Alopecia is also an issue here…sorry!

Wigs made with a thin sheer lace base at the hairline are called lace front wigs

Close up of a monofilament top lace front wig. [Photo courtesy of Wigs.com]

Wigs
Wigs vary in price from about £20 from a very low-end dress up wig to £6,000 for a high-end human hair wig. What’s the difference? It’s STAGGERING!!

Synthetic Wigs
These are improving and the ranges are getting better and better every year. Care is minimal and you can play with these wigs and make mistakes without too serious repercussions. The only big NO NO is heat and this includes heat from bedside lights, an oven etc that will melt the artificial fibres and cause frazzling.

Because of the artificial materials used, they tend to be hot, heavy and itchy and you really need to wear a wig liner, tho few people do. Fit can be an issue too.

Cheaper wigs will be all wefted, which is rows of hair sewn together, which leaves big gaps. More expensive wigs will be monofilament or part monofilament, designed so it looks like the hair is growing out of the scalp. You can also purchase synthetic wigs, which have a micro skin top. Here, the hair is tied in to a nylon base and a coating of thin latex is applied, creating the effect of a natural scalp/parting.

With regards to size, synthetic wigs all come with Velcro tabs, which are helpful for improving fit. Fortunately most women have an average size head and can therefore fit the majority of wigs, which cater for this size (21-22.5”). If in doubt you can measure your head with a tape measure going around the forehead at the hairline, under the hair, behind the ears and around the nape of the neck. If this is too difficult to do by yourself, it’s a good idea to have someone help you.

Most people choose wigs, which are closest to their natural style, but when shopping for a wig also take in to consideration how easy the wig will be to look after, your face shape, eye colour and complexion (with and without make-up). Whilst there is always a great temptation to steer away from your ‘old’ hair and go for something dramatically different, in my experience this rarely works, as women just want to look ‘normal’ and not stand out in a crowd.

Human Wigs
Again, can be purchased off the rack or hand made. Sometimes you can buy blends of both synthetic and human. If you are having a wig made for you, this will usually involve three visits – one for a consultation and to make a mould of your head, one to check the foundation (base) for fit and one to collect the wig. Sometimes they are all one length (a la cousin ITT!) and require you to take them to a good salon to be cut and sometimes they are ready to wear.

Bases tend to vary from cotton type bases to suction bases to coarse nets to finest lace bases…. Ideally you want a very light base, which will let as much air thro as possible.

If a competent wig maker has measured you, the wig will fit well, but you may like to use double sided tape or glue (which comes in every conceivable type and strength you can imagine). You can wear the wig all day, over night, for a few days or for a few weeks, but note with the latter, we are talking about bonding and extra precautions are necessary.

It is possible to sleep/swim in your wig, although most women choose not to because of the expense of replacing it. Many women buy two human hair wigs and wear them in rotation.

Repairs are sometimes necessary and good handling is essential to maintain the longevity of the wig. Fine lace bases can snag easily and will need repairing straight away to prevent tearing.

The disadvantages to buying human hair hand made wigs are simple – they are more expensive and more care is required in terms of looking after them. If you are sold a human hair wig, you WILL be told you need special tools and Equipment. I was recently contacted by a lady who had bought £500 worth of ‘essentials’ from a reputable wig maker. In actual fact, the real cost she should have paid is about £70.

The advantages? You can have anything made from the size of a penny up to a full head of hair and fit should be perfect as it is designed for you. You can have any colour, any density, any length, any texture and you can style it as your own. If you are having European, Virgin hair, you should be prepared to work at keeping it looking good. Often when your wig arrives it is not looking as good as it could and you need to be prepared to get it in to condition for a couple of weeks (this is because of the chemical processes the hair itself is put thro).

The wig will be light, airy, cooler than anything else you could have and if used with bonding can be worn 24/7, swam and slept in.

