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! Women’s hair loss is just as common as men’s hair loss and sometimes is completely reversible with lots of patience.
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. We are proud to say that we are the only hair loss forum run by a certified hair loss specialist who can answer your questions honestly with evidence-based information and treatment options. The topics covered on our site and in our forum include telogen effluvium, alopecia areata, totalis, and universalis as well as androgenetic alopecia (female pattern baldness). You can also find information about recent studies released by leading dermatologists on women’s hair loss, the types of treatments they recommend, and the different causes of women’s hair loss.
Please be sure to join us on Facebook to get information, learn about treatments available, find 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. Have a question for our certified hair loss specialist? Just ask for Melanie.
Video created Karr & Karr Productions (uploaded by Lauren French) for a public speaking event to raise awareness of alopecia universalis. Kylie Bamberger, a teenage alopecian, embraces her beauty and breaks away from the norm. Many women experience emotional distress when losing their hair as well as a great loss of self esteem and confidence.
This is a very special girl and an incredibly moving video… What a fantastic smile!
“Hair loss is very common. I see on average four patients everyday with hair loss in my clinic,” Dr. Rita Pichardo-Geisinger, assistant professor of dermatology at Wake Forest Baptist Health, said in a recent news feature. In losing hair, many women also feel that they lose their identity… and their confidence.
Dr. Pichardo-Geisinger says generally women are affected with hair loss between their 30s and 60s. The causes can run the gamut from genetic disorders to hormonal disturbances and even stress.
“50 percent of Caucasian women present with female patterned alopecia,” Pichardo-Geisinger said.
Perception throughout the years has been that genetic hair loss strikes mostly men but there is a significant percentage of women who suffer from hair loss as well. According to the American Academy of Dermatology, forty percent of women have visible hair loss by the time they are age 40.
Throughout history, women have enhanced their physical features in many different ways such as corsets, piercings, make-up, and (most prevalently) hairstyles. For many women, their hair is what makes them feel beautiful… their “crowning glory”. It’s also a major form of enhancing their esteem and status in society as our billion dollar cosmetic industry can attest to. Losing hair density or patches of hair missing can be quite devastating.
Angel, a mother of two from Michigan recently visited her primary care doctor over concerns of finding excessive hair in her brush each morning and was given a quick glance over by her doctor. Her diagnosis? “He told me my bloodwork came back fine and that my hair will probably bounce back in time,” Angel said. “I’m so frustrated with doctor’s acting nonchalant about a problem that I have that may not be killing me on the outside but is slowly eating away at me from the inside.” Her alopecia began progressing after her second child was born.
“I was already dealing with esteem issues brought on by my pregnancy weight. Losing my hair was just the frosting on the cake.” Shortly after her doctor’s appointment, Angel joined HerHairLossHelp.com, a women’s hair loss support forum, to learn to cope with her alopecia and research ways to treat her alopecia that she could share with her physician. “I feel like I’m going through an immense period of personal and spiritual growth at this time. Two years ago, the thought of losing hair permanently and possibly having to go under a wig was paralyzing to me. Now I’m working toward accepting it. I don’t really know what my genes have in store for me, but thanks in large part to the ladies on this forum, I now realize that I can handle whatever they throw at me.”
Many physicians pay little attention to the issue of women’s hair loss since it is not a life-threatening problem. Women are told that there is nothing they can do and that it’s just something they will have to learn to live with. Unfortunately, by ignoring the complaints of their patients, much of the medical community is negligent in addressing the psychological impact hair loss has on women which can lead to emotional turmoil directly affecting the woman’s physical health.
It is an expression of our individualism, a symbol of health and femininity. Beautiful hair affects not just our self-esteem, but also our influence on others: our hair is a fundamental part of our personality.
It has been scientifically proven through studies that women who are diagnosed with hair loss tend to suffer more emotionally and psychologically than men. In fact, the psychological effects were much more severe than effects men went through when losing hair. A study published in the Journal of American Academy of Dermatology found that hair loss clearly was a stressful experience for both sexes, but substantially more distressing for a woman learning to live with her alopecia. “Relative to control subjects, women with androgenetic alopecia possessed a more negative body image and a pattern of less adaptive functioning.” The study confirmed the detrimental effects on women experiencing hair loss.
A more recent study published in the British Medical Journal found that there is an important link between hair and identity, especially in women. “About 40% of women with alopecia have had marital problems as a consequence, and about 63% claim to have had career related problems. The extent of alopecia is one of the predictors of psychological distress. People with severe hair loss are more likely to experience psychological distress.”
