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.
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.
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 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.
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.
Well, maybe that’s a new adage from instagram, but it’s true all the same: eyebrows are the essential defining feature of every woman’s face. That’s exactly why eyebrow loss can feel like a death sentence to the beauty-conscious woman. With thick, lush eyebrows in style, eyebrow loss can feel more traumatizing than ever. Hair one day, gone the next!
While you wait for your doctor’s recommendations to take effect, you can mask the problem with a high-quality eyebrow gel. Unlike eyebrow pencils that can lead to a brow that looks drawn on, an eyebrow gel enhances your eyebrow shape with a soft color and strong hold. We like Laura Mercier Eye Brow Gel, available at Nordstrom for $20. Prior to using the gel, pencil in small sections of the brow that may be entirely bare of hair. Using a pencil sparingly will prevent a brow line that’s too harsh for your face.
Toxic alopecia occurs when there is a disruption of hair growth in the anagen phase. This usually occurs following chemotherapy and radiotherapy.[94] Radiotherapy for various types of ocular tumors, eyelid and choroidal tumors have been reported to produce madarosis.[95–97] Hair loss due to radiation is usually reversible, but may be permanent when the dose of radiation is in the range of 50 to 60 Gy.[94]
Topic prostaglandin analogues are used for the treatment of glaucoma. Uniocular increase in length, thickness, and pigmentation of the lashes were described by Johnstone in 1997 by patients using latanoprost in one eye.[184] There are reports of a response of alopecia of eyelashes to cutaneously administered latanoprost,[185,186] though others report limited success.[187] Eyelash growth has also been reported following bimatoprost 0.03% topically to the base of the eyelashes in healthy individuals[188–190] and in individuals with alopecia areata.[191] Bimatoprost ophthalmic solution 0.03% is the only Food and drug administration (FDA)-approved product to safely and effectively enhance the growth of a patient's own eyelashes.[192,193]
When this process is disrupted you end up with thinner hair, increased hair loss, a failure to regrow new hair and all in all a super sad experience! No one love losing their hair and it’s such a huge source of upset for women I work with but I’ll be honest, it is often the last thing to change as we work through getting your hormones and metabolism more balanced. It’s simply not your body’s priority.

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.
Giorgos Tsetis: Hair loss completely shattered my confidence, and losing your confidence in modeling isn't a good thing. It was a very high price to pay. For eight years I was struggling, trying different solutions, searching for answers, not knowing what was going on. It was exhausting to say the least. So, when I made the decision to close down my company and started working on Nutrafol, people really thought I was crazy. They wondered why I was taking the chance of getting into this industry. To me, it wasn't really a choice, because there was nothing on the market that was healthy, accessible and helping the other 80 million people who are effected in the United States. We wanted to help ourselves, but really help others by making a valuable product that addressed an unsolved issue.
The first step in treatment is to identify the cause of the hair loss. Then, treat it appropriately. If an internal cause is the culprit, it should be addressed — for example, thyroid medication for thyroid disease or supplements for a nutritional deficiency. External skin conditions are often treated with topical medications, and, once treated, the hair loss usually recovers. I often recommend Latisse as an adjunctive treatment. Though frequently associated with eyelash lengthening, it is a great option for thickening brows. In fact, people with brows that thin with aging (I typically don't see this in women under 50) may want to opt for Latisse.

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Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.

Hansen’s disease – Hansen’s disease, popularly known as leprosy could cause loss of eyebrows. This condition is cause by infection of a bacterial known as mycobacterium leprae and if it affects your eyebrows region, you expect to lose some eyebrows i.e. if it affects your eyebrow skin region, a place it often afflicts, you could suffer from permanent eyebrow hair loss as ‘Tulay Cakiner-Egilmez, Ph.D., R.N’ reports in ‘Journal of the American Society of Ophthalmic Registered Nurses’. This and other infections that can cause loss of eyebrows.


Women using oestrogen supplementation or taking birth control pills will also experience hair loss when they cease supplying their body with extra oestrogen. These forms of hair loss may be temporary but this, however, does not mean that there is no link between oestrogen and permanent hair loss. Scientists have noted up to 30 hormones that could play a role in female pattern hair loss – the genetic kind of hair loss – and oestrogen, whilst poorly explored, may be one of them. It’s alright if the excess hairs are the ones that are lost but when normal hair falls out, there’s a problem.

