Hair Loss; Alopecia; Baldness
Hair Restoration Treatment Partial or complete loss of hair is called alopecia
According to Dr. Rothfeld at the Hair Loss NYC Treatment Center, hair loss usually develops gradually and may be patchy or diffuse (all over). Roughly 100 hairs are lost from your head every day. The average scalp contains about 100,000 hairs.
Each individual hair survives for an average of 4-1/2 years, during which time it grows about half an inch a month.
Usually in its 5th year, the hair falls out and is replaced within 6 months by a new one. Genetic baldness is caused by the body's failure to produce new hairs and not by excessive hair loss.
Both men and women tend to lose hair thickness and amount as they age. Inherited or "pattern baldness" affects many more men than women.
About 25% of men begin to bald by the time they are 30 years old, and about two-thirds are either bald or have a balding pattern by age 60.
Typical male pattern baldness involves a receding hairline and thinning around the crown with eventual bald spots. Ultimately, you may have only a horseshoe ring of hair around the sides.
In addition to genes, male-pattern baldness seems to require the presence of the male hormone testosterone. Men who do not produce testosterone (because of genetic abnormalities or castration) do not develop this pattern of baldness.
A pioneer in Platelet Rich Plasma (PRP), we have treated countless patients with PRP to aid in hair loss and has generated incredible results.
What it is Platelet Rich Plasma (PRP)?
Thinning hair can be effectively treated with PRP Hair Stimulation Therapy. PRP, platelet rich plasma, is effective in treating male-pattern baldness, where the hairline has receded or thinning occurs on the crown.
Alopecia in women also responds well to this treatment. This type of hair loss occurs as the hair follicle shrinks over time, resulting in shorter and finer hair. The follicles are still there, so using the power of blood platelets, the follicles are stimulated to grow new hair.
PRP is a proven therapy that uses the patient’s blood platelets to act below the skin with the body’s natural ability to grow hair. The platelets contain proteins and growth factors that increase circulation to the hair follicles and stimulate their growth.
Platelet Rich Plasma, often termed as PRP, is concentrated blood plasma that contains five to 10 times the number of platelets found in normal circulating blood. PRP contains white and red blood cells and it contains cells known as platelets. Platelets play a significant role in the human body. They are the reason your body has the ability to heal itself at the site of a wound. Platelets contain growth factors that promote regeneration of the cells in the body and also assist in clotting the blood, which is essential for the body to heal wounds.
How is PRP administered?
This therapy is administered via injections to the scalp. PRP procedures begin with the collection of 54 milliliters of the patient’s blood retracted from their arm. The blood is amalgamated with 6 milliliters of Anticoagulant Citrate Dextrose Solution, and is then placed in a centrifuge for fifteen minutes to separate the platelet-rich plasma from other components the blood harbors. The scalp is prepped with betadine solution to help reduce bacteria that can potentially cause infection. When the blood is centrifuged, approximately 11 milliliters of concentrated platelets remain, which are then injected 4 millimeters deep into the dermis using 1 cc syringes with 27 gage needles. Results will be visible roughly four months following the procedure.
What does PRP do?
The idea behind PRP therapy is that by increasing the platelet count in a wounded area, the body’s healing capacity in that area would be accelerated thus also accelerating the growth and characteristics of hair follicles such as thickening and creating density. If the hair follicle and its root are healthy then the growth will be healthy as well. Hair follicles survive through the nutrients they receive from its supply of blood so by introducing platelets to the blood via the administration of PRP, it amplifies the body’s scalps ability to produce healthier follicles. PRP thickens hair follicles thus improving hair density, reverses hair thinning, accelerates healing when used during hair restoration surgery, may be a positive alternative for non-surgical hair restoration treatment
How long does it take?
The procedure takes about an hour to an hour and a half.
How often should it be administered?
The frequency of Platelet Rich Plasma Therapy depends on the degree of hair loss of a person.
According to Dr. Gary Rothfeld, a board certified Dermatologist
in New York, NY male hair loss is the most common type of hair loss. It is caused by increased sensitivity to male sex hormones (androgens) in certain parts of the scalp, and is passed on from generation to generation.
Some men have areas on the scalp that are very sensitive to the male sex hormones that circulate in men's blood. The hormones make the hair follicles - from which hair grows - shrink. Eventually, they become so small that they cannot replace lost hairs. The follicles are still alive, but are no longer able to perform their task.
