Skin Deep

What you can do about hair thinning or hair loss

Approximately 80 million men and women in the United States are experiencing hair thinning, hair loss or a combination of the two.

Dr. Patricio Fajnwaks oversees my hair loss clinic, and he explains some of the new treatments for hair thinning and loss.

What are the main causes of hair loss?

The most common cause is androgenetic alopecia (AGA), which affects both males and females and causes a gender-related pattern of hair loss. This is a hereditary condition that makes the hair follicles more sensitive to DHT, which is a byproduct of the male hormone testosterone.

In cases of AGA, DHT causes the follicles to shrink and stop producing hair. Keep in mind that women have testosterone in their bodies, too, and the balance of testosterone and estrogen plays a role in hair thinning and loss in females. For example, most women see thicker healthier hair when estrogen levels rise with pregnancy — this is also why many women report hair shedding after giving birth, as hormone levels get back to normal. Other causes of hormonal shifts include ovarian cysts, birth control pills and menopause, so these can cause changes in the hair as well.

Though less common, other causes of hair loss include medical conditions like thyroid problems and anemia, nutritional deficiencies, autoimmune conditions and even prescription medications. Hair loss can also be triggered by straightening, bleaching or wearing tight braids for an extended period of time.

When is it time to see a doctor?

It’s normal to lose 50 to 150 strands of hair a day, but if you suspect that you might be suffering hair loss or thinning, the first thing that you need to do is look within your family. If a direct family member has experienced hair loss, you might be affected too. If you notice patchy hair loss or abnormal persistent changes in the scalp (pain, itchiness, etc.), schedule a consultation immediately because this can be a sign of an autoimmune condition.

What is used to diagnose the cause(s) of a person’s hair loss or thinning?

There are several tools used to diagnose a patient’s cause of hair loss: physical exam, universally used hair loss pattern scales, microscopy, blood tests and biopsies.

What are the treatments?

Medical treatments include topical and oral medications and minimally invasive procedures. The first line of treatment usually involves a combination of these (plus a supplement such as Viviscal), and the approach is dictated by a patient’s diagnosis.

Minimally invasive procedures include PRP (platelet-rich plasma), which involves isolating growth factors from your own blood and reinjecting them into the scalp to stimulate circulation and promote the formation of new hair follicles and collagen. Another effective procedure is microneedling, which creates superficial injuries on the scalp to enhance the penetration of topical treatments and promote collagen production. When appropriate, laser brushes, combs and other hand-held devices may be used as well.

Depending on the cause and stage of hair loss, surgical procedures such as hair transplantation may be recommended. This is not the case in all patients, especially if treatment begins in the earlier stages of hair loss.

Dr. Leslie Baumann is a board-certified dermatologist and CEO of Baumann Cosmetic & Research Institute in Miami.