Hair loss may also occur due to dieting. Franchised diet programs which are designed or administered under the direction of a physician with prescribed meals, dietary supplements and vitamin ingestion have become popular. Sometimes the client is told that vitamins are a necessary part of the program to prevent hair loss associated with dieting. From a dermatologists’s standpoint, however, the vitamins cannot prevent hair loss associated with rapid, significant weight loss. Furthermore, many of these supplements are high in vitamin A which can magnify the hair loss.
Madarosis is a terminology that refers to loss of eyebrows or eyelashes. This clinical sign occurs in various diseases ranging from local dermatological disorders to complex systemic diseases. Madarosis can be scarring or non-scarring depending upon the etiology. Appropriate diagnosis is essential for management. Follicular unit transplantation has been found to be a useful method of treating scarring madarosis and the procedure relevant to eyebrow and eyelash reconstruction has been discussed. A useful clinical approach to madarosis has also been included for bedside diagnosis. The literature search was conducted with Pubmed, Medline, and Google scholar using the keywords madarosis, eyebrow loss, and eyelash loss for articles from 1960 to September 2011. Relevant material was also searched in textbooks and used wherever appropriate.
At Hair Club, you can be part of a well-established, stable company with more than 40 years of success. We are the industry leader in providing hair loss solutions. Our company culture is fun, fast-paced, empathetic and comes with a conscience. Not only do we make a difference in the lives of our clients every day, we also contribute to the community locally through our charitable and volunteer programs. If you’re enthusiastic, motivated and confident, we’d love to talk to you about joining our team of hair restoration professionals.

Eyebrow thinning that manifests in irregular patches, especially accompanied by red and itchy skin, may indicate atopic dermatitis. This condition—commonly called eczema—can occur just about anywhere on the body and is usually hereditary. People with atopic dermatitis may be more sensitive to topical irritants, but eczema just from topical irritants is called allergic contact dermatitis or irritant contact dermatitis. While you wait on the appointment with your dermatologist, you can help ease eczema around the eyebrows by switching to mild soaps or a soap-free facial cleanser, and applying an intensive facial moisturizer within three minutes after bathing.
Low iron and low B12 can arise from a variety of causes including autoimmunity, poor intake, depletion due to medications (i.e. antacids) or bad digestion and are common causes of hair loss. But other common nutrient deficiencies can arise as part of a less than stellar diet low in zinc, protein (especially the amino acid lysine) or a deficiency of vitamin B6 (a very common issue with women taking hormones like the birth control pill). Low vitamin D has also been linked to excessive hair loss as has excessive vitamin A intake (less common.)

Topical estrogen and progesterone creams and oral medications are generally the forms prescribed for post-menopausal women with androgenetic alopecia. But HRT will rarely, if ever, be prescribed for treatment of hair loss alone.] If you have other bothersome symptoms which might warrant HRT, in addition to hair loss, you'll first need to undergo a thorough gynecologic and physical exam, and will likely have blood tests done to measure hormone levels before these drugs are prescribed.
Hair loss in women isn't always as straightforward as it is in most men. In men, about 95 percent of all cases are caused by male pattern baldness. In women, however, hair loss can be triggered by a multitude of conditions and circumstances. During the consultation, Dr. Yaker utilizes specialized hair and scalp scanning technology to assess the distribution of hair loss, hair thickness, and how much hair is present in a particular area. It is important to note, that for women, a proper diagnosis begins with a process of elimination. More than one cause for the hair loss may coexist and need to be recognized or excluded. A comprehensive medical history, which includes a list of all medications, history of hair loss, a thorough scalp exam, a discussion of medical and skin disorders, and a complete nutritional evaluation will be needed. Blood work analysis may be required, and a scalp biopsy may also be performed if the cause of hair loss is uncertain or there is a concern for scarring alopecia.