The condition usually starts in men aged 20 to 30 and follows a typical pattern. First, a receding hairline develops, and gradually the hair on top of the head also begins to thin. Eventually, the two balding areas meet to form a typical U-shape around the back and sides of the head. The hair that remains is often finer, and does not grow as quickly as it used to.
Some women also develop a particular pattern of hair loss due to genetics, age, and male hormones that tend to increase in women after menopause. The pattern is different from that of men. Female pattern baldness involves a thinning throughout the scalp while the frontal hairline generally remains intact.
ABOUT HAIR LOSS IN WOMEN
Unlike hair loss in men according to Dr. Gary Rothfeld at NYC Cosmetic Dermatology and Hair Loss Center female scalp hair loss may commonly begin at any age through 50 or later, may not have any obvious hereditary association, and may not occur in a recognizable "female-pattern alopecia" of diffuse thinning over the top of the scalp. Woman who notice the beginning of hair loss may not be sure if the loss is going to be temporary or permanent—for example, if there has been a recent event such as pregnancy or illness that may be associated with temporary hair thinning.
In women as in men, the most likely cause of scalp hair loss is androgenetic alopecia—an inherited sensitivity to the effects of androgens (male hormones) on scalp hair follicles. However, women with hair loss due to this cause usually do not develop true baldness in the patterns that occur in men—for example, women rarely develop the "cue-ball" appearance often seen in male-pattern androgenetic alopecia.
Patterns of female androgenetic alopecia can vary considerably in appearance. Patterns that may occur include:
-Diffuse thinning of hair over the entire scalp, often with more noticeable thinning toward the back of the scalp.
-Diffuse thinning over the entire scalp, with more noticeable thinning toward the front of the scalp but not involving the frontal hairline.
-Diffuse thinning over the entire scalp, with more noticeable thinning toward the front of the scalp, involving and sometimes breaching the frontal hairline.
Unlike the case for men, thinning scalp hair in women due to androgenetic alopecia does not uniformly grow smaller in diameter (miniaturize). Women with hair loss due to androgenetic alopecia tend to have miniaturizing hairs of variable diameter over all affected areas of the scalp. While miniaturizing hairs are a feature of androgenetic alopecia, miniaturization may also be associated with other causes and is not in itself a diagnostic feature of androgenetic alopecia. In post-menopausal women, for example, hair may begin to miniaturize and become difficult to style. The precise diagnosis should be made by a physician hair restoration specialist.
It is important to note that female pattern hair loss can begin as early as the late teens to early 20s in women who have experienced early puberty. If left untreated, this hair loss associated with early puberty can progress to more advanced hair loss if it is left untreated
Hair Loss and Its Causes
What is the normal cycle of hair growth and loss?
The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.
It is normal to shed some hair each day as part of this cycle. However, some people may experience excessive (more than normal) hair loss. Hair loss of this type can affect men, women and children.
What causes excessive hair loss?
A number of things can cause excessive hair loss. For example, about 3 or 4 months after an illness or a major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness and is temporary.
Hormonal problems may cause hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This hair loss usually can be helped by treatment thyroid disease. Hair loss may occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop your hair loss.
Many women notice hair loss about 3 months after they've had a baby. This loss is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.
Some medicines can cause hair loss. This type of hair loss improves when you stop taking the medicine. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemotherapy to treat cancer, vitamin A (if too much is taken), birth control pills and antidepressants.
Certain infections can cause hair loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines.
Finally, hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it
Can improper care of my hair cause hair loss?
Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: al-oh-pee-sha). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called "perms") may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.
What is common baldness?
The term "common baldness" usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.
Women may develop female-pattern baldness. In this form of hair loss, the hair can become thin over the entire scalp.
Can my doctor do something to stop hair loss?
Perhaps. Your doctor will probably ask you some questions about your diet, any medicines you're taking, whether you've had a recent illness and how you take care of your hair. If you're a woman, your doctor may ask questions about your menstrual cycle, pregnancies and menopause. Your doctor may want to do a physical exam to look for other causes of hair loss. Finally, blood tests or a biopsy (taking a small sample of cells to examine under a microscope) of your scalp may be needed.
Is there any treatment for hair loss?
Depending on your type of hair loss, treatments are available. If a medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognizing and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss.
Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.
If adequate treatment is not available for your type of hair loss, you may consider trying different hairstyles or wigs, hairpieces, hair weaves or artificial hair replacement.