The results of these studies, and many others like them, confirm that women are much more worried about their physical appearance and the way people perceive them. Whether the loss is sudden or gradual, women go through emotional stress with the loss of their hair.
Hair loss in women is more than just a visual problem. Many women also suffer emotionally beginning with subtle insecurities such as avoiding situations where their thinning hair may be noticed. Examples include swimming pools, beaches, public speaking, or even avoiding certain lighting.
No one has to suffer from hair loss alone.
HerHairLossHelp.com offers information and support for women suffering from hair loss through our online forum and our Facebook group. Join us and discuss the effect hair loss has on your daily life. Learn about treatments available, find support, and chat with other women from all over the world who are affected by hair loss. Ask a question and most likely you will be overwhelmed by the honest and straightforward answers you will receive.
Female Androgenetic Alopecia Causes, Diagnosis, and Treatments
Understand the causes, how to diagnose, and what type of treatment for androgenetic alopecia is available to women.
Androgenetic alopecia is the most common form of hair loss in women. This type of hereditary hair loss can begin anytime after puberty and usually occurs, if at all, before the age of sixty.
What does androgenetic alopecia (AGA) look like?
Women who have androgenetic alopecia (AGA) usually have increased thinning or diffuse hair loss all over. It is most noticeable at the part line and top area just behind the bangs, while often maintaining the front hairline. Female pattern baldness is measured with the Ludwig Scale, as seen below, ranging from 1, 2 and 3, with varying degrees inbetween.
courtesy of www.dermalogix.net
How does androgenetic alopecia in women work?
Androgenetic alopecia (AGA) causes a woman’s hair follicles to become more sensitive to hormones, or androgens that already exist within the body. Inside these follicles are androgen receptors. The androgens (hormones) tell the androgen receptors to produce less hair. Consequently, the individual hair growth cycle is shortened while hair becomes thinner and finer. Even though the follicle itself is still intact, it becomes ‘miniaturized’ and eventually will not produce new hair. How does this happen? An enzyme known as 5 alpha-reductase exists in the follicle. When the hormone (typically testosterone) binds to the androgen receptor, it triggers 5-alpha reductase to convert that testosterone into something called DHT. Its the DHT which plays the most active role in damaging hair production. This is why “inhibiting DHT” is such a big catch-phrase in hair loss circles. That, and “anti-androgens”. Things which inhibit DHT, or work against this androgen process, are considered legitimate hair loss treatments.
Causes of Androgenetic Alopecia (AGA) in Women
Most commonly, a genetic predisposition is the cause of androgenetic alopecia in women. However, there are other causes of thinning hair in women which is why physicians typically recommend hair growth stimulants before prescribing medications to inhibit DHT or antiandrogens. Combining both growth stimulants and antiandrogens in a multi-faceted treatment routine can be highly effective in slowing down the hair loss process.
Causes for hair loss in women can be numerous. That is why numerous blood tests are usually the first step in narrowing things down. Many conditions such as menstrual irregularities, hirsuitism, acne, and naturally higher testosterone levels can all be factors associated with hair loss. Birth control pills are common, pregnancy is one of the MOST common, and pre- or post- menopause are all hormonally related factors that can trigger hair thinning on a small to large scale. Stress can exacerbate hair loss progression but is not usually the cause of hair loss itself.
Treatments for Androgenetic Alopecia in Women
Luckily many women who have androgenetic alopecia respond well to various treatments. There are three main types of treatments for women with thinning hair: growth stimulants, antiandrogens, and anti-inflammatories.
Growth Stimulants encourage new hair growth despite whatever is causing the hair loss. Whether you are losing hair because of a thyroid imbalance or recent pregnancy, hair growth stimulants can work around these causes and spur new growth.
Anti-androgens and Androgen Blockers go right to the ‘root’ of the follicle problem for women experiencing androgenetic alopecia. The follicle is more sensitive to the hormone levels in your body. Anti-androgens and androgen blockers work to inhibit or block androgen activity in your scalp. Most women who have female pattern baldness benefit tremendously from anti-androgen treatment.
Anti-inflammatories block the hormonal activity in the scalp playing an incredibly important role in calming the growth environment for your hair. Inflammation is a common side symptom of thinning hair and can nearly double the speed at which you lose hair. Calming that inflammation is imperative for the anti-androgens and growth stimulants to work effectively.
