In women with PCOS(polycystic ovarian syndrome), high levels of androgens (male hormones) in the body may cause hair loss. DHT (dihydrotestosterone), more abundant in men, is created from a combination of testosterone and5-alpha-reductase enzymes. DHT can bind to hair follicle sites, accelerate the natural hair growth cycle, and cause hair to go into resting (catagen) sooner causing thinning hair with each cycle.
Women with PCOS are more susceptible to androgenic alopecia, more commonly referred to as male pattern baldness or genetic female hair loss. Androgenic alopecia is also the number one cause of hair loss and thinning hair in the world.Women with androgenic alopecia typically lose hair in a pattern similar to the ludwig scale,and less commonly the norwood scale.
If you suspect you have PCOS, you should consult with a physician and get tested for it. Only a physician can diagnose you and recommend a proper treatment.
Alopecia areata (sometimes referred to as“spot baldness”) is a medical condition that typically results in patchy hairloss or bald spots on the scalp, beard, arms and legs. Though the exact cause of alopecia areata is unknown, it is thought to be an autoimmune disorder causing the body’s immune system to attack its own hair follicles, resulting in hair loss.
Roughly 2% of the world’s population suffers from alopecia areata and approximately 5% of these have a family history of "alopecia", the medical term for hair loss.
Alopecia areata is normally diagnosed through the observation of symptoms. However, occasionally a scalp biopsy or blood tests may be performed.
There is no cure for alopecia areata and current treatments, while sometimes effective, offer limited success. Current treatments for alopecia areata include; steroid injections, topical corticosteroids (steroid hormonesnaturally produced in the adrenal cortex of vertebrates), topical immunotherapy, Rogaine(minoxidil) and ultraviolet light therapy.
Although permanent hair loss is a possibility, the course of the disease is unpredictable and varies from patient to patient. The good news is that, even without treatment and after many years,the hair follicles do remain viable and ready to resume normal hair production if and when they receive the appropriate signal. Hair regrowth may, and often does, occur in time.
Patients suffering from alopecia areata are rarely considered good candidates for hair transplant surgery because donor hair grafts harvested from the “safe” zone at the rear and sides of the scalp are still vulnerable to the effects of the body’s immune system once transplanted to the recipient sites. However, if the affected area is small, has remained unchanged for an extended period of time and if there is no sign of inflammation below the scalp, hair transplantation may be an option. This would require a thorough consultation with a skilled and experienced hair restoration surgeon and the patient would need to fully understand and accept the risks of such a procedure.
Depending upon the severity of the condition, hair loss concealers like Toppik, Nanogen and DermMatch may help disguise bald patches. In more severe cases, a hair replacement system or full wig may be necessary.
Aswith all forms of hair loss, patients suffering from alopecia areata may experience emotional and psychological trauma. It’s important to reach out to family and friends, join an alopecia support group and/or seek the services of a mental health professional if you are experiencing intense, prolonged and overwhelming psychological effects.
Many cases of female hair lossare caused by hormonal fluctuations or changes in the body including those who have PCOS (polycystic ovarian syndrome), birth control pillside effects, a recent pregnancy,postmenopausal trauma, or menopause. Women with hair loss experience varying balding patterns These patterns can help determine the type of alopecia you have along with a thorough examination by a physician.
Because of an imbalance between estrogen and testosterone due to declining estrogen levels, thinning hair and accelerated hair loss is common in women during menopause. Hair on certain areas of the head that is more sensitive to androgen hormones like DHT(associated with male pattern baldness) may thin or fall out. Similarly, declining estrogen levels may result in unwanted facial hair growth.
In some cases, polycystic ovarian syndrome(PCOS), may accompany menopause and hair loss.
Be sure to speak with your doctor on the most effective ways to cope with menopause and minimize hair loss during this transitional time.
The Ultimate in fullness and naturalness in one surgery session.
We’ve all seen the “pluggy” hair transplants of the past. But we don’t see today’s state of the art hair transplants because they go unnoticed.
Plugs Mini Micros Follicular Units
Surgical hair restoration has dramatically evolved from the big round “plug” grafts of the 1960 ’s and 70’s, to the “mini micrografts” of the 80’s and early 90’s, to modern hair transplant procedures using entirely follicular unit grafts .
Now hair restoration surgery is going through another important evolution that is improving both the naturalness and fullness that can be achieved from any one surgical hair transplant session.
Today ’s micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to “dense pack” select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.
Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.
Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.
This procedure also requires more careful patient selection, as “dense packing” of grafts is not appropriate for all patients.
In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.
While the standard micro “follicular unit” hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.
The many patient benefits of this new procedure are significant and include:
All members of the Coalition of Independent Hair Restoration Physiciansare required to perform ultra refined grafting with excellent results. Learn more about the membership standards.
