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Distress can also come from more than a change in body image. Dlova et al. (2016) found that in a group of black South African women, 52% reported serious worry that others would mistakenly assume that their hair loss was secondary to HIV infection or AIDS. It is critical that clinicians who care for such patients be compassionate and understanding but also have a solid understanding of hair loss so that reasonable expectations can be established and a therapeutic relationship can develop.


When men have hereditary hair loss, they often get a receding hairline. Many men see bald patches, especially on the top of the head. Women, on the other hand, tend to keep their hairline. They see noticeably thinning hair. The first sign of hair loss for many women is a widening part. In rare cases, men see noticeably thinning hair. And in rare cases, women can see a receding hairline or bald patches. The reasons for this are unknown.

You can buy minoxidil over the counter, for about $25 for a three-month supply. But you’ll also need to invest some patience. Minoxidil can take six months or even a year to work. Dr. Avram estimates that the drug, which must be applied twice a day, stops hair loss in 80 percent of the women who use it properly and it can actually stimulate hair regrowth in about half the users.


It is perfectly normal for people to shed 50 to 100 hairs per day. This generally doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time that hair is shedding. However, hair loss occurs when this hair growth cycle and shedding is disrupted or when the hair follicle becomes destroyed and replaced with scar tissue. Female pattern hair loss (androgenetic alopecia) is the most common form of hair loss in women. This occurs gradually and is caused by genetics (from either side of the family), age, and the action of a specific male hormone, dihydrotestosterone (DHT). This hormone is found in lesser amounts in women and it preys on the hair follicles, preventing them from receiving vital nutrients for proper hair follicle growth, leading to the hairs shrinking, and resulting in a shorter lifespan. Interestingly, DHT does not need to be elevated to generate hair loss. Estrogen, when lowered as commonly seen in menopause, creates a change in the ratio of male to female hormones, giving an edge to these male hormones. Compounded with the sensitivity of DHT to the hair follicles, heredity can affect the age at which a woman begins to lose her hair, as well as the rate of hair loss and the extent of baldness. 
If, however, you aren’t so sure that any of the causes listed above are a problem for you, then a good place to start may be to talk with your healthcare provider about testing. It is important to learn the root cause – especially if dealing with infertility – because that which is causing hair thinning and shedding may also be contributing to your inability to conceive.
Contact dermatitis causes skin inflammation and when severe it can affect the hair follicles as well. It can either be due to some irritant making contact with the skin of the eyebrows or due to a substance to which a person has an allergy. This gives rise to the two types of contact dermatitis – irritant contact dermatitis or allergic contact dermatitis. Substances that could cause contact dermatitis at the eyebrow includes eye makeup including eyebrow pencils, hair removal creams and waxes, other cosmetics, hair dyes and scalp hair styling products.
Hansen's disease, also known as leprosy, is an infection of the skin and nerves caused by the bacterium Mycobacterium leprae. The disease often affects the skin of the eyebrow region, leading to loss of sensation and permanent loss of the eyebrow hairs. There are numerous other rare and uncommon causes of eyebrow hair loss, including vitamin A toxicity, nutritional disorders and other dermatological disorders. If you experience loss of eyebrow hair, see your doctor to evaluate the cause and to discuss a treatment plan.
Androgenetic alopecia, a type of hair loss commonly called male or female pattern baldness, was only partially understood until the last few decades. For many years, scientists thought that androgenetic alopecia was caused by the predominance of the male sex hormone, testosterone, which women also have in trace amounts under normal conditions. But while testosterone is at the core of the balding process, dihydrotestosterone (DHT) is now thought to be the main culprit.
There are numerous nonsurgical treatments that when combined, can offer significant hair improvements. Dr. Yaker’s TCHR Volumizing Glycolic Acid Shampoo and Conditioner help restore vitality to the hair by deep cleaning the scalp and reestablishing lost moisture content and physiological pH to the scalp and hair. Dr. Yaker has also formulated his own oral supplement, which is a blend of Aminoplex hair repair vitamins. This is made up of amino acids (building blocks of protein) that produce keratin, which makes up close to 97% of our hair. In addition, Dr. Yaker’s specially compounded FDA approved topical medication, Minoxidil (brand name: Rogaine®), is clinically proven to help slow down, stop and even reverse hair loss in women. Other nonsurgical therapies offered are Low Level Laser Therapy (LLLT) using the advanced LaserCap®, and Platelet Rich Plasma (PRP) with placenta-derived extracellular matrix therapy to help restore thinning hair. Lastly, Dr. Yaker offers scalp and facial micropigmentation where permanent ink is applied to the skin, creating micro dots that replicate the natural appearance of hair. This is used for the scalp and eyebrows.
Liver support: is necessary to eliminate unneeded wastes from the body. Everything we take in is processed through the liver and toxins are broken down into water soluble byproducts so they can be moved into the intestine and pulled into the stool for elimination. Foods like cruciferous vegetables (kale, broccoli, collard greens) and lemon support the liver detox pathways. Herbs like milk thistle, dandelion root, and burdock root help to support  liver cleansing.

