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As many of us witnessed during the recent Oscar Awards, hair loss can be stressful and emotional for those who are experiencing it, as well as their loved ones.  Let’s explore the many causes of hair loss and treatment options.

Hair growth is a cycle of growing, shedding, and re-growth.  When hair reaches the end of its growth stage, it falls out naturally.  A new hair grows at the same hair follicle.  When hair follicles become damaged, hair loss occurs because the new hair doesn’t grow back.

Stress causes hair loss.  It stimulates a hormone called cortisol which prevents oxygen and nutrients from getting to hair cells.  When we’re really stressed, it can cause hair shedding and loss. 

Anemia can be a source of hair loss.  It results in low red blood cell counts (RBCs), low hemoglobin, and less oxygen to the hair cells, leading to hair loss.

Diabetes damages blood vessels.  Hair cells receive less oxygen and nutrients as a result.  Hair might look thin, dull, brittle or dry.  There may be shedding and patches of no hair at all.

Thyroid diesease, both hyperthyroidism and hypothyroidism, can cause hair loss and thinning.  Fluctuations in T3 and T4 disrupt the hair growth cycle.  Hair loss is uniform across the scalp and appears as thinning, dull, dry hair.

Alopecia Areata is an autoimmune disease in which the immune system attacks hair follicles, damaging them.  It causes hair loss anywhere on the body, most often in patches.

Nutrient deficiences can cause hair loss.  The usual culprits are iron, Vitamins B12, B6, and Folate.  Biotin is a B-complex vitamin often thought to affect hair growth.  You probably don’t need to be worried about this one because in most developed countries it is rare to have a Biotin deficiency.

Medications can affect hair loss.  Blood pressure and anti-anxiety medications are in this category but the incidence is very low.  Their benefits likely outweigh the risks.

Hair loss treatments and costs are wide and varied.  Make sure you research a treatment before moving forward to be sure it’s effective, long-lasting, and fits in your budget.

If you have an underlying disorder such as diabetes or thyroid disease, work with your doctor to determine which medications you should be taking.  Getting illnessees under control can help reduce hair loss.

If you’re under stress, seek counseling to get help.  Anti-anxiety medications should also be considered.

Your doctor can help determine if you have vitamin deficiencies.  It can be risky to self-treat.  If dosages are too high there can be side-effects.  Your doctor can draw blood levels of Vitamin B12, B6, folic acid, and iron to see if deficiencies are the source of your hair loss.  There is not much scientific evidence that Zinc, Saw Palmetto, or Collagen supplements help prevent hair loss.

Rogaine (Minoxidil) is an over-the-counter product that can stimulate blood flow to the hair follicles.  It is helpful to start Rogaine at the first signs of hair loss or thinning.  It is used in women with thinning hair at the top of the scalp. In men, it is used for hair loss at the back of the head (not for a receding hairline or baldness at the front of the head).  Rogaine is applied to the balding areas on the head twice a day.  It shouldn’t be applied to other areas of the body.  Hair shedding can be experienced for 2-6 weeks while the growth phase transitions from “resting” to “growing”.  Women might experience fine hair growth on the cheeks and forehead for a short period.  Peak hair growth occurs around 4 months.  Treatment must be continued indefinitely or hair loss will go back to baseline.  The cost is approximately $15-25/month.

Low-level laser therapy stimulates the hair follicles.  It’s been shown to increase hair counts and slow hair loss.  There are several FDA approved over-the-counter products including iRestore Caps, HairMax Laser Hair Growth Comb, and the Theradome EVO Laser Hair Growth Helmet.  These devices should be used for 20 minutes 2-4 times a week.

Wigs and hair pieces are an option.  It’s important to feel good about yourself when stepping outside your home.  Prices and styles vary.  If your hair is thin, choose all-natural, organic care products to prevent further damage.

Some treatments have to be prescribed by your doctor.  Finasteride (Propecia or Proscar) is a treatment for men only.  It is typically used to treat an enlarged prostate and male-pattern baldness (receding hairline or baldness).  It blocks the production of male hormones that interfere with hair growth on the scalp.  It is taken once a  day and should be used for 3 months or longer to see an effect.  It should be avoided in men with depression – it has been linked to suicidal thinking.  It may also worsen erectile dysfunction with side effects of decreased sexual desire and ejaculatory disorder.  It can lower PSA values, giving false information regarding prostate function or cancer.  Cost is approximately $10/month.

Cortisone injections are sometimes used to stimulate hair follicles.  The effects are variable and not long-lasting.

There are several procedures available for hair loss treatment.  Most are performed by dermatologists.  They have varying success rates and long-term results.  They tend to be expensive.

Micro-needling is a procedure using multiple fine needles to puncture the scalp.  It can release growth factors and increase blood flow.  Reported effectiveness is variable.

PRP treatment is platelet rich plasma.  It is extracted from your vein and spun down, then injected around your hair follicles.  It contains growth factors that help stimulate delivery of oxygen and nutrients to the hair.  Some people have seen moderate growth in 3-4 months.  PRP is not a permanent solution to hair loss.  Cost varies but can be expensive.

Hair or Follicle Transplants can offer hair replacement with permanent results, usually seen within 6-8 months.  This is the most expensive hair replacement treatment.  If you’re considering it, speak to your doctor to be sure your hair follicles are healthy enough to support new hair growth.

The take-away message is hair loss can be managed.  The key is noticing hair loss early so you can intervene to stop it.  Dealing with hair loss can lead to improved health, less stress, and feeling better about yourself!

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