Combining a growth stimulant, antiandrogen, and anti-inflammatory shampoo will triple your chances of success. You not only kick start new growth, but you also block the cause, and create a non-inflamed environment for the products to work. The three classes of treatments work fundamentally, and complement each other perfectly.
Most people normally lose anywhere from 50 to 100 strands of hair a day, according to the American Academy of Dermatology. With about 100,000 hairs on your scalp, this amount of hair loss shouldn’t cause noticeable thinning of your scalp hair. As people age, hair tends to gradually thin. Other causes of hair loss include hormonal factors, medical conditions and medications which can interfere with a normal hair growth cycle. Illness, infection, or chemicals also have the potential to stop hair from forming properly and altering its growth cycle causing hair loss in women.
The most common cause of hair loss is a medical condition called hereditary hair loss. About 80 million men and women in the United States have this type of hair loss. Other names for this type of hair loss are female pattern baldness or androgenetic alopecia. Although hair loss may seem like a more prominent problem in men, women are nearly as likely to lose, or have thinning, hair. Most women notice it in their 50s or 60s, but it can happen at any age and for a variety of reasons. Many women report that they notice a more than usual amount of hair on their pillow in the morning or hair begins clogging their brush or comb without vigorous brushing. Visual cues such as a widening part or being able to see more scalp than usual are also signs to look for in hair loss in women. Preliminary blood work is usually done by a primary care physician to ensure the thyroid gland or an autoimmune disease (such as alopecia areata) isn’t the culprit.
Hair Growth Cycle
Hair grows in three different cycles: anagen, catagen, and telogen. About 90% of the hair on the head is in the anagen, or growth phase, which lasts anywhere from two to eight years. The catagen, or transition phase, typically lasts 2-3 weeks, during which the hair follicle shrinks. During the telogen cycle, which lasts around two to four months, the hair rests.
An overwhelming majority of the time the hair is on the scalp, it is growing. Only about 10% of the strands are in transition or resting at any one time. Hair grows about 6 inches a year for most people.
Normal hair growth cycle
Maybe You’re Born With It
Looking at your mother, aunt or grandmothers hair can be a good indication if androgenetic alopecia (heredity hair loss) runs in your family. A dermatologist or trichologist can use magnification on the scalp to view a woman’s hair follicles. A telltale sign of androgenetic alopecia is follicles varying in size — some thick and others thin. Androgenetic alopecia affects about 30 million American women, according to the American Academy of Dermatology, and is the most common kind of hair loss in women. Although it mostly occurs in the late 50s or 60s, it can happen at any time, even during teenage years.
Typically, each time a normal hair follicle is shed, it is replaced by hair that is equal in size. But in women with female pattern hair loss, the new hair is finer and thinner – a more miniaturized version of itself. The hair follicles are shrinking and eventually they quit growing altogether.
Medical and Other Conditions
If hair follicles are uniform in size, or if the hair loss is sudden, it is likely to be caused by something other than heredity, like a medical condition. There are a wide range of conditions that can bring on hair loss, with some of the most common being pregnancy, thyroid disorders, and anemia. Others include autoimmune diseases, polycystic ovary syndrome (PCOS), and skin conditions such as psoriasis and seborrheic dermatitis.
Environmental and physical stressors on your hair growth cycle can be an underlying cause of hair loss in women.
Environmental and Physical Stress
Other reasons for hair loss include extreme stress; physical trauma like surgery or intense illness; dramatic weight loss over a short period of time; and taking too much Vitamin A. Hair loss can occur a couple of weeks to six months after any of these experiences. One other way to thin hair is self-inflicted – hairstyles like cornrows or too-tight braids can cause hair loss called traction alopecia.
All of the things women do to manipulate their hair — dyes, chemical treatments, bad brushes, blow dryers, and flat irons — can result in damage and breakage. This includes brushing too much and towel drying aggressively when the hair is wet.
Luckily, for most of these issues, the hair grows back or the loss can be reversed with medical treatments. But it is important to see a dermatologist if there seems to be something wrong, because the sooner treatment is started, the better the chances are for improving your growth cycle.
Hair on the scalp grows about .3 to .4 mm/day or about 6 inches per year. Unlike other mammals, human hair growth and shedding is random and not seasonal or cyclical. At any given time, a random number of hairs will be in one of three stages of growth and shedding: anagen, catagen, and telogen.
