Hair loss can range from mild hair thinning to total baldness. Hair can fall out for many different reasons. Medically, hair loss falls into several categories, including:

Telogen effluvium — This common form of hair loss happens two to three months after a major body stress, such as a prolonged illness, major surgery or serious infection. It also can happen after a sudden change in hormone levels, especially in women after childbirth. Moderate amounts of hair fall out from all parts of the scalp, and may be noticed on a pillow, in the tub or on a hairbrush. While hair on some parts of the scalp may appear thinner, it is rare to see large bald spots.

Drug side effects — Hair loss can be a side effect of certain medications, including lithium, beta-blockers, warfarin, heparin, amphetamines and levodopa (Atamet, Larodopa, Sinemet). In addition, many medications used in cancer chemotherapy — such as doxorubicin (Adriamycin) — commonly cause sudden hair loss affecting the entire head.

Symptom of a medical illness — Hair loss can be one of the symptoms of a medical illness, such as systemic lupus erythematosus, syphilis, a thyroid disorder (such as hypothyroidism or hyperthyroidism), a sex-hormone imbalance or a serious nutritional problem, especially a deficiency of protein, iron, zinc or biotin. These deficiencies are most common in people on restrictive diets or in women who have very heavy menstrual flow.

Tinea capitis (fungal infection of the scalp) — This form of patchy hair loss happens when certain types of fungi infect the scalp. This causes the hair to break off at the scalp surface and the scalp to flake or become scaly. Tinea capitis is a common form of patchy hair loss in children.

Alopecia areata — This is an autoimmune disease that causes hair to fall out in one or more small patches. The cause of this condition is unknown, although it is more common in people who have other autoimmune diseases. When the same process causes total loss of hair from the scalp it is known as alopecia totalis.

Traumatic alopecia — This form of hair loss is caused by hairdressing techniques that do one of the following: pull the hair (tight braiding or cornrowing), expose hair to extreme heat and twisting (curling iron or hot rollers) or damage the hair with strong chemicals (bleaching, hair coloring, permanent waves). In addition, some people have an uncommon psychiatric disorder (trichotillomania) in which compulsive hair pulling and twisting can cause bald spots.

Hereditary pattern baldness, or androgenetic alopecia — In men, hair loss may follow the typical male pattern (receding front hairline and/or thinning hair at the top of the head). This is the most common type of hair loss, and it can begin at any time in a man's life, even during his teen years. It usually is caused by the interaction of three factors: an inherited tendency toward baldness, male hormones and increasing age. Many women will develop some degree of female-pattern baldness. In women, thinning occurs over the entire top or crown of the scalp, sparing the front of the scalp.

What is baldness?

Baldness, also known as alopecia, is hair loss, or absence of hair. Baldness is usually most noticeable on the scalp, but can occur anywhere on the body where hair grows. The condition is more common in men than in women.

What causes hair loss?

Hair loss is believed to be primarily caused by a combination of the following:

• aging
• change in hormones
• illness
• family history of baldness
• burns
• trauma

However, hair loss is not caused by the following:

• poor circulation to the scalp
• vitamin deficiencies
• dandruff
• excessive hat-wearing
• a gene passed on from an individual's maternal grandfather

Generally, the earlier hair loss begins, the more severe the baldness will become.

What are the different types of baldness?

Baldness can be classified into various types, depending on the cause. Several of the many different types of baldness include the following:

• female-pattern baldness
  Although less common, female-pattern baldness differs from that of male-pattern baldness in that the hair generally thins all over the head, but the frontal hairline is maintained. Female-pattern baldness rarely results in total hair loss.
• male-pattern baldness
  Male-pattern baldness usually is a hereditary condition. The condition may begin at any age. Hair loss often begins on the front, sides, and/or on the crown of the head. Some men may develop a bald spot or just a receding hair line, while others may lose all of their hair.
• alopecia areata
  This hair loss disorder is characterized by sudden loss of hair in one particular area, which grows back after several months. However, if all body hair is suddenly lost, regrowth may not occur. The cause of this type of hair loss is unknown.
• toxic alopecia
  Toxic alopecia may occur following a high fever or severe illness. Certain medications, especially thallium, high doses of vitamin A, and retinoids, may cause toxic alopecia. Medical conditions, such as thyroid disease, and after giving birth may also trigger toxic alopecia. The condition is characterized by temporary hair loss. Also, some cancer medications can cause hair loss.
• scarring alopecia
  Scarred areas may prevent the hair from growing back. Scarring may occur from burns, injury, or x-ray therapy. However, other types of scarring that may cause hair loss can be caused by diseases such as lupus, bacterial or fungal skin infections, lichen planus, sarcoidosis, tuberculosis, or skin cancer.
• trichotillomania (hair pulling)
  Hair pulling, a habit most common among children, may cause hair loss.

How is the type of baldness diagnosed?

In addition to a medical history and physical examination, a biopsy of the skin area may help to identify the type of baldness and/or its cause.

Treatment for baldness:

Specific treatment for baldness will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the condition
• your tolerance for specific medications, procedures, and therapies
• expectation for the course of the disease
• your opinion or preference

Most forms of baldness have no cure. Some types of baldness will disappear on their own. Treatment may include:

• certain medications to promote hair growth (such as minoxidil and finasteride)
• corticosteroid injections (when treating alopecia areata)
• treating any underlying condition or disease
• hair transplants
• scalp reduction
• skin lifts and grafts

What is hair replacement surgery?

The interest in hair replacement has significantly increased over the past 10 years. Two out of every three men, and one in five women, suffer from hair loss. For men, the main cause of a diminishing hairline is heredity. Hormonal changes such as menopause can cause both thinning and hair loss in women.

There are a number of hair replacement techniques that are available, although hair replacement surgery cannot help those who suffer from total baldness. Candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will serve as hair donor areas where grafts and flaps will be taken.

There are four primary different types of hair replacement methods, including the following:

• hair transplantation
  During hair transplantation, the surgeon removes small pieces of hair-bearing scalp grafts from the back or sides of the head. These grafts are then relocated to a bald or thinning area.
• tissue expansion
  In this procedure, a device called a tissue expander is placed underneath a hair-bearing area that is located next to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Another operation is then required to place the newly expanded skin over the adjacent bald spot.
• flap surgery
  Flap surgery is ideal for covering large balding areas. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply.
• scalp reduction
  Scalp reduction is done in order to cover the bald areas at the top and back of the head. This technique involves the removal of the bald scalp with sections of the hair-bearing scalp pulled together filling in the bald area.

