Hair Loss (Alopecia), Spring/Summer 2016 Newsletter

While there are many causes of alopecia the most common by far are hormonal (male/female or androgenetic alopecia).

Male/female androgenetic alopecia is extremely common and appears to be due to an increased sensitivity of the hair follicle to testosterone (male hormone). It may come as a surprise to many women that they also have testosterone and female pattern alopecia is often associated with aging when females have less estrogen to oppose the effects of testosterone. There is a genetic susceptibility and it can be from either side (NOT only from the mother’s father as it is so often incorrectly stated). However this is a simplification! Hair growth and loss is very complicated!

Male hair loss typically begins either on the crown (top of the back of the head) or as recession of the hairline. This can occur at any time from teenage years to old age and can progress to maximal baldness (a fringe around the back to the ears) or can stay stable for many years.

Women lose hair typically on the top of the head slowly, with the front fringes being preserved, or as a noticeably increased width of the part. It can progress to a noticeable central scalp severe loss but that is less common. Also, this type of hair loss is seen mainly in postmenopausal women, although it can occur at younger ages.

Both men and women with androgenetic alopecia can benefit from 5% minoxidil applied daily to the scalp. Many myths have arisen about minoxidil use. While it is true that you may experience more fallout initially after starting, this is due to making all the hair follicles cycle together and this is followed by an increased percent of hair in the growing (anagen) phase, meaning there is an increased numbers of hairs. Another myth is that you can’t stop using minoxidil. Minoxidil is not a cure for hair loss, so if you do experience hair regrowth you will need to continue it to continue the benefit. If you stop it, you will lose the growth you got due to the medication, but you will not lose hair you wouldn’t have lost without it. So you can stop it, but you will lose the effect. What we have found with minoxidil is that it can be irritating to the scalp. We often mix it with an anti-inflammatory medication which helps reduce inflammation in the scalp and makes it so that it does not cause irritation.

We have a new RX service called ADV RX where we are able to provide you with high quality low cost medications. We have made two new hair loss preparations. The one for women contains 5% minoxidil and the anti-inflammatory along with something that increases circulation of the scalp. The men’s formula contains what is in the female mixture but also contains a unique topical version of finasteride (the main ingredient of what is in Propecia) which helps to block the formation of testosterone in the hair follicle. What is important about using this form of finasteride is that it is only absorbed in the areas you need it, rather than the entire body.

There are many other causes of hair loss. These include telogen effluvium (lots of hair falling out at once which can be caused by pregnancy, medications, low iron stores, stress and other causes), alopecia areata (autoimmune cause of hair loss which results in round or apostrophe shaped bald spots that occur suddenly), frontal fibrosing alopecia (inflammation causing the hairline to become sparse in women), and others. In these cases the ADV RX formulas can help on a short-term basis, but will not treat the underlying cause.

What is most important before purchasing any products or drugs for the purpose of reversing hair loss and improving hair growth is a full scalp diagnosis and consultation with one of our providers at Advanced Dermatology to make sure you have the best options for your particular type of hair loss.