Hair Today

Hair loss (or alopecia) is a fact of life for more than 35 million men and 21 million women in the US—and, for both, it can be a source of anxiety, stress, and embarrassment. What causes hair loss, and can it be prevented or treated? We spoke with board-certified dermatologist Cindy Hoffman, DO, FAOCD, MBA, who has offices in Yorktown, Carmel, and Hyde Park, to share her expertise.

Q. What are the most common types of hair loss men and women face in their 40s and 50s?

A. Alopecia areata (patches of hair loss, often caused by stress or autoimmune conditions, on the scalp, eyebrows, beard, and other areas); telogen effluvium (temporary thinning of scalp hair triggered by a traumatic event such as pregnancy, surgery, or a major illness); and androgenetic alopecia (male or female pattern baldness due to aging).

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Q. What are the differences between men’s and women’s hair loss?

A. Alopecia areata and telogen effluvium are usually similar in men and women. Androgenetic alopecia may be different. Female pattern baldness occurs as a general thinning over the entire scalp and loss at the crown. Male pattern baldness is characterized by a receding hairline and gradual disappearance of the crown and rest of the scalp.

Q. Are there medications that cause hair loss as a side effect?

A. There are many, including chemotherapy drugs, steroids, thyroid medications, hormone-replacement therapy, nonsteroidal anti-inflammatory treatments, isotretinoin used for acne, antidepressants, antibiotics, high blood-pressure and cholesterol-lowering drugs, birth-control pills, and weight-loss drugs.

Q. Is there anything a man/woman can do if he/she starts to lose hair?

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A. The patient needs to see a dermatologist to find out what the type of hair loss they have and what is causing it. Sometimes blood work is done and/or possibly a biopsy of the area. If blood work is necessary to rule out autoimmune or other illnesses, such as anemia or thyroid disease, the doctor will order tests that may include thyroid-function tests (TFT’s), a complete blood count (CBC), anti-nuclear antibodies (ANA), DHEAS, and testosterone.

Q. Do over-the-counter treatments work to reverse baldness or restore hair?

A. OTC treatments such as minoxidil (Rogaine) come in 2 percent and 5 percent topical solutions and work for female and male pattern baldness. It mostly stops further hair loss, but a large percentage of patients have actually reported new hair growth. It should be used for at least a year to see the results. 

Q. How about prescription topical treatments?

A. Topical cortisone, progesterone, and tretinoin are used and must be prescribed by a physician. I have a pharmacist who makes a compound for me called Prohair. This product includes different combinations of minoxidil, tretinoin, progesterone, and spironolactone. Hair replacement is also an option, and it does work.

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Q. Are there any supplements or other medications in pill form that work? 

A. Biotin is a vitamin that helps strengthen hair and nails. Spironolactone is a water pill that has some effect on hair growth for women. Finasteride (Propecia) is a pill that can help men with hair loss. These medications do work. They have a higher percentage of helping prevent further hair loss than promoting hair growth, although they do both.


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