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Hair Loss

Hair loss is referred to as gradual or sudden loss of hair from the scalp or other parts of the body where hair normally grows. Hair is made of keratin protein and produced in hair follicles in the outer layer of the skin. On average, a human has around 100,000 to 200,000 hair follicles on the scalp. Every hair has a life cycle: active hair growth phase, transitional hair growth phase, and resting phase. After completing the resting phase, hair is shed, and new hair replaces it to continue the cycle. As people age, their rate of hair growth slows. However, losing up to 100 strands of hair per day is considered normal.

What is alopecia?

Alopecia is the medical term for hair loss. Alopecia is a generic term that doesn’t imply any particular cause of hair loss. There are several types of alopecia, each with different causes and characteristics. Alopecia is divided into 2 major categories: non-scarring alopecia where hair follicles are intact and scarring alopecia, where the hair follicles are irreversibly damaged. Some of the common alopecia types in the non-scarring category include following:

  • Androgenic alopecia: A genetic condition that can affect both men and women and it is the most common type of hair loss. It is also known as male-pattern baldness or female-pattern hair loss. Male-pattern baldness is characterized by a receding hairline and gradual disappearance of the hair from the crown and front of the scalp. The onset of female androgenic alopecia can be any time after puberty, but the hair loss can become severe with age 1. In women, overall thinning of the hair can be seen with this condition.
  • Alopecia areata: This type of hair loss is sudden. It is caused by an autoimmune disease where your own cells attack hair follicular cells by accident. The affected individual will notice small round patches of areas with no hair on the scalp or other parts of the body.
    Alopecia totalis and universalis: Alopecia totalis is total loss of hair on the scalp. Alopecia universalis is the total loss of hair from all over the body including eyebrows, pubic hair, and eyelashes.
  • Traction alopecia: This kind of hair loss is due to the constant pull or tension to the hair. It could develop due to tight ponytails, braids or hair extensions. Over time, this tension can damage hair follicles and lead to hair loss.
  • Telogen effluvium is one of the common forms of hair loss. This type of hair loss is triggered by stress, illness, surgery, hormonal changes, or medications. People with this condition will never completely lose all their scalp hair, but the hair can be noticeably thin in severe cases. In most cases telogen effluvium is limited to the scalp, but in more serious cases it can affect other areas, like the eyebrows and pubic hair. This is usually a temporary condition and once the underlying cause is treated, hair growth will resume.

Scarring type hair loss is less common and often caused by autoimmune diseases. There are multiple scarring type hair loss including, lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), central centrifugal cicatricial alopecia (CCCA), discoid lupus erythematosus(DLE),and folliculitis decalvans.

The potential for reversing hair loss depends on several factors, including the underlying causes of hair loss, types of hair loss, and the individual’s health conditions and overall response to treatments.
Different types of hair loss require different treatment approaches. A consultation with a dermatologist can help to evaluate your specific situation, determine the underlying cause, and recommend the appropriate treatment based on your needs and goals. Early intervention often leads to better outcomes in managing and potentially reversing hair loss.

Causes of Hair Loss

It is important to note that diagnosing the specific cause of hair loss requires a medical evaluation. If you are experiencing significant hair loss, consulting a healthcare professional, preferably a board-certified dermatologist is crucial to identify the underlying condition. There are many factors that can cause alopecia.

