top of page

Hair Loss

Writer's picture: Aislyn Aislyn

Hair loss is something so many of us experience at one time or another.  Some people win the genetic lottery and really never worry about their hair.  This article is not for them, it is for the rest of us.  There are many factors that play a role in hair loss - most of the time it is not just one but a combination of factors that are at fault.  Hair loss can cause quite a lot of anxiety and negatively affect your quality of life; it is worth addressing it and trying to get on a treatment regimen.  


Causes of Hair loss


Factors that contribute to hair loss
Factors that contribute to hair loss

There are a number of reasons we can develop alopecia (hair loss).  Again, most alopecia is caused by a combination of factors, some of which are controllable and some that are not.  The main categories the drive hair loss are:

  1. Stress 😧

Stress comes in many forms - having a baby, starting a new job, moving, going through a relationship change, losing a loved one

  1. Weightloss 🏋️

Very strict diets and/or losing weight rapidly can lead to hair loss

  1. Genetics 🧬

Genetics play a critical role in hair loss - if your family has a history of hair loss - you should mention it

  1. Trauma to the Hair 🪮

Harsh products, hair styling, very tight ponytails, all of these habits can apply a physical stress on the hair which damages the hair and can lead to hair loss

  1. Inflammation 😷

Many inflammatory conditions have hair loss as a symptom - Lupus, Dermatomyositis, Thyroid conditions, scalp infections, and hormonal conditions

  1. Medications 💊

Many medications can cause hair loss including: chemotherapy, blood thinners, beta-blockers, hormone therapy (birth control, testosterone), and some antidepressants 


Hair loss Work-up

Many times seeing a physician is necessary to understand the reason(s) for a sudden/gradual change in your hair density.  It is important to look at the hair shafts themselves - many times a physician can do a hair pull test or perform tricoscopy (looking at a hair under the microscope).  Blood work is often necessary to rule out a thyroid, autoimmune and/or hormonal component of hair loss.  Finally a biopsy can be performed to determine if and what type of inflammation is present around the hair follicles.  It is important to remember that a biopsy is done at one moment in time and can help put the alopecia in a category but it does not always tell us the exact diagnosis, most of the time the type of alopecia is a clinical diagnosis.  The earlier you see a physician the better.  Unfortunately, once a hair follicle scars over, you cannot make it grow back.


Hair Loss Treatment Options 

Here is where hair loss can get very overwhelming.  Many shampoos advertise that they can help grow hair.  There are 100s if not 1000s of supplements on the market.  New procedures come out all the time - what actually works?

The FDA has approved two medications for genetic (called androgenic) hair loss - that is it!:


Hair loss facts, causes and treatments


  • Minoxidil: there is a topical form and an oral form. Topical minoxidil is over the counter and can be found in 2% and 5%.  I strongly recommend 5% to all patients because it is the most effective.  Oral minoxidil is also a great option but since it is a vasodilator  it can cause a decrease in blood pressure, which can cause negative sexual side effects and it is not safe for females who can become pregnant.


  • Finasteride: typically found in oral form but now compounding pharmacies are creating topical combinations. Finasteride is a DHT blocker and can cause sexual side effects and depression.  It is only FDA-approved for men.

*** These are life-time medications***


** Jak inhibitors have been approved for alopecia areata only 

** Topical and intralesional steroids are very helpful for inflammatory alopecia

** Cold caps have been shown to help with chemo-induced alopecia


There is also an FDA-approved “procedure” for hair loss:


  • Low Level Laser Therapy: the exact mechanism is unknown but it is thought that the energy from the laser increases stem cell activity in the hair follicles. You can purchase a low level laser machine over the counter.  For the best results you want to use the machine 3-4 times weekly, for 12 months. Hair growth always takes time


Currently there are no FDA-approved supplements or shampoos.

That being said, there are several products out there that do have good clinical data that I do recommend to patients - especially those that do not want to go on a prescribed medication.

  1. Biotin has no data behind it - I do not recommend biotin supplements to any of my patients

  2. Pumpkin seed oil and rosemary oil do have data showing that they can help genetic hair loss, but again this is a permanent scalp treatment and should be done daily

  3. Nutrafol is a branded supplement that has substantial clinical data showing hair growth after 3 months of treatment.  The ingredients target hormones, collagen, stress and the microbiome. 

  4. Platelet-rich plasma treatments have shown good results but tend to be costly, painful and typically, the best results are in concert with additional treatments. 


There are many other natural ingredients, supplements, and technologies that are available, but the above mentioned recommendations are the ones I have found most helpful for patients. 


If you have any questions or are suffering from alopecia, please call Aislyn Dermatology at 719-992-0127 or make an appointment online.


Comments


bottom of page