Anagen is the active phase of the hair. The cells in the root of the hair are dividing rapidly. A new hair is formed and pushes the club hair (a hair that has stopped growing or is no longer in the anagen phase) up the follicle and eventually out.
During this phase the hair grows about 1 cm every 28 days. Scalp hair stays in this active phase of growth for two to six years.
Some people have difficulty growing their hair beyond a certain length because they have a short active phase of growth. On the other hand, people with very long hair have a long active phase of growth. The hair on the arms, legs, eyelashes, and eyebrows have a very short active growth phase of about 30 to 45 days, explaining why they are so much shorter than scalp hair.
Normal hair growth cycle [courtesy of American Hair Loss Association]
The catagen phase is a transitional stage and about 3% of all hairs are in this phase at any time. This phase lasts for about two to three weeks. Growth stops and the outer root sheath shrinks and attaches to the root of the hair. This is the formation of what is known as a club hair.
Telogen is the resting phase and usually accounts for 6% to 8% of all hairs. This phase lasts for about 100 days for hairs on the scalp and longer for hairs on the eyebrow, eyelash, arm, and leg. During this phase, the hair follicle is completely at rest and the club hair is completely formed. Pulling out a hair in this phase will reveal a solid, hard, dry, white material at the root. About 25 to 100 telogen hairs are shed normally each day.
As many as 10% of women may have some degree of thyroid hormone deficiency. Many will also experience thyroid hair loss. Hair loss is another sign that thyroid hormones may be out of balance. Both hypothyroidism and hyperthyroidism can cause hair to fall out. In most cases, the hair will grow back once the thyroid disorder is treated. 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
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.
If 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.
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
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.
Hereditary 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 such as minoxidil or spironolactone depending on any medical conditions you may have in conjunction with your hair loss.
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.
Androgenetic alopecia (AGA), also known in women as female pattern hair loss, is a common and distressing cause of hair loss in women and men. In spite of its prevalence, many clinicians and clinical investigators have difficulty making the diagnosis in women. The hair thinning begins between the ages of 12 and 40 years in both sexes and approximately half the population expresses this trait to some degree before the age of 50 years. Inheritance pattern of AGA is polygenic (complex inheritance) and is inherited from either or both sides of the family. ~ Journal of Investigative Dermatology Symposium Proceedings
Vera H. Price of the University of California San Francisco, Department of Dermatology reported in a recent study in the Journal of Investigative Dermatology Symposium Proceedings that minoxidil-treated women had significantly higher hair counts and an increase in hair weight compared to women who received placebo. A double-blind study of women ages 22–41 years using 2% topical minoxidil solution showed a significant increase over placebo in mean change in hair weight at 16 weeks.
While there is neither a cure for alopecia universalis nor drugs approved for its treatment, some people find that medications approved for other purposes can help hair grow back, at least temporarily. The following are some treatments for alopecia universalis. Keep in mind that while these treatments may promote hair growth, none of them prevent new patches or actually cure the underlying disease. Consult your health care professional about the best option for you.
Corticosteroids: Corticosteroids are powerful anti-inflammatory drugs similar to a hormone called cortisol produced in the body. Because these drugs suppress the immune system if given orally, they are often used in the treatment of various autoimmune diseases, including alopecia universalis. Corticosteroids may be administered in three ways for alopecia universalis:
Local injections: Injections of steroids directly into hairless patches on the scalp and sometimes the brow and beard areas are effective in increasing hair growth in most people. It usually takes about 4 weeks for new hair growth to become visible. Injections deliver small amounts of cortisone to affected areas, avoiding the more serious side effects encountered with long-term oral use. The main side effects of injections are transient pain, mild swelling, and sometimes changes in pigmentation, as well as small indentations in the skin that go away when injections are stopped. Because injections can be painful, they may not be the preferred treatment for children. After 1 or 2 months, new hair growth usually becomes visible, and the injections usually have to be repeated monthly. The cortisone removes the confused immune cells and allows the hair to grow. Large areas cannot be treated, however, because the discomfort and the amount of medicine become too great and can result in side effects similar to those of the oral regimen.
Oral corticosteroids: Corticosteroids taken by mouth are a mainstay of treatment for many autoimmune diseases and may be used in more extensive alopecia areata. But because of the risk of side effects of oral corticosteroids, such as hypertension and cataracts, they are used only occasionally for alopecia areata and for shorter periods of time.