In Summary
The subject is enormously complicated and I have barely scratched the surface of the endless list of possibilities, but rest assured if your desire is to have a natural head of shiny, bouncy hair, which is comfortable and ‘part of you’ – it can be done, but what you put in, you will get out and I want you to avoid making expensive mistakes. People WILL always try to sell you things you don’t need and for every single piece of advice you receive from now on, I want you to ask yourself ‘Does this person have anything to gain?’ Almost all wig salons/people/stores/shops/consultants have some vested interest in steering you towards buying something.

I do not sell anything EVER nor do I promote anything. I am here in the UK and 99% of the people I advise are overseas. You know what… I have a vested interest too! It’s true! I have a vested interest in each and every one of you and giving you the most honest advice I can, because when you feel good, I feel good!

sally_miniSally Turney
Resident Wig Expert

HerHairLossHelp.com

“Personally, I think hair is overrated.”

Story from a woman who has alopecia universalis:

I’m 40 years old and have had alopecia for more than 20 years. Up until the last year, my hair would grow in spots. I decided last year I was tired of the wigs and showed the world my bald head with a little peach fuzz. I have since lost even the peach fuzz with no hair in sight. I hope they come up with a treatment that works, but if not, I have come to grips with the fact that I may never have a full head of hair again. Personally, I think hair is overrated.

Thank you for sharing your story!

Information on Telogen Effluvium & Tips on How to Deal with Hair Loss

Her Hair Loss Help has an outstanding Discussion Forum specifically for women with telogen effluvium and other forms of hair lossTelogen effluvium (TE) is the second most common form of hair loss most dermatologists see. When a woman is actively shedding hair during an effluvium (meaning ‘outflow’), it can be exasperating, depressing, and scary.

Sometimes a TE shed, as our forum members frequently call their thinning hair loss, can last for months or even years. Occasionally, it will appear as if the shedding occurs along with your menstrual cycle (cyclical shedding). Women with TE never completely lose all their scalp hair, but the hair can be noticeably thin in severe cases. Whatever form of hair loss your telogen effluvium takes, it is fully reversible.

Things that can help minimize a telogen effluvium shed (or hair thinning):

  • Sometimes skipping a shampoo for a day will make it seem as though more hair comes out the next time you wash. Many of our forum members say it helps to shampoo your hair every day.
  • Use an apple cider vinegar hair rinse once per week.
  • Blot your hair dry with a towel instead of vigorously rubbing your hair.
  • Apply a light conditioning cream to your hair after towel drying to protect it from unnecessary breakage.

Things that can help boost volume and give the illusion of thick hair:

  • Visit a professional hair salon professional in your area and request a cut that will give your hair more bounce and move lightly (generally just below the chin and lightly touching the shoulders). Highlights and lowlights using foil can also give the illusion of thicker, fuller hair.
  • Use a gentle hair care product that has thickening properties. Some of our forum members’ favorites include: Tigi Bedhead Superstar Sulfate Free Thickening Line, WEN Lavender Conditioning Cleanser, WEN Sweet Almond Conditioning Cleanser, Aquage Sulfate Free Shampoos and Conditioners, and Aquage Thickening Style Gel.
  • Loosely piling your hair up on top of your head and then piecing random pieces of hair with a good hair texturizer makes thinning hair look healthy and thick.

Supplements
Supplements can be a controversial topic in matters of hair loss. Many women who have recovered from telogen effluvium agree that you should steer clear of unnecessary supplements unless you have had blood tests to diagnose any vitamin deficiencies that can contribute to your hair loss. For example, if you are iron deficient or anemic, you should take a doctor recommended amount of iron supplements. Iron deficiency is known to cause or aggravate hair loss.

It’s important to remember that one supplement that worked for one woman may not work for you. Our bodies are unique and unnecessary supplements and medicines may do more harm than good.

Finding a Good Dermatologist (or Doctor in General)

doctorFinding a good dermatologist or doctor can prove to be one of the most difficult things to face when you are experiencing hair loss…

  • A good physician will say, “I’m sorry. This must be hard for you to understand.”
  • He/she will give you the address of the National Alopecia Foundation or other support organizations and tell you about the information they provide.
  • He/she will tell you there are others with this same condition and the medical field just doesn’t understand what’s going on.
  • He/she will understand that you have NEVER heard of this condition and that you are scared.
  • A good physician won’t scoff at your questions or minimize your concerns. He/her will appreciate your questions and will be willing to learn with you as much as possible about the condition.