Thyroid hormone receptors were detected in both dermal and epithelial compartments of the human pilosebaceous unit.[48] T4 and T3 decrease the apoptosis of hair follicles and T4 prolongs the duration of anagen in vitro.[49] Thyroidectomy delays initiation of anagen. Administration of thyroxine advances anagen, initiation of which is however delayed once toxic doses are given. Therefore, ratio of telogen to anagen hairs is increased in hypothyroidism as well as hyperthyroidism.[50] Thus, the hair follicles are affected in thyroid disorders, and madarosis is caused due to disturbances in hair cell kinetics. Hypothyroidism is associated with generalized hair loss probably due to coarse, dull, and brittle hair with reduced diameter.[51] The eyebrows and eyelashes may also be lost. Loss of lateral one-third of eyebrows known as Hertoghe sign[38] is a characteristic sign of hypothyroidism.[52] Some people also refer to it as Queen Anne's sign,[53] after Anne of Denmark whose portrait with shortened eyebrows has been interpreted by some as indicative of the presence of goiter, even though such a fact has not been proved by any known sources of information. Madarosis may even be the presenting sign in hyperthyroidism.[21] In hyperthyroidism, there is thinning with breaking off and shortening of hair.[54] Madarosis can also occur in hypopituitarism, hypoparathyroidism,[21] and hyperparathyroidism.[55]
The hormonal process of testosterone converting to DHT, which then harms hair follicles, happens in both men and women. Under normal conditions, women have a minute fraction of the level of testosterone that men have, but even a lower level can cause DHT- triggered hair loss in women. And certainly when those levels rise, DHT is even more of a problem. Those levels can rise and still be within what doctors consider "normal" on a blood test, even though they are high enough to cause a problem. The levels may not rise at all and still be a problem if you have the kind of body chemistry that is overly sensitive to even its regular levels of chemicals, including hormones.
“When I went in for my Bosley consultation, my senior counselor was the one who walked me through the procedure. He also had had the procedure done, and his results were phenomenal. And I was thinking, ‘Wow, if I can get that, that’s what I’m looking for.’ He really got it — he understood me. He understood what I went through, and that was really important to me.
Balancing your hormones is not an easy process, whether you are in perimenopause, menopause, or post-menopause. You may find that just one of these herbs is sufficient to do the trick, but in many cases you will achieve the best results by taking a combination of herbs. Start gradually and track your results carefully to make sure you are choosing the right products to balance and adjust your particular hormone profile.

Hair transplants and restoration is an area of medicine that is included in the primary training of two main medical specialties recognized by the ACGME. These 2 specialties are Dermatology & Plastic Surgery. Within these fields, doctors from around the world have worked on advancing our understanding of hair loss. The history of restoration is very interesting and many of the advances can be reviewed right here on our website. We are greatly appreciative of our predecessors work.
For other women, the problem with estrogen dominance is that they’re also experiencing lower levels of progesterone relative to estrogen—and progesterone helps protect hair follicles from the hair-thinning effects of testosterone, DHT, and estrogen. Evidence suggests that progesterone may act as an aromatase inhibitor and other research suggests that the genes involved in aromatase activity are implicated in female hair loss.
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.”
Physicians such as dermatologists and plastic surgeons have long recommended essential vitamins and supplements for hair growth to women and men. Now read why top medical experts including Dr. Craig Ziering and Dr. Steven Dayan have been telling their patients for years about Viviscal hair growth supplements to help grow thicker, longer and healthier looking hair.
MICHAEL REED, MD: Over-the-counter minoxidil, which is the brand Rogaine, is FDA approved. It's been shown to be effective in scientific studies. Propecia is the new drug on the block, and that probably is more effective. It's a pill that you take once a day, and that has been shown to slow down hair loss and grow hair in a significant number of individuals. Most of the other preparations that are heavily advertised or marketed are not proven to be effective.