Giorgos Tsetis: I am an entrepreneur and have an engineering background that allows me to think in strategic ways to solve complex problems. Of course, I did have this very personal experience. But, to be honest with you, getting into this category wasn't directly a choice, it felt more like destiny. I say that, because their are literally millions who suffer from what I was suffering from. Aside from being a model, I owned an engineering company in New York, and business was steadily growing. The tipping point came when I found out the University of Washington published research that said my issue could cause permanent sexual dysfunction without the specific drug I was taking. That's when I panicked, reached out to my business partner and dear friend, and we begun to dig deeper into the issue. As we started diving deep, we recognized there was a tremendous white space.
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.
Giorgos Tsetis: I am an entrepreneur and have an engineering background that allows me to think in strategic ways to solve complex problems. Of course, I did have this very personal experience. But, to be honest with you, getting into this category wasn't directly a choice, it felt more like destiny. I say that, because their are literally millions who suffer from what I was suffering from. Aside from being a model, I owned an engineering company in New York, and business was steadily growing. The tipping point came when I found out the University of Washington published research that said my issue could cause permanent sexual dysfunction without the specific drug I was taking. That's when I panicked, reached out to my business partner and dear friend, and we begun to dig deeper into the issue. As we started diving deep, we recognized there was a tremendous white space.
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.

Other hair loss conditions that may be of an autoimmune nature that can involve the loss of eyebrows such as an underactive thyroid or vitiligo are termed “markers of underlying conditions”. It would be a trichologist’s responsibility to highlight these to the GP for further testing, these can also be investigated privately. In addition, there are conditions such as nutritional deficiencies like pernicious anaemia (unable to store B12) and of course anxiety and stress hair loss which can cause an overall reduction in the hair density. Patients attending with this concern often report that their general density is less dense.
Mistakenly thought to be an exclusively male disease, women make up a significant percentage of hair loss sufferers all around the world. Forty percent of women have visible hair loss by the time they are age 40. After menopause, that number increases even more. Hair loss in women can be absolutely devastating for self-confidence, self-image and emotional well-being. Although it is not a life threatening disease and sometimes underestimated by physicians, hair loss can take an emotional toll that directly affects physical health. Hair is an important part of woman’s face and beauty, therefore it is not easy for any woman to face changes that affect the quality and especially the quantity of her hair. Hair loss in women is a serious life-altering condition that shouldn’t be ignored and has to be diagnosed and treated in the best possible way.
Protein: When the body does not get enough protein, it rations the protein it does get. One way the body can ration protein is to shut down hair growth. About 2 to 3 months after a person does not eat enough protein, you can see the hair loss. Eating more protein will stop the hair loss. Meats, eggs, and fish are good sources of protein. Vegetarians can get more protein by adding nuts, seeds, and beans to their diet.
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.
When your body goes through something traumatic like child birth, malnutrition, a severe infection, major surgery, or extreme stress, many of the 90 percent or so of the hair in the anagen (growing) phase or catagen (resting) phase can shift all at once into the shedding (telogen) phase. About 6 weeks to three month after the stressful event is usually when the phenomenon called telogen effluvium can begin. It is possible to lose handful of hair at time when in full-blown telogen effluvium. For most who suffer with TE complete remission is probable as long as severely stressful events can be avoided. For some women however, telogen effluvium is a mysterious chronic disorder and can persist for months or even years without any true understanding of any triggering factors or stressors.

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.


Hormones are cyclical. Testosterone levels in some men drop by 10 percent each decade after thirty. Women's hormone levels decline as menopause approaches and drop sharply during menopause and beyond. The cyclic nature of both our hair and hormones is one reason hair loss can increase in the short term even when you are experiencing a long-term slowdown of hair loss (and a long-term increase in hair growth) while on a treatment that controls hair loss.
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While these factors contribute to hair loss for any woman, it’s particularly dicey for those of us with PCOS because when the follicle is exposed to our elevated androgens such as DHT (di-hydro testosterone, an active metabolite of testosterone) it gets damaged. Whenever a cell is damaged it generates oxidative stress which further alters the androgen receptor in the follicle perpetuating the issue.
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