Alopecia areata is a disorder in which the immune system attacks its own healthy body tissue. In the case of autoimmune hair loss, the body attacks its own hair follicles. The cause is unknown; however, about a fifth of people with this condition have a family history of alopecia. This condition can affect men, women, and children and can occur after a major life event such as illness, pregnancy, or trauma. Double board-certified dermatologist and laser surgeon Dr. Rokhsar successfully treats Alopecia Areata and hair loss in NYC.
This autoimmune disease affects approximately two percent of the population overall, including five million people in the United States alone. Affected individuals will notice round areas of hair loss in the scalp as well as other body areas. Alopecia Areata is only when one loses patches of hair. There are other, more serious conditions such as Alopecia Totalis, the complete loss of scalp hair, and Alopecia Universalis, the total loss of all body hair.
Some people may experience an itching or burning sensation. There are treatments available to make the hair regrow more rapidly, including topical medications and cortisone injections. It merely takes multiple cortisone injections to grow the hair follicles back, but coupled with other treatments will allow patients to see optimal results.
This is a hair loss due to excessive use of hair weaves or excess styling of the hair. If scarring occurs, the hair follicles will be damaged due to scarring, and regrowth is less likely, depending on the degree of scar formation.
Treatments to stimulate hair growth may include:
Dr. Rokhsar has extensive experience in hair loss and the treatment of hair loss. He will evaluate your situation, take a thorough history, determine the cause of your hair loss, and discuss any possible treatment options. Schedule an appointment today to start restoring your natural hair growth and feel like yourself again.
Hairs are a long collection of proteins that extend from the hair follicles. Our hair is an external indicator of our internal health. Hair is arguably one of the most personal and beloved parts of our bodies; a statement to the world of our style, culture, attitude.
It is important to understand the different phases in the hair growth cycle, which are:
Hair loss can be one of the most devastating cosmetic effects of an underlying disorder. Dealing with hair loss is frustrating. Treatment requires strict adherence and much patience. Most types of hair loss are responsive to treatment.
This type of hair loss is characterized by the sudden onset of a dramatic loss of hair each day. You may notice clumps of hair in your brush, in the shower, on your pillow, or even when you simply run your hand through your hair. This type of hair loss happens after stress such as dieting, surgery, illness, or childbirth. The hair loss will occur about three months after a stressful event. Pulling gently on your hair will result in the loss of more than three clubbed hairs.
Hair grafting, also known as hair transplants, is also a viable option for those suffering from hair loss. Dr. Rokhsar can perform micrografts that contain only one to two hairs per graft, slit grafts that contain between four and ten, and punch grafts that can hold between 10 to 15 hairs. A local anesthetic is injected into the scalp and, if desired for comfort, sedation is available.
Also called male pattern hair loss, this is a very common hereditary loss of hair. Hair usually thins at the crown of the head and begins to recede above both temples. Women rarely suffer from classic male pattern baldness, but when they do, their hair becomes thinner across the whole scalp.
It is the most common cause of hair loss and thinning in humans. It is a common autoimmune skin disease that results in the loss of hair on the scalp or other places of the body. The body attacks its own hair follicles, causing hair to fall out in clumps, and hair is lost in a diffused, central pattern.
Unfortunately, hair can grow back in or fall out again at any time, making alopecia a highly unpredictable disease that manifests itself differently in each person. It typically begins at a relatively early age.
This type of hair loss may disappear without any type of treatment. There are three different forms of alopecia: alopecia areata, which is the partial loss of hair, usually leaving behind patchy sections of hair anywhere along the body; alopecia totalis is the loss of all hair on the scalp; and alopecia universalis, a rare type of hair loss in which a total hair loss all over the body occurs.
Dr. Rokhsar will advise you of both medical options including medications and surgical options including hair transplantation.
Balding is sometimes fear for young men, who may notice their hair thinning out at early as their 20’s. It can be a surprising and embarrassing natural occurrence that may seem hopeless. The most common reason is that it is an inherited condition known as male-pattern baldness that results in hair loss to the front and top of the hair.