Possible complications associated with hair transplantation procedures:

Possible complications associated with hair transplantation procedures may include, but are not limited to, the following:

• patchy hair growth
  Sometimes, the growth of newly placed hair has a patchy look, especially if it is placed next to a thinning area. This can often be corrected by additional surgery.
• bleeding and/or wide scars
  Tension on the scalp from some of the scalp reduction techniques can result in wide scars and/or bleeding.
• grafts not taking
  Occasionally, there is a chance that the graft may not "take." If this is the case, surgery must be repeated.
• infection
  As with any surgical procedure, there is the risk of infection.

Confronting the stigma of hair loss poses considerable psychological and emotional challenges for both men and women. For every five men with hereditary hair loss, three women experience the same condition. Yet women’s hair thinning remains a “taboo” subject for the media, the public and the woman herself. Women will talk to their friends about their beauty enhancements, but will not talk about her thinning hair concerns.

Hair thinning is common, among otherwise healthy women, and can begin in women as early as their twenties. Women need to better understand the various reasons why hair loss occurs and seek treatment options available to them. Thinning hair and hair loss can have a profound effect on self-image and self-confidence, causing women to feel unattractive, embarrassed and helpless.

It is important for anyone experiencing hair loss to remember that they are not alone, to confront their hair loss and take action to safely regain control of their appearance and self-esteem.

Female hair loss does not progress the same way it does with men. You do not see the same “male pattern baldness” with thinning crown and receding temples. It is more likely to be a diffuse thinning that could go unnoticed for years.

How Your Hair Grows

Your hair is made of keratin, the same protein that makes up your nails and the outer layer of your skin. The part you see and style is called the hair shaft. It’s actually dead tissue made by your hair follicles – tiny bulb-like structures beneath your scalp’s surface. The average head has about 100,000 hairs. Your hair grows and is shed regularly. But many factors can disrupt this cycle. About 90 percent of the hair on most people’s scalp is in a 4 to 5 year growth stage at any given time.

The other 10 percent is in a 2 to 3 month resting phase after which it is shed. Most people shed 50 to 100 hairs a day. Once hair is shed, the growth stage begins again as a new hair from the same follicle replaces the shed hair. New hair grows at a rate of approximately ½ inch each month although this slows as you age. Hair loss may lead to baldness when the rate of shedding exceeds the rate of re-growth, when new hair is thinner than the hair shed or when hair comes out in patches.

Did you know that over 20 million women in the United States are suffering from some type of hair loss? About 40% of them are also under forty years old. The emotional aspects of hair loss range from anxiety, depression, frustration and poor self-esteem. Fortunately there are more options available now to help slow down and even reverse hair loss.

The first and foremost important step in the search for answers is to educate yourself. Being proactive by researching information and seeking solutions is the best way to manage your treatment.

Unfortunately, treating and diagnosing female hair loss is not as simple and straightforward as male pattern baldness. Many physicians subscribe to the theory that women should immediately begin a regimen of growth stimulants (whether it be Rogaine for Women, or others). Like men's hair loss however, there are underlying causes, and the good news is that a large percent of women's hair loss is completely reversible. The general idea behind diagnosing and treating it involves a responsible informed physician and a series of tests to rule out, or rule in, the causes.

The most common causes of hair loss in women are hormonally related. Whether it is an overactive thyroid or the after effects of menopause or pregnancy, there usually is a "good" reason why women lose their hair. The key is to find out what the reason is, and to then evaluate your options in dealing with it.

It is extremely important to find a qualified physician to treat hair loss. A dermatologist is usually a good doctor to start with, as they specialize in treating skin diseases, including problems associated with hair and hair loss. A good starting place for finding a board certified dermatologist is through the American Academy of Dermatology’s website. Unfortunately, if your insurance carrier is enrolled in an HMO, you may not have the freedom in choosing a dermatologist. You will have take charge with your HMO to work with you, and coming in armed with all the appropriate information is the key to making the best of your situation.

As mentioned, preparing for your doctor’s visit can help you receive a more accurate diagnosis. This preparation includes a blood test and writing down or being aware of your hair loss and medical history by answering these questions:

-How long have you been losing your hair and when did it start?
-Is your hair falling out fully intact or is it breaking off?
-Do you have a family history of baldness?
-Or of diabetes, thyroid problems, asthma, arthritis, lupus, vitiligo, anemia, or Addison's disease?
-Are you on any medications, and if so, what are they?
-What does your normal diet consist of?
-Have you experienced sudden weight loss?
-Have you recently given birth, had a hysterectomy or gone through menopause?
-What kind of hair products do you use, and what do you use to style your hair?

Also, bringing in a picture of yourself prior to the hair loss, or some hairs that have recently fallen out may be helpful.

Blood tests are equally as important in accurately diagnosing hair loss. It is absolutely imperative to get these blood tests done:

-Hormone levels (DHEAS, Testosterone, Androstenedione, Prolactin, Follicular Stimulating Hormone, and Leutinizing Hormone)
-Serum Iron, Serum Ferritin, TIBC (Total Iron Binding capacity), Transferrin Saturation
-Thyroid Stimulating Hormone (TSH)
-VDRL
-Complete Blood Count (CBC)
-T4 Free

In conclusion, treating women's hair loss requires a knowledgeable physician, and the appropriate tests. Even if you are unable to find a qualified dermatologist, you can insist on having the above blood tests done. If an abnormality is found in your levels, any doctor should be able to give you direction on returning them to normal. A simple supplement or the appropriate medications should fix the imbalance, and result in full regrowth of your hair within a year.

Who Gets Alopecia Areata?

Anyone can have alopecia areata. It often begins in childhood. There is a slightly increased risk of having the disease if you have a close family member with the disease.

What Causes Alopecia Areata?

Alopecia areata is an autoimmune disease. Normally the immune system protects the body against infection and disease. In an autoimmune disease, the body's immune system mistakenly attacks some part of your own body. In alopecia areata, the immune system attacks the hair follicles.

The cause is not known. Scientists think that a person's genes may play a role. For people whose genes put them at risk for the disease, some type of trigger starts the attack on the hair follicles. The triggers may be a virus or something in the person's environment.

Will My Hair Ever Grow Back?

There is every chance that your hair will grow back, but it may fall out again. No one can tell you when it might fall out or grow back. You may lose more hair, or your hair loss may stop. The hair you have lost may or may not grow back. Even a person who has lost all of his hair may grow all of his hair back. The disease varies from person to person.

How Is Alopecia Areata Treated?

There is no cure for alopecia areata. There are no drugs approved to treat it. Doctors may use medicines approved for other diseases to help hair grow back. Talk to your doctor about the treatment that is best for you.

The following are some treatments for alopecia areata. They may help hair grow back, but none of them prevent new patches of hair loss or cure the disease.

Corticosteroids:

Corticosteroids are drugs that reduce swelling and pain. They also affect the immune system. Corticosteroids may be given in three ways for alopecia areata:

• Injected in the skin
• Swallowed as pills
• Rubbed on the skin as a cream or ointment.

