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.
Additionally, two other considerations are important for a patient who receives treatment for FPHL. First, there is a set of reasonable expectations in patients. Maintaining the current hair density can be considered a successful treatment because women tend to have further thinning as they age (Harfmann and Bechtel, 2015). Second, it is important to ensure that patients understand that progress is slow, and months or years can be required to see a significant improvement (Boersma et al., 2014, Yeon et al., 2011). In our practice, we wait at least 6 months to assess treatment efficacy.
The term “common baldness” usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.
Like with low thyroid, there can be a myriad of imbalances at play with PCOS related hair loss making it a complex issue that’s often written off as merely high testosterone. While androgen excess and hypersensitivity of the hair follicles to these hormones are part of the issue, these are other contributing factors to PCOS related hair loss as well:
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.
Eight of 69 eyes receiving intra-arterial chemotherapy with melphalan for retinoblastoma were found to develop a cutaneous periocular erythema with partial loss of eyelashes. Gobin et al. also reported a 12.6% incidence of madarosis following intra-arterial chemotherapy for retinoblastoma. Moti and Fausel described a case of cyclical alopecia areata including the eyebrows and eyelashes after treatment with paclitaxel and carboplatin. Other drugs which have been implicated in hair loss due to anagen effluvium are adriamycin, cyclophosphamide, daunorubicin, epirubicin, etoposide, ifosfamide, irinotecan, topotecan, vindesine, and vinorelbine.[98,113]
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. There are reports of a response of alopecia of eyelashes to cutaneously administered latanoprost,[185,186] though others report limited success. 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. 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]
In order to prevent drying and breakage, it’s best to stay away from heat tools, such as hair dryers and straightening irons. Extensions and other styling methods can also weaken your hair and cause early hair loss. If you must dye your hair, choose an all-natural hair color. Artificial chemicals found in dyes and perms can compromise your scalp and hair health. When you wash your hair, always use a nourishing conditioner to keep your scalp healthy and promote healthy hair growth.
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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.
Reproductive hormone changes can also play a part, and dermatologists believe the same factors that cause hair loss from the scalp, a common problem for women as they age, may contribute to thinning brows. Nanette Santoro, M.D., ob/gyn and professor of reproductive endocrinology at the University of Colorado at Denver, says, “Abrupt hormone changes can cause sudden hair loss (telogen effluvium) that recovers over about six months' time. It happens postpartum to many women and can happen at menopause.”
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.
There can be any number of different factors contributing to your hair loss. If you’re reading this and thinking, “well I have that and that, and am going through that,” then you may already have an idea of what is a contributing cause for you. You may already be doing much of what is suggested here and may learn of additional ideas to consider trying.