The most common type of hair loss seen in women is androgenetic alopecia, also known as female pattern alopecia or baldness. This is seen as hair thinning predominantly over the top and sides of the head. It affects approximately one-third of all susceptible women, but is most commonly seen after menopause, although it may begin as early as puberty. Normal hair fall is approximately 100-125 hairs per day. Fortunately, these hairs are replaced. True hair loss occurs when lost hairs are not regrown or when the daily hair shed exceeds 125 hairs. Genetically, hair loss can come from either parents side of the family.
Hormonal changes are a common cause of female hair loss. Many women do not realize that hair loss can occur after pregnancy or following discontinuation of birth control pills. It is important to remember that the hair loss may be delayed by three months following the hormonal change and another three months will be required for new growth to be fully achieved.
Dozens of other causes of eyebrow loss are also possible including a variety of infectious, autoimmune and inflammatory conditions. Consultation with a dermatologist or hair transplant surgeon is recommended. I strongly advise consulting a dermatologist before proceeding to hair transplantation for women over 40 with new onset eyebrow hair loss after age 40.
“When I went in for my Bosley consultation, my senior counselor was the one who walked me through the procedure. He also had had the procedure done, and his results were phenomenal. And I was thinking, ‘Wow, if I can get that, that’s what I’m looking for.’ He really got it — he understood me. He understood what I went through, and that was really important to me.
The hormonal process of testosterone converting to DHT, which then harms hair follicles, happens in both men and women. Under normal conditions, women have a minute fraction of the level of testosterone that men have, but even a lower level can cause DHT- triggered hair loss in women. And certainly when those levels rise, DHT is even more of a problem. Those levels can rise and still be within what doctors consider "normal" on a blood test, even though they are high enough to cause a problem. The levels may not rise at all and still be a problem if you have the kind of body chemistry that is overly sensitive to even its regular levels of chemicals, including hormones.
Because there are a number of different factors that can contribute to hair loss, it’s best to ask your doctor for a few different tests. I recommend checking: fasting glucose, iron levels and complete blood count (which can determine if you have anemia), as well as thyroid, estrogen and testosterone levels. These assessments should give you a better understanding of what hormonal issues may be at the root of your problem.
Hair loss is one of the most irritating and worrisome issues anyone would ever have to meet with. It is obvious that there are various reasons which may cause hair loss in individuals. One of the causes of hair loss can be a low level of estrogen hormone. There is a connection between estrogen and hair loss. In this current article, we will talk about if low estrogen can cause hair loss and also know of ways to prevent it. Hope this would be a beneficial read for you.
A. I think it's a personal preference, but why is a cosmetic solution such a big deal? To use sprays, powders and hair extensions? It doesn't address the problem, but it can do wonders for your self-esteem. I see patients who are extremely depressed, and this is ruining their life. We always have hope for that miracle solution, but it's very hard to do research studies. … As much as this affects people's mentality, there's not a lot of (National Institutes of Health) funding because hair loss isn't killing anyone.
A decline of estrogen, whether due to menopause or other hormonal imbalances, can also affect hair growth. You'll experience a thinning or loss of pubic hair as well as hair on your scalp if you have low levels of estrogen in your body. You might also experience unwanted hair growth on your face during menopause, when your estrogen levels are at their lowest. This phenomenon occurs because the lack of estrogen leaves you with a hormonal imbalance of sorts; you have more androgens, or male hormones, than female hormones in your body, which contributes to some male-like symptoms such as body and facial hair.
Male pattern hair loss has been established as androgen-dependent because it is associated with changes in the androgen receptor and responds to antiandrogen therapy (Ellis et al., 2002). With FPHL, genes that encode aromatase, which converts testosterone to estradiol, are also implicated (Yazdabadi et al., 2008, Yip et al., 2009). The process of androgen biosynthesis is depicted in Figure 1.
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. 

The majority of women with androgenic alopecia have diffuse thinning on all areas of the scalp. Men on the other hand, rarely have diffuse thinning but instead have more distinct patterns of baldness. Some women may have a combination of two pattern types. Androgenic alopecia in women is due to the action of androgens, male hormones that are typically present in only small amounts. Androgenic alopecia can be caused by a variety of factors tied to the actions of hormones, including, ovarian cysts, the taking of high androgen index birth control pills, pregnancy, and menopause. Just like in men the hormone DHT appears to be at least partially to blame for the miniaturization of hair follicles in women suffering with female pattern baldness. Heredity plays a major factor in the disease.
Also, what we tend to forget is that while it’s easy for most women to recognize financial, emotional or overwhelm type stress, we also have internal metabolic and biochemical stresses like anemia, inflammation and nutrient deficiencies that we are often less aware of. Diet and exercise can also become stresses. It is well known that low calorie dieting or excessive exercise are commonly associated with hair loss.
Scurf refers to the scales and greasy crusts that accumulate along the hair shaft and indicates the presence of seborrhea.[26,27] Collarettes are composed of hard fibrinous scales[25,28] surrounding each individual eyelash. They travel upward along with the growth of the lashes and are indicative of staphylococcal infection. Sleeves or cylindrical dandruff comprise scales that form a cuff around the lash root and are connected with it, in contrast to greasy scales which are not connected to the lash root.[29] Sleeves indicate infestation with Demodex folliculorum.

