Shiny, free-flowing, healthy hair worthy of a shampoo commercial is intertwined with our collective view of beauty, and, by extension, the state of our stands often impacts how we feel about ourselves. But, if you’ve started to notice more hair on your pillowcase or in your hairbrush, then what? First, don’t panic: The American Academy of Dermatology (AAD) estimates that 80 million Americans experience androgenetic alopecia (read: hereditary hair loss), in addition to millions more who deal with temporary shedding as a result of hormones, life stressors, and age — among many other easy-to-miss factors.
Hair loss may be common but that doesn’t make it any less stressful. One route to avoid in the quest to restore your mane? “Blindly taking supplements or self-diagnosing by Google to try to treat yourself,” cautions Jennifer MacGregor, MD, a board certified dermatologist at UnionDerm in New York City. Not only could it not help your thinning hair, but it could actually hurt your cause, she adds.
So, if your daily hair shedding goes beyond the average 50 to 100 strands, it may be time to consult with an expert. While there are surgical hair restoration options (hi, hair transplants), there are also an array of at-home and in-office non-surgical solutions — and it all starts by consulting with a dermatologist for a proper diagnosis and path forward. Here’s what you need to know.
What Causes Hair Loss?
First things first, it’s important to understand what causes hair loss. “Hair loss is a complicated subject because there are so many different hair types, stressors, genetic predispositions, and also scalp and inflammatory or autoimmune disorders, along with general health problems that can lead to shedding, thinning, or patchy hair loss,” Dr. MacGregor explains. In fact, skin conditions, like dandruff, psoriasis, and eczema, can all lead to hair thinning if they aren’t managed. “Just by that list of potential causes, you can see it needs a real evaluation if you want real advice and a plan for how to address it,” she continues. It’s especially important to rule out some of the more serious health issues linked to hair loss.
It should also be noted that hair loss and thinning impact men and women differently. The American Hair Loss Association reports that about 40 percent of Americans dealing with hair loss are women, yet the condition is often temporary as a result of hormones (think: postpartum or as a result of birth control), diet, styling damage, and the like. Men’s manes can be affected by similar factors, but genetic predisposition is very often the driving force.
Start With Lifestyle Changes
Some cases of hair thinning can be corrected with lifestyle adjustments. “First, if your hair is changing and you experience mild thinning or shedding, it’s okay to implement general hair care to see if it helps,” Dr. MacGregor shares. It’s totally possible that simple product swaps or slight routine changes could solve, or at least help, thinning hair.
Starting at the (literal) root of the problem, pay attention to your scalp. Scalp care is the most important element of hair care, and if yours is dry and itchy or you have dermatitis, ditch your shampoo for a simple but seriously soothing formulation. Dr. MacGregor’s favorite? Shea Moisture Oat Milk & Rice Water Baby Shampoo.
Take a close look at your hair styling and hair care routine. Do you constantly heat style or chemically treat your tresses, including coloring and relaxers? Stretch the time in between appointments to reduce inflammation and always use a hydrating heat protectant beforehand. Additionally, Dr. MacGregor says to avoid any unnecessary traction with hair, and she suggests a gentle hair towel or even repurposing an old t-shirt to dry off out of the shower, along with a silk pillowcase or bonnet for sleeping.
The old adage ‘you are what you eat’ is especially true when it comes to hair. Optimize your diet with a vitamin D and omega-3 fatty acid supplement to promote healthy growth and avoid high glycemic carbs, as they “increase sebum yeast inflammation in the scalp,” Dr. MacGregor says.
Dermatologist-Approved Hair Loss Treatments
While the healthy lifestyle tips above will do no harm and should be incorporated into your hair care routine regardless, they may not be enough to stop your shedding. If that’s the case, there are an array of non-surgical in-office and at-home hair loss treatments to consider:
1. Over-the-Counter Treatments
“There's not a uniform protocol when it comes to hair loss,” says Dendy Engelman, MD, a board certified dermatologist in NYC. “But there are a number of over-the-counter products on the market that can be really effective in improving hair growth.” She is a fan of the Prose Root Source Supplements because they are “customized based on several factors” and made-to-order in small batches that are free of common irritants (think: mineral oils, dyes, and GMOs).
Don’t underestimate the power of a scalp scrub a few times a week to curb scalp buildup. Look for antibacterial ingredients, like pyrithione zinc, ketoconazole, or selenium sulfide, for best effects. Dr. MacGregor says Nizoral A-D Anti-Dandruff Shampoo is a solid first line of defense against inflammation.
So, when is it time to consult a doc? If the shedding is new, worsening, or severe, if your scalp is bumpy, itchy, or significantly red, if you have bald patches, or if your ’do is not responding to general hair care measures, Dr. MacGregor says it’s time to book.
2. Prescription-Strength Topicals
If hair doesn’t respond to the OTC Nizoral shampoo, a more intense Nizoral formulation with 2 percent zinc pyrithione can be prescribed along with a selenium sulfide solution, but Dr. MacGregor warns that these options are not color-safe. For significant scalp inflammation, Dr. MacGregor adds pulsed topical steroid solutions into the mix, which is “a stronger topical steroid application” that is limited to once every one to two weeks. “It’s rubbed into the scalp, then you’ll sleep overnight with a shower cap, before washing it out in the morning with one of the medicated shampoos, leaving it on for five minutes before rinsing,” she explains.
3. Platelet-Rich Plasma (PRP) Therapy
A favorite of Dr. Engelman, platelet-rich plasma (PRP) treatments essentially use your own blood to stimulate hair growth. “PRP therapy uses injections of a concentration of a patient’s own blood platelets to restore and accelerate hair growth,” she explains. First, your doctor will draw your blood, then it’s “placed in a centrifuge to separate out the platelets, before injecting the serum back into the hair follicle,” she shares. “The plasma contains white blood cells and platelets, which are rich in growth factors and stem cells.”
You may recall Kourtney Kardashian gave PRP a try during an episode of Keeping Up With the Kardashians to treat an area of her scalp that had thinned as a result of a too-taut ponytail, and men can benefit as well. Regardless, you should expect to book a PRP therapy appointment every four to six weeks for up to 6 months, depending on the severity of your condition. From there, annual or semi-annual maintenance should do the trick.
4. Steroid Injections
Cortisone shots, performed by a board certified dermatologist, can be used to address some forms of hair loss. It is especially effective for treating the common autoimmune disorder alopecia areata, which is when “the body’s own immune system starts fighting hair follicles,” Dr. Engleman says. We’d be remiss not to mention that it can be a doozy of a treatment though. As many as 80 pricks may be injected during just one appointment. Steroid treatments are scheduled every four to six weeks, with visible hair regrowth usually within one or two months.
5. Laser Therapy
Low level light therapy (LLLT) is a treatment that is approved by the United States Food and Drug Administration (FDA) for hair growth. By harnessing the effects of laser and light, it works to “reactivate your hair’s natural growth pattern by promoting blood circulation and collagen production,” Dr. Engelman shares. This in-office procedure works in three stages: stopping hair loss, thickening of current hair, and regrowth of new hair with a stronger, fuller hair follicle that replaces the thin, original follicle. The result? “Increased growth and thickness,” she says.
There is a good chance you may experience hair thinning at some point in your life. When healthy lifestyle changes and OTC remedies don’t work, it’s time to consult with a board certified dermatologist. Since the causes of hair loss are numerous and complex, now is not the time to multitask. “Make an appointment just for this,” Dr. MacGregor says. “Don’t just mention, ‘Oh, by the way, I’m losing hair,’ at the end of a visit for something else.”
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