Hair loss--Androgenetic Alopecia

Most cases of hair loss are due to androgenetic alopecia (AGA). Fifty percent of men by age 50 years and 40% of women by menopause have some degree of AGA. Hair loss is gradual, with miniaturization of genetically programmed hair follicles. Uptake, metabolism, and conversion of testosterone to dihydrotestosterone by 5-alpha-reductase is increased in balding hair follicles. AGA appears different in men as compared with women. In men with AGA, hair loss occurs in the fronto-temporal regions and on the vertex of the scalp, depending on severity. In female AGA patients, it is more diffuse and located centroparietally. The frontal hairline is usually intact in women.

Treatment is either medical or surgical. The only proven medications that are indicated for AGA are topical minoxidil (Rogaine®) and oral finasteride (Propecia®). Minoxidil's success for cosmetically acceptable regrowth is approximately 10% in men. In women, 50% show minimal regrowth and 13% moderate regrowth. Treatment is lifelong. Seven percent of patients may experience some irritation (burning, itching, redness) from the minoxidil solution. The 5% minoxidil solution has greater efficacy than the 2% minoxidil solution (Rogaine®). Finasteride recently has been shown to have significant efficacy in male AGA. Finasteride reversed hair loss in 66% of men and stabilized hair loss in 83% of men after two years of follow-up. In women, the use of a systemic antiandrogen such as spironolactone (Aldactone®) 50 to 200 mg per day, cyproterone acetate (Androcur®), or flutamide (Eulexin®) may have some benefit in reducing the amount of hair thinning. Finasteride in not indicated in women.

Hair transplantation of permanent hairs from the back and sides of the scalp to balding areas in the front is a successful procedure but usually requires three to four sessions over 2 years to fill in an area with adequate density. The advent of mini- and micrografting has revolutionized hair transplantation into a more natural-looking process, eliminating clumping or tufting. Donor harvesting with strips rather than plugs has made the donor site more cosmetically acceptable. Hair transplantation is useful not only in men but also in women.

Women's Guide to Androgenetic Alopecia

Over 20 million women in the United States alone, are suffering from some type of hair loss. This does not take into account the rest of the world, and a little less than half are under 40 years of age. The emotional effects of hair loss range from anxiety and depression, to frustration and poor self-esteem. Fortunately there are more options available now, to help slow down and even reverse hair loss in women.

The most important step in the search for answers is to educate yourself. Being proactive both in your research of treatments, and in communication with your doctor, are extremely important.

Unlike male hair loss, female hair loss many times doesn't have a straight-forward cause. As a result, treating it can be a more complex process. If you are reading this guide, you are experiencing the various forms of thinning hair or hairline recession seen in some women.

If you are experiencing patchy hair loss or total hair loss, you should instead focus on our Guide to Women's Alopecia.

Many physicians subscribe to the theory that women with thinning hair should immediately begin a regimen of growth stimulants. This thinking is reasonable as the cause of the hair loss has not yet been determined, and growth stimulants can begin stimulating new hair growth despite whatever is causing the loss.

Like men's hair loss however, there are underlying causes. The good news is that a large percent of women's hair loss is completely reversible. This ray of sunlight is not available to the guys, so allow yourself some hope with it. Once a thinning hair treatment regimen has been started, the focus turns towards working with your physician to run the necessary tests, and rule out, or rule-in the possible causes. At that point, assuming its a cause that can be addressed, you can begin to actually stop the hair loss at the source.

As with men, the most common causes of hair loss in women are hormonally related. Whether it is an overactive thyroid, after effects of menopause or pregnancy, or a genetic hormonal response to an autoimmune condition - - there usually is a specific reason why women lose their hair. The key is to find out what the reason is, and to then evaluate your options in dealing with it.

Let's get started...

Types of Hair Loss in Women

Excessive or abnormal hair loss is known as alopecia, and there are several kinds. What all hair loss has in common, whether it's in men or women, is a symptom of something that's gone wrong in your body. Your hair will remain on your head where it belongs unless hormone imbalance, disease, or some other condition occurs. That condition may be as simple as having a gene that makes you susceptible to male or female pattern baldness or one of the forms of alopecia areata, or it may be as complex as a whole host of diseases.

