Our hair is one thing we wear every day. We have gym day hair, workwear hair, I’m-going-to-a-fabulous-event hair, and messy-don’t-care hair. But as we mature and see more of our hair in the shower drain or on our brush, we care greatly.
Thinning hair can be a highly emotional event for women, 30 million of whom suffer from female-pattern hair loss, according to the American Association of Dermatology.
The Problem: Hair Begins to Fall Out
Our hair is made of protein strands and single healthy strands of hair typically have a normal life cycle of between two and seven years depending on whether you have naturally healthy thinner or thicker hair. When hair falls out, it’s replaced with new hair. But as we age, hair strands naturally become smaller with less pigment, and regrowth rate slows as some follicles stop producing new hairs all together. The reason? There are many.
“The most common thing is genetic tendency, especially if others in your family have experienced thinning hair,” explains Dr. Carolyn Goh, a medical dermatologist with a specialty in hair loss and scalp disorders at Ronald Reagan UCLA Medical Center in Los Angeles. “Other causes to look out for are thyroid problems, anemia, stress, and eating and nutrition issues.” She says some popular diets can be the culprit of periods of shedding, too.
High stress has an impact, and more hair loss than usual can be a side effect of some medications, such as commonly taken blood pressure meds. “We don’t really know why, but hair loss is more associated with blood pressure meds, like beta blockers such as Toprol,” Goh says. Another whammy for women? Coming off birth control, typically around 40, can also initiate early hair loss. And avoid hair elastics and hats (especially baseball caps with Velcro straps) that inevitably and unnecessarily tug out more strands.
The good news, according to Goh and other experts, is that there are products that work to combat hair loss before you might be tempted to try more futuristic-looking solutions, including laser caps, laser combs, and light bands (which Goh hesitantly says “might help a little, but not much”) — or turn to costly surgical hair grafting or hair transplant procedures as a last resort for severe hair loss.
Goh says most dermatologists prefer patients try the solutions below first, because they’re proven to help grow back hair: “You just have to stick with the program as they can take six months to start working and have a noticeable effect.” If not, book an appointment with a dermatologist specializing in hair — and talk to her or him honestly.
Note: If you experience significant hair loss for three to six months with bald spots, rashes, itching, or pain, get thee to a dermatologist.
Solution #1: Good Scalp Care
There is only one FDA-approved hair-loss product ingredient proven to regrow hair. But before we get to that, scalp health is critical and the first thing to address and assess. “It’s scientifically proven that scalp inflammation can impair hair growth,” explains hair transplant surgeon and hair-loss specialist Dr. Alan J. Bauman, of eponymous Bauman Medical in Boca Raton, Florida. “Reducing triggers of inflammation at the level of the scalp and balancing the health of the scalp has been shown to help improve hair growth and quality.”
In his practice, Bauman performs a series of noninvasive, scalp skin diagnostic tests to assess sebum (an oily secretion of the sebaceous glands), pH, hydration, and toxin and cortisol levels. Depending on the results, Bauman may recommend a variety of at-home or in-office scalp therapies, from sebum-regulating topical serums and specially tailored hair care regimens, to scalp steaming, scalp massage, hair-boosting dermal patches, laser therapy, and more. “Generally improving the health of the skin of the scalp and reducing inflammation can help overcome common hair and scalp problems, including itching, dandruff, and breakage, as well as hair thinning and excessive shedding.”
Goh says a simple first step for anyone with hair loss is switching to a quality anti-dandruff shampoo. “Hair loss is complicated by dandruff, and people with hair loss tend to stop washing as often, afraid of losing more. But washing less exacerbates dandruff, which then exacerbates hair loss.” She recommends a top-rated anti-dandruff shampoo to see if your hair is simply trapped in the dandruff/hair-loss/dandruff/hair-loss loop.
Solution #2: Nonprescription Medication & Treatments
The treatment that most dermatologists and hair-loss specialists agree does work with good effect, and are most likely to recommend (except in severe cases) is over-the-counter nonprescription medication Rogaine (minoxidil), clinically proven to regrow hair. Topically applied as a wash or foam, Rogaine works by penetrating the scalp and stimulating hair follicles. It has even been shown to reverse progression of hereditary, genetic hair loss.
Goh says generic topical minoxidil works well. But if you’re like us, we prefer the Rogaine-based hair loss and volumizing brands that take aesthetics into considerations, including a nice scent. Trusted brands make it clear that it may take at least three to six months to see signs of hair regrowth. If a brand promised results in less time, beware.
Solution #3: Prescription Meds
Though there are prescription pills for male hair loss (Finasteride and Dutasteride), according to the Mayo Clinic, there are none yet specifically for female hair loss. Mayo reports that some doctors will prescribe men’s meds for women, but there are side effects around the testosterone component. Prescription treatment could include oral contraceptives and spironolactone — a diuretic used to treat, among other things, high levels of the hormone aldosterone.
Solution #4: Nutraceuticals
There are many over-the-counter brands claiming to help regrow hair, but as with any supplement claiming to be a magic bullet, knowing what’s snake oil and what’s not is very difficult. Two nutraceutical supplement brands Goh recommends are daily Nutrafol and Viviscal. The all-natural ingredients work in synergy together, with the key ingredients being stress adaptogens and DHT inhibitors, which block the DHT androgen hormone.
Many women take biotin religiously for hair, nails, and skin. The B vitamin found naturally in egg yolk, yeast, and liver helps synthesize glucose and fatty acids, but Goh says “it doesn’t really help the hair.”
Solution #5: Medical Procedures
If Rogaine/minoxidil, diligent scalp care, and other approaches don’t have an effect, your dermatologist may recommend platelet-rich plasma therapy. Used for decades to help healing after surgery, some specialists will consider it for women suffering severe hair loss. It’s a process in which your blood is drawn and the platelets and plasma are separated. The plasma is then injected into your scalp in areas of hair loss at intervals over a couple of years to stimulate collagen and repair blood vessels. The cost is $500 to $1,000-plus per injection session.
The last step for most severe cases of patchy or complete baldness is a hair transplant. Find a qualified medical doctor to discuss if grafts or hair transplant surgery are right for you.