Many Factors Can Contribute to Hair Loss

No one is happy about losing their hair, but it is especially troubling for women. And hair loss is far more common among women than most people realize: In the U.S., 40 percent of people who experience hair loss are female, according to the American Hair Loss Association.

“The good news is that there are effective treatments for most causes of hair loss. High stress levels, an underlying disease, your diet, and medications you are taking are all possible causes of hair loss,” says Shari Lipner, MD, PhD, a dermatologist at Weill Cornell Medicine. “For the best results, see a dermatologist as soon as you start experiencing hair loss. Once your dermatologist determines the cause of your hair loss, he or she can recommend strategies and treatments that may put a stop to it.”

Common Causes

Androgenetic alopecia affects more than 30 million American women. While men often have a receding hairline, women usually keep their hairline but may have thinning hair and a widening part.

Alopecia areata is an autoimmune disease in which the body attacks its own hair. This results in circular patches of hair loss on the scalp. It may also occur on other areas of the body, such as the eyebrows, eyelashes, and body hair.

This type of hair loss usually begins in childhood or teenage years, but it can occur at any age. Thinning hair is sometimes related to other health conditions.

“Hair loss may be an early sign of an underlying systemic disease,” Dr. Lipner explains. “More than 30 different conditions and diseases can cause hair loss. Some examples include overactive or underactive thyroid, anemia, scalp infections, and some types of lupus. By treating these conditions, we can often halt and even reverse hair loss.”

The drop in estrogen that occurs during menopause can cause hair loss, as can hormonal changes that occur after pregnancy or discontinuing birth control or hormone replacement therapy.

Dr. Lipner notes that telogen effluvium is a type of stress-induced hair loss that causes shedding. This condition usually resolves without treatment in six to nine months.

Topical Treatments

Among the most successful treatments for hair loss is minoxidil (Rogaine), a topical medicine applied directly to the scalp. It is available in 2% and 5% solutions that are most effective when applied twice daily. Minoxidil is the only FDA-approved medication for hair loss in women.

“Minoxidil may take at least six months to a year to see results, but it stops hair loss and/or stimulates hair growth in more than half of patients who use it properly,” Dr. Lipner says. However, she notes that it should not be used by women who are pregnant or breastfeeding.

Oral Medications

Some prescription drugs are effective for treating androgenetic alopecia. Dr. Lipner notes that these medications are approved by the FDA for other conditions, but not for androgenetic alopecia, so they are considered offlabel. Spironolactone is a diuretic that has a long history of use as a treatment for hair loss. Other oral medications used off-label are finasteride, flutamide, and dutasteride.

Skip the Supplements

Many patients turn to vitamins and supplements as a ”natural” way to treat hair loss, but Dr. Lipner says that there is no evidence that any supplements reduce or stop hair loss.

“Some supplements are advertised as ‘hair vitamins,’ but they are often pricey, and there is no reason to take them,” advises Dr. Lipner.

Other Options

There are also surgical treatments for hair loss. With hair transplantation, skin on the scalp with good hair growth is harvested and transplanted to areas of the scalp that have sparse hair.

The use of platelet-rich plasma (PRP) is an experimental treatment that has shown some promise at treating hair loss. PRP is blood plasma that has been enriched with platelets and nutrients and is injected into the patient’s scalp.

“PRP is believed to contain growth factors that stimulate hair growth,” Dr. Lipner says. “However, there are no long-term clinical trials that have evaluated this therapy.”

If you notice your hair is thinning, don’t wait: See a dermatologist and talk about your treatment options. Early treatment may prevent significant hair loss in the future.

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