Fortunately, hair loss can be a symptom of a short-term event such as stress, pregnancy, disease, or medication, which can all alter hair's growth and shedding phases. In these situations, hair will grow back when the event has passed. Once the cause of the loss is addressed, hairs go back to their random pattern of growth and shedding, and your problem stops.

Androgenetic Alopecia

The majority of women with androgenetic - also called androgenic - alopecia have diffuse thinning on all areas of the scalp. (Men rarely have diffuse thinning but instead have more distinct patterns of baldness.) Some women have a combination of two pattern types.

Androgenic alopecia in women is due to the action of androgens, male hormones that are typically present in only small amounts. Androgenic alopecia can be caused by a variety of factors tied to the actions of hormones, including some ovarian cysts, taking high androgen index birth control pills, pregnancy, and menopause.

Just as in men, the hormone DHT appears to be at least partially to blame for the miniaturization of hair follicles in women suffering with female pattern baldness. Heredity plays a major factor in the disease.

Telogen Effluvium

When your body goes through something traumatic like child birth, malnutrition, a severe infection, major surgery, or extreme stress, it can impact your hair. Many of the 90% or so of hairs in the growing (anagen) or transitional (catagen) phases can actually shift all at once into the resting (telogen) phase.

About six weeks to three months after the stressful event, the shedding phenomenon called telogen effluvium may begin. It is possible to lose handfuls of hair at a time when in full-blown telogen effluvium.

For most who suffer with this, complete remission is probable as long as severely stressful events can be avoided. For some women, however, telogen effluvium is a mysterious chronic disorder and can persist for months or even years without any true understanding of the triggering factors or stressors.

Anagen Effluvium

Anagen effluvium occurs after any insult to the hair follicle that impairs its cellular-level mitotic or metabolic activity. This hair loss is commonly associated with chemotherapy. Since chemotherapy targets rapidly dividing cancer cells, your body's other rapidly dividing cells -- such as hair follicles in the growing (anagen) phase -- are also greatly affected. Soon after chemotherapy begins, approximately 90% or more of hairs in the anagen phase can fall out.

The characteristic finding in anagen effluvium is the tapered fracture of the hair shafts. The hair shaft narrows as a result of damage to the matrix. Eventually, the shaft fractures at the site of narrowing and causes the loss of hair.

 

Alopecia Areata

An inappropriate inflammatory reaction is behind alopecia areata. A person's own immune system attacks the roots of hair follicles. Symptoms include patchy shedding of hair, which sometimes develops quite suddenly. About 70% of patients recover their hair within two years, whether or not they receive treatment.

Traction Alopecia

This condition is caused by localized trauma to the hair follicles from tight hairstyles that pull at the hair over time. If the condition is detected early enough, the hair will regrow. Braiding, cornrows, tight ponytails, and extensions are the most common styling causes of traction alopecia.

Stop hair loss and damage with these natural remedies

Americans are not known for their lush locks and it is no wonder — their diet tends to be high in harmful fats, laden with sugar and heavy in animal protein along with dairy. All these foods contribute to hair loss and breakage according to traditional Chinese medicine (TCM). Harsh shampoo as well as chemicals in the water aren’t helping the matter either. But there’s hope. By revamping the diet, adding a few supplements and introducing shampoo-free cleansing, a healthy head of hair is possible.Most don’t make the connection between diet and hair loss, but the link is strong. Traditional Chinese medicine believes that immoderate consumption of sugar is the main culprit of shedding hair. This would explain why Americans suffer from the malady in greater numbers than most. Even excessive fruit consumption can lead to thinning hair. Many who embrace a raw food diet have experienced this phenomena. On the other end of the spectrum, overindulging in animal protein and dairy also contributes to balding and weak hair due to acidic blood. Yet another offender, unhealthy fats congest the hair follicles — encouraging hair loss. Iodine deficiency and hypothyroidism along with dehydration are obstacles to healthy hair too. The best bet for glossy, thick locks is to adopt a whole food diet that is abundant in vegetables, healthy oils like coconut and olive, nuts, seeds, low sugar berries and seaweed. Flax and chia seeds are especially beneficial due to their high essential fatty acid content.

Focus on hair-enhancing supplements like B vitamins (especially biotin), zinc, iron and calcium. It is also important to inhibit hair thinning DHT which is derived from the hormone testosterone. Natural remedies that block DHT include saw palmetto, stinging nettle, green tea, pygeum extract and pumpkin seed oil.