This hair loss product is a 5% custom solution that combines Minoxidil with Azelaic Acid. Developed by Dr. Richard Lee, a hair loss physician, it’s available by prescription only.
Xandrox’s two main ingredients tackle hair loss in two ways. The minoxidil stimulates hair growth, while the Azelaic Acid, which contains the 5 Alpha Reductase enzyme, blocks DHT. However, while minoxidil is a proven hair loss treatment, Azelaic Acid is only proven as an acne medication. Many patients feel that Xandrox is preferable to Rogaine because it’s less greasy.
As of yet, Xandrox has shown few side effects, and may cause less itching and flaking than Rogaine.
There may be some burning irritation though, due to the Azelaic Acid. But one type of Xandrox counteracts this side effect. It contains a Betamethasone Valerate, a corticosteroid.
However, you need to know that corticosteroids may cause problems. Short-term use is pretty safe, but if used long-term, they may cause thinning of the skin or skin damage. It may also lead to brittle bones or diabetes. For this reason, it’s recommended that if you have no itching problems that you should use the Betamethasone-free Xandrox. It is available, and it works as well as regular Xandrox.
There are other types of Xandrox, including the Day Formula, the Night Formula, and Xandrox 12.5%, a cream that’s used for more stubborn areas, such as the frontal hair line, and contains 12.5% Minoxidil. One ml of Xandrox should be applied twice per day, and a routine should be established.
Use of low level laser therapy (LLLT) devices for treating hair loss has been heavily debated for some time by reputable hair restoration physicians and patients on our hair loss forum. While some physicians reject its use entirely, others use laser hair treatment as a regular part of their practice. Additionally, some physicians believe that laser light therapy can assist with postoperative healing after hair transplant surgery.
Shortly after the first working laser was invented in 1964, a researcher from Semmelweis University of Budapest named Andre Mester developed a theory that exposure to cold laser light (similar to UV radiation emitted by the sun) may eventually lead to cancer. To test his theory, Mester shaved a group of mice and trapped some of them in a cage with constant cold laser light exposure leaving the other half unexposed as a control group. To his surprise, the light didn’t cause cancer in any of his animal subjects. Instead, mice that were exposed to the laser light therapy grew back their shaved fur much faster than the control group. Mester named his discovery photo-biostimulation. His theory was that somehow, the laser light had stimulated the hair cells into an accelerated state of hair growth.
Today, low level laser therapy is being used as a hair loss treatment. To treat baldness with laser light therapy, laser rays are directly applied to the scalp by a mechanical device so that red blood cells are stimulated. Lasers are said to work by converting ATP (Adenosine Triphosphate) to ADP (Adenosine Diphosphate), releasing energy and causing cellular metabolic changes. During this process, additional nutrients and oxygen are provided to the scalp assisting the normal chemical processes performed by those cells, increasing overall blood circulation. Lasers, when applied to the scalp and hair, have been said to improve overall hair quality, promote hair growth, and increase hair shaft diameter.
Laser treatment devices have a similar appearance to a hood hair dryer which is placed over top of your head. The low level laser toll will rotate allowing laser rays, usually red in color, to be discharged into your scalp. Hand held devices such as the Hairmax comb have also been developed and resemble a brush in appearance.
Promoting healthy hair growth however, is not the same as the regrowth of miniaturized hairs brought on by genetic female hair loss or male pattern baldness (MPB). So what clinical evidence exists, if any, that laser therapy is an effective treatment? Below we take a closer look at the available data including exclusive interviews of leading hair restoration physicians.
Physicians have long shared varying views on whether or not laser treatment is viable. While some well respected physicians reject its use entirely, some believe that LLLT can provide marginal benefit for men and women suffering from androgenic alopecia (genetic baldness). Additionally, some physicians believe that laser hair treatment can assist a hair transplant patient’s postoperative wound healing process and expedite hair growth.
Dr. Charles (one of our well respected members of the Coalition of Independent Hair Restoration Physicians) believes it may provide similar hair loss prevention benefit to Rogaine in the mid vertex area and crown. Benefits in the frontal area include an increase in overall hair quality rather than hair loss prevention.
Dr. Charles believes LLLT works better when combined with Propecia (finasteride) and Rogaine (minoxidil). Like Propecia and Rogaine, he believes low level laser therapy may help some patients more than others and works better in patients with only minimal thinning hair.
Dr. Charles believes in helping balding men and women develop and maintain realistic expectations and he doesn’t oversell its benefits. Because lasers are free from side effects, he always tells his patients that the biggest risk is the money. Dr. Charles believes more research on laser hair treatment is needed.;
Dr. Williams of the Coalition has been using laser hair treatment as a regular part of his practice for over 2 years and feels quite confident in its success in some patients. In his experience, LLLT promotes healthy hair growth and can increase hair shaft diameter of miniaturized hair affected by genetic female hair loss and male pattern baldness in some patients.
