Recent research, focused on the biologic and genetic basis for certain types of hair loss, is resulting in new treatment options that are important to women as well as men.
Would it surprise you that 40 percent of hair loss sufferers are women? If that sounds high – we just don’t see that many bald women – it’s because hair loss in women is less obvious than it is in men. Women lose hair differently – instead of the receding hairline, and complete loss of top-of-head hair seen in bald men, in women the hair simply thins. Women can also choose a hairstyle that masks the loss.
Dr. Panagiotis Mitropoulos, a Doctor of Osteopathic Medicine at Advanced Dermatology & Cosmetic Surgery in Vero Beach, says that hair loss in women is a complicated issue, with many causes. “Some amount of hair loss comes naturally with age,” he says. “There are hereditary causes and immune system causes. In women, there are often hormonal and dietary factors.” While maintaining a healthy weight has obvious benefits, women must be careful not to deprive their bodies of protein and other nutrients, as this can lead to hair loss beyond that associated with the aging process.
The most common cause of hair loss in both men and women is androgenetic alopecia, a hereditary condition in which the hormone DHT – a derivative of testosterone – binds to and shrinks hair follicles. As men have higher levels of testosterone, their hair loss is more pronounced, resulting in what is known as male pattern baldness.
People with androgenetic alopecia have a couple of non-invasive treatment options:
• Minoxidil (Rogaine) which is applied to the scalp and is intended to stimulate hair growth. Dr. Mitropoulos says he will recommend it as an easy treatment, but in his experience it helps retain existing hair rather than grow new hair. “The results I’ve seen aren’t all that great,” he says.
• Finasteride (Propecia) a drug that lowers DHT levels and therefore stops the progression of hair loss. It can cause fetal mutations if used by women of childbearing years, so it must only be used by women who are past menopause.
Another common causes of hair loss in women is telogen effluvium. It occurs when the body is put through extreme stress, and as a result shifts to a “hair shedding” phase. Stress factors that can lead to telogen effluvium are childbirth, surgery, and malnutrition; the hair loss becomes apparent six to twelve weeks after the stressful event.
Certain medications can also cause telogen effluvium; Dr. Mitropoulos mentioned cancer drugs specifically. “They arrest growth of cancer cells; they also arrest the growth of hair follicles,” he said. Other medications that can cause telogen effluvium include antidepressants, beta blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Thyroid disease – both hypothyroidism and hyperthyroidism – is more common in women and can cause hair loss. Hypothyroidism (too little thyroid hormone) is the much more prevalent of the two forms; with it, hair can become brittle and break more easily. In hyperthyroidism, metabolism speeds up; this, too, can cause hair loss. Fortunately, both of these conditions are highly treatable once diagnosed.
Another genetic form of hair loss, occurring in both men and women, is alopecia areata, an autoimmune disease affecting about 2 percent of the U.S. population. The immune system misfires, and attacks cells in hair follicles; while this can result in complete baldness, usually the hair falls out in small patches.
There is one form of hair loss, seen mostly in women, that is mostly avoidable. Traction alopecia is trauma to the hair roots due to repeated pulling; this can be caused by tight ponytails, barrettes that hold the hair tightly, cycling helmets that pull on the same area of hair, headbands, tight hairpieces and hair rollers.
Dr. Marc Glashofer, a fellow of the American Academy of Dermatology, told Medical News Today, “Most recent groundbreaking hair research is attempting to define the biologic and genetic basis for certain types of hair loss. This obviously has value to both sexes [including women].” A recent study, from the Sanford-Burnham Medical Research Institute in California, claims to have found a way to generate hair growth using human stem cells. It has only been tested in mice, but the researchers say it has the potential to be more effective than current hair transplant methods, and could be used to treat a variety of conditions which cause hair loss.
A new outpatient procedure called Platelet Rich Plasma (PRP) also has had early promising results, although there is no definitive clinical proof that it works. The patient’s own blood is drawn, and spun in a centrifuge to extract the plasma. Nutrients are then added to the plasma, and the resulting mixture is injected in one inch intervals into the top of the scalp. The treatment requires eight sessions at two week intervals; it can be used alone or with other treatments. Dr. Mitropoulos says, “In theory, it sounds great. Whether it actually works is another matter.”
Dr. Mitropoulos spoke to us of “low level laser therapy” which can be done at home via a hand-held device; it is geared to both women and men with hereditary hair loss. Research results vary, but it seems as if, when used consistently over many weeks, it works to stabilize further hair loss in about 90 percent of patients and stimulate hair regrowth in about half. It does not seem to have any undesirable side effects, but the device is not inexpensive; it runs a few hundred dollars.
While there are more treatment options available than there were just a few years ago, Dr. Mitropoulos says it’s also important to determine and, when possible, treat the underlying cause of the hair loss. This is important if the cause is something other than androgenetic alopecia – which is entirely hereditary and not preventable.
Advanced Dermatology & Cosmetic Surgery is located at 49 Royal Palm Pointe #100 in Vero Beach; the office phone is 772-569-5056.