Two chemical culprits found in city water, chlorine and fluoride, weaken hair — leading to breakage, clogged follicles and shedding. Both irritate the cuticle on the hair shaft too, thereby creating dull, lifeless locks. A trusted shower filter is a must for healthy hair.

Shampoo is antagonistic as well. Filled with harsh cleansers and additives, hair doesn’t stand a chance. Even when natural brands are used, hair is stripped of natural oils and subsequently revolts against the abuse. Conditioner is then required to tame the disorder. Follicles are subsequently clogged — triggering fallout. To avoid this anarchy, a simple and cost effective remedy is available: baking soda and vinegar. Hair settles down, loss is minimized and luster restored. To cleanse the hair with baking soda, mix one tablespoon of powder to one cup of water in a squeeze bottle. Shake well and apply to the roots, massaging for a minute or two. Rinse well. Next comes the vinegar wash which conditions, calms and boosts shine. Mix a quarter cup white or apple cider vinegar with one cup water. Pour over hair, avoiding the face and eyes. Rinse thoroughly with water.

A full head of hair need not be a pipe dream. By choosing a nutrient rich diet, supplementation and shampoo-free cleansing, tiresome hair frustrations can be laid to rest.

10 Best Ways to Stop Hair Loss and Regain New Hair Volume

Losing your hair is no laughing matter. When it comes to hair loss and regaining new hair volume, the most important thing is to take action early and not wait till you start balding.

On average, a normal person can lose up from 50 strands to 100 strands of hair each day. But things become serious when you lose more than that amount, especially when our hair only grows about one inch every four to eight weeks.

There are plenty of hair loss treatments in the market now. Not all solutions are effective which is why you should do some research to see if it will be effective for you before using it. If you are serious about stemming hair loss and regrowing new hair, then you need to make use of the information here to help yourself.

Here are a few ways on how you regain new hair volume and prevent excessive hair losses.


1. Use herbs like saw palmetto and pygeum as they can inhibit the activity of DHT.

2. Eat foods that are high in biotin because biotin can promote healthy hair follicles.

3. Reduce stress because too much pressure and strains can lead to hair loss.

4. Drink green tea as it contains powerful antioxidant that can help you deal with DHT.

5. Massage your scalp daily with a hair thinning lotion.

6. Sleep at least 8 hours each day to get enough rest for healthy hair reproduction.

7. Limit the use of hair care products like dyes or shampoos that contain sulphate.

8. Try out pharmaceutical treatment like Minoxidil.

9. Avoid ingredients like propecia because it can cause side effects.

10. Do not rinse your hair with hot water as it can cause follicles breakages.

And now, I want to share with you an all-natural, dermatologist-formulated solution to help slow thinning hair in both men and women. This wonderful hair loss remedy helps stop hair loss and stimulates healthy hair growth so you can grow new hair naturally.

How to Stop Hair Loss Naturally

Men, and sometimes women, notice that their hair is thinning prematurely for a number of different reasons. Age, menopause, pregnancy, genetics, illness and other factors all play a role in hair loss. Sure, you can use drugs like Rogaine, or you can go in for a hair transplant or hair fusion, but sometimes the easiest and most inexpensive solution is to try to stop hair loss naturally.

 

Steps
Method 1: Herbs and Supplements

1. Treat with saw palmetto. Native Americans use saw palmetto to promote healthy hair and skin. Saw palmetto also blocks the production of DHT (a metabolite of testosterone), a contributing factor to enlarging of the prostate. Because DHT production also causes hair loss, saw palmetto has been shown in some small studies to be effective for preventing hair loss in some men.
2. Try nettle root. Like saw palmetto, nettle root blocks the production of DHT and other chemicals that enlarge the prostate and cause hair loss. Some evidence suggests that nettle root may not only stave off baldness but also regenerate hair growth.
3. Take vitamins. Your mother told you they were good for you, but you may not know they're good for your hair too. Add some extra milligrams of these vitamins to your daily regimen:Vitamin A: Vitamin A is an anti-oxidant which promotes healthy production of sebum in the scalp.Vitamin E: This vitamin stimulates circulation, and good blood circulation in the scalp is important in keeping your hair follicles productive.B vitamins: The B vitamins help your body produce melanin, which gives hair its healthy color. Melanin also stimulates blood circulation.