Drugs that are rubbed on the skin as a cream or lotion include:

• Minoxidil (5%)
• Anthralin
• Squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP).

Drugs that affect the immune system include:

• Sulfasalazine
• Cyclosporine.

Photochemotherapy:

In photochemotherapy, a person is given a drug called a psoralen, which is affected by light. The drug can be swallowed or rubbed on the skin. Once the drug is taken or applied, the area with hair loss is exposed to an ultraviolet light source. This combined treatment is called PUVA.

Alternative therapies:

Some people with alopecia areata try other treatments. These alternatives include acupuncture, aroma therapy, evening primrose oil, zinc and vitamin supplements, and Chinese herbs. Because many alternative therapies have not been studied in clinical trials, they may or may not help hair grow back. In fact, some may cause more hair loss. Talk with your doctor before you try alternative therapies.

How Will Alopecia Areata Affect My Life?

Alopecia areata does not make you feel pain and does not make you feel sick. You can't give it to others. People who have the disease are, for the most part, healthy in other ways. Alopecia areata will not shorten your life, and it should not affect activities such as going to school, working, marrying, raising a family, playing sports, and exercising.

How Can I Cope With the Effects of This Disease

Living with hair loss can be hard. There are many things you can do to cope with the effects of this disease, including:

• Learning as much as you can about the disease.
• Talking with others who are dealing with the disease.
• Learning to value yourself for who you are, not for how much hair you have or don't have.
• Talking with a counselor, if necessary, to help build a positive self-image.

Here are some things you can use to reduce the physical dangers or discomforts of lost hair:

• Use sunscreens for the scalp, face, and all exposed skin.
• Wear eyeglasses (or sunglasses) to protect eyes from sun, and from dust and debris, when eyebrows or eyelashes are missing.
• Wear wigs, caps, or scarves to protect the scalp from the sun and keep the head warm.
• Apply antibiotic ointment inside the nostrils to help keep germs out of the nose when nostril hair is missing.

Here are some things you can do to reduce the disease's effects on your looks:

• Try wearing a wig, hairpiece, scarf, or cap.
• Use a hair-colored powder, cream, or crayon applied to the scalp for small patches of hair loss to make the hair loss less obvious.
• Use an eyebrow pencil to mask missing eyebrows.

What Research Is Being Done on Alopecia Areata?

Researchers are seeking a better understanding of the disease. Scientists are studying:

• Genes
• Hair follicle development
• The immune system
• Drugs and treatments for other autoimmune diseases like rheumatoid arthritis and lupus
• Better ways to get drugs directly to the hair follicles
• Stem cells in the skin.

Want to know how much hair you're losing?

Start counting -- the hairs on your comb, not on your head.

In the June issue of Archives of Dermatology, scientists demonstrate that a so-called "60-second hair count" is a simple and reliable away to get a grip on whether you're balding and, if so, how fast.

The procedure, which can be carried out in the convenience of your own home, may reassure the adult male -- or not.

"Hair loss is fraught with emotions... Here is a hair count that allows the person to get a handle as to what's going on with their hair," said Dr. Jeffrey Miller, senior author of the study and associate professor of dermatology at Penn State College of Medicine in Hershey, Penn. "With something like the 60-second hair count, you can participate and monitor in an objective fashion what's going on with your hair."

"The reality is that hair loss is incredibly common among men and women. Fifty percent of both genders will have hair loss by the age of 50. That's a big number," added Dr. Doris Day, an attending physician in dermatology at Lenox Hill Hospital in New York City. "It affects how you're perceived, your ability to date and climb that corporate ladder."

Both the media and dermatology experts are fond of proclaiming that shedding 100 hairs a day is normal. (That's probably too high, Miller said.) But there is little scientific evidence for that number, which is based on the assumption that the average scalp holds 100,000 hairs, 10 percent of which are at any one time in the telogen, or resting, phase.

Not only do experts not know how much hair loss is normal, they also don't have any standardized way of assessing the amount of hair lost on an average day.

"We keep saying the same things over and over, that it's normal to lose 100 hairs a day," Day said. "The question is, how normal is it and what is normal in terms of hair loss."

The "wash test" involves washing one's hair over a sink five days after the last shampoo, a waiting period some might find objectionable.

A more up-to-date method is the 60-second hair count, used in this study.

Sixty healthy men aged 20 to 60 without evidence of baldness participated. All were white and all but one had straight hair. (The authors excluded, for the most part, men with curly hair and long hair "because of the difficulty of running a comb through the hair, which would lead to increased numbers of broken" hairs, which weren't counted.)

The men washed their hair three mornings in a row with Neutrogena T/Sal shampoo. On the fourth day, they were issued identical combs and instructed to comb their hair forward over a towel or pillowcase of contrasting color. They were then asked to count the hairs that had dropped out. This comb-and-count procedure was repeated on the next two days and the number of hairs was validated under a microscope.

After six months, the participants repeated the full procedure.

Based on these results, the authors concluded that losing 10 hairs is "normal." In younger men (aged 20 to 40), the shedding range was 0 to 78 hairs with a mean of 10.2 hairs. In the older men, the range was 0 to 43 hairs with a mean of 10.3 hairs.

Here are instructions on how to perform the count:

• Comb your hair for 60 seconds over a pillow or sheet of contrasting color before shampooing. Pull the comb from the back top of the scalp forward to the front of the scalp for 60 seconds. "That 60 seconds allows you to dislodge any of the resting hairs that are supposed to be shed," Miller said.
  
• Repeat the procedure before three consecutive shampooing sessions, always using the same comb.
  
• Count and record the number of hairs in the comb and on the pillow or sheet.
  
• Repeat the procedure every month and discuss results with your dermatologist.
  

The study was funded by Merck & Co. and Miller has received consulting fees from drug company Pfizer Inc.

The authors will be releasing comparable data for women in the near future, they said.

When to start panicking over hair loss? Miller counsels men who lose more than 50 hairs a day (as counted in the 60-second period) to check with their physician.

"The hair acts like a window to the inside of the body," he said. "If there's something going on inside the body that is not right, for example, low thyroid output or low iron, your hair can react by shedding more. So if you notice that you're shedding a lot of hair on the 60-second hair count, it would be worthwhile to be evaluated by physician to rule out underlying medical causes."

Sudden changes in the amount of hair you lose should also be evaluated, he said.

Hair changes, including thinning, color loss, dryness, changes in texture, and hair loss, are common features of autoimmune disease. Of these, hair loss can be the most devastating. Overall, hair loss can have many medical causes including hormonal imbalances, medication effects, and autoimmune diseases. Among the autoimmune diseases that cause hair loss or baldness, aleopcia areata is the most common. Alopecia areata may affect small localized scalp patches (alopecia areata molocularis) or it may affect the entire body (alopecia areata universalis). Treatment is available for alopecia areata although, in general, the more hair lost, the less successful the treatment will be.