Dr. Williams offers 16 free laser therapy sessions to local males following hair transplant procedures and encourages his female transplant patients to undergo laser light therapy for one full year at a highly discounted rate. Dr. Williams usually notices faster transplanted hair regrowth and a quicker resolution of postoperative telogen effluvium or “shock loss”, if it occurs.
Because androgenic alopecia is a progressive condition, Dr. Williams encourages male patients to use Propecia while encouraging out of town females to use the Hairmax laser comb to help maintain their existing hair. Dr. Williams would like to see more formal studies defining the benefits of lasers as a hair loss treatment, but he is encouraged by his experience with it to date.
Dr. Alan Feller (also a member of the Coalition) is one doctor who remains skeptical. "Medical lasers work in only one way, and that is to deliver energy to a target. When it strikes the target the energy is absorbed and converted to heat. That's it". Dr. Feller believes that more compelling evidence is needed to promote low level laser therapy (LLLT) as a hair regrowth solution or to stop hair loss.
study presented at the last International Society of Hair Restoration Surgery (ISHRS) meeting in Las Vegas (2007) by Maria A Muricy, MD, confirms increase in hair shaft diameter, fullness, and overall quality with laser hair treatment alone. Additionally, some statistically significant evidence reveals that low level laser therapy when combined with 5% minoxidil (the active ingredient in FDA approved Rogaine) provided noticeable cosmetic benefits for women in particular. However, this study also showed that laser hair loss treatment alone produced no statistically significant new hair growth in both men and women.
Another important issue to consider is the significance and meaning of the FDA clearance (not approval) of the Hairmax laser comb. Though some have proposed the Hairmax laser comb was only approved for safety, apparently the FDA did require Lexington International (who funded the study) to provide it with a study on its efficacy (effectiveness) in treating baldness. But this study and its results have not been released to the public since Lexington International had the option of submitting the study to the FDA privately. The obvious question then is – why would Lexington hide their study from the public if it proved the efficacy of laser hair regrowth?
While the Hairmax laser comb device was found by the FDA to be safe based on its “substantial equivalence” to previously approved laser light therapy devices and thus “cleared” (not “approved”), it was unclear to what extend the FDA reviewed or cleared it based on its effectiveness in treating hair loss. To learn more about the FDA standards for “approving” food and drugs and for “clearing” medical devices visit www.fda.gov
It appears that much of the laser hair treatment industry is now promoting their devices as “FDA Approved for Hair Loss” as if they are on par with the two only FDA approved hair loss solutions Propecia (finasteride) and Rogaine (minoxidil). However, until laser hair treatment provides compelling public evidence of its effectiveness in treating hair loss, it is quite possible that the effectiveness of low level laser therapy may be oversold by some companies. We expect that time will tell.
This hair loss product, meant for women, is a synthetic form of Progesterone, a hormone and steroid that occurs naturally in the ovaries. The body uses the Progesterone treatment to control a variety of functions. These include the regulating of the menstrual cycles, anticancer properties, the slowing and prevention of bone loss and ensuring the female sexual organs’ health. Another important function of Progesterone is to maintain the hormone balance of estrogen.
But in regards to hair loss, Progesterone treatment is an effective DHT-inhibitor. However, there has not been much research conducted as to Progesterone’s impact to male and female pattern baldness (MPB, FPB). What research was conducted showed that it may be effective at stopping hair loss, but not at hair regrowth.
Nevertheless, topical Progesterone has been used by some European dermatologists in Europe to treat MPB and FPB. For this, they only used 1% or 2% topical concentrations, and no more than 40mg a day. Researchers believe that higher doses could cause menstrual irregularities.
Topical Progesterone is available as capsules, vaginal creams and suppositories. Patients use the medication by rubbing it into the body’s soft areas, such as the breast, abdomen, inner thighs and the palms of the hands (which is thought to be the most effective area).
It’s advised that women use about 1/8-1/2 teaspoon, once to twice daily, for 21days. Physicians also advise women to stop using the medication for 5-7 days each month. They also advise women to change the application areas periodically.
Alopecia is the medical name for hair loss to the scalp or body. While Androgenetic Alopecia (genetic hair loss) is the most common, there are many other forms of alopecia related hair loss worth discussing. Each medically named alopecia comes with distinct symptoms, a unique cause and exclusive treatments. Below, we've compiled a list of and description for the most common types of alopecia related hair loss along with the available treatment options for each.
While the information on this website can be used as a guide, men and women who believe they are experiencing hair loss should always be properly diagnosed by a qualified hair restoration physician to determine its cause. To learn more about each distinctive alopecia hair loss condition, click the links below.
