People looking for a treatment to help prevent or regrow hair have several potential options. The effectiveness of each option will vary from person to person and may depend on the cause of the hair loss. People should talk with a doctor before starting a new hair loss treatment or taking supplements.
Hair loss - Diagnosis and treatment
What is hair loss?
Most healthy people lose up to 100 strands of hair per day. When you start to shed more strands — and fewer or none grow back — the condition is considered alopecia (hair loss). There are several types of hair loss, and it can affect adults of any gender and even children. You may lose hair just on your head or from your body as well.
What are the types of hair loss?
Some types of hair loss are permanent, while others are temporary. The most common types of hair loss include:
- Androgenic alopecia: This type of hereditary baldness can affect anyone (male pattern baldness or hair loss in women.
- Telogen effluvium: This type of hair loss involves rapid shedding of hair in a short amount of time. It typically happens a few months after your body goes through something physically or emotionally stressful. It can also result from sudden hormonal changes.
- Anagen effluvium: This very rapid hair loss occurs due to certain medical treatments, such as chemotherapy.
How common is hair loss?
Baldness (androgenic alopecia) is the most common type of hair loss. It affects an estimated 80 million individuals in the U.S.
Hair loss is one of the most common side effects of chemotherapy. Alopecia areata affects up to 6.8 million people in the U.S.
Diagnosis
Before making a diagnosis, your doctor will likely give you a physical exam and ask about your diet, your hair care routine, and your medical and family history. You might also have tests, such as the following:
- Blood test. This might help uncover medical conditions that can cause hair loss.
- Pull test. Your doctor gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process.
- Scalp biopsy. Your doctor scrapes samples from the skin or from a few hairs plucked from the scalp to examine the hair roots under a microscope. This can help determine whether an infection is causing hair loss.
- Light microscopy. Your doctor uses a special instrument to examine hairs trimmed at their bases. Microscopy helps uncover possible disorders of the hair shaft.
Treatment
Effective treatments for some types of hair loss are available. You might be able to reverse hair loss, or at least slow it. With some conditions, such as patchy hair loss (alopecia areata), hair may regrow without treatment within a year. Treatments for hair loss include medications and surgery.
Medication
If your hair loss is caused by an underlying disease, treatment for that disease will be necessary. If a certain medication is causing the hair loss, your doctor may advise you to stop using it for a few months.
Medications are available to treat pattern (hereditary) baldness. The most common options include:
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Minoxidil (Rogaine). Over-the-counter (nonprescription) minoxidil comes in liquid, foam and shampoo forms. To be most effective, apply the product to the scalp skin once daily for women and twice daily for men. Many people prefer the foam applied when the hair is wet.
Products with minoxidil help many people regrow their hair or slow the rate of hair loss or both. It'll take at least six months of treatment to prevent further hair loss and to start hair regrowth. It may take a few more months to tell whether the treatment is working for you. If it is helping, you'll need to continue using the medicine indefinitely to retain the benefits.
Possible side effects include scalp irritation and unwanted hair growth on the adjacent skin of the face and hands.
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Finasteride (Propecia). This is a prescription drug for men. You take it daily as a pill. Many men taking finasteride experience a slowing of hair loss, and some may show new hair growth. It may take a few months to tell whether it's working for you. You'll need to keep taking it to retain any benefits. Finasteride may not work as well for men over 60.
Rare side effects of finasteride include diminished sex drive and sexual function and an increased risk of prostate cancer. Women who are or may be pregnant need to avoid touching crushed or broken tablets.
- Other medications. Other oral options include spironolactone (Carospir, Aldactone) and oral dutasteride (Avodart).
Hair transplant surgery
In the most common type of permanent hair loss, only the top of the head is affected. Hair transplant, or restoration surgery, can make the most of the hair you have left. During a hair transplant procedure, a dermatologist or cosmetic surgeon removes hair from a part of the head that has hair and transplants it to a bald spot. Each patch of hair has one to several hairs (micrografts and minigrafts). Sometimes a larger strip of skin containing multiple hair groupings is taken.
This procedure doesn't require hospitalization, but it is painful so you'll be given a sedation medicine to ease any discomfort. Possible risks include bleeding, bruising, swelling and infection. You may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery.
Surgical procedures to treat baldness are not usually covered by insurance.
Laser therapy
The Food and Drug Administration has approved a low-level laser device as a treatment for hereditary hair loss in men and women. A few small studies have shown that it improves hair density. More studies are needed to show long-term effects.