Other autoimmune conditions in which localized or diffuse hair loss (cicatricial alopecia) can occur include: systemic lupus erythematosus (SLE), Hashimoto's thyroiditis, Graves' disease, central centrifugal cicatricial alopecia, and postmenopausal frontal fibrosing alopesia. In systemic lupus malar rash can cause scarring of the scalp that leads to permanent hair loss. Hashimoto's thyroiditis causes hair to coarsen and become dry, contributing to hair loss, which is seen in more than 50 percent of patients. In Graves' disease, hair tends to become fine and brittle with a reluctance to hold curl and a tendency towards hair loss. Hair loss is reported in 20-40 percent of patients with Graves' disease.

Besides the abovementioned conditions, hair loss can occur in nearly every autoimmune disease, especially conditions in which oral corticosteroids are the mainstay of treatment. Hair loss is one of the undesirable side effects associated with the use of prednisone. Chemotherapeutic agents, such as methotrexate, used in many of the systemic rheumatic conditions, can also cause hair loss. Hair loss is also caused by the following drugs: cimetidine (Tagamet), ranitidine (Zantac), coumadin, heparin, allopurinol for gout, penicillamine, indomethacin, naproxen, isotretinoin, trimethadione, tricyclic antidepressants, atenolol, metoprolol, naldolol, propranolol, timolol, levodopa, and clofibrate.

In vitiligo, autoantibodies that destroy melanin cause pigment loss in both the skin and hair. Conditions affecting hair usually affect the skin in a similar fashion. For instance, the skin in hypothyroidism tends to become thick and dry, and in hyperthyroidism it becomes thin and moist. In patients with relapsing polychronditis, antibodies to cartilage proteins may contribute to hair loss and well as joint damage.

Cartilage hair hypoplasia is a rare autosomal recessive disorder causing short-limbed dwarfism and fine fragile hair, with a tendency toward hair loss. Cartilage hair hypoplasia has been reported in conditions of idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia.

TREATMENT

In endocrine disorders, correcting the hormone imbalance helps restore hair growth and improve its texture. Hair growth also responds to dietary changes. In particular, adding high quality protein to the diet can help restore hair growth. When hair loss suddenly increases it can reflect inadequate dietary protein or malabsorption, a condition of poor nutrient absorption from dietary sources. Malabsorption is common in thyroid disorders, Crohn's disease, pernicious anemia, and celiac disease.

A nutrient-rich diet with adequate protein and dietary supplements, particularly vitamin B complex, can help promote hair growth. Biotin promotes hair and scalp health and can help prevent hair loss. Excellent sources of biotin include nuts, brown rice, brewer's yeast and oats. Iron deficiency (confirmed by blood tests) can also cause hair loss and restoring iron levels can reverse hair loss. Foods rich in iron include green leafy vegetables, leeks, cashews, berries, dried fruits and figs. Vitamin C is necessary for iron absorption. Eating citrus foods after an iron-rich meal helps absorption. Vitamin E, zinc, methylsulfonylmethane (MSM), and essential fatty acids, such as flaxseed and fish oils, are also important for hair growth. A greens formula containing chlorella, spirulina, barley and wheatgrass also promotes hair growth.

The drugs minoxidil (Rogaine) and finasteride (Proscar) promote hair growth in some patients. Proscar is also reported to stop hair loss. Rogaine is applied topically and finasteride is taken orally, using 1 mg daily. Other topical hair stimulators include the oxygen radical scavenger, superoxide dismustase (SOD) Surgical procedures include hair transplantation and scalp reduction. Dr. Peter Proctor's Hair Regrowth Shampoo is reported in Life Extension to be superior to Rogaine and the only FDA-approved hair-treatment product on the market. A world-renowned expert on balding, Dr. Proctor has developed several preparations for restoring hair growth. Rosemary essential oil used as a scalp massage ingredient or added to shampoo can help hair growth by improving the scalp circulation.

Antibiotics such as co-trimoxazole and sulfasalazine help restore autoimmune hair loss in alopecia by inhibiting nuclear factor beta signaling activation, which contributes to anti-inflammatory and immunosuppressive effects.

In his book on Natural Healing, Gary Null reports experiencing regrowth of hair following the use of colonics. He attributes this to increased absorption of nutrients including chlorophyll in green juices. Other recommendations for hair growth include aromatherapy, Bach flower remedies, homeopathic preparations, particularly Natrum muriaticum and silicea, and stress reduction techniques.

Los Angeles, California, June 21^st, 2008 –Richard Farrell, owner of Farrell Hair Replacement announced today that he is adding an extra stop on his personal design tour. Richard will be at his Hair Salon & Production Center Los Angeles, CA on June 27^th and 28^th.

The Farrell Los Angeles location (which is conveniently located at 5059 W. Pico Boulevard, Los Angeles, CA 90019) has an artistic factory/loft type atmosphere dedicated to hair system perfection. The trendy location is dedicated to making Farrell Hair clients feel comfortable and cared for, Richard went on to say that “along with our very private salon rooms and our plush consultation area, one just can’t help but feel relaxed when they come in for a no cost/no obligation consultation”.

Richard Farrell who is always striving for completely undetectable and natural looking hair systems says: “Hair systems need to be produced under watchful eyes.” And no one is more precise in Hair system making than Richard Farrell himself.

The Farrell Los Angeles personal design tour is scheduled for June 27^th and June 28^th, since this is only a 2 day tour Richard has added a free registration page on his website where anyone can set their own appointment to see Richard in person. All of this and the Los Angeles appointment page are all posted on Richard’s website at: http://www.farrellhair.com/meetrichardcut.asp.

The Hair...
What do people look at first? The Hair... Is your real hair fine & limp? Well, that is the type of hair that needs to be on your hair replacement system. 99% of the companies who want to sell you a system buy inexpensive systems for overseas factories that produce their systems with Indian or Asian hair. If you want beautiful, natural looking hair, Farrell Hair Replacement will make your hair system with hair that matches your own hair texture, behaviors and characteristics.

The Front Hairline...
Not all women want to wear their hair with bangs on their forehead. With most factory hair systems you will be condemned to wearing bangs because those bangs are necessary in order to cover a thick base which could never pass for a natural hairline. Farrell hair systems are renown for their undetectable hairlines. Our hairlines can be brushed straight back from your hairline - exposing your hairline - enabling you to create most of today's fashionable hairstyles.