Whether you are a man or a woman, your hair is composed of a protein called keratin, which grows out of the hair follicles in the skin. The growth of hair cells is at a rate of approximately six inches a year, in which the new cells push out the older ones. This creates the strand of dead keratin cells we shampoo, brush and groom on a daily basis. The average adult has about 100,000 to 150,000 hair upon their head and they lose about 100 of them a day.
Male pattern baldness follows from a combination of genetic influence and hormonal changes that occur in adulthood. Baldness in men is related to the male hormone dihydrotestosterone, which causes old hairs on the scalp to be replaced by progressively shorter and thinner hairs in a predictable pattern, beginning at the temples and crown of the head.
A study found that the root cause of male pattern baldness is that as we age, stem cells in the scalp lose the ability to develop into the type of cells that make hair follicles. There are different types of natural hair loss, including involutional alopecia, androgenic alopecia, and more.
There are two non-invasive solutions to male baldness, one of which is Rogaine. Rogaine is a topical treatment that must be used on a daily basis to increase follicle size and create thicker and fuller hair. By age 50, about half the male population experience thinning hair, which is why it is important and not uncommon to find solutions that fit your lifestyle and skin type.
Propecia is an oral medication treatment approach for male pattern baldness, which works by blocking the formation of the main cause of hair loss, which is DHT. By lowering the effectiveness of DHT, it inhibits follicle shrinking and thus slows the thinning of hair. Talk to your dermatologist about which treatment is right for you and if hair transplantation may be the solution for your balding condition.
Propecia is a prescription-only oral drug used to treat male pattern baldness. Propecia prevents testosterone, a naturally occurring male hormone, from converting into DHT (dihydrotestosterone). Men who experience male pattern baldness have higher levels of DHT in their scalp than men who do not. Follicular miniaturization occurs when DHT causes the hair follicles to close, ultimately resulting in thinner, shorter hair. 50 percent of men over the age of 50 experience male pattern baldness.
Propecia works by stopping the conversion process. Testosterone stops converting into DHT, which directly results in a slowing down of the hair thinning process. Propecia works effectively for 90 percent of men who suffer from male pattern baldness. Their hair follicles will enlarge, allowing thicker hairs to grow into the scalp.
Initially, DHT levels are reduced very quickly after starting treatment, it takes approximately three months for the hair follicles to recover and begin their regrowth. A continual improvement of results lasts for about one year, however, the daily medication must indefinitely continue in order to prevent further hair loss from reoccurring.
By age of fifty, an estimated half of men have significantly thinning hair. Male pattern baldness can begin anywhere from their teens, to their 20’s or 30’s.
Rogaine is a highly recommended topical treatment for hair loss. After administering in foam form onto the head, thinner and older hairs will shed for two weeks. The active ingredient, minoxidil will cause the hair follicles to increase in size, allowing for thicker hair to grow in the lost hairs place, which may take up to four months to reach desired results.
This treatment is applied twice a day, every day, and once minoxidil penetrates the scalp and begins working, thin, older hair will shed during the first two weeks of use. This makes room for thicker hair with increased size in hair follicles. The hair regrowth process will have the hair looking thicker and fuller over time.
Double board-certified New York Dermatologist Dr. Rokhsar can effectively diagnose and recommend a treatment route depending on the individual. However, Rogaine is a proven effective treatment for both men and women and is known to provide patients with long-lasting results.
While many people may get stressed seeing hair in the shower or leftover in a comb, it is 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 us examine them and their treatments one by one.
Alopecia Areata: This is a disease where the body’s immune system attacks hair follicles, leading to smooth, round patches of hair loss. Typically, Dr. Rokhsar treats these patients with steroid injections.
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 antifungal cream.
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.
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 is possible.
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 you are either not getting enough in your diet, or can mean an issue like malabsorption, serious illness, or an eating disorder.
Styling: Tight ponytails, excessive shampooing, vigorous brushing, can all cause extra hair loss.
Hormones: Sometimes pregnancy, childbirth, birth control pills, and hormone replacement therapy can alter the way your hair grows.
