I am experiencing hair loss, what can I do?
There can be many reasons why someone may experience hair loss. Let’s talk about a few of them and the ways Central Minnesota Dermatology can help.
The medical term for hair loss is alopecia. Alopecia has two main categories: scarring alopecia and non-scarring alopecia. In scarring types of hair loss, the hair follicle is damaged, and the hair loss is permanent. There are often symptoms including itching, burning or redness of the scalp. In non-scarring types of hair loss, the hair follicle is preserved, and the hair loss is potentially reversible. These are often asymptomatic and described as diffuse hair shedding, sudden hair loss, patchy hair loss, or progressive slow hair loss over years. It is important to determine the cause of the hair loss early to prevent further damage especially in the case of a scarring type of hair loss. Untreated non-scarring hair loss can often not be reversed.
How does hair grow?
There are 3 main phases of the hair growth cycle:
- Anagen phase: actively growing hair. This is the phase of most hair follicles and can last up to 6 years on the scalp. Areas like the eyebrows, arms & legs have a shorter anagen phase duration.
- Catagen phase: phase between active growth and the resting phase where the hair follicle begins to shrink. This includes 1-3% of hair follicles and lasts 2-3 weeks.
- Telogen phase: the resting phase. This lasts 1-4 months of which the hair is not actively growing. Approximately up to 10% of hair follicles are in this phase.
How can a dermatology provider help me with my hair loss?
During your visit with one of our medical providers, they will complete a thorough medical history to determine any symptoms you may be having and any identifiable causes of your hair loss. They will ask questions about medications, recent illnesses, hospitalizations, or excessive times of stress that may have triggered your hair loss. They will ask about personal or family history of hair loss. Your provider will examine the hair pattern & the hair follicles to determine if there is any evidence of a scarring alopecia or infection to cause your hair loss. They will perform what is called a hair pull test, where they will gently tug at the hairs to assess how many hairs may shed at that time. It helps to not wash your hair immediately prior to your appointment for this test to be most helpful.
What other tests might my dermatology provider recommend?
You and your provider will discuss any potential causes that can be identified during your history and physical exam. They may recommend further testing including lab work or a biopsy to aid in determining the cause of your hair loss.
Can my hair loss be treated?
There are many treatment options depending on your type of hair loss. These are listed below depending on hair loss type.
Alopecia areata:
This type of hair loss is an autoimmune disorder in which the immune system causes inflammation in the hair follicle causing, typically, circular patchy hair loss. If severe this may also cause extensive hair loss of the entire scalp and other areas of the body. The goal for treatment of this type of hair loss is to decrease inflammation at the hair follicle. This can be achieved through topical medications, intralesional corticosteroid injections directly into the scalp and oral medications. Approximately 50% of people with this type of hair loss will re-grow their hair without any treatment within one year. You and your provider will discuss the best treatment option for your type of hair loss at your visit.
Androgenetic alopecia:
This type of hair loss is typically known as patterned hair loss or male pattern baldness; however, this occurs in both men and women. This type of hair loss is often hereditary with a known family history of slow progressive patterned hair loss with advancing age. Women tend to experience hair loss of the central scalp often described as a thinning and widening of the part. Men tend to experience slow hair loss of the mid-frontal scalp (near the forehead), bi-temporal scalp (sides of the scalp above the ears near the forehead) and the vertex (top of the scalp near the back of the head). Treatment of this type of hair loss is aimed to halt the progression of further hair loss, maintain the hair that the patient has and induce new hair growth to re-grow lost hair. Your dermatology provider will discuss several options available at Central Minnesota Dermatology including:
- Nutritional Supplements: It is important to ensure the necessary nutrients are available to help grow hair and maintain the hair patients have. There are several options available such as: Nutrafol, Viviscal, Votesse, Hair La Vie and Protervis, to name a few. Here at Central Minnesota Dermatology, we make it easy for you, as we have partnered with Nutrafol to sell Women’s, Women’s Balance and Men’s Hair Growth supplements in our office.
- Topical medications: Some topical medications such as minoxidil which can be either over the counter or prescription strength and finasteride solution may be recommended to stimulate new hair growth.
- Oral medications: Oral medications may include minoxidil, finasteride or dutasteride, or spironolactone specifically for women. These medications help to re-grow, maintain hair density, and help to prevent further hair loss.
- PRP/PRF injections (Platelet-Rich Plasma/Platelet-Rich Fibrin): With this treatment a trained nurse will draw your blood and collect growth factors and stem cells from your plasma. These will then be injected directly into the scalp to help stimulate hair follicles to grow and increase the thickness of hair.
- TED (Transepidermal Delivery): This treatment involves applying a hair growth serum to the scalp and using a non-invasive, PAIN FREE, ultrasound-technology to create acoustic waves to deliver the serum through the top layers of the skin and into the hair follicles to stimulate hair to grow and increase hair thickness.
Telogen Effluvium:
This type of hair loss typically follows a stressful event such as an illness, hospitalization, chronic medical condition, or even psychological stress such as a move, job change or divorce. The goal of this type of hair loss involves identifying the cause of the stressor and correcting it. This type of hair loss is typically described as sudden onset diffuse hair shedding following a stressful event. The shedding can start as early as 2 months after the event and typically lasts for 2-3 months. Chronic telogen effluvium is often due to chronic medical condition or a prolonged emotional stressor (prolonged divorce). Treatment includes taking nutritional supplements, topical medications such as minoxidil and/or finasteride, PRP/PRF injections, or TED treatments. You and your treatment provider will discuss the best treatment options for you.
For more information visit the American Academy of Dermatology Association Website link:
https://www.aad.org/public/diseases/hair-loss
References:
Al Aboud AM, Zito PM. Alopecia. [Updated 2023 Apr 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538178/
Katherine A Gordon & Antonella Tosti (2011) Alopecia: evaluation and treatment, Clinical, Cosmetic and Investigational Dermatology, 4:, 101-106, DOI: 10.2147/CCID.S10182 Retrieved from: https://doi.org/10.2147/CCID.S10182
James, W. D., Elston, D. M., Treat, J. R., & Rosenbach, M. A. (2019). Andrews’ Diseases of the Skin (13th ed.). Elsevier – OHCE.
Lebwohl, M. G., Heymann, W. R., Berth-Jones, J., & Coulson, I. H. (2017). Treatment of Skin Disease (5th ed.). Elsevier – OHCE.