The Side Hairline...
This area is very important. Women might want to brush their hair back into a ponytail. With a Farrell system you will be able to wear many hairstyles which are brushed, pinned or clipped back from the face.

Hair Density...
If hair is too dense it simply has no room to move into certain hairstyles. When other companies use their thinning shear in order to adjust the density of a factory system they lose the scalp-like appearance that the system should have. A system needs to be made with approximately the same amount of hair tied into the base as the hair you have in the area that the system will be placed against. This is necessary because an undetectable hair replacement system requires that a certain amount of scalp be seen through the hair system.

The Right Base Material...
We at Farrell Hair Replacement custom make all of our own systems which allow us to offer you many options in regard to base materials or combinations of materials. Each material has plusses and minuses which we can discuss during your consultation.

Breathability & Washability...
I believe in designing and producing systems for women that breathe. Today's women are very active. So, whether you are training for a triathlon or jogging on a treadmill, your system must be as breathable as you own hair. Farrell system can be shampooed in the shower, worn in a pool or a hot tub. When you are laying on a chaise lounge by a hotel pool it should look as good as growing hair would when damp or wet. Only at Farrell will you find hair with these characteristics.

Lightweight...
Base materials need to be thin and lightweight. If they are too thin they can wear out quickly. If they are too thick then they are too detectable to the touch. We will help you choose base materials that make sense for you and will give you the longevity you might expect from Farrell Hair Replacement systems. Our systems for women are ultra custom, comfortable and undetectable to both sight and touch in most situations.

Hidden beneath Elline Surianello's beautiful hair is a woman few ever see.

Since she was 14, Surianello has suffered from a condition called alopecia, commonly known as hair loss. She wears a wig to hide the bald spots.

"To be like this all the time and think that this is how you have to be all the time, every day a little part of you dies," she said.

Surianello is among 30 million American women, about 1 in 5, living with female hair loss.

"Very few men are shocked that they are losing their hair," said Dr. Mark Kaufmann, a dermatologist. "With women, there's a complete shock and disbelief."

Surianello agreed to walk outside without her hairpiece with "Good Morning America" cameras following her.

"How do I function in the world knowing that everyone's paying attention to this," Surianello said, pointing to her hair. "Now they're not going to say anything to me because this is not a conversation, but they're going to ignore me. I become a nonentity. I become not a person that makes a statement. And I don't want to live my life that way."

About 70 percent of female hair loss is genetic. Other causes include stress, illness, medication and diet. Crash diets, tight ponytails/braids/weaves/extension, thyroid disorders, pregnancy, going off birth control and general anesthesia can all result in hair loss.

Dermatologist Susan Taylor had the following advice for preventing female hair loss.

• Don't ignore the problem. Get help soon.

• Hair care should be gentle, not painful. If it hurts, it's going to harm your hair.

• Avoid tight pony tails.

• Use gentle shampoos, nothing that itches.

• Don't skip conditioner.

• Don't over brush.

For those who have already lost a significant amount of hair, Taylor said Rogaine and cortisone injections or creams may help stabilize growth and in some cases regrow it. Rogaine costs about $25 per month. Cortisone requires a doctor's prescription and may be covered by insurance. Without insurance, the treatments cost approximately $50 to $150, Taylor said.

Hair transplants are the most expensive and time consuming treatment for female hair loss, at about $5,000 to $10,000 for a series of transplants over several months.

"There's a lot of research being done on stem cells," Taylor said. "The cells that grow hair have been identified, and hopefully we'll be able to use them one day to regrow hair in people who have lost it."

On the causes of female hair loss, the human hair growth cycle, and safe, natural options for women to help stop thinning hair and reverse hair loss.

by Marcy Holmes, NP, Certified Menopause Clinician

One of the most common and emotionally devastating complaints I hear from my patients is thinning hair and hair loss. At Women to Women, we understand that a woman’s head of hair is her crowning glory — and losing too much hair can be a serious and frightening blow to her self-esteem.

Reacting so strongly to the physical state of your hair may seem like vanity — who hasn’t had a bad hair day — but it’s not. Your hair is one of the first areas, along with skin and nails, to manifest signs of hormonal imbalance, poor nutrition and illness. Understanding how hair regenerates and paying attention to any changes in your hair growth and appearance are important parts of taking care of your self.

The truth is, a certain amount of hair loss is normal (anywhere from 50–100 strands per day), but excessive hair loss and hair thinning indicates that something is not right. The causes of accelerated hair loss are very individual and depend on a complicated set of factors, including hormonal and metabolic imbalances, emotional stress and nutritional deficiencies.

Unfortunately many conventional doctors downplay hair loss as an inevitable part of aging for both sexes, treating it with topical products like Rogaine that enhance existing hair but offer no real solution to the causes of hair loss, and therefore no prevention of continued hair thinning. This leads many women — especially those in menopause — to think that there is nothing they can do to stop their hair loss.

Regularly referred to with the catch-all term alopecia, female hair loss actually has different degrees of severity, causes and treatment. The good news is we’ve seen many cases resolve over time with an active, holistic and hopeful approach.

While we don’t claim to know the ultimate cure for hair loss (don’t believe anyone who says they do!), we don’t think a balding woman should resign herself to shopping for hair thickeners and wigs when there are so many other fundamental choices she can make to support natural hair growth where it counts — at the root, not just of her hair, but of her whole health picture.

So let’s talk about why women lose hair and what you can do about it.

Causes of hair loss in women

A strand of hair is made up of extruded, compacted dead cells. Everything you put into your body eventually comes out in your hair, usually within three to six months. Similar to growth rings in a tree, the strata of cells in a strand of hair paint an unflinching picture of where you’ve been and under what conditions. This is one reason many alternative practitioners look at the quality and quantity of patients’ hair as a valuable diagnostic tool.

But hair itself is only the visible part of the story. Hair grows from living follicles in the skin of the scalp. At the shaft, or root of the hair, all of your major systems are at work, including your circulatory, endocrine and central nervous system. That’s why it hurts when someone pulls your hair!

Every hair follicle has four distinct phases it cycles through on a regular basis: growth or anagen, transition or catagen, resting or telogen, and returning growth or mesanagen (see figure below). A full cycle can last anywhere from two to five years per follicle. Unusual hair loss and thinning occurs when a follicle is stuck in the telogen or resting phase. Bald spots occur when a large group of follicles turn off all in one place. Most of the time this happens slowly, but in some severe cases can happen all at once, causing a clump of hair to fall out.