Giorgos Tsetis: Consumers are lost, and that's the sad part about it. You have a serious problem, you go on the internet and see thousands of products making similar claims, and you can't choose. Most likely, you're going to try the cheapest product with the most compelling claims, realize it doesn't work, and only add further stress. When an industry is not properly regulated, this is the result. Education is such a big component of what we do. Reverse engineering a solution requires a tremendous amount of time and research. What we did was connect all these dots reading hundreds of pages of scientific literature. Education, when it comes to this, is broken into education for the physicians and education for the consumers. It's always hard to educate, because what you're really doing is changing behavior. Slowly but surely, we're actively changing the mindset of physicians and consumers, evolving the way they view and treat hair loss. That is huge, and one of the key reasons Unilever invested in the company. What we did was raise the bar by introducing a new category in the medical channel that remained untapped. That's how we disrupted the market, where now you see hundreds of doctors using Nutrafol as a trusted alternative for men and women. We also have several writers in the company who imagine how we can make this world simple and digestible for people. We want consumers to make smart choices.


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Here is one small European study which looked at 20 pre-menopausal women with female pattern hair loss to check their serum levels of estradiol, free and total testosterone, SHBG, LH, FSH, and DHEAS. These levels were compared to those of a control group without hair loss. Estradiol is one of the three naturally occurring forms of estrogen found in the body.
Yeah right! The way Policing works in this country now if you stopped someone giving a cop a good hiding the same cop would then nick you for assaulting his attacker. NO CHANCE! The police got themselves into this by not doing their jobs properly and PROTECTING innocent people. Now? What trust and support there ever was for them is almost gone.....by their own hand.

Hair loss in women is not easy to diagnose because it is very often multifactorial in etiology and thus requires well-designed specific steps so that the patient is evaluated properly. The best way to do this is to evaluate the patient in person (rather than sending photos via email or Skype) because the patient gets a chance to meet her doctor to permit the development of a trusting relationship- critical because very often the treatment of hair loss is an involved process that requires a strong doctor-patient relationship.
If you’ve gotten through this list and still don’t know what’s going on, it’s time to talk to your doc. Unfortunately, madarosis–typically used to mean the loss of eyelashes, but also referring to the loss of brows–may be due to many, many things, including a number of vision and life-threatening conditions, like herpes zoster, leprosy, HIV/AIDS, trachoma, malignant eyelid tumors, discoid lupus, scleroderma, and hypothyroidism (Khong, Casson, Huilgal, Selva; Survey of Opthamology, 2006). Brow and lash loss are both indicators of underlying diseases, so yes get to your doc stat.
There are a couple of other reasons why soy is a great choice too. For one, it is really good for you, protecting your cardiovascular health by reducing your LDL cholesterol levels. For another, soy is an easy, cost-effective choice. Instead of searching everywhere for quality herbal supplements you are unfamiliar with, you can simply add some soy milk to your diet or eat some tofu.
Alopecia areata is a patchy hair loss associated with immune disturbances. In this condition the immune system attacks the hair follicles thereby impairing hair growth. It is more likely to occur in people with other immune-related disorders and has also been linked to psychological stress as well as with certain drugs like some types of ARVs used for HIV treatment. Alopecia areata does not only affect the scalp as commonly thought. The eyebrows and beard area, as well as hairy parts anywhere on the body may be affected.
Thyroid hormone receptors were detected in both dermal and epithelial compartments of the human pilosebaceous unit.[48] T4 and T3 decrease the apoptosis of hair follicles and T4 prolongs the duration of anagen in vitro.[49] Thyroidectomy delays initiation of anagen. Administration of thyroxine advances anagen, initiation of which is however delayed once toxic doses are given. Therefore, ratio of telogen to anagen hairs is increased in hypothyroidism as well as hyperthyroidism.[50] Thus, the hair follicles are affected in thyroid disorders, and madarosis is caused due to disturbances in hair cell kinetics. Hypothyroidism is associated with generalized hair loss probably due to coarse, dull, and brittle hair with reduced diameter.[51] The eyebrows and eyelashes may also be lost. Loss of lateral one-third of eyebrows known as Hertoghe sign[38] is a characteristic sign of hypothyroidism.[52] Some people also refer to it as Queen Anne's sign,[53] after Anne of Denmark whose portrait with shortened eyebrows has been interpreted by some as indicative of the presence of goiter, even though such a fact has not been proved by any known sources of information. Madarosis may even be the presenting sign in hyperthyroidism.[21] In hyperthyroidism, there is thinning with breaking off and shortening of hair.[54] Madarosis can also occur in hypopituitarism, hypoparathyroidism,[21] and hyperparathyroidism.[55]