Traction Alopecia
Alopecia Areata
Diffuse Patterned Alopecia
Diffuse Unpatterned Alopecia (DUPA)
Cicatricial alopecia (Scarring Alopecia)
Alopecia Universalis and Alopecia Totalis
To date, the only two FDA approved hair loss treatments include Propecia (finasteride) and Rogaine (minoxidil). However, a number of alternative oral and topical products are marketed daily as effective hair regrowth solutions. Though there is no question that marketing often over-reaches in order to sell a product, the real question balding men and women ask is, is there any proof that these products are effective in treating baldness? What is the chance of regrowing hair?
For centuries men and women have been rubbing hair loss products including solutions, ointments, treatments and concoctions on their thinning hair in the hope of stimulating hair regrowth. In ancient Egypt it was popular to rub the fats of various animals, including lions, hippopotamuses, crocodiles, ibex, serpents and geese, onto the scalp as a hair loss cure.
Hippocrates had a personal interest in finding a treatment for baldness as he suffered from hair loss. He developed a number of different treatments, including a mixture of horseradish, cumin, pigeon droppings, and nettles to the scalp. These concoctions failed miserably and he became prominently bald. These and other treatments failures have continued to disappoint balding men and women.
Today topical hair loss products such as special shampoos, conditioners, Rogaine, various scalp treatments, and cover up products can offer a potentially helpful adjunct to more effective and proven treatments such as Propecia (finasteride), Avodart (dutasteride), and or surgical hair restoration. However, many of the claims made by these topical treatments are unproven and even false.
In addition to a multitude of topical hair loss treatments available, there’s an abundance of oral supplements that are conjectured to treat baldness. Most oral solutions include ingredients that attempt to stop hair loss by inhibiting the production of DHT, the hormone responsible for androgenic alopecia (male pattern baldness). However, much like topical treatments, very little proof exists for the majority of these claims.
Many products such as Provillus, Procerin, and Extreme Hair Therapy include both an oral and topical solution that attempt to stop hair loss at its source while working to stimulate hair follicles. But how effective are these topical, oral and all-in-one solutions?
DHT Blockers– These topical such as Revivogen, Crinagen, Progesterone Creams, and Xandrox claim to minimize the amount of dihydrotestosterone (DHT) present in the balding scalp. They are applied directly to the scalp.
Growth Stimulators- These topical solutions claim to work by stimulating hair growth. They include Rogaine, Tricomin, Folligen, Proxiphen (along with Prox-N and Nano Shampoo) and Retin-A.
Azelaic Acid– An active ingredient found in popular topical hair loss treatments such as Xandrox and Provillus conjectured to inhibit the production of DHT.
Superoxide Dismutase– These topicals such as Tricomin, Proxiphen, Proxiphen-N and Folligen, claim to stop hair loss by reducing Super Oxide and also stimulating hair growth and reducing tissue inflammation.
Anti-Inflammatories- These anti-inflammatory treatments claim to reduce itching, flaking, redness, and inflammation that may increase hair loss. These topical treatment options include Tricomin, Folligen, Proxiphen and Proxiphen-N, Betadine and T-Gel and Nizoral Shampoo.
Cover Ups / Concealers- Topically applied scalp/hair cover ups like Toppik, Prothik, and Couvré can do a surprisingly good job of masking and minimizing a person’s appearance of being bald. These topical concealers and “cover ups” act by reducing the contrast between a hair loss sufferer’s thinning hair and balding scalp, while increasing the volume and fullness of the thinning hair.
Rogaine (Minoxidil)) – Applied twice daily to the balding areas, this treatment has only been shown to work in the crown (back of the head). It is the only topical treatment for hair loss that is FDA approved.
Propecia (Finasteride)– An FDA approved oral hair loss solution proven to inhibit the production of DHT, the hormone responsible for genetic male pattern baldness (MPB).
Provillus– A popular oral and topical solution containing FDA approved hair regrowth solution minoxidil and a number of all-natural ingredients that supposedly inhibit the production of DHT
Saw Palmetto– A popular herbal treatment contained in many marketed hair loss products including but not limited to Provillus, Procerin, and Extreme Hair Therapy (EXT)
Extreme Hair Therapy (EXT) – A nonsurgical 5 step hair loss treatment process provided by Hair Club
Xandrox– Topical hair loss solution containing azelaic acid and FDA approved hair regrowth solution minoxidil
Revivogen– Topical hair loss solution containing a number of all natural ingredients said to inhibit the production of DHT
Crinagen – A topical spray containing ingredients said to inhibit the production of DHT
Progesterone– A synthetic form of the female hormone progesterone that has been used to treat female hair loss
TRX2- TRX2 is marketed to hair loss suffering men and women and claims to help promote and sustain healthy hair growth through potassium channels.
To learn more about these and other treatments, see what real patients are saying about them on our hair loss forum.