Hair loss is something more people deal with than you might realize. In fact, about 1 in 5 people in this country is losing their hair for various reasons.
However sensitive the topic of hair loss is, it’s important to understand it in order to discover how to treat it. Here to help us with both is Dr. Nely Aldrich.
What is hair loss?
Female and male pattern hair loss, also known as androgenetic alopecia, are the most common types of hair loss.
For women the hair loss varies in severity depending usually on genetic factors. In men, the condition is very common with approximately 50% of men over age 50 experience hair loss.
What are the symptoms of hair loss?
Typically in women there is a pattern of diffuse thinning around the crown of the scalp. Symptoms of hair loss will start around age 50-60, but some may experience it earlier.
“The hair loss is usually without any symptoms in the scalp like itching or pain. Losing hair can be very psychologically distressing.”
In men, the pattern of hair loss is usually the crown and the temples giving the pattern of a receding hairline. Like women, there are minimal scalp symptoms.
Are there different types of hair loss?
Yes. There are many different types of hair loss with various causes (and therefore different treatments) and it is important to see a trained practitioner in order to be able to differentiate the causes and any underlying health conditions.
What causes hair loss?
“Pattern hair loss is caused by a hormone called dihydrotestosterone (DHT). DHT causes a change in the hair follicles called ‘miniaturization’, where the follicle becomes progressively smaller and eventually stops producing hair.”
There are other factors that may contribute to different types of hair loss that can be identified by a trained professional.
How is hair loss treated?
There are several approaches to treating hair loss medically.
“It is important to note that these treatments will work only as long as the treatment is continued. If treatment is discontinued, the hair will shed back to its baseline – as if treatment had never been commenced in the first place.”
With that said, these are the various treatment options for hair loss. Keep in mind that only a trained professional who has assessed your unique hair loss situation can help determine which will work best for you.
Minoxidil solution or foam (Rogaine) is the first-line therapy for pattern hair loss. This is a medication that is applied topically to the scalp daily. I instruct my patients to apply the 5% “men’s strength” for both men and women. Minoxidil is a vasodilator, which means that it opens the blood vessels that feed the hair follicle and provide the nutrients it needs to keep hair in the growing cycle longer. It needs to be used for at least 6 months before any benefit may be noted. Any benefit is only maintained for as long as the treatment is used. Minoxidil solution may cause an initial hair fall in the first 2-8 weeks of treatment, and this usually subsides when the new hairs start to grow.
Ketoconazole shampoo is a prescription dandruff shampoo that has been shown to have some anti-DHT or anti-androgen properties when applied to the scalp.
Other options that I provide to my patients are making specialty formulations of stronger topical minoxidil strengths with added anti-DHT ingredients at compounding pharmacies.
Men: finasteride (Propecia) tablets can be used to block the DHT hormone and stop the progression of hair loss. Finasteride can cause possible side effects of erectile dysfunction and mood disorders, so it is important to have this discussion of risks vs benefits and be aware to tell your prescriber if you experience any of these symptoms.
Women: spironolactone and finasteride tablets can also be used in women to stop the progression of hair loss by blocking the hair loss hormone. Side effects can include loss of libido and it is important to avoid pregnancy on these medications as it can cause birth defects on the fetus.
Emerging and off-label treatments for both men and women include use of very low dose minoxidil tablets to induce the same benefits that topical minoxidil has on the scalp. Since minoxidil is a vasodilator, possible side effects of this can include lowered blood pressure.
The use of hair pieces, extensions, and wigs is a great way to disguise hair loss.
“Technology has come a long way in order to make them appear very natural.”
Hair transplantation is a way of surgically moving hair follicles from the back of the head into parts of the scalp that are thinner. We do not provide hair transplantation at Apex, but can refer you if this is something you’re interested in.
PRP or platelet-rich-plasma is an emerging therapy where nutrient-rich plasma is obtained from your own body through a blood draw and then injected into the scalp. Several treatments are needed and then serial upkeep over the years is done for maintenance. Ask about which offices in Apex provide this treatment and schedule a consultation if interested.
Is there a cure for hair loss or can it be prevented?
No, there is no cure for hair loss and there is no good way to prevent it from occurring. But many treatments have been shown to help.
If you want to discuss your own hair loss, how to treat it, and methods to feel your very best going forward, schedule an appointment with an experienced professional for hair loss.
Dr. Aldrich graduated from Kent State University with an undergraduate degree in Integrated Life Sciences. She then attended medical school in Northeastern Ohio Medical University in Rootstown, Ohio where she was inducted into the medical honor society Alpha Omega Alpha.
During medical school, Dr. Aldrich developed an interest in dermatology and was accepted into University Hospitals Cleveland Medical Center for residency. She published research on rosacea twin studies during her residency. Dr. Aldrich served as Chief Resident in the last year of training and worked as a dermatologist in Westlake for two years after graduating residency.
Dr. Aldrich specializes in general dermatology. She sees various conditions including acne, rosacea, skin cancer, eczema, psoriasis, and many others. Dr. Aldrich is Board Certified by the American Board of Dermatology.