Physicians such as dermatologists and plastic surgeons have long recommended essential vitamins and supplements for hair growth to women and men. Now read why top medical experts including Dr. Craig Ziering and Dr. Steven Dayan have been telling their patients for years about Viviscal hair growth supplements to help grow thicker, longer and healthier looking hair.


It takes more than just an apple a day to keep the doctor away; if your diet lacks the key vitamins A, B, D and E or nutrients such as iron, calcium or the amino acid L-lysine, your hair may suffer. Nutrient deficiency doesn’t just affect the eyebrows—it may lead to hair loss on the scalp, feelings of fatigue and physical weakness, lightheadedness or inhibited concentration, heart palpitations and pale skin, among other serious symptoms.
Hair loss is something that everyone experiences sooner or later, but some get it earlier than others. Losing hair prematurely can be traumatic. Because of that, there is an infinite number of products that claim to cure and reverse the problem. But what if you could find out the likelihood that you will experience hair loss so that you could prevent it before the symptoms even showed? Researchers in the United Kingdom have reportedly found a way to predict who is at risk.
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.
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The role of estrogen and progestogen drugs in the treatment of hair loss and growth is also unclear. Estrogen is made when androstenedione or testosterone are modified by the enzyme aromatase. It is synthesized in the ovary and other peripheral tissues and then travels to its receptors, some of which are located in scalp hair follicles (Thornton et al., 2003a, Thornton et al., 2003b). At the scalp follicle, estradiol has been reported to induce aromatase activity (Hoffmann et al., 2002). Estrogen has been hypothesized to have a protective role against hair loss on the basis of the observation that patients with lower estrogen levels during menopause, postpartum, or treatment with aromatase inhibitors or selective estrogen receptor modulators are more likely to develop FPHL (Atanaskova Mesinkovska and Bergfeld, 2013, Park et al., 2014). Another supporting observation is that in the frontal hairline of women, which tends to be spared with FPHL, there is a higher level of aromatase enzyme when compared with the rest of the scalp (Levy and Emer, 2013). This variation in hair loss could be the result of locally increased levels of estradiol or decreased levels of testosterone and DHT that is secondary to greater amounts of conversion.

Other important vitamins for eyebrow hair growth to consider include vitamin B complex especially vitamin B-12, B-7 (biotin), can ensure healthy hair and skin. In addition, vitamin D can help in hair growth by creating new pore and thus a possibility of more hair (see more on Stem Cells Translational Medicine. Finally ensure you have zinc, enough protein, and omega 3 fatty acids.
“…a beauty editor told me she had been using Viviscal... Since beauty editors see truckloads of products every week, I was immediately convinced when she said it worked – so I bought it myself. I started taking it twice a day for the first six months and saw dramatic results within three to four months. My hair was less thinned out …and it was also less brittle. I’ve gone to the same hairdresser since I was 19, and he was the first to comment on how full and strong my hair looked…”
Skin Conditions: There are tons of skin conditions like eczema, psoriasis, seborrheic dermatitis or an infection in the hair follicle that can cause itching, redness, and inflammation around your eyebrows. Scratching the skin around that area can cause your hair to fall out. However, since you’re not damaging your hair follicle in this case, your eyebrow hair can grow back in a few weeks’ time.