Androgenic alopecia, hair loss when androgen levels are not too high, is an indicator of inflammation. Hair loss is just one sign of inflammatory issues like Celiac disease or gluten intolerance. Naturopathic Doctor Lara Bridden says, “Inflammation hyper-sensitizes your hair follicles to a normal amount of androgen. Reduce inflammation by avoiding food sensitivities such as wheat and/or dairy, and by correcting intestinal permeability.”

Before you start hormone replacement therapy, it's important to talk to your doctor about the possible risks and negative effects versus the benefits of HRT. If you're already at an increased risk for health conditions like heart disease, cancer, and blood clots, HRT may not be the best hair loss treatment for you. If you are prescribed HRT, it important to take the lowest doses that are effective, and to only take the drugs for the shortest amount of time needed to control symptoms.
There are a lot of myths out there about balding men. One of them is that men with MPB are more virile and have higher levels of testosterone. This isn’t necessarily the case. Men with MPB may actually have lower circulating levels of testosterone but higher levels of the enzyme that converts testosterone to DHT. Alternately, you may simply have genes that give you hair follicles that are highly sensitive to testosterone or DHT.
Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: al-oh-pee-sha). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called “perms”) may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.
In men, finasteride (originally marketed as Proscar) is approved for hair loss associated with androgens. In one study, 62% of women also taking oral contraceptives containing the synthetic progestin drospirenone reported improvement. So it may be effective for female hair loss in the setting of increased androgen. But studies are limited and it is harmful to the male fetus so should not be used by women thinking about becoming pregnant or who are pregnant.
DLE is an autoimmune condition and is the most common form of chronic cutaneous lupus erythematosus.[35] Clinically, the lesions start as discoid erythematous patches which then develop into plaques with follicular plugging and scaling. Eyelid findings include blepharitis, lid scarring, entropion, and ectropion. Scaly plaques on the eyelids with loss of hair follicles results in madarosis[60] [Figure 3]. Numerous studies have reported the mimicking of a chronic blepharitis by DLE.[35,61–63] A high index of suspicion is necessary in such cases, where the diagnosis is very often delayed by months to years.[35] Biopsy with histopathological examination should be done to confirm the diagnosis. Treatment with hydroxychloroquine results in a regrowth of the eyelashes.[61]
Estrogen, the power player in women’s bodies, is your friend when it’s appropriately balanced. It makes you feel energized, helps stabilize your moods and contributes to a healthy sex drive. Yet too much estrogen, which can be caused by weight gain, perimenopause or toxicity from exposure to endocrine disruptors (which are rampant in our food, water and plastic products), can lead to thinning hair. During and after pregnancy, for example, estrogen levels peak and then dip, causing sudden hair loss for many women.

