Hair Loss

Hair loss is a common issue that can affect men and women of any age. At Kirsch Dermatology, we offer a wide range of effective hair loss treatments that can slow or stop hair loss and, in many cases, help you regrow a fuller head of hair.

The Most Common Cause of Hair Loss: Androgenetic Alopecia

Androgenetic alopecia is the most common cause of hair loss in both men and women. It is a combination of genetic factors that account for differences in age of onset, progression, pattern, and severity of hair loss. Because androgenetic alopecia is inherited genetically from either the mother or the father (or both) and involves multiple genes, it is difficult to predict with reliable accuracy. Without intervention, once this condition has begun, hair loss will continue indefinitely.

Male Pattern Hair Loss

Male pattern hair loss (androgenetic alopecia) is the most recognized type of hair loss. It can begin for men as early as in their twenties and is characterized by a receding hair line and loss of hair on the top and front of the head. With male pattern hair loss, the hair follicles gradually diminish, and the hair becomes increasingly fine. Eventually, male pattern hair loss can lead to bald spots where no hair grows at all (hence the phrase “male pattern baldness”). As much as 85 percent of men over age 50 have some extent of male pattern hair loss.

Female Pattern Hair Loss

Female pattern hair loss (androgenetic alopecia) typically begins around or after menopause. It is characterized by a diffuse thinning of hair across the top of the scalp caused by increased shedding and/or gradual thinning of the hair. Because women with androgenetic alopecia do not usually have a receding hairline and bald patches, female pattern hair loss may be less obvious than male pattern hair loss. Still, the condition is progressive and often becomes more noticeable over time. While it is less common than male pattern hair loss, female pattern hair loss is still very common and affects as much as 50 to 65 percent of women post-menopause.

Telogen Effluvium

Telogen effluvium is hair loss caused by a traumatic experience, such as childbirth, major surgery, illness, or extreme stress. While healthy hair follicles are all in various phases of the hair growth cycle, this condition forces many hair follicles to shift all at once into the resting (telogen) phase. After six weeks to three months, these hairs are shed all around the same time, sometimes in handfuls and clumps. Most cases of telogen effluvium are temporary, although some individuals have chronic telogen effluvium with no known cause.

Alopecia Areata

Alopecia areata is hair loss caused by an inappropriate inflammatory reaction where the immune system attacks the roots of hair follicles. This usually causes patchy hair loss, but in extreme cases it can cause full hair loss over the entire body. While the condition itself is incurable, in many cases treatment for alopecia areata can regrow hair.

Other Causes of Hair Loss

Here are some other relatively common causes of hair loss:

  • Pressure/Traction Alopecia: Hair loss that occurs from repeated pulling or pressure on the hair follicles. It is more common with certain hairstyles (such as dreadlocks, cornrows, braids, and buns), excess blow-drying or flat-ironing, certain hair treatments (such as chemical treatments, weaves, or extensions), and frequent wearing of wigs, hats, tight hairbands, and headbands. This type of hair loss can be permanent if it is not addressed early on.
  • Central Centrifugal Cicatricial Alopecia: Permanent, scarring hair loss that is believed to have many potential causes, including genetics, hair care practices, autoimmune diseases, and fungal or bacterial infections.
  • Frontal Fibrosing Alopecia: Permanent hair loss that occurs across the frontal scalp margin. This type of hair loss is increasingly common worldwide and is believed to have many potential causes, including genetics, hormones, autoimmune diseases, inflammation, and environmental factors.
  • Medication-induced Alopecia: Hair loss that occurs as a side effect of medication. This can lead to telogen effluvium (where the hair follicles are forced into resting phase and fall out early) or anagen effluvium (which interferes with new hair cell formation). Many drugs can inadvertently cause hair loss, including antibiotics, oral contraceptives, antidepressants, NSAIDs, steroids, chemotherapy, and others. Medication-induced hair loss is usually temporary, and normal hair typically occurs after the medication has been stopped.

Hair Loss Treatments

At Kirsch Dermatology, we offer a wide range of effective treatments for hair loss. It is important to note that, because hair loss is a complex issue, the best results come from using multiple different treatments at the same time. Treatments include:

Minoxidil (Topical and Oral): Minoxidil is a medication that can regrow hair for individuals with androgenetic alopecia. This medication may be taken orally or applied topically to the scalp.

Oral Finasteride and Dutasteride: Finasteride and dutasteride are medications that decrease the amount of DHT, which makes it easier to regrow hair and slow hair loss at the crown of the head and middle of the scalp.

Ketoconazole Prescription Shampoo: Ketoconazole prescription shampoo is an antifungal shampoo that can disrupt DHT and prevent hair loss. This treatment can be used by men or women with androgenetic alopecia.

Oral Spironolactone: Oral spironolactone is a medication that slows down androgen production. It can slow hair loss and encourage hair regrowth for women with female pattern hair loss.

Steroids (Topical and Oral): Steroids/corticosteroids may be given to individuals with alopecia areata to suppress the immune response that attacks hair follicles. This can allow