Hair Loss

 Common Causes of Hair Loss in Men and Women

Androgenic Alopecia-More than 95% of hair-loss in men is due to this condition. Women can also be affected by this common type of hair loss.

FACT: Most people normally shed 50 to 100 hairs a day. But with about 100,000 hairs in the scalp, this amount of hair loss shouldn’t cause noticeable thinning of the scalp hair- The Mayo Clinic

FACT: Almost half of all people have inherited hair loss by about 50 years of age.

Poor Nutrition-Usually complete baldness is not seen in people with nutritional deficiencies, thinning of the hair is more common. Studies show that limited food intake and deficiencies in certain nutrients can cause thinning. These include deficiencies of biotin, amino-acids (protein), zinc, and iron. Consuming a diet high in animal fat, such in fast food, can also have a negative effect on hair loss.

Stress-Stress has been shown to restrict the blood supply to capillaries which prevents oxygen and nutrients from reaching the hair follicle which can prevent hair growth. This effect is similar to having poor circulation.

Medications-Some medications can cause hair loss, especially medications which affect hormone levels. These medications include contraceptive pills, some forms of hormone replacement therapy, anabolic steroids, and acne medication. Other medications which can have an effect on hair loss include those for blood pressure problems, diabetes, heart disease, and cholesterol.


Hair Loss in Women

Although it’s very common for men to lose hair as they age, many women will experience some degree of hair loss during their lifetime as well.

Hair loss (formally known as “alopecia”) generally falls into two categories scarring and nonscarring alopecia. Scarring alopecia is so named because it’s created when inflammation within and around the hair causes the follicle to “scar over”. A few examples of this type of alopecia would include that seen in Lupus, a condition called Lichen Planus, and certain deep hair follicle infections. The bad news with scarring alopecia is that the scarring can permanently destroy the follicle and prevent regrowth of the affected hair. The good news, though, is that the ‘scarring’ alopecias are less common. Even when they do occur, further scarring (and permanent hair loss) can be prevented if properly diagnosed and treated early into its course.

There are a number of socalled nonscarring alopecias. As the name implies, they are not associated with scarring and therefore do not permanently destroy the hair follicle. In other words, the hair is physically capable of regrowing. The two most common examples of nonscarring alopecia are androgenetic alopecia and telogen effluvium.
Androgenetic alopecia results when an individual’s hormones (androgens) cause certain follicles to shrink and eventually shed their hair. Exactly which follicles become sensitive to the effect of these hormones is determined by the genetics of the individual hence the name androgenetic alopecia. This is essentially the “female version” of hair loss that men tend to experience. Although such hair loss in women is usually less pronounced, it tends to be more diffuse. Generally speaking, the “female pattern” of androgenetic hair loss is seen as mild to moderate thinning throughout the entire top of the scalp. In contrast to the alopecia which occurs in men, it very rarely causes the front hairline to recede.

Telogen effluvium is the second most common cause of hair loss in women and its underlying cause is very unique. What happens in telogen effluvium is that hair growth is suspended when our body senses that we are experiencing significant stress. This stress can take the form of significant psychological stress (new job, death in the family, etc.) or even physiological stress (surgery, pregnancy, etc.). Remember that our body senses ‘stress’ as a threat to our survival With telogen effluvium, hair production is halted in response to stress because the body feels that the resources normally devoted to hair growth are better utilized elsewhere. Usually, only 10-15% of hairs are in the dormant (‘telogen’ phase), but when significant stress occurs, as much as 70% of hairs can quit growing. The affected hairs will then gradually shed over the following months.



Hair Loss in Men

Male Pattern Baldness, also known as “Androgenic Alopecia”, is the most common cause of hair loss and will affect up to 70% of men, at some point in their lifetime. People who suffer from this type of hair-loss have an underlying sensitivity to “hair follicle miniaturization” due to androgenic hormones. Miniaturization refers to the shrinking of the hair follicle which results in the thinning or loss of hair. Dihydrotestosterone (DHT) is the primary hormone associated with the miniaturization of hair follicles. DHT is a by-product of the hormone Testosterone, found in both men and women although typically much higher in men. Testosterone converts naturally to DHT through a hormonal pathway called 5 Alpha Reductase. Certain hairs on your head may genetically susceptible to thin if exposed to excess levels of DHT. DHT can attach to the hair follicle and prematurely make it shed while shrinking the follicle which prevents normal hair re-growth. Instead of normal, healthy hair re-growing in its place, a thinner, finer hair replaces it.

