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Alopecia Areata

Written by Dr. Rokhsar

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.

What is Alopecia Areata?

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.

Traction/Chemical Alopecia

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:

  • Steroid injections under the surface of the skin
  • Topical corticosteroids
  • Topical immunotherapy
  • Topical minoxidil
  • Ultraviolet light therapy

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.

What is Hair Loss?

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:

  1. Anagen: This is the growth phase. The length of time the hair remains in this growth phase, which lasts for up to three years and is controlled entirely by genetics. In anagen, the hair follicle cells multiply; resulting in increased length of the hair. Normally about 85 to 90 percent of hairs are in this phase at any time.
  2. Catagen: This is the transitional phase and lasts about 1 to 2 weeks. The hair follicle cuts off the hair from its supply of blood and nutrients.
  3. Telogen: This is the resting phase and lasts from 1-3 months. At any time, 10-14% of hair is in this phase. A telogen hair pulled out will reveal a whitish club at the root area.

Conditions that Cause Hair Loss

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.

Telogen Effluvium

This type of hair loss is characterized by the sudden onset of a dramatic loss of hairs 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.

Rogaine is a highly recommended topical treatment for hair loss. After Rogaine foam is applied to the head twice a day, the active ingredient minoxidil penetrates the scalp. Thinner, older hairs then shed for the next two weeks, allowing room for thicker-looking hair to grow in. Minoxidil increases the size of hair follicles which allows for the thicker hair to grow. Early regrowth may appear as soft, colorless, peach fuzz, but after four months of use, desired results will develop.

Propecia is another option to treat hair loss and pattern baldness. It is an oral pill that can be prescribed by Dr. Rokhsar. Rogaine and Propecia are the only FDA approved drug options to treat hair loss.

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.

Androgenic Alopecia

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: Why Do Men Bald?

Balding is sometimes a 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 in 2011 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.

Non-Invasive Solutions for Male Baldness

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 a hair transplantation may be the solution for your balding condition.

Propecia for Hair Loss

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.

Rogaine for Hair loss

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 of minoxidil penetrates the scalp and begins working, thin, older hair will shed during the first two weeks of use. This makes room for the thicker hair with an increased size in hair follicles. The hair regrowth process will have the hair looking thicker and fuller overtime.

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.

Hair Loss 101

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 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.

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 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 Transplant Therapy in NYC and Long Island

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.

Contact a Board-Certified Dermatologist in Your Area

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.

Locations

Upper East Side Manhattan
121 East 60th Street, Suite 8AB New York, NY 10022
(212) 285-1110
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Garden City Long Island
901 Stewart Ave, Suite 240, Garden City, NY 11530
(516) 512-7616
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