Why do certain hair follicles break their normal cycle and switch into a resting or “off” position — temporarily or permanently? And why do some women experience thinning hair on their head and darker thicker hair on other parts of their bodies? The reasons are highly individual, but can include any combination of the following:

• Stress (emotional and physical)
• Hormonal imbalance, specifically androgen sensitivity
• Genetics
• Immune system irregularities
• Thyroid disorders
• Nutritional deficiencies (especially iron or vitamin A)
• Cosmetics (allergies and harsh treatments)
• Radiation/chemotherapy
• Dental treatment
• Blood loss
• Drugs
• Disease
• Surgery
• Scarring

The thing to emphasize about the resting or telogen phase is that it is designed to be temporary. Hair follicles can be shocked into the resting phase by so many stressors — emotional, physical or cosmetic — and just as suddenly switch back to “on” when the stress is reduced. Hair appears to be amazingly adaptive, which is why so many scientists believe that a cure for hair loss is right around the corner. But the lack of a remedy now doesn’t mean you should give up hope. A majority of women with moderate hair loss may notice big improvements just by paying more attention to their stress levels and their diet.

No one knows for sure why some women maintain a thick, natural head of hair throughout their lives while others don’t. My grandmother was always very proud of her hair, which remained on her head with only minimal graying or hair loss until she died at age 95. Why was she so lucky? Probably some good Scandinavian genes and healthy living (which included a daily helping of native Maine blueberries). She had her battles, too, suffering thyroid disease and a thyroidectomy, osteoporosis and high blood pressure. On the plus side, she managed stress well, did not drink or smoke and kept a regular sleep schedule. Somehow in the individual give-and-take of her body’s needs, her hair was able to maintain its resilience.

But, before you know how to proceed, you need to know whether or not your hair loss is unusual. Let’s take a look at what causes hair thinning in women and how it is diagnosed.

Diagnosing hair loss

As I said before, human beings lose hair every day, typically 50–100 strands a day. You can test hair loss with the “pull test.” Take about 60 hairs between your fingers and pull gently but firmly. Normally about 5–8 hairs will come out — reflecting the average 10% of hair follicles that are transitioning towards the resting phase at any one time. More than 15 hairs may indicate a perfectly normal but more unusual period of hair loss called telogen effluvium.

Telogen effluvium is sudden and uncharacteristic loss of hair that is usually not localized. More follicles than average are shocked or move into the resting state. When this happens, you may notice more hair than usual in your hairbrush or on the bathroom floor. But I’ve also had patients suddenly lose a clump of hair or their eyebrows after shock. Keep in mind that the darker and thicker your hair is, the more noticeable it will be against the shower floor or sink. You may think you are losing more hair than you actually are.

You often hear of this kind of hair loss after a pregnancy or change in hormonal birth control. It is also a very common side effect of emotional stress (like a death or divorce) and physical stress (such as surgery or illness). Other causes of telogen effluvium are crash or liquid protein diets leading to sudden, dramatic weight loss; yeast overgrowth or fungi; hypothyroidism and other endocrine-related upsets; anti-coagulants and anti-convulsants; heavy metals; antithyroid medication; hormone therapy; and severe psychological distress or life-threatening situations.

There are also dietary causes of hair losses, such as vitamin D, vitamin A, iron and protein deficiencies. Working with your practitioner, you should be able to diagnose and treat any of these nutritional deficits with a more optimal diet and nutritional supplements.

Some women may experience periods of noticeable hair loss (and growth) at different times in their menstrual cycle, or during different seasons. If this is your experience, be assured that it is very common and tends to resolve itself naturally.

If you are currently under a lot of stress, providing your body with a little more support through supplements and TLC can really boost your hair growth. For this reason, I always tell my patients who report surprising hair loss to follow our Nutritional and Lifestyle Guidelines for three to six months, including hair–specific vitamins and supplements, before proceeding to more intrusive diagnostic methods.

Testing for more severe hair loss

If hair loss does not improve with some basic stress reduction and positive lifestyle changes, I often recommend that my patients look at all of the markers that indicate their hormone and thyroid status, including a hormone panel (testing specifically both free and total testosterone levels); metabolic panel (for kidney and liver function); fasting insulin test (to measure insulin resistance); ferritin stores (for iron deficiency) and CBC with differential (a hematological panel); allergy testing; and thyroid function test.

It’s important to know that conventional doctors have a wide range of test results that they consider “normal”; specifics vary by the type of test, but for argument’s sake, let’s say it’s 1–100. If your number falls near the edge of this range but still within it (say 2 or 99) you are still considered normal. At Women to Women, we look for test results that fall at the midline. Anything way below or above we take a hard look at. In our opinion, clinging to the edge of normal is not conducive to good health.

Testing for insulin resistance, testosterone levels and thyroid or other metabolic dysfunction can tell us if a woman is experiencing androgen sensitivity, hypothyroidism or other endocrinologic disturbances as possible causes for thinning hair. Many women will experience male pattern baldness if their bodies have too much testosterone or have become sensitive to normal circulating levels of androgens. Let’s discuss how that happens.

Hormones and hair loss

Many women experience more dramatic, localized hair thinning, even a noticeable bald spot. This condition is called male pattern baldness, or androgenetic alopecia (AGA) , and it is the most common form of hair loss in both men and women. It almost always occurs on the top and sides of the head and above the forehead, and may also include excessive facial and body hair. The range of severity is wide here, ranging from a barely noticeable thinning at the part line to bald spots at the crown of the head that spread forward.

While hair loss in women is different from that in men, there are some similarities in the way in which male hormones affect hair growth. Like your body’s own version of Miracle-Gro, androgens (testosterone and DHEA) are naturally converted into a substance called DHT (dihydrotestosterone) that stimulates blood flow to the hair follicle, promoting hair growth. Problems arise, however, when the follicle’s receptors become oversensitive to androgens and shut down — like locking a door. This can happen when one or all of the following conditions are present: a genetic proclivity, abnormally high levels of free testosterone, or a change in sensitivity to normal levels of circulating androgens.

Menopause, PCOS and male pattern baldness

Androgenetic alopecia partially explains why you may experience hair loss in one specific area and nowhere else — your hair falls out only where particular hair follicles have been sensitized. It also explains why you can lose hair in one area (where the follicles are sensitive) and grow coarser hair in another (where androgens have stimulated excessive hair growth).

Hormonal imbalance due to menopause or PCOS is the primary causes of male pattern baldness in women. Because so many women with PCOS have high levels of circulating androgens and are also insulin resistant, a growing number of practitioners are looking at the connection between insulin resistance, testosterone, and hair loss. It’s possible that receptor resistance to insulin and sensitivity to androgens go hand in hand. One Finnish study of women in their 60’s showed a definitive correlation between insulin resistance and increased risk of hair thinning, particularly when a subject had a paternal history of hair loss.