SIGNS OF A BAD DERMATOLOGIST!!!

  • Inappropriate Commentaries
  • Disbelief
  • Cruelty
  • Callousness
  • Impatience

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The craft of the physician may be judged by the thoroughness of the history and physical examination. The following list provides a schematic of some of the things that a physician should do, or consider doing, when first examining a patient with alopecia. Subsequent visits may be shorter but the physician should always be vigilant to the appearance of other autoimmune conditions, of which, thyroid disease appears to be the most common.

History
The initial part of the history is aimed at providing a background to the patient’s condition and allowing the physician to focus on particular problems. Some of the initial questions include:

  1. Is the hair coming out by the roots or is it breaking off?
  2. Is the loss slowing down or getting worse?
  3. Is your hair becoming thinner or do you have totally bald spots?
  4. Do you color, bleach or straighten your hair?
  5. Do you shampoo or condition the hair?
  6. Do you blow dry your hair or use a hot comb?
  7. Is your father’s, mother’s, sister’s or brother’s hair thinning?

The physician then documents all alopecia episodes including age of onset, duration, remissions, patterns of hair loss, relieving or exacerbating factors, treatments, and associated systemic diseases (autoimmune diseases, allergic rhinitis, asthma, atopic dermatitis, connective tissue disease, bowel disorders involving malabsorption, endocrine abnormalities, chromosomal disorders, or cancer). Some of the questions include:

  1. Do you have anorexia nervosa?
  2. Do you have a thyroid disorder?
  3. Have you gained or lost weight?
  4. Are you anemic?
  5. Are your mentrual periods heavy?

The history should date any medication and events within the past 6 months before the first and subsequent episodes of alopecia. The drugs include aminosalicylic acid, amphetamines, bromocriptine, capatopril, carbamazepine, cimetidine, coumadin, danazol, enalapril, etretinate, levodopa, lithium, metoprolol, propanolol, phenytoin, pyridostigmine, and trimethadione. Other pertinent questions include:

  1. Do you take vitamins?
  2. Do you take separate vitamin A tablets?

An inventory of stressful life events and psychiatric disorders. Specific questions will include:

  1. Did you have a baby?
  2. Have you started or stopped oral contraceptives?
  3. Have you gone through menopause?
  4. Have you had a high fever, the flu, been hospitalized or had major surgery?
  5. Have you been on a crash diet? Are you a vegetarian?
  6. Have you had any major stresses during this time?

Physical Exam of the entire cutaneous surface, oral cavity, nails, and sweating. Some of the special exam maneuvers are individualized and not done in every patient but include:

  1. Scalp examination to determine the patterns of hair loss and associated lesions. The presence or absence of hair follicles and sebaceous glands.
  2. Hair Pull Test where 50-100 hairs are pulled in several sections of the scalp. Normally 2-5 telogen hairs will be obtained in this manner, depending on when the last shampoo and styling were done. An active telogen effluvium condition will produce 3-4 times the normal amount of hair pulled; androgenetic alopecia or resolving telogen effluvium has a slight to moderate increase in the number of hairs shed.
  3. Quantitative Analysis of Hair Shedding – The patient is asked to collect ALL hairs shed daily for 7 days in individual plastic bags. The hair is then counted and averaged per day. Normal daily loss is 50-100 hairs. Patients with active telogen effluvium have a 10-40% greater loss.
  4. Density determination – By shaving a small area of the scalp, marking with a skin punch and ink pad, the hairs are counted per square centimeter (normally 150 hairs/cm). The growth rate is measured one month later (normally 1.0-1.2 cm/mo).
  5. Microscopic Hair analysis looking for telogen bulbs, broken hairs (exclamation point hairs), anagen hairs, hair diameter (a high variability in diameter of the hair shaft is evident in androgenetic alopecia), anagen-telogen ration, and sometimes potassium hydroxide is applied to an individual hair strand sample allowing visualization of fungal spores (blackdot ringworm) which causes broken hairs.
  6. Scalp Biopsy which will show them the following:
    • A normal 4-6 mm skin sample should contain 30 terminal hairs, sweat glands, and hair follicles. When alopecia appears to be scarring, the absence of these establishes the diagnosis.
    • The biopsy must go deep enough to include subcutaneous tissue in order to capture anagen hair bulbs. It is closed with suture to ensure proper healing.
    • Various stains are used to detect scarring, lupus, lichen planus, or a blistering disease.
    • Evidence of inflammation may be an indication for the use of steroids.
    • Amino acid and sulfur analysis may be done for certain rare genetic hair disorders.

