Treatments May Minimize Hair Loss in Both Men and Women
By Erinn Hutkin Special From U-T San Diego
Television commercials tell us that hair loss in men and women can be easily solved with this or that treatment. But while there are treatments that do help, it's best to talk to your doctor about available options rather than buy into the advertising.
The problem of hair loss is widespread among men and women, said Dr. Richard Chaffoo, surgical director of La Jolla Hair MD. In fact, he said, one study showed 16 percent of men ages 18 to 29 had moderate to extensive hair loss, and by age 40 to 49, more than 53 percent of men are affected. The same study showed two-thirds of men begin balding by age 60, and by age 80, 75 percent of men have lost their hair.
While several factors contribute to hair loss, genetics appear to be the leading indicator as to whether one will shed hair as they age.
Dr. Doris Day, a dermatologist who specializes in laser, cosmetic and surgical dermatology in New York City, tells patients the three most common types of loss include the following:
- Hereditary hair loss. Day said hereditary hair loss accounts for 95 percent of all hair loss in men and women. "Hereditary hair loss can come from the mother's or father's side, and those with a family history may be more likely to experience the condition," she said.
- Telogen effluvium (temporary hair loss). This can be triggered by hormonal changes after pregnancy, thyroid conditions and other stressors such as crash-dieting and the use of medications such as blood thinners, anti-anxiety medications, chemotherapy and steroids. Unlike hereditary hair loss, this condition is temporary and hair typically grows back on its own.
- Alopecia areata. This is an autoimmune condition that causes round patches of hair loss. Hair can grow back or fall out again at any time.
In addition, excessive shampooing, styling, coloring and over-processing the hair can cause thinning of the hair and some temporary hair loss.
Chaffoo said more than 95 percent of hair loss in men is male pattern baldness, or MPB, which is characterized by the frontal hairline receding and/or thinning in the crown area.
While he said the genetics of MPB are not entirely understood and there are most likely multiple genes involved, it's thought to be caused by the male hormone dihydrotestosterone (DHT) working on genetically susceptible scalp hair follicles. DHT causes hair loss by shortening the growth phase, producing progressively shorter, finer hairs that ultimately disappear.
However, it's not just men who suffer from hair loss. Day said while thinning hair is common in women, it's talked about a lot less. In fact, she said one in three women notice hair thinning in their lifetime, with the most extensive hair loss often occurring on the top of the head and along the part.
Similar to men, she said the onset of female pattern hair loss can start between puberty and the 20s, with a second peak in the early 40s. Another cause is menopause, which leads to decreased estrogen production in women, which, in turn, can cause hair to become thinner.
"Left untreated, hair thinning can worsen over time," she said.
According to an online study of 1,000 Americans ages 18 and older called "Hair Today, Gone Tomorrow: The Myths & Truths Behind Thinning Hair and Hair Loss" – which was conducted by Wakefield Research in 2009 — 50 percent of Americans believe there's no effective treatment for hair loss.
"I see many people with hair loss and I see how much it can affect their self-esteem, even in the early stages when the thinning or loss is not readily visible to others," Day said. "I understand it's especially important to recommend treatments and solutions that really work and have strong science behind them."
For those suffering from hair loss, there are treatment options available. Chaffoo said the two most effective treatments are minoxidil — better known as Rogaine — and propecia (Finasteride). He said Rogaine is most effective for preserving existing hair, and clinical studies show the greatest effect on the crown.
"It's unlikely to regrow hair, but it seems more effective to stabilize your existing hairline," he said.
Day explained that Rogaine previously had a 5-percent formula for men and a 2-percent liquid formula for women, but a new 5-percent foam formula for women was recently introduced.
Chaffoo said the other drug, Finasteride, inhibits the production of follicle-harming DHT, which shrinks hair follicles and makes it difficult for healthy hair to survive. He said it works well to prevent hair loss and trigger regrowth for most men, and it may work for some women.
He said the best treatments are usually initiated after a person has already noticed hair loss. While he said both Finasteride and Rogaine are helpful to stabilize existing hair loss, they aren't foolproof.
"No other methods have any scientific evidence of efficacy in arresting or reversing hair loss," he said. "Claims that laser combs, special shampoos and other over-the-counter regimens are helpful are merely anecdotal and have not stood up to scientific scrutiny."
For instance, Day said while volumizing and thickening products may temporarily help hair appear thicker, they will not regrow hair.
In addition to medications, Chaffoo said there are surgical options available. One of the most promising for male pattern baldness and for select women is a hair transplant method called the Neograft hair restoration device.
He said the FDA-approved device allows surgeons to harvest individual follicular units from the back of the head, an area where follicles are resistant to DHT. From there, he said the units are suctioned into a saline reservoir for transplantation into balding areas in the scalp.
He said there's an average of 95 to 98 percent permanent growth. The donor area of the head heals without a scar. Hair begins to grow in the harvested area within a week, while transplanted follicles begin growing in the balding area after a few months, he said.
Day said as one ages, there are measures both men and women can take to prevent hair loss. Her suggestions include managing stress, which can accelerate hereditary hair loss and cause stress shedding; avoid over-processing the hair; start using Rogaine at the first signs of thinning; and investigate options such as laser therapy or Viviscal — natural hair growth supplements aimed at optimizing hair growth.