By Cynthia Golomb, MD
Hair loss in women and men is so common that an estimated 80 million people within the U.S. are affected. Aging, genetics, medications and underlying medical conditions can be to blame. These factors can leave individuals of all ages with pattern baldness, patchy spots or thinned hair. Hair loss not only affects your appearance, but it can also take an emotional toll, affecting self-confidence and psychological well-being.
Fortunately, some new treatments offer promising solutions. However, before you select a treatment, know that an effective regimen requires a proper diagnosis. It’s essential to understand what triggered your hair loss if you want your hair to return. A personalized hair loss treatment plan is your best chance at growing hair again.
Determining the Cause of Your Hair Loss
Learning why your hair is disappearing should always be the first step in hair loss treatment. Rather than trying random medications and serums, a simple exam and discussion of your medical history can allow for a proper diagnosis. With that information, we can come up with a treatment plan that targets your specific problem. The Journal of the American Academy of Dermatology notes “due to the multitude of causes… it is important to have an appropriate diagnostic work-up to ensure that the treatment addresses the underlying cause of the alopecia.”
What to expect during the diagnosis process:
- Scalp & Hair Examination – An examination of your scalp and possibly the hair elsewhere on your body allows me to draw some initial theories on what’s causing your hair loss. I will take note of your hair density, as well as visual signs of crust, pustules or scales. If you are experiencing any tenderness of the scalp or itching or burning, a scalp examination could be particularly helpful in identifying the cause of your hair loss.
- Medical History Evaluation – I also analyze medical factors that may contribute. Details such as your medications, nutrition, hair care habits, relatives with hair loss and psychosocial stress all may play a role in alopecia.
- Bloodwork – Additionally, bloodwork may be necessary for more insight. Iron and vitamin D levels both have an impact on hair follicle development. A deficiency in zinc and B12 may also contribute.
- Scalp Biopsy – For some of my patients, a scalp biopsy can provide critical information on why they are losing hair. This can definitively indicate a scarring alopecic disorder.
Before your appointment, write some notes about when the hair loss began and if it came on suddenly or gradually. Create a list of all medications (with the dosage) you are currently taking, as well as any other medications you’ve taken 12 months prior (especially any drug(s) you suspect caused hair issues). The more information you can provide, the more I can tailor your treatment plan and provide an effective solution.
What is the main cause of hair loss?
Androgenetic alopecia is the most common cause of hair loss for both men and women. Androgenetic alopecia is a hereditary disorder in which the male hormone testosterone creates a chemical in the hair follicles called DHT. The chemical miniaturizes the hair follicle, causing hair to thin, strands to become finer and the hair to fall out. In androgenetic alopecia, hair does not usually grow back unless you take steps to reverse it.
Drug-Induced Hair Loss May Affect You
Pharmaceuticals are frequently the cause of hair loss. Oftentimes, when you are trying to treat another condition or issue, your hair becomes more vulnerable.
I’ve found that drugs prescribed for blood pressure, thyroid disorders, ulcers and Parkinson’s may contribute to hair falling out. Additionally, anticoagulants, anticonvulsants and anti-inflammatories have also been known to thin hair. Depending on the scenario, these pharmaceuticals may cause permanent or temporary hair loss. However, the best way to know if your hair loss is treatable is to consult with a board-certified dermatologist.
A Solution to Hair Loss for Men & Women
A hair loss treatment plan might include vitamins or mineral supplements, Minoxidil applied topically, or oral prescription drugs such as spironolactone, finasteride or Dutasteride. Another option might be Mesotherapy or PRP injections.
Your initial diagnosis will provide further insight into what will work for you. For example, a simple blood test may reveal a vitamin deficiency as the cause. Low levels of vitamin D (which affects immune regulation) are often found in patients with alopecia areata.
Prescription Drugs to Treat Hair Loss
- Finasteride – An oral medication used to reduce hair loss and stimulate hair regrowth. This is primarily for male patients, as studies show women don’t always have the same hair growth benefits with Finasteride. For females, other treatments are preferred. However, Finasteride is the most used treatment for hair loss, with approximately 66% of patients trying this treatment.
- Dutasteride – A medication that blocks unwanted chemical reactions in hair follicles. Clinical studies have shown that when taken orally, Dutasteride is more effective than Finasteride in treating diffuse hair loss in men. The original use of both of these medications was to treat prostate issues in men. However, when these two medications are taken orally, they can have unwanted sexual side effects for men.
- Spironolactone – An oral medication and anti-androgenic drug used by women to reduce hair loss. However, women of childbearing age need to take special precautions.
- Oral Minoxidil – Minoxidil is another oral prescription with significantly fewer reports of sexual side effects for men. It is a blood pressure medication, which could have other side effects, depending on the dose.
- Topical Minoxidil – I often recommend using the foam or liquid 5% Minoxidil as a daily topical treatment. For best results, you have to use it consistently. You may use the brand-name Rogaine or generic Minoxidil. Both are available over the counter. Many of my patients have found this treatment helpful.
Hair Loss Treatments
- Mesotherapy – One hair loss treatment, called “mesotherapy,” involves microinjections in the upper dermis of the scalp of Dutasteride or Minoxidil. This very superficial injection has resulted in significant increases in hair growth in women. Three months of injections once a month combined with Minoxidil or Dutasteride taken orally in pill form can make a huge impact on hair growth.
- KeraLase Hair Restoration – KeraLase is a fairly new therapy that became available in 2020. KeraLase promotes the growth of thicker, stronger and fuller-looking hair. By combining the Lutronic LaseMD Ultra laser with a scalp hair growth serum, patients have seen new hair growth as soon as three months.
- Platelet Rich Plasma (PRP) – PRP is another method to treat hair loss due to androgenic alopecia. After several PRP treatments, patients often notice a reduction in hair loss and improved hair coverage. PRP is unique in that it is an injectable made from your blood that can speed healing. For years, PRP has been used by athletes to recover from injuries.
Over-the-Counter Supplements and Scalp Serums
I’ve found topical serums such as Nutrafol Growth Activator Hair Serum to be particularly effective in my patients. Additionally, oral supplements such as Nutrafol and Visviscal Professional can be helpful. For patients experiencing hair loss due to stress, I often recommend Nutrafol, and for women, Viviscal has shown impressive results. I sell both of these supplements at my office.
Start Your Hair Loss Treatment Plan
With all the different causes and treatments available for hair loss, you’ll find greater success by being well-informed before you rush into the first treatment you come across. Fortunately, for those in the Hallandale Beach, Aventura, Sunny Isles Beach, Pembroke Pines and Hollywood, FL areas, I am happy to offer my guidance as a triple-board-certified dermatologist. I can help you determine what has caused your hair loss, as well as identify a treatment plan that would work for you. If you’re eager to have hair growing again, I invite you to book your appointment online today!