  • Genetics(family history): Genetics plays a significant role in hair loss. The most common type of hair loss known as androgenic alopecia, often referred to as male-pattern baldness in males or female-pattern hair loss in females, has a strong genetic component. Androgenic alopecia is influenced by a combination of genetic factors and hormonal changes. If your parents or grandparents experienced hair loss, you are more likely to develop it as well. It is believed that multiple genes contribute to this type of hair loss and their interactions with hormones like dihydrotestosterone (DHT) play a crucial role.
  • Hormonal imbalances: Fluctuation or disruption in hormone levels can inhibit hair growth and lead to hair loss. Increased levels of some of the hormones such as testosterone, DHT, thyroid hormones, and cortisol (stress hormone) can cause hair loss. However, increased levels of estrogen during pregnancy can prolong the growth phase of hair leading to thicker and fuller hair. During menopause, estrogen levels drop, and this can trigger excessive shedding, causing telogen effluvium.
  • Medical conditions: There are several medical conditions that can lead to hair loss, either directly or as a secondary symptom. Some of the common medical conditions that can contribute to hair loss include, hypothyroidism (decrease thyroid hormone), hyperthyroidism (increased thyroid hormone), polycystic ovary syndrome, lupus, Cushing’s syndrome, iron deficiency, vitamin deficiency 2 [vitamin B, D, biotin (vitamin B7)], malnutrition, eating disorders, diabetes, and autoimmune diseases.
  • Medication and supplements: Several medications and supplements have been associated with hair loss as a potential side effect. Hair loss caused by medications is known as drug induced hair loss or medication induced alopecia. Some examples of medications and supplements that can potentially lead to hair loss includes, chemotherapy drugs, anticoagulants, antidepressants, beta blockers, anticonvulsants, acne medications, hormonal medications, thyroid medications, gout medications, weight loss medications, vitamin A supplements, excess selenium supplements for muscle growth, and iron deficiency. It is important to note that not everyone who takes these medications or supplements will experience hair loss. If you suspect that a medication or a supplement is causing hair loss, consult with your provider for alternative medication.
  • Stress: Chronic stress can increase the level of cortisol hormone (stress hormone) in your body. Cortisol can disrupt the normal hair growth cycle leading to increased shedding.
  • Hair styles and hair treatments: Certain hair styles, especially those that exert tension or stress on the hair and scalp can lead to a type of hair loss known as traction alopecia. Different hair styles that can cause traction alopecia includes, tight ponytails, braids and cornrows, extensions and weaves. Hair treatments such as chemical treatments and heat styling can also damage the hair and lead to breakage and hair thinning.
Managing hair loss involves a combination of lifestyle changes, proper hair care, and in some cases medical treatments. Here are some strategies you can consider for managing hair loss.

  • Adopt a healthy diet rich in vitamins, minerals, and nutrients essential for promoting hair growth and maintaining overall health.
  • Try to manage stress by practicing relaxation techniques such as meditation, yoga, deep breathing, and regular exercise.
  • Try to use gentle hair care, avoiding over styling and tight head gear (such as helmets).
  • Use mild shampoos that are gentle on your scalp and avoid harsh chemicals.
  • Stay hydrated.
  • Regular scalp massaging can improve blood circulation to the scalp and promote hair growth.
  • Avoid smoking.
  • Some supplements such as Nutrafol and other vitamins can promote hair growth. Consult with a healthcare professional before starting supplements.
  • Medical treatments may be given to improve hair growth and reduce hair loss.
  • Hair restoration procedures.
  • Use of wigs and hairpieces to cover areas of extensive hair loss.

As the effectiveness of these strategies can vary based on the underlying cause of your hair loss, it is important to consult a dermatologist to pick the best hair loss management strategies for you.

Hair Loss Treatments in Greater Phoenix, AZ

There are multiple treatment options available for hair loss in both men and women. Following are some of the commonly used hair loss treatments.