AGA happens to some degree to every woman as she ages and estrogen levels fall. Decreasing levels of estrogen may allow the body to convert more available testosterone without opposition. This is so common that many conventional doctors pay it little mind unless hair loss becomes severe. Conventional topical solutions like minoxidil (Rogaine) enhance and thicken existing hair — they do not generate new growth. This may be useful for some women who can deal with a small bald spot or expanding part line by changing their hairstyle but these products do nothing to restore your body’s natural hormonal balance or metabolic function — the factors that are causing the excessive hair loss in the first place.

New testosterone–blocking drugs like flutamide have been only minimally effective in reversing hair loss in women and should not be taken by women of childbearing age — they are generally only appropriate for men and could even exacerbate hormonal disorders in women. Besides, once again, these drugs only take aim at the surface of the problem; they can’t rebalance the body from the inside out.

Some women carry a genetic predisposition to male pattern baldness (usually inherited from their father). But before you panic, know that duration and pattern of hair loss, as well as where the hair is shedding (along the shaft or at the root) are all critical pieces of the puzzle. Some cases of AGA resolve or limit themselves once internal balance has been restored.

Immunological and infectious factors in hair loss

If hair loss worsens over time, or if hair falls out in great clumps creating patchy bald spots all over the head, it may indicate a more serious auto-immune condition called alopecia areata, or an infection-induced alopecia called cicatricial alopecia.

These hair concerns go beyond the scope of this article and must be diagnosed by a punch biopsy, in which a minute section of the scalp is removed and tested. As of this point, there is no cure for alopecia areata, only topical solutions and injectable steroids. But we believe our holistic approach can help boost immune function and help stem the progression of the disease.

Occasionally an overgrowth of fungus or yeast can trigger severe follicular inflammation that results in hair loss. This can be diagnosed by a dermatologist after a thorough scalp examination. Treatments vary depending on the practitioner, but usually involve some kind of topical anti-fungal shampoo or solution.

New inroads into hair transplants, laser stimulation and topical products are a great reason not to despair if you’ve been diagnosed with alopecia areata or other troublesome scalp conditions. You may not have the head of hair you were born with, but some of these developments may in the future provide the next best thing.

Natural hair loss solutions — the Women to Women approach

If your hair loss is mild to moderate, the most important thing to do is weigh the immediate stressors in your life against how much support you’re giving your body. Start with an honest inventory of your healthy and not-so-healthy habits. Then take some steps toward shifting the balance to the support side. Here’s what we recommend:

• Eliminate dietary causes of hair loss. Eat a balanced diet comprised of whole, protein-rich foods — the more organic the better. Avoid or limit refined sugar and other simple carbohydrates to ameliorate insulin resistance. Read how in our Nutritional and Lifestyle Guidelines.
• Address vitamin deficiency hair loss. Take a rich multivitamin daily that includes hair-healthy vitamins such as B, C and E. Other important nutrients are calcium, magnesium, copper, zinc, and iron. A fish oil supplement containing vitamin D and essential fatty acids will help boost immunity and soothe inflammation.
• Consider herbal supplements. Kelp-derived supplements add iodine to the diet, which assists in the manufacture of thyroid hormones. Ginkgo biloba increases blood flow to the scalp (without androgens).
• Scalp massage and acupuncture can be helpful in stimulating blood flow to the scalp and supporting normal follicle function.
• Balance your hormones. If you are premenopausal, consider gentle endocrine support to help naturally rebalance your hormones.
• Examine your emotional health and your relationship with anger. Rage may be associated with higher levels of testosterone. Finding healthy ways to express yourself and your anger can go a long way toward reducing stress. If you are under severe psychological stress, your hair loss should improve a few months after the stress is relieved.
• See your healthcare provider. If your hair loss does not improve with these measures after six months, talk to your practitioner. He or she may recommend undergoing the tests I outlined above. Ask to see the results and where they fall in the range of normal. The closer to the midline the better. If you notice any irregularities, talk to your practitioner about targeted supplements or treatment targeted toward hair growth.

Remember that the condition of your hair mirrors what’s going on inside your body. It only makes sense to consider natural options that nurture your whole health before you spend a lot of money on expensive shampoos, conditioners and hair thickening products. While some of these products may enhance the appearance of your existing hair, they don’t generate new hair. Nurturing your health from the inside out, including your emotional health, should improve the quality and quantity of your hair, as well as your life!

While studying the role of stem cells in skin regeneration, researchers at the University of Pennsylvania medical center say they've been able to regenerate new hair follicles in adult mice. They weren't trying to cure baldness, but they say that they may have, by combining stem cells with a secret compound. This is different from hair loss drugs like Propecia and Rogaine, which help people maintain their hair but don't grow new hair. As Dr. Nancy Snyderman said, this treatment could be on the market for humans within three years.

You brush your hair and the brush becomes full of strands that should be on your head. The drain in your shower gets clogged and suddenly you see your scalp no matter how you part or style you hair. Is this a sign of a serious illness? Will it stop? Are you going bald? Dr. Judith Reichman, "Today" health contributor, was invited to appear on the show to share some insight on female hair loss. Here's even more:

Let’s start with 101 in hair physiology. How does hair grow and should it recycle?
A single hair follicle grows its hair strand over a period of four to six years (the anagen phase). It then rests for two to four months (the telogen phase), after which it loses the “old” hair as a new hair shaft grows and pushes out its predecessor. When the new hair grows in, it does so at a rate of approximately half an inch per month. At any time, 10 percent of your hair is in the telogen phase and 90 percent is in the anagen phase.

What causes a change in this hair loss/ hair growth process?
If lots of hair begins to fall out throughout the scalp, it’s obviously due to a change in the normal hair cycle: either a short anagen phase or an increase in the number of  follicles that enter the telogen phase. When the majority of hair follicles “go telogen” it’s called telogen effluvium or stress alopecia. A shock to the body’s system, which stresses the hair follicles, is often to blame for this change in cyclical hair events. Two to three months after the stressor hits, up to 70 percent of hairs can enter the telogen phase and commence a massive “fall out”. There are a number of shocks that are known to cause this. They include:

• A sudden hormone change (usually a drop in hormone levels)
• After the birth of a baby ( delivery of the placenta causes the levels of pregnancy hormones to plummet)
• Discontinuing birth control pills or hormone replacement therapy
• High fever
• Acute trauma (surgery, physical injury or psychological trauma)
• Severe dieting ( inadequate protein and iron intake)
• Underactive or overactive thyroid
• Diseases such as diabetes and lupus
• Chemotherapy
• Medications: These include retinoids, blood pressure medication, anti-depressants, certain birth control pills and even NSAID’s (including Ibuprofen)
• Burns or radiation therapy

Note with stress alopecia, the loss over the scalp is general, not patchy and hair loss on other parts of the body can also occur. You and your doctor may be able to ascertain if your hair loss falls in the category of stress alopecia by simply running your fingers through your hair and seeing if the many hairs that are shed have clubbed shafts.

