HAIR LOSS-ALOPECIA

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Types of Hair Loss

There are several different types of alopecia (hair loss), which can be caused by genetics, infection, inflammatory and autoimmune conditions, emotional stress and severe illness, and physical strain on the hair due to applied chemicals, heat or excessive tight braiding.  The 2 most commonly seen types are Pattern Hair Loss and Alopecia Areata.

Androgenetic Alopecia ("Pattern" Hair Loss)

Androgenetic alopecia (pattern hair loss) is a genetic condition due to an excessive response to androgens. This condition affects up to 50 percent of males and females and is seen as progressive loss of scalp hair any time after puberty. It follows a different pattern in males and females. In males, hair loss is most prominent in the vertex (crown) and front-temple areas, while in women the frontal hairline is typically spared, but there is diffuse hair loss at the crown and top of head, with loss often marked by a wider center part.  

Treatment

Because diet and lifestyle are important factors in hair loss, we provide our updated Diet and Lifestyle Guidelines pdf with useful recommendations for all initial hair loss consultations. 

There are additional effective over-the-counter treatment options for both men and women, including: 

• topical Rogaine (minoxidil), especially when used in combination with prescription topical tretinoin;
• nutritional supplements; we believe the most comprehensive and clinically effective is Nutrafol.  It should be used for at least 6 months to see stabilization and improvement.  It contains adaptogens and several beneficial components.  It also contains biotin, which strengthens hair and nails, but may cause certain blood tests to show false-readings, since some blood tests use it as a reagent, so you should tell any medical provider performing blood tests that you are taking it, or hold it for 3 days before doing a blood test.  Because we believe this is the most effective supplement, we have partnered with the company to sell 3-month packs at a significant discount at our Nutrafol store here. 
• LED (light-based) devices, which work by boosting local nitric oxide levels and improving circulation around hair follicles.  Because we believe the most effective device is the Revian cap-style unit, which should be used for 10 minutes daily for at least 6 months, we have partnered with the manufacturer to sell the device at a significant discount using code ACCESSMYDERM at checkout here.  Although the device is expensive even with our coupon ($945), it requires no ongoing costs, and the manufacturer offers a refund if there is no improvement after you have used it consistently for 6 months. 

In women, we can also prescribe spironolactone,  a more effective oral medication for female-pattern hair loss.  It is a diuretic (makes you urinate), and can cause fatigue and may affect potassium levels, which may need to be monitored by a blood test.  It cannot be used in men due to the potential side-effect of breast enlargement. 

Men have the option of prescription oral Propecia (finasteride), which is very effective at halting the progression of male-pattern hair loss, and many men will grow new hair.  However, it may cause sexual side effects in a some men, which may persist for months or longer in some cases, even after stopping the medication.  There are conflicting studies which show that it may decrease the risk of prostate cancer in general, but increase the risk of high-grade prostate cancer.  If you do take it, you should inform your urologist or primary care provider who may be checking your PSA blood test levels to screen and monitor for prostate cancer, as finasteride affects PSA values.