Method 2: Topical Treatments

1. Use essential oils combined with scalp massage. Massage promotes good circulation in the scalp to keep your hair follicles active. Massage your scalp daily by hand for a couple of minutes. To enhance the massage, use a few drops of lavender or bay essential oil in an almond or sesame oil base on your scalp.
2. Restore moisture through hot oil treatments. You can use any natural oil including safflower, canola or olive oil.Heat the oil up so that it is warm but not too hot. Then, massage the oil into your scalp.Put on a shower cap for about an hour. When the hour is up, rinse or shampoo out the oil.Mayonnaise also works well as a conditioner. Slather your hair with a generous dollop, put on a shower cap for up to an hour and then rinse it off.
3. Try rubbing your scalp with garlic juice, onion juice or ginger juice. Make sure you only use 1 of these juices; don't mix them together. Leave the juice on your scalp overnight and wash it out in the morning.
4. Try rubbing your hair with rangoli henna. Use powder that is green in color and that has the texture of talc. Henna seals the cuticle, which strengthens the hair shaft at the root.
5. Rub green tea into your hair. The tea contains antioxidants, which may prevent hair loss and help hair growth.Brew 2 bags of green tea in 1 cup of water. Let the tea cool slightly and then apply it to your hair.Leave the tea on for 1 hour. Then, rinse your hair thoroughly.
6. Boil potatoes and rosemary in water on your stovetop. Strain the liquid and use it daily as a hair rinse.

Method 3: Lifestyle Changes

1. Include more high-protein foods in your diet. Eating lean meats, fish, soy or other proteins may help to curb hair loss. In addition to containing protein, many foods rich in protein also contain Vitamin B-12.
2. Take care of the hair that you have. Never brush wet hair, and avoid rubbing your hair dry with a towel. Instead, let it air dry or else blow dry it to the point of dampness and let it dry from there.
3. Reduce stress. Sometimes, the root cause for hair loss is stress.Practice meditation. Meditation can help to both reduce stress and restore your hormonal balance. Practicing meditation can also help you in other aspects of your life.Get some exercise. Walk, swim or bike for 30 to 60 minutes per day. Or try playing a sport like tennis so that you can take out your aggression by hitting a ball. The exercise will help to lower your stress levels.Talk or write it out. Talk to your spouse, to a friend or family member, or to a therapist about what you're experiencing. Take the time to record your feelings in a journal.
4. Avoid wigs or hairpieces. While these may seem like good cosmetic solutions, they may also speed up hair loss by damaging your hair follicles.

Tips When you apply topical treatments to your scalp, make sure that you don't use them around clothes, furniture or bedding that could either be ruined or acquire an unpleasant odor from the treatments.

Treating hair loss - Female-pattern baldness

Minoxidil is currently the only medicine available to treat female-pattern baldness.

Minoxidil lotion may help hair to grow in around 1 in 4 women who use it, and it may slow or stop hair loss in other women. In general, women respond better to minoxidil than men. As with men, you need to use minoxidil for several months to see any effect.

Other treatments for hair loss include wigs and surgery (see below).

Alopecia areata

There is no completely effective treatment for alopecia areata. However, in most cases, the hair grows back after about a year without treatment. So ‘watchful waiting’ is sometimes best, particularly if you just have a few small patches of hair loss.

Some treatments for alopecia areata are outlined below.

Corticosteroid injections

Corticosteroids are medicines containing steroids, a type of powerful chemical called a hormone. They work by suppressing the immune system (the body’s natural defence against infection and illness). This is useful in alopecia areata because the condition is thought to be caused by the immune system damaging the hair follicle.

Corticosteroid injections appear the most effective treatment for small patches of alopecia. As well as your scalp, they can also be used in other areas, such as your eyebrows.

A corticosteroid solution is injected several times into the bald areas of skin. This stops your immune system from attacking the hair follicles. It can also stimulate hair to grow again in those areas after about four weeks. The injections are repeated every few weeks. Alopecia may return when the injections are stopped.

Side effects of corticosteroid injections include pain at the injection site and thinning of your skin (atrophy).

Topical corticosteroids

Topical corticosteroids (creams and ointments) are widely prescribed for treating alopecia areata, but their long-term benefits are not known.