  • Topical minoxidil: This is the only over the counter medication approved by FDA to treat hair loss in both men and women. There are different strengths to this topical medication and both 2% and 5% minoxidil solution can be bought without a prescription. Minoxidil is applied directly to the scalp to promote hair growth and slow down further hair loss. If you stop using it, you will start losing hair again and your hair might fall out faster than before. It comes in different forms, such as a foam or liquid. It is sold under the names Rogaine® or Theroxidil® or under the generic name, minoxidil. At Saguaro Dermatology, we offer a topical minoxidil and finasteride treatment.
  • Oral finasteride: A prescription medication that inhibits the conversion of testosterone to DHT (dihydrotestosterone), which is responsible for shrinking hair follicles in androgenic alopecia patients. This is also approved by the FDA to use in the treatment of hair loss.
  • Low level laser therapy (LLLT): LLLT devices such as laser combs or caps use low-level lasers or light-emitting diode (LED) to stimulate hair follicles and improve hair growth.
  • Platelet rich plasma (PRP) therapy: PRP therapy involves drawing a small amount of a patient’s blood, processing it to concentrate platelets, and then injecting the platelet-rich plasma into the scalp. The mechanism behind PRP injections is not completely understood. Studies show that the increased concentrations of growth factors in PRP may stimulate or encourage hair growth.
  • Hair transplant surgery: Follicular unit transplantation (FUT) or follicular unit extraction (FUE) involves transplanting hair follicles from donor areas to areas with thinning or no hair. In FUT, an area of donor tissue is removed and transplanted to individual hair follicles. In contrast, during FUE, the grafts are extracted as individual follicular units and implanted the same ways as FUT. However, the FUE procedure is more popular than the FUT procedure as it leaves no visible scarring in the donor area.
  • Shampoos and other topical treatments: Prescription strength shampoos, corticosteroid creams, and other topical treatments can address underlying scalp conditions and inflammation that contribute to hair loss. Some hair care products contain ingredients like ketoconazole, caffeine or botanical extracts that promote hair growth and improve hair health.
  • Nutritional and hormonal supplements: Nutrafol, vitamin D, iron, zinc, and other vitamins and minerals play a role in hair health. It is recommended to consult a healthcare professional before starting supplements. In some cases, hormone replacement therapy may be used to address underlying hormonal imbalance contributing to hair loss.

It is important to note that the effectiveness of these treatments can vary depending on the underlying cause of hair loss, individual’s response, as well as other factors. Consulting a dermatologist is the best option before starting any treatment because a dermatologist can diagnose the cause of hair loss and prescribe the best personalized treatment options for you.

While complete reversal of genetic hair loss (male-pattern baldness) is typically not possible, there are treatment options available that can slow down its progression and promote some degree of hair regrowth. Following are some of the popular treatment options for hair loss in men.

  • Topical minoxidil: Minoxidil works for about 2 out of 3 men. It does not cure baldness. It is most effective if you are under age 40 and have recently started to lose hair.
  • Oral medications: Finasteride is an oral medication approved by FDA for androgenic alopecia in men. It can be used in combination with topical minoxidil treatments for hair loss in men. Dutasteride is a FDA approved drug for the treatment of benign prostate enlargement in men. But some studies show that dutasteride can improve hair growth in male androgenic alopecia 3. Sometimes it is used off-label for hair loss treatment in men.
  • Hair transplant surgery is another option for those seeking a more permanent solution.
  • PRP therapy: PRP injections can be effective in treating male pattern baldness, both in preventing hair loss and promoting new hair growth. PRP can also aid in the stimulation of hair growth after hair transplant.

Treatment for hair loss in women depends on the cause of the hair loss. Women of any age can be affected by hair loss. However, hair loss is common in women older than 40, postpartum mothers, women who often have hair styles that pull on the hair (tight ponytails, braids), and menopausal women. Following are some of the popular treatments for hair loss in women.

  • Topical minoxidil: Minoxidil is an over the counter topical medication approved by FDA to treat female patterned hair loss 4.
  • Low level laser therapy: This is approved by FDA to treat androgenic alopecia in women (female pattern hair loss). It is an over-the-counter product and can be used at home without going to a clinic.
  • Nutritional and hormone supplements: If hair loss is due to hormonal imbalance or nutritional deficiency, proper hormone replacement therapies or nutrition supplements could restore the hair loss in women. At Saguaro Dermatology, we offer Nutrafol in three different formulations which may be offered.

Does hair loss treatment work?

It has been shown that the effectiveness of minoxidil on hair growth is significant. The FDA has approved both minoxidil and finasteride for hair loss since those treatments have shown efficiency in clinical trials 5. Individual results can vary depending on the overall health and the underlying cause of hair loss. As hair regrowth takes time, you have to be patient and consistent with your chosen approach.

What hair loss treatment is the best?

Effectiveness of hair loss treatment would depend on multiple factors. Individual treatment plans depend on the type of alopecia you have. You might have to combine a few different treatments at the same time to see a positive result. It takes time to see the effect of treatments on hair loss. Some patients see a reduction in hair loss and new hair growth within 3-6 months. However, hair loss treatment response varies.

