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Don’t Let Hair Loss Tangle You Up: Dermatologists Can Identify Common Hair Disorders and Offer Solutions
Noticing a few extra hairs in your comb lately? Is your new hairstyle a result of trying to conceal areas of thinning hair rather than a fashion choice? Are you paying more attention to the multitude of advertisements promoting hair growth? If you answered yes to any of these questions, you might be one of the millions of people experiencing some form of hair loss. But to whom should you turn for help? The key to managing the condition is to consult a dermatologist, a physician trained in the diagnosis and treatment of all forms of hair loss.
Speaking today at the 66th Annual Meeting of the American Academy of Dermatology, dermatologist Amy J. McMichael, MD, FAAD, associate professor of dermatology at Wake Forest School of Medicine in Winston-Salem, N.C., discussed the most common forms of hair loss, current treatment options and possible futuristic therapies.
“For both men and women, hair loss can be devastating and adversely affect one’s overall quality of life,” said Dr. McMichael. “As with most medical conditions, the key to controlling the hair loss cycle is to seek treatment early. The problem is that most people tend to ignore the first signs of hair loss or delay treatment, hoping that their hair will regrow on its own. Since there are many types and causes of hair loss, it is vital that patients seek a proper evaluation by a dermatologist at the first sign of a problem.”
Androgenetic Alopecia (Pattern Hair Loss)
The most common form of hair loss, androgenetic alopecia (commonly referred to as male- or female-pattern hair loss) is a hereditary condition that affects men and women. In male-pattern hair loss, a receding hairline is common, as well as hair loss on top of the scalp. Women, on the other hand, typically maintain their frontal hairline but tend to have visible thinning over the front and top of the scalp. However, occasionally a man will experience female-pattern hair loss and a woman will show signs of male-pattern hair loss for reasons unknown to researchers.
A significant amount of research in male-pattern hair loss has identified the enzyme that can be blocked to stop the production of dihydrotestosterone (DHT), which is a byproduct of the male hormone testosterone that is linked to baldness in men. This research has led to the development of finasteride, the FDA-approved medication for treating male-pattern hair loss.
While the cause of female-pattern hair loss is not as clearly understood as male-pattern hair loss, Dr. McMichael discussed several treatment options that work well for many women. Currently, minoxidil 2 percent is the only FDA- approved treatment for female-pattern hair loss. Available over the counter in 2 percent and 5 percent solutions, minoxidil must be applied topically and works on hair follicles to reverse the shrinking process and stimulate new growth on the top of the scalp. Minoxidil also is FDA-approved for use by men.
“There are some cases where dermatologists will use other treatments off-label to treat hair loss in women, such as the anti-androgens spironolactone and flutamide that work by blocking the male hormone testosterone at the cellular level of the hair follicle,” said Dr. McMichael. “Even higher doses of finasteride have been used in women to regrow hair. But it is important that women – and especially younger women – see their dermatologist for hair loss, especially if other symptoms such as acne or abnormal menstrual cycles also are present. In some cases, hair loss along with these other symptoms may indicate a more serious medical condition, such as a tumor or polycystic ovary disease.”
Another proven technique for men and women looking to restore their hair is hair transplantation. Dr. McMichael noted that the technology involved in this surgical procedure has improved significantly over the years, with tiny hair grafts now being implanted through various new techniques to create a natural look that is virtually undetectable. However, Dr. McMichael cautioned that hair transplants are simply filling in lost hair and should still be used in conjunction with a topical or oral medical therapy to prevent further hair loss.