They are usually prescribed for a three month period. Possible corticosteroids include:

• betamethasone
• hydrocortisone
• mometasone

These are available as a lotion, gel or foam depending on which you find easiest to use. However, they cannot be used on your face –for example, on your beard or eyebrows.

Possible side effects of corticosteroids include thinning of your skin and acne (spots).

Corticosteroids tablets are not recommended due to the risk of serious side effects, such as diabetes and stomach ulcers.

Minoxidil lotion

Minoxidil lotion is applied to the scalp and can stimulate hair regrowth after about 12 weeks. However, it can take up to a year for the medication to take full effect.

Minoxidil is licensed to treat both male- and female-pattern baldness, but is not specifically licensed to treat alopecia areata. This means it has not undergone thorough medical testing for this purpose.

Minoxidil is not recommended for those under 18 years old. It is not available on the NHS, but it can be prescribed privately or bought over the counter.

Immunotherapy

Immunotherapy may be an effective form of treatment for extensive or total hair loss, although fewer than half of those who are treated will see worthwhile hair regrowth.

A chemical solution called diphencyprone (DPCP) is applied to a small area of bald skin. This is repeated every week, using a stronger dose of DPCP each time. The solution eventually causes an allergic reaction and the skin develops mild eczema (dermatitis). In some cases, this results in hair regrowth after about 12 weeks.

A possible side effect of immunotherapy is a severe skin reaction. But this can be avoided by increasing the DPCP concentration gradually. Less common side effects include a rash and patchy-coloured skin (vitiligo). In many cases, the hair falls out again when treatment is stopped, therefore treatment needs to be maintained.

Immunotherapy is only available in specialised centres. You will need to visit the centre once a week for several months. After DPCP has been applied, you will need to wear a hat or scarf over the treated area for 24 hours because light can interact with the chemical.

Dithranol cream

Similar to immunotherapy, dithranol cream is applied regularly to the scalp before being washed off. It causes a skin reaction, followed by hair regrowth in some cases.

However, it has not been proven that dithranol cream is significantly effective in the long term. It can also cause itchiness and scaling of the skin and it can stain the scalp and hair. For these reasons, dithranol is not widely used.

Ultraviolet light treatment

Two to three sessions of light therapy (phototherapy) are given every week in hospital. The skin is exposed to ultraviolet (UVA or UVB) rays. In some cases, before your skin is exposed to UV light, you may be given a medicine called psoralen, which makes your skin more sensitive to the light.

The results of light therapy are often poor. The treatment can take up to a year to produce maximum results and responses vary, with a high relapse rate. It is often not a recommended treatment because side effects can include:

• nausea (feeling sick)
• pigment changes to the skin
• an increased risk of skin cancer

Tattooing

For many people, it is possible to replicate hair with a tattoo. This is known as dermatography, and it generally produces good long-term results, although it is usually expensive and can only be used to replicate very short hair.

This is usually carried out for eyebrows over a few hourly sessions and can even be used as a treatment for scalp hair loss caused by male-pattern baldness.

Wigs
Wigs can be a useful treatment for people with extensive hair loss.

Synthetic wigs

The cheapest wigs are made from acrylic, and can cost anywhere between £60 and £200. As of April 2012, an NHS stock acrylic wig costs £63.35.

Acrylic wigs last for six to nine months. They are easier to look after than wigs made of real hair (they do not need styling). However, acrylic wigs can be itchy and hot, and need to be replaced more often than wigs made from real hair.

Read about wigs and fabric supports costs for information on who is entitled to free wigs on the NHS and who can get help with costs.

Real-hair wigs
Some people prefer the look and feel of wigs made from real hair even though they are more expensive, costing anywhere between £200 and £2,000. As of April 2012, an NHS partial human hair wig costs £167.85 and an NHS full human hair wig that is made-to-order costs £245.40.

Real hair wigs last for three to four years, but is harder to maintain than a synthetic wig because it may need to be set and styled by a hairdresser and professionally cleaned.

A human-hair wig is only available on the NHS if you are allergic to acrylic or if you have a skin condition made worse by acrylic. You may wish to buy your wig privately.

Alopecia UK has useful information about synthetic wigs and human hair wigs, including advice about choosing the right wig and how to care for it.

Complementary therapy

Aromatherapy, acupuncture and massage are often used for alopecia, but there is not enough evidence to support their use as effective treatments.