Tips from a dermatologist about thinning hair

Losing one’s hair can be stressful… in fact, hair loss is so profoundly distressing that those undergoing chemotherapy typically rate hair loss as their most dreaded complication!

All of us undergo hair loss as we age. Our hair is its most thickest the day before we undergo puberty- from then on it’s all downhill… But if we all are on a steady downward curve regarding our hair count, why is it that some people look to have a thick head of hair even into their late years? The reason is our genetics- some of us loose hair very little, and therefore have a very shallow curve such that the hair loss is minimally perceptible; whereas others have a very steep hair loss curve, and show marked hair loss as early as their 20s! Both men and women undergo a patterned hair loss, with men able to go completely bald on the tops and backs of their scalps, whereas women can go very thin, but not completely bald, on the crown of the scalp, with a little fringe of hair retained at the frontal hairline. How shallow or steep our curve is, is that perfect blend of what our parents passed on genetically. This genetic trait is complicated, and just looking at mom or dad is not always helpful to predicting your own hair loss.

Certainly, there are other contributors to hair loss- sometimes rapid and dramatic. Examples are delivering a baby, severe psychological stress, autoimmune disease particularly thyroid disease, certain medications (rx or even herbals), chemotherapy, severe illness, etc… but we’re not talking about this type of hair loss here. These sources of hair loss DO need to be evaluated- as they can have simple cures- but they occur in addition to the native- androgenetic alopecia, or typical male and female patterned balding- that we ALL experience to some degree.

Sometimes people will notice their androgenetic alopecia coming on rather rapidly, say around the time of menopause. The hair loss curve in a woman can be exaggerated around this time, which can be normal. More often than not however, there is a tipping point phenomenon, whereby folks start to really notice their hair loss when they start to see their scalp or notice their temporal hairline recession. Much like it just takes one more drop of water to fill a cup to overflowing, it sometimes only takes a few more hairs lost to notice hair thinning.

So what can we do about androgenetic alopecia? First of all, it is important to rule out the other treatable forms of alopecia. The key person to give advice is a dermatologist, whose expertise is in the disorders of skin, hair and nails. Once you have gotten definitive diagnosis of androgenetic alopecia, there are a few treatments you can consider. The most effective treatments are compounded prescription solutions that trained dermatologists are able to provide. Men and women can both benefit from topical minoxadil solution, with the prescription strength being more beneficial than the over the counter. Men can also benefit from oral or topical finasteride, whereas women can benefit from topical progesterone. Both sexes can benefit from topical retinoids as well, and combination therapy can be best of all. Using the medications encourages the reversal of the miniaturization of hairs within the follicles, the hallmark of androgenetic alopecia, and keeps the larger hairs within the follicle longer. Basically, these treatments make the hair loss curve more shallow, and slow the genetics of hair loss.

Hair regrowth is not an overnight sensation, and Dr. Kenner always recommends folks try the medications for a minimum of 6 months to determine the effectiveness. While the clock cannot be completely turned back, most people respond to these topical medications. In addition to using the prescription hair medications, it is important to have a good diet containing protein, b-vitamins (especially biotin), iron, zinc and vitamins A&C.

While it is true that one needs to use the topical medications daily to reap the benefit of the hair growth stimulation, this is not such a hard thing to do and is how many other conditions, such as blood pressure, are managed chronically. If one stops the medication the hair loss resumes at the earlier pace, with an initial shedding to adjust the curve back to the previous steeper state.

Newer therapies for hair loss are coming along all the time, so stay tuned for things to change in the future. Talk to your dermatologist and get “hair happy”.