According to the Foundation for Hair Restoration, the onset of miniaturization from androgenic alopecia is due to three factors.

  • Genetic predisposition- Miniaturization of hair is genetic, the genes come from either parent or both.
  • Presence of Dihydrotestosterone – The presence of DHT is the second factor
  • Age – The older you are, the more likely you are to experience miniaturization of your hair


Platelet-Rich Plasma Injections for Hair Restoration

Dermablue provides Platelet-Rich Plasma (PRP) injections as part of an integrative approach to restore your hair and prevent the further loss of your hair.

PRP is an exciting non-surgical therapeutic option for patients who require stimulation of hair growth for hair loss conditions. Human blood contains stem cells, which contain specific growth factors that assist in tissue regeneration and healing.    PRP contains many growth factors that stimulate the hair follicle’s growth. The primary purpose of using PRP in hair restoration is to stimulate inactive or newly implanted hair follicles into an active growth phase.

Blood is drawn in our office as though you are having routine blood testing at your primary care physician’s office. The blood is spun in a centrifuge and the PRP is separated and removed from the rest of the blood. The highly concentrated platelet rich plasma (PRP) is then injected into the scalp.  There is very little discomfort and no downtime.  There is good medical evidence to support the use of PRP for hair growth in men and women.


Who is a good candidate for PRP Hair Restoration?

In the medical treatment of male and female pattern baldness (androgenetic alopecia), PRP can be injected into the balding scalp to potentially stimulate thin (miniaturized) hair to grow into thicker (terminal) hairs. Patients with thinning, but not totally bald, areas would be the best candidates.

Who is not a good candidate for PRP?

If the hair follicles are entirely lost, the treatment will not work. Patients who have lost their hair follicles completely require hair transplant surgery.

PRP Safety and Contraindications

PRP is safe and natural because the procedure concentrates the good cells from your own blood and injects them directly back into the area where it is needed. PRP is immunologically neutral and poses no danger of allergic, hypersensitivity or foreign-body reactions.

Post Treatment

A brief period of inflammation at wound sites may be experienced by a patient after application of PRP. Inflammation may be associated with release of platelet-associated factors at the wound site. In addition, the scalp is usually tender for a few days after the procedure.

Treatment Schedule

After the initial treatment, a second treatment is recommended at 4 weeks and then repeated every three months for the first year. After the first year, treatments are administered every 6-12 months depending upon your response.

Hormone and Hair Loss

Hair thinning and loss is common with aging. Testosterone and thyroid deficiency (or thyroid excess) can cause hair to become finer, losing body, wave and shine. Hair becomes dry and brittle, breaking easily. The scalp becomes dry and may flake or itch. Like other cells in the body, skin and hair follicles require adequate levels of hormones to remain healthy. Even after a patient receives hormones, the damaged hairs may continue to ‘fall out’. When thyroid deficiency or excess is corrected, it may take months to see the new hair growth. With testosterone therapy, the skin and scalp become healthier and new hair growth is noticeable within a month.

Some people may be confused over the term ‘androgenic alopecia’. This refers to male pattern baldness and is not usually associated with testosterone or androgen excess. Hair loss, in postmenopausal women is NOT associated with androgen excess.  At Dermablue, we see significant hair loss in women who have low testosterone.  Rarely, women with high levels of androgens may experience ‘male pattern’ hair loss if they convert testosterone to DHT in the scalp/ hair follicle.  DHT is the metabolite of testosterone that can cause hair loss. The conversion can be blocked by a medication called Finasteride. Lowering the dose of testosterone may help. Also, low estrogen may contribute to hair loss. Estrogen therapy may be added in women who do not ‘aromatize’ or make enough estrogen from testosterone.