If you are suffering from hair loss on your head AND your brows, you might be suffering from a protein deficiency of some sort. A supplement like Viviscal (available here), which is packed with marine protein, could help your condition. Viviscal has been shown to treat alopecia areata, as well as androgen-related hair loss (Journal of International Medical Research, 1992; FutureDerm). It will take some time, though: changes in protein in the diet have been shown to correspond with protein in the hair within 6-12 months (American Journal of Physical Anthropology, 1999; Futurederm).
The first thing you'd want to try is to talk to your doctor about stopping the medicine -- ask if there's a substitute. If you can't find a substitute for the medication and you must take it, then you could consider filling in your eyebrows. You can find brow products at any local drugstore. YouTube has many, MANY brow tutorials you could learn from. 

Insulin regulation is also a big factor in hair health, as an imbalance can lead to various hormonal effects. Insulin helps to regulate blood sugar levels, which effects fat storage and hormone balance. Fat storage and hormone balance play a role in hair growth because fat storages will secrete excess estrogen in the body, and can desensitize hormone signals.  
The startup recently closed its Series A round of funding, with Unilever Ventures, the investment and private-equity vertical of the consumer goods company, stepping in as the lead investor. Unilever was introduced to Nutrafol through investment platform, CircleUp. The investment from Unilever Ventures, along with other strategic partners, will be used to advance research efforts, product development and expand within the medical, salon and e-commerce channels. With continued investment in research and clinical studies, Nutrafol is poised to take the lead in the fragmented multibillion-dollar global hair loss industry.

The real culprit appears to be dihydrotestosterone (DHT), a more potent form of testosterone. DHT is made from testosterone by a specific enzyme in the body, and while both testosterone and DHT are known to have a weakening effect on hair follicles, there appears to be something unique about the conversion process of testosterone to DHT that relates to thinning hair. This is why some drugs that are marketed for hair loss block the conversion of testosterone to DHT. (It’s important to note, however, that these drugs tend to be less effective in women than men, and that one of them—finasteride—is only approved for hormonal hair loss in men, not women. What’s more, the drug has been associated with increased risk of sexual side effects, depression, nausea, hot flashes, and increased estrogen levels—and too much estrogen is its own risk factor for thinning hair; more on that below.)
Male pattern baldness is connected to the male sex hormone androgen. So naturally, reducing your stress levels will also reduce the risk of suffering from the different symptoms that stress cause. You can reduce stress by practicing mindfulness and yoga. You can also cut down on work and make sure to get enough sleep. Minimize your exposure to negative people or experiences. Spending time in nature and exercising also contribute greatly to your mental health.
Estrogen and combined oral contraceptive (COC) drugs with estrogen or progestogen have been reported as effective, but data are limited (Adenuga et al., 2012, Raudrant and Rabe, 2003, Scheinfeld, 2008). They are thought to function through several mechanisms. Both components of COC drugs increase the levels of sex-hormone-binding globulin (Schindler, 2013). They also send negative feedback signals that suppress the hypothalamic secretion of gonadotropin and releases the hormone and pituitary secretion of the luteinizing and follicle-stimulating hormones, which results in a decreased androgen production (Gilman et al., 1990, Varothai and Bergfeld, 2014). These actions decrease androgen secretion from the ovary and the quantity of free, biologically active androgens, which reduces their effects on the hair follicles (Schindler, 2013). Our practice when prescribing COC drugs is a combination of ethinyl estradiol 20 mcg plus drospirenone 3 mg. Drospirenone is an analogue of spironolactone. This treatment combination is approved by the FDA for the treatment of acne but not alopecia.

Lichen planopilaris and frontal fibrosing alopecia inflammatory conditions, in which the inflammation destroys the hair follicle, can cause a scar or permanent hair loss (usually present as red patches with redness and scale around each hair follicle). In the very advanced stages, they may appear as smooth, bald patches where the hair follicles have been destroyed. Androgenetic hair loss is another non-scarring type. The most common type of hair loss, it is due to the complex interplay of genes, hormones, and age.
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