Hair Loss 101

It’s been a while since my last blog, and this time I’m going to focus on a topic that isn’t cosmetic, but is something that dermatologists frequently see and treat, and which I think my patients should be informed about.

While many people may get stressed seeing hair in the shower or leftover in a comb, it’s actually quite normal to shed 50 to even 100 hairs a day. As people age, hair thins as well. However, hair loss that is severe enough to cause patches of baldness or noticeably thin hair may warrant further medical investigation.

A few main factors are usually to blame for hair loss. Let’s examine them and their treatments one by one.

1. Alopecia Areata: This is a disease where the bodies immune system attacks hair follicles, leading to smooth, round patches of hair loss. Typically, I treat these patients with steroid injections.

2. Scalp Infections: Bacterial or fungal infections (such as ringworm), can invade the skin and cause temporary hair loss that resolves itself once the infection is treated with a topical anti-fungal cream.

3. Thyroid Problems: Hyper OR hypothyroid can manifest itself as a wide variety of symptoms, including hair loss. Your physician can investigate this as a cause with a simple blood test examining the levels of thyroid hormones in your blood.

4. Medications: The most common medication most people think about for causing hair loss is chemotherapy. Because chemotherapeutic agents attack quickly rejuvenating cells, hair often is affected. Other drugs, however, such as arthritis, depression, heart, or blood pressure medication can also cause hair loss. The key to treating this type of loss is simply to discontinue the medication if it’s possible.

5. Anemia: Hair can thin if you lack an adequate amount of iron or protein, nutrients that can be found in dairy, meat, and fortified products. This could mean your’e either not getting enough in your diet, or can mean an issue like malabsorption, serious illness, or an eating disorder.

6. Styling: Tight ponytails, excessive shampooing, vigorous brushing, can all cause extra hair loss.

7. Hormones: Sometimes pregnancy, childbirth, birth control pills, and hormone replacement therapy can alter the way your hair grows.

8. Stress: Yes, stress can in fact cause hair loss! This phenomena is known as telogen effluvium, and occurs with major life change, drastic weight loss, surgery, or after pregnancy. The loss is usually noticed 6 weeks to 5 months after the stress and can be diagnosed by looking at the hairs roots for a “club-shaped” bulb.

And finally…..genetics. Patterns of baldness can suggest that the hair loss may just be hereditary. This diagnosis can be confirmed by taking a small biopsy of the hair follicle and seeing if the follicles are smaller than usual.

So…what can we DO about all this? Well, minoxidil (Rogaine) can slow hair loss, but it does nothing to stop it. Using it on the scalp twice daily can be effective, but women should use a lower-strength formula and watch out for side-effects or avoid it while pregnant or nursing. Men can take finasteride (Propecia), an oral medication. But the only way to actually make an amazing difference in hairs appearance is hair restoration, a process that I specialize in.

Hair transplantation has been available for over 40 years. Unfortunately for many people, hair transplantation conjures up images of the old technique with unnatural-looking hairlines and “corn row” appearance. However, as a fellowship trained hair restoration physician, I utilize the new technique of micro-grafting. After all, hair restoration is only acceptable if it goes unrecognized!

A session involves taking a thin strip of hair-bearing skin from the back of the head, where hair growth is at its fullest. This tissue is transplanted in its own natural-growing follicular unit. These follicular grafts contain one to four hairs and are used as micro-grafts, with the hair transplanted in its own natural grouping. This revolutionary technique allows the hair to be placed more evenly and densely, which is critical in achieving a more natural appearance and a fuller head of hair. These mini-grafts also heal more quickly, resulting in better hair growth. Because of their smaller size, mini- and micro-grafts allow uniform hair placement without clumping or tufting of hair, resulting in a natural appearance and hairline.

Hair restoration surgery is a safe, pain-free, minor surgical procedure performed in our onsite operating room under local anesthesia. Two to three sessions, spaced about six months apart, may be required to produce the most natural-looking, dense hair re-growth. Following a hair transplant session, patients return to normal hair styling and showering within one week.

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