Stress: Yes, stress can in fact cause hair loss! This phenomenon is known as telogen effluvium and occurs with major life changes, 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 hair’s roots for a “club-shaped” bulb.
Genetics: Patterns of baldness can suggest that 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 you 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 hair appearance is hair restoration, a process that Dr. Rokhsar specializes 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, Dr. Rokhsar utilizes 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 regrowth. Following a hair transplant session, patients return to normal hair styling and showering within one week.
Full recovery of hair is common for many types of alopecia, even without treatment. However, if any hair loss occurs, it is important to seek medical consultation from a fellowship-trained dermatologist like Dr. Rokhsar.
Alopecia areata is a type of alopecia that typically begins with sudden hair loss in round or oval patches on the scalp, but it can also affect other parts of the body such as the beard area in men or the eyebrows and eyelashes. The hair on these patches falls out very quickly and extremely, and around the edges of the patch, there are often short broken hairs or “exclamation point” hairs that are narrower at their base than their tip. Alopecia areata may occur on the scalp and can also develop slowly and recur after years between. The condition may be caused by the immune system attacking the hair follicles.
Alopecia totalis is a more severe form of alopecia areata, where all hair on the scalp is lost. This form of alopecia can begin as alopecia areata, where you may start off with small patches of hair loss.
Androgenetic alopecia, commonly known as male or female-pattern baldness, is another type of alopecia that usually occurs gradually and in predictable patterns. In men, it usually results in a receding hairline and bald spots, while in women, hair thinning along the crown of the scalp is common. Hormonal changes and medical conditions can also cause androgenetic alopecia.
The causes and the way alopecia starts can vary depending on the type of alopecia. In some cases, alopecia may start with sudden hair loss in round or oval patches on the scalp or other parts of the body, while in other cases, it may occur gradually and in predictable patterns. Understanding the type of alopecia is important to determine the best course of treatment. Dr. Rokhsar is an expert in treating alopecia and he offers several non-surgical treatments to remedy alopecia including PRP injections, steroid injections, and prescription medications. If you are experiencing hair loss, Dr. Rokhsar will discuss your treatment options with you and determine the best course of action.
The appearance of alopecia can vary depending on the type and cause of the condition.
Alopecia areata, for example, often starts as a round or oval bald patch on the scalp. This type of alopecia can also affect other parts of the body, such as the eyebrows, eyelashes, and face.
Androgenic alopecia, on the other hand, typically causes gradual hair loss, starting at the temples and crown of the head. This type of alopecia is also known as male-pattern baldness, as it is more common in men, but it can also affect women.
Traction alopecia can cause missing and broken hairs, as well as little bumps on the scalp that look like pimples.
Scarring alopecia, which is a type of hair loss caused by the destruction of hair follicles, usually appears as a bald patch where hair used to be, and the skin in that area may look smooth and shiny.
Gradual thinning on the top of the head is the most common symptom of hair loss, which usually affects people as they age. On the other hand, alopecia areata usually presents as sudden hair loss in patches on the scalp that can grow larger and eventually merge into a large bald spot. Gray and white hairs often remain where hair loss has occurred, and hair may start to regrow where it fell out.
To diagnose alopecia, Dr. Rokhsar examines the areas where hair loss has occurred and looks at your nails, hair, and hair follicle openings using a handheld magnifying device. He may also ask about your medical and family history since other health conditions can cause hair to fall out in the same pattern as alopecia areata. A pull test may be done, where he will gently tug on about 60 hairs to see if more than 6 hairs come out, which may be sent for further testing. He may also recommend you to get blood work done to rule out any systemic causes of hair loss. In some cases, a scalp biopsy may be performed to look at your scalp. Different types of alopecia may require different treatments, and in some cases, medications such as minoxidil and finasteride may be prescribed to promote hair regrowth.
If you suspect that you have alopecia, we recommend you to schedule a consultation with our double board-certified Dermatologist and Dermatologic Surgeon, Dr. Rokhsar, to perform a physical examination to check the pattern of hair loss and confirm a diagnosis.