Are there other tests that should be done to diagnose telogen effluvium?
Your doctor may want to check your iron and thyroid levels, but in most cases, your history is the most important factor for diagnosis.

What is the therapy for this type of hair loss?
Mostly reassurance. If the loss is due to a birth, illness, or a self-limited problem, it will stop and will not progress to baldness. New hair shafts will come in and in a few months the hair loss will diminish. Eventually the hair will grow back and become normal. Obviously if the loss was due to a medication, the drug should be stopped. (Note: If it was due to chemotherapy the course should be completed and hair growth will subsequently return.)

If iron levels are low, iron should be supplemented (after making sure that the cause was not abnormal bleeding, which could be a sign of a serious disorder), and if the thyroid level is “off,” this should be treated.

Can dyes, hair treatment, or certain hairstyles cause hair loss?
Pulling the hair tightly in a ponytail and the repeated traction used for hair extensions and tight braiding can cause some hair loss, especially in the temple area. This is called traction alopecia. If not corrected, the hair follicle may be permanently damaged. Chemicals that dye, bleach, straighten or perm the hair can also cause the shaft to break off, but once the chemical insult has stopped, the root portion should grow back.

What if patches of hair are coming out?
This may be due to a condition called alopecia areata. This is thought to be an autoimmune disease in which antibodies attack the hair follicles and hair falls out in small, round patches. In some individuals, this can progress to total loss of hair on the head (alopecia areata totalis), or even complete loss of hair on the head, face (eyebrows, eyelashes) and body (pubic and underarm hair). The latter rare condition is called alopecia areata universalis.

What causes alopecia areata?
White blood cells attack cells in the hair follicles that make the hair, the follicle becomes small and hair production is diminished. However, the stem cells that continually supply the follicle with new cells don’t seem to be targeted, so the follicle does have a potential to regrow hair. Although it’s not clear why this occurs, there is some thought that it has a genetic basis, making individuals from the same family predisposed to developing this disease. There also may be some sort of trigger that initially causes the onset of hair loss, perhaps a virus or an environment contaminant.

There are currently about four million Americans of both sexes and all ages and ethnic backgrounds who suffer from alopecia areata. One in five individuals with this disease has a family member who has had it as well.

Alopecia areata also seems to occur in family members who have had other autoimmune diseases such as diabetes, rheumatoid arthritis, thyroid disease, systemic lupus, pernicious anemia or Addison’s disease. Those who develop alopecia areata have been found to have a higher occurrence of thyroid disease, eczema, nasal allergies and asthma.

If I develop this type of hair loss, will it grow back?
In general, there is a very good chance that the hair will grow back, but it can also fall out again. There’s no way of predicting the ultimate course. Some individuals lose just a few patches of hair, it grows back and the condition doesn’t recur. Others continue to lose and regrow hair for years and still others lose all the hair on their head, face and body; rarely this is permanent.

How is this treated?
There are a number of therapies that are currently being used (when there are multiple therapies, it generally means that no one is going to be absolutely effective). They include:

• Corticoid steroids: These are cortisone types of anti-inflammatory drugs that help to suppress the immune system; they can be given as a pill, topical ointment or as a local injection, directly into the hairless patches on the scalp.
• Minoxidil 5%: (known under the brand name of Rogaine) This promotes hair growth in several conditions in which the hair follicles are small and not growing to their full potential. It needs to be used on a daily basis. New hair growth can appear in about 12 weeks, however if use of the drug stops, the new hair may fall out.
• Anthralin (Psoriatic): This is a tar like substance that is used to treat psoriasis; it changes the immune function in the affected skin. If it does work, new hair growth is seen in eight to twelve weeks. It is often used in combination with other medications.
• Sulfasalazin: This sulfa drug is used to treat autoimmune disorders.
• Topical sensitizers: These, when applied to the scalp, cause an allergic reaction that leads to itching and scaling, but also stimulate the hair follicles and can cause hair growth. Again, results are only seen after long-term use, usually three to twelve months.
• Photo chemotherapy: This too is used for psoriasis. It has helped about half those treated, but requires special equipment and treatment two to three times a week. There are concerns that it could increase risk of skin cancer. 

Are there other causes for “patchy hair loss”?
Yes, it can be caused by fungal infections such as ringworm and even syphilis.

What about genetic or inherited hair loss?
We all know that men can become bald as they get older. As a matter of fact, inherited or male pattern baldness occurs in 25 percent of men by 30 and two-thirds are bald or balding by the time they reach 60. This male pattern baldness usually occurs in the hairline and around the crown. It continues until there is just a ring of hair along the side. The male pattern of balding occurs from the effects of testosterone, after it is converted to the more potent DHT (which is the only form that will attach to receptors on the hair follicle). Men who tend to male pattern balding don’t have more testosterone; they simply have an increased conversion of testosterone to DHT in the scalp.(Note: The drug that helps prevent this conversion is called Finasteride, and is used to treat this form of baldness. It is for men only and has not been shown to be effective in women. As a matter of fact, there is concern about a woman being exposed to Finasteride, especially during her reproductive years, since it could cause fetal malformations.)

Women, however, do develop thinner hair as they get older and often this is accompanied by gradual hair loss. It occurs over the top and sides of the head, not in the crown. Once more, it is felt that genetics play a role and it is far more likely to occur if relatives on either side of their family has experienced balding as they age.

What therapies target this hair thinning and loss?
The drug Minoxidil, which was first developed to treat high blood pressure, was found to have a side effect of thickening hair growth in some of those treated. It’s now available over the counter as a lotion applied to the scalp. No one quite knows how it works, but it seems to be effective in about 20 percent of women who develop diffused hair loss or thinning, especially if they are younger when they begin to lose their hair. The disadvantage is that if daily use is stopped, the new hair will fall out.

There are also surgical techniques for restoring hair. The two main options are:

• Hair transplantation: Minute punch holes of skin containing a few follicles of hair are taken from elsewhere in the body or the back of the head where there is more hair, and implanted into the thinning areas. Because women are more likely to have overall loss of hair on their scalp, this technique may be less successful for them than it has been for men.
• Scalp reduction: Devices are inserted in the skin to stretch the area of scalp that still has hair and the bald areas are removed. Flaps of scalp with hair can also be moved around the head.

What about all those so-called wonder products that are advertised on the Internet?
Beware if they say they are going to quickly and easily cure female pattern hair loss. They probably won’t. You are providing money for the individuals who are using the Internet to promote their product, and there’s a good chance the product will not promote your hair growth.

Dr. Reichman's Bottom line: In most cases your hair loss is due to trauma to the hair follicle and after several months your hair will grow back. Make sure that you talk to your doctor before you try any products on your own. Reassurance and patience may be all you need.