Hair loss treatment in Ahwatukee, Phoenix and Mesa

The staff at Saguaro Dermatology are dedicated to providing you with the highest quality of care, innovative practices, helpful resources, and the state-of-the-art technology to prevent and treat a multitude of skin disorders for patients in the Ahwatukee, Central Phoenix and Mesa. Our dermatologists are experienced in treating skin conditions including hair loss and are ready to help you.

Final word on hair loss

Maintaining a healthy lifestyle, managing stress, and staying hydrated can contribute to overall hair health improvement. It is natural to lose up to about 100-150 hair a day. But severe hair loss can affect the way you feel about your appearance. If you are not sure what is causing your hair loss and which treatments to choose, contact an experienced dermatologist. The team at Saguaro Dermatology has successfully treated individuals with a multitude of skin conditions, including hair loss. Our board-certified dermatologists along with our caring and experienced staff are always ready to help you at Saguaro Dermatology, conveniently located at three campuses in Ahwatukee, Central Phoenix and Mesa.

Suggested Resources
Telogen Effluvium: https://www.webmd.com/skin-problems-and-treatments/hair-loss/effluviums
lichen planopilaris: https://dermnetnz.org/topics/lichen-planopilaris
Folliculitis decalvans: https://my.clevelandclinic.org/health/diseases/22784-folliculitis-decalvans
Topical minoxidil: https://www.webmd.com/drugs/2/drug-3503/minoxidil-topical/details
Oral finasteride: https://www.webmd.com/drugs/2/drug-1548-167/finasteride-oral/finasteride-oral/details
Platelet-rich plasma therapy: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/plateletrich-plasma-prp-treatment
Articles Cited

  1. Starace M, Orlando G, Alessandrini A, Piraccini BM. Female Androgenetic Alopecia: An Update on Diagnosis and Management. Am J Clin Dermatol. 2020;21(1):69-84. doi:10.1007/s40257-019-00479-x
  2. Saini K, Mysore V. Role of vitamin D in hair loss: A short review. J Cosmet Dermatol. 2021;20(11):3407-3414. doi:10.1111/jocd.14421
  3. Choi GS, Sim WY, Kang H, et al. Long-Term Effectiveness and Safety of Dutasteride versus Finasteride in Patients with Male Androgenic Alopecia in South Korea: A Multicentre Chart Review Study. Ann Dermatol. 2022;34(5):349-359. doi:10.5021/ad.22.027
  4. Gupta AK, Foley KA. 5% Minoxidil: treatment for female pattern hair loss. Skin Therapy Lett. 2014;19(6):5-7.
  5. Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002;47(3):377-385. doi:10.1067/mjd.2002.124088

Saguaro Dermatology Reviews

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I had an awesome experience with Dr Hamann and staff. I was very comfortable and i was able to have all my questions answered without feeling rushed. The staff was courteous and welcoming.

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Staff was friendly, & on time. office is super clean!! Doctor was awesome, felt like a family member taking care of me.

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Great doctor and friendly, professional staff. The doctor spends time listening and answering questions, something rare to find anymore. The office is beautiful and very clean. I love all the artwork with saguaros.

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“The office was recently renovated–it is a beautiful, clean, and calm environment. I would highly recommend this practice for anyone who is looking for a general dermatologist.”

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Dr. Hamann is very knowledgeable, nice, and professional. You can tell that he truly cares about his patients by the way he operates. He took the time to listen to all of my concerns then address them with good, well-informed answers.

Saguaro Dermatology | Phoenix Dermatology

About Saguaro Dermatology

Our comprehensive dermatology clinic is dedicated to providing you with the highest quality of care, innovative practices, helpful resources and state-of-the-art technology to prevent and treat a multitude of skin disorders. Led by Carsten R. Hamann, MD, PhD, Dathan Hamann, MD, FAAD, Michael McBride, DO, Millard Thaler, MD, Mohs Surgeon and Jenna Wald, MD, Mohs Surgeon, our passionate team looks forward to serving you with respect and compassion.

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Set up an appointment with our friendly staff at: 480.681.3300