While the condition is not usually life-threatening, it can cause a lot of anxiety and sadness for those who experience it. Alopecia areata can occur on the scalp, as well as other parts of the body, and may develop slowly and recur after years between occurrences.
There is no cure for alopecia areata, but there are treatments available to help regrow hair. With some conditions, such as patchy hair loss, hair may regrow without treatment within a year. However, in more severe cases, medication and surgery may be necessary.
In terms of prevalence, current research suggests that there aren’t any differences in rates of alopecia between men and women, and the mean age of onset is between 25 and 36 years, though it can frequently occur in children and young adults too. While alopecia areata is not usually a serious medical condition, it can cause a significant impact on an individual’s emotional and psychological well-being. Support groups are available to help those dealing with the psychological effects of alopecia areata.
Other types of hair loss, such as those caused by chemotherapy or radiation treatment, may also be referred to as alopecia. In these cases, hair loss is often temporary, and regrowth may occur after treatment has ended.
Alopecia in women can be caused by an autoimmune disease known as alopecia areata. This occurs when the immune system mistakenly attacks hair follicles, resulting in hair loss in clumps the size and shape of a quarter. People with certain autoimmune diseases like psoriasis, thyroid disease, or vitiligo, and those with allergic conditions such as hay fever, are more likely to get alopecia areata. Other causes of alopecia in women include genetics, hormonal imbalances, and hair care practices. Additionally, excessive hairstyling, such as tight ponytails, cornrows, or braids, and hot-oil hair treatments can cause a type of hair loss known as traction alopecia. In rare cases, frontal fibrosing alopecia, which causes hair loss on the front and sides of the scalp, may be caused by an autoimmune reaction, genetics, or hormones.
Stress, standing on your head, brushing your hair excessively, wearing hats or wigs, or any other number of myths are not scientifically proven to cause or prevent hair loss in women. If you are experiencing hair loss, we recommend you see Dr. Rokhsar for a proper diagnosis and treatment plan.
There are several ways to stop alopecia areata from spreading, including topical treatments, injections, diet changes, stress management, and natural remedies.
Corticosteroid injections and topical treatments remain popular first-line treatments for alopecia areata. These treatments can have side effects like skin thinning and atrophy. Dr. Rokhsar also offers platelet-rich-plasma, or PRP, injections. He can easily perform the procedure in the office. After your blood is drawn, the vial is spun in a centrifuge and the supernatant fluid containing nutrient-rich factors that aid in hair regrowth is injected in the affected areas. Most patients notice significant improvement after 3-6 sessions a month apart. You may also need to continue sessions annually to maintain long-lasting hair growth.
In addition to conventional treatments, there are several alternative ways to stop alopecia areata from spreading. Dietary changes can help prevent alopecia areata from spreading, such as temporarily cutting out certain foods or incorporating foods like yogurt, beetroots, apples, and lemon into the diet. Nutritious diets, including supplements such as phosphorus, protein, and vitamins, can also help prevent the condition from occurring.
Reducing stress, avoiding hair or scalp trauma, and identifying unique triggers can also be helpful in stopping alopecia areata from spreading. Massage, brush, and essential oils, including coconut oil, can help stimulate hair growth and reduce inflammation on the scalp. Natural remedies like probiotics and anthralin can also be beneficial in preventing the condition from spreading.
In addition to avoiding these things, it is advisable to include antioxidants, probiotics, biotin, zinc, and healthy oils in your diet if you have alopecia areata. Also, consider wearing eyeglasses or sunglasses to protect your eyes from sun and dust if you have lost hair from your eyebrows or eyelashes, and consider cosmetic solutions such as wigs or hairpieces to cover up hair loss. Most importantly make an appointment with dr. Rokhsar to diagnose your specific type of alopecia and to come up with a treatment plan.
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Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.
Dr. Rokhsar was chosen by
magazine as a top dermatologist in its Best Doctors 2017, 2018, 2019, 2020, 2021, 2022 and 2023 issues.