Topical ointments: Ointments or creams containing steroids rubbed directly onto the affected area are less traumatic than injections and, therefore, are sometimes preferred for children. However, corticosteroid ointments and creams alone are less effective than injections; they work best when combined with other topical treatments, such as minoxidil or anthralin.
Minoxidil (5%):Rogaine: Topical minoxidil solution promotes hair growth in several conditions in which the hair follicle is small and not growing to its full potential. Minoxidil is FDA-approved for treating male and female pattern hair loss. It may also be useful in promoting hair growth in alopecia areata. The solution, applied twice daily, has been shown to promote hair growth in both adults and children, and may be used on the scalp, brow, and beard areas. With regular and proper use of the solution, new hair growth appears in about 12 weeks.
Anthralin:Psoriatec: Anthralin, a synthetic tar-like substance that alters immune function in the affected skin, is an approved treatment for psoriasis. Anthralin is also commonly used to treat alopecia areata. Anthralin is applied for 20 to 60 minutes (“short contact therapy”) to avoid skin irritation, which is not needed for the drug to work. When it works, new hair growth is usually evident in 8 to 12 weeks. Anthralin is often used in combination with other treatments, such as corticosteroid injections or minoxidil, for improved results.
Sulfasalazine: A sulfa drug, sulfasalazine has been used as a treatment for different autoimmune disorders, including psoriasis. It acts on the immune system and has been used to some effect in patients with severe alopecia areata.
Topical sensitizers: Topical sensitizers are medications that, when applied to the scalp, provoke an allergic reaction that leads to itching, scaling, and eventually hair growth. If the medication works, new hair growth is usually established in 3 to 12 months. Two topical sensitizers are used in alopecia areata: squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP). Their safety and consistency of formula are currently under review.
Oral cyclosporine: Originally developed to keep people’s immune systems from rejecting transplanted organs, oral cyclosporine is sometimes used to suppress the immune system response in psoriasis and other immune-mediated skin conditions. But suppressing the immune system can also cause problems, including an increased risk of serious infection and possibly skin cancer. Although oral cyclosporine may regrow hair in alopecia areata, it does not turn the disease off. Most doctors feel the dangers of the drug outweigh its benefits for alopecia areata.
Photochemotherapy: In photochemotherapy, a treatment used most commonly for psoriasis, a person is given a light-sensitive drug called a psoralen either orally or topically and then exposed to an ultraviolet light source. This combined treatment is called PUVA. In clinical trials, approximately 55 percent of people achieve cosmetically acceptable hair growth using photochemotherapy. However, the relapse rate is high, and patients must go to a treatment center where the equipment is available at least two to three times per week. Furthermore, the treatment carries the risk of developing skin cancer.
Alternative therapies: When drug treatments fail to bring sufficient hair regrowth, some people turn to alternative therapies. Alternatives purported to help alopecia areata include acupuncture, aroma therapy, evening primrose oil, zinc and vitamin supplements, and Chinese herbs. Because many alternative therapies are not backed by clinical trials, they may or may not be effective for regrowing hair. In fact, some may actually make hair loss worse. Furthermore, just because these therapies are natural does not mean that they are safe. As with any therapy, it is best to discuss these treatments with your doctor before you try them.
Ever wonder what could be causing your hair loss? Looking for answers as to why your hair is falling out? It could be the medicine you’re taking. I’ve compiled a listing of medications that are either known to cause hair loss OR attribute to the immature (anagen or telogen) loss of hair… the list is EXTENSIVE so I’ve created a simple .pdf file for easier reading/printing. I was (once again) surprised by some of the additions.
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.
This 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!
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
Women 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.
Most store bought lace front wigs are made by machine or largely made by machine, but hand finished. When a lace front 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.
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 front wig 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 lace front 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.
It’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.
Simple blood tests to be ordered if you think your hair loss may be caused by a lack of nutrients in your diet.
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
The lack of zinc is a known cause of hairloss. Be careful though, too much of zinc could cause hairloss as well.
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: 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.
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
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
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
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 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
Cortisol: normal 8am levels: 6 to 23 mcg/dl
Serotonin: normal levels: 101 to 283 ng/ml
These are ESSENTIAL blood tests to have done if you believe that you may be experiencing hair loss due to hormonal imbalances.
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
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: normal levels: 0 to 20 ng/ml
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.
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
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
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.
Another 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.