Insulin, that helper hormone in charge of regulating blood sugar levels, also affects a number of different body processes, including fat storage, heart health and, you guessed it, hair growth. One study published in the European Journal of Cardiovascular Risk found that women with some markers of insulin resistance have a greater risk for androgenic alopecia (AGA), or female pattern baldness.
If you’re in good health but would like your brows to be a bit fuller, you’ve got plenty of options. Massage a bit of moisturizing coconut oil into your eyebrows about three times weekly, to make for healthier, shinier and more eye-catching hair. Eyebrow pencils remain an effective choice as a go-to filler; go a shade lighter than your brows for a natural look. To shake things up a bit, opt for a brow shadow. These powders, which look like eye shadow, go on with a brush and fill in thin or patchy brows with a soft and subtle fullness.
Interestingly, 40% of the genes causing male pattern baldness were located on the X chromosome. You inherit that chromosome from your mother. By analyzing all these genes, researchers could also make a “scorecard” which predicts what risk a man runs for experiencing hair loss based on his genes. The hope is that in the future, this could be refined and used to prevent early signs of hair loss.
 Estrogen dominance is an extremely common imbalance and it can fuel thinning hair as well as an arms-length list of annoying symptoms, from bloating and PMS to irregular periods and infertility. Your first, best step in clearing excess estrogen from the body is doing a liver supportive detox. My 4-Day Hormone Detox has you eating fresh, nourishing foods for three meals a day, plus snacks. You won’t feel hungry or deprived and, most importantly, you will help kickstart hormonal healing. A hormone detox is one of the best first steps you can take to reverse thinning hair.
When compared with no treatment, patients who received ethinyl estradiol 50 μg and cyproterone acetate 2 mg with cyproterone acetate 20 mg on days 5 to 20 of the menstrual cycle for 1 year had a significant increase in their percentage of anagen hairs with trends toward a larger shaft diameter of full anagen hairs and a decreased number of hairs that were less than 40 microns (Peereboom-Wynia et al., 1989). A 12-month randomized control trial of 66 women compared treatment with topical minoxidil 2% plus an oral contraceptive (ethinyl estradiol 30 μg + gestodene 75 μg) with treatment with cyproterone acetate 50 mg plus an oral contraceptive (ethinyl estradiol 35 μg + cyproterone acetate 2 mg) and demonstrated that treatment with cyproterone was more effective in hyderandrogenic patients but otherwise less effective (Vexiau et al., 2002). Side effects of cyproterone acetate include weight gain, breast tenderness, and a decreased libido (Kelly et al., 2016). Hepatotoxicity and development of multiple meningiomas may occur when doses exceed 25 mg daily (Medicines and Healthcare products Regulatory Agency, 2009). Cyproterone acetate is used widely in Europe and Canada, either in an isolated form or in combination with ethinyl estradiol, but it is only available in the United States as an orphan drug for the treatment of hirsutism (Carmina and Lobo, 2003, Jurzyk et al., 1992, Kelly et al., 2016). Cyproterone acetate is classified as pregnancy category X.
In this section, our Houston Hair Transplant Team discusses current trends in hair loss and restoration research with published experts. We choose our interviewees based on those who have had NIH or Medline indexed published medical research that is peer-reviewed. The list will be organized by country and then alphabetically by physician last name. Click on the name to read about the latest research in thinning hair and hair restoration from around world. We thank our specialists below for giving us the valuable time and sharing of insight. We are deeply grateful and honored to have had the privilege to get the insight provided by these world renown specialists
Every child deserves the opportunity to just be a kid—to fit in and feel normal. Kids experiencing hair loss don’t get that chance. That’s why we offer the Hair Club For Kids® program. Hair Club For Kids provides non-surgical hair replacement services, completely free of charge, to children ages 6-17 who are suffering from hair loss. These services are available at all Hair Club locations throughout North America to help reach as many kids as possible. Call 800-269-7384 for details. 
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