FAQs concerning the diagnosis of PCOS

How should Polycystic Ovary Syndrome (PCOS) be diagnosed?

PCOS should be diagnosed by a credible physician who will begin with a basic physical examination. He/she may also want to have an ultrasound done of your ovaries and require a number of blood tests. Be sure to let your physician know if you are experiencing any of the symptoms of PCOS. There are a number of doctors who feel that a woman must have at least three of the symptoms prior to diagnosing PCOS. Other doctors may make the diagnosis based on the emphasis on lack of ovulation.

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How are polycystic ovaries diagnosed by ultrasound?

Ovary ultrasound showing cystic ovaries courtesy of LearningRadiology.com

Ovary ultrasound showing cystic ovaries courtesy of LearningRadiology.com

An ultrasound of the ovaries is usually done by placing a probe into the vagina to view the ovaries. Sometimes, an abdominal ultrasound is done but a transvaginal ultrasound is preferred.

A classic PCOS ovary is enlarged and has a “string of pearls” appearance, where the “pearls” are the cysts. Usually ultrasound diagnosis of polycystic ovaries is made if there are at least 8-10 cysts that are less than 10mm in size on each ovary. The polycystic ovary tends to be enlarged to 1.5-3 times the size of a normal ovary.

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Is it possible to have polycystic ovaries without having the syndrome?

Yes. It is estimated that out of 20 to 30% of women, only 5 to 10% will be diagnosed as having Polycystic Ovary Syndrome based on their symptoms. Having cysts on your ovaries is not a definitive criteria to having PCOS. However, a large number of women with ovarian cysts also display other symptoms hormonally of having a predisposition for PCOS.

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Is it possible to have PCOS without having cysts?

The medical jury is still out on this subject. Some physicians believe that if a woman is exhibiting a number of PCOS symptoms but do not have cysts, that does not necessary mean that they do not have the syndrome. However, it is difficult to make a firm diagnosis of PCOS without the presence of either an increased number of small cysts or ovarian enlargement. Furthermore, in most cases, if a patient is displaying other symptoms, the likelihood of some ovary irregularities.

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Woman with Alopecia Areata since childhood

Story from a 41-year-old woman with alopecia areata who has difficulty getting comfortable with her hair loss:

Bald patches began at age seven. Cortisone shots directly into the patches worked temporarily. When patches came back around age nine I was treated with: more shots in scalp, Topsyn ointment and also fluorescent light treatments. Eventually all of my hair fell out. By age 15 I was asked to participate in the Minoxidil study. I used it at (what is now considered to be) 100x current market strength. It did not work for me. By age 17 my eyebrows fell out. By age 23 my eyelashes, once lush and long, also fell out. Half of my mons is also bald–the rest is pale blonde and thin. I have transparent hair growth under my armpits and shave it off once every ten days or so. I haven’t shaved my legs since I was thirteen. I am now 41 years old, married, and have two children who do not have this disease. I wear a wig, and every day is hell for me because it is not comfortable. I just want my hair to grow back, once and for all, so I can feel normal again. I have never settled and gotten used to this, but I’ve made the best of it from what I have.

Thank you for sharing your story!