Hair loss- it takes a village, and the kitchen sink!

hair loss hair loss treatment May 27, 2024

Not a day goes by without someone asking me about hair loss, both in and outside of my clinic. While I used to think hair loss was just something that affected and bothered men, I now realize it affects both men and women, and can be just as devastating, if not more so, for women!

Why? Because for women, our hair is so intertwined with our femininity and associated with beauty. When we lose it, it can be psychologically devastating!

First things first, take a deep breath! And make an appointment with your dermatologist. The cause of hair loss can be varied, and it's important to get to the root cause. Sometimes hair thinning can be a sign of an underlying medical condition like thyroid disease, lupus, anemia, or low vitamin D levels. So it's important to figure this out first.

During your appointment, plan on a lengthy visit, as your dermatologist will want to ask you many questions such as when you noticed the hair loss, any changes in health, recent surgeries or pregnancies, new medications, diet, and hair styling techniques, just to name a few! It may feel a bit like an interrogation, but hang in there. It's important to get answers to all these questions so that we know how best to treat you.

Your dermatologist will also examine your hair and skin to assess the integrity of your scalp. When your skin is inflamed with flakiness, crusting, or even scarring, it's difficult to have healthy hair. Your dermatologist will also look at your eyebrows, eyelashes, and even the skin on other parts of your body like your ears and armpits. This all gives us clues to what's going on. If your hairstyle makes a full scalp exam difficult, your dermatologist may ask you to come back another time when you can have any hair extensions or braids removed for a more thorough exam.

On that first visit, your doctor may want you to get blood work or review any recent blood work that you've had. Your dermatologist may also do a scalp biopsy, but this is not always necessary. Don't stress if they do a hair pull test; this just gives us important information on the integrity of your hair and the type of hair loss you may have.

Next, your dermatologist will likely want you to start taking care of your diet. Yes, believe it or not, our gut health can impact so much of our general health, including hair health and absorption of nutrients and supplements. A whole food diet with lots of fiber, lean protein, healthy fats, and minimal processed sugar is key! A probiotic may also be necessary for optimal gut health and supplement absorption.

Even with a healthy diet, sometimes we need to supplement our diet. If you are vitamin D deficient, you will likely want to take a vitamin D supplement. Please, please, please do not think that you can get adequate vitamin D levels from burning in the sun! A daily multivitamin can be helpful, too. Biotin can help keep your hair and nails strong but isn't effective for hair loss. Make sure you are not getting excessive amounts of biotin or other nutrients by 'double dipping' with duplicate supplements. Hair-specific supplements like Nutrafol and Viviscal can also be game changers for many patients.

After treating any underlying medical cause, getting your gut health, diet, and nutrients optimized, what's next for your hair loss? Fortunately, nowadays there are many treatments ranging from at-home topical therapy, oral medications, to in-office treatments and more.

So where to begin? It really depends on the amount of time and money you want or can devote to your hair loss, and that will be determined by how much it bothers you. Topical therapies range from over-the-counter minoxidil 5% to more complex compounded formulations containing other powerful ingredients like dutasteride. Minoxidil is also available as an oral pill, and when taken in really low doses, it can have remarkable hair regrowth. For younger women, spironolactone is also a great option.

Now, what about LED masks? Believe it or not, there is actually data supporting the use of these products for hair loss. The downside is that they can be expensive and must be used consistently for results. There are also products with growth factors that can help with hair loss like Kerafactor or platelet-rich plasma (PRP), which can be injected or applied topically after microneedling. With so many options nowadays, it's important to have a discussion with your dermatologist on what will work best for you based on your type of hair loss, your lifestyle, and financial and time commitments.

Don't miss this week's podcast episode, where I'm joined by Drs. Diane Orlinsky and Eva Simmons-O’Brien to discuss everything you need to know about hair loss. If you or someone you know has been struggling with hair loss, this episode is an absolute must-listen!

Find Drs. Diane Orlinsky and Eva Simmons-O’Brien here:

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