Baldness is not usually caused by a disease, but is related to aging, heredity, and testosterone. In addition to the common male and female patterns from a combination of these factors, other possible causes of hair loss, especially if in an unusual pattern, include:
- Hormonal changes (for example, thyroid disease, childbirth, or use of the birth control pill)
- A serious illness (like a tumor of the ovary or adrenal glands) or fever
- Medication such as cancer chemotherapy
- Excessive shampooing and blow-drying
- Emotional or physical stress
- Nervous habits such as continual hair pulling or scalp rubbing
- Burns or radiation therapy
- Alopecia areata -- bald patches that develop on the scalp, beard, and, possibly, eyebrows. Eyelashes may fall out as well. This is thought to be an immune disorder.
- Tinea capitis (ringworm of the scalp)
Hair loss from menopause or childbirth often returns to normal 6 months to 2 years later.
For hair loss caused by illness (such as fever), radiation therapy, or medication use, no treatment is necessary. The hair will usually grow back when the illness has ended or the therapy is finished. A wig, hat, or other covering may be desired until the hair grows back.
For hair loss due to heredity, age, and hormones, the topical medication Rogaine (minoxidil) can be helpful for both male and female pattern baldness. Expect to wait 6 months before you see results. The oral medication Propecia (finasteride) is effective in some men. This medicine can decrease sex drive. When either medication is stopped, the former baldness pattern returns.
Hair transplants performed by a physician is a surgical approach to transferring growing hair from one part of the head to another. It is somewhat painful and expensive, but usually permanent.
Hair weaves, hair pieces, or changes of hair style may disguise hair loss. This is generally the least expensive and safest approach to hair loss. Hair pieces should not be sutured to the scalp because of the risk of scars and infection.
Call your Board Certified Dermatologist if
- You are losing hair in an atypical pattern.
- You are losing hair rapidly or at an early age (for example, teens or twenties).
- You have any pain or itching associated with the hair loss.
- The skin on your scalp under the involved area is red, scaly, or otherwise abnormal.
- You have acne, facial hair, or menstrual irregularities.
- You are a woman and have male pattern baldness.
- You have bald spots on your beard or eyebrows.
- You have been gaining weight or have muscle weakness, intolerance to cold temperatures, or fatigue.
What to expect at the office of Board Certified Dermatologist Dr. Gary Rothfeld at NYC Dermatology Center
A careful medical history and examination of the hair and scalp are usually enough to diagnose the nature of your hair loss.
Your doctor will ask detailed questions such as:
- Are you losing hair only from your scalp or from other parts of your body as well?
- Is there a pattern to the hair loss like a receding hair line, thinning or bald areas on the crown, or is the hair loss throughout your head?
- Have you had a recent illness or high fever?
- Do you dye your hair?
- Do you blow dry your hair? How often?
- How often do you shampoo your hair?
- What kind of shampoo, hair spray, gel, or other product do you put on your hair?
- Have you been under unusual stress lately?
- Do you have nervous habits that include hair pulling or scalp rubbing?
- Do you have any other symptoms like itching, flaking, or redness of your scalp?
- What medications do you take, including over the counter drugs?
Diagnostic tests that may be performed (but are rarely needed) include:
- Microscopic examination of a plucked hair
- Skin biopsy (if skin changes are present)
Ringworm on the scalp may require the use of an oral drug, such as griseofulvin, because creams and lotions applied to the affected area may not get into the hair follicles to kill the fungus.
Treatment of alopecia areata may require topical or injectable steroids or ultraviolet light.
Dr. Gary Rothfeld at NYC Dermatology has over 25 years of experience in Hair Loss. He is one of the pioneers of medical hair transplantation. He has performed over 10000 hair transplants in his career.
Any questions or to make an appointment click here
Dr Gary sees every patient himself and believes in personalized care. The Doctor does not employ any physician assistants, nurse practitioners, or other physician substitutes to do his treatment. He sees every patient himself at every visit.
A significant percentage of my Dermatology Conditions are diagnosed on listening to medical history of the patient alone, a further percentage on examination and the remainder on further investigation and my patients teach me the rest. It is clear to me that history and examination skills remain at the very core of my dermatology practice. Older Dermatologists like myself rely on history and physical to a greater degree than the younger dermatologists. I think that the pendulum has swung too far towards all these cosmetic procedures where the younger dermatologists are just doing cosmetic procedures and not listening to their patients. This is an important point because if the Dermatologist does not spend enough time with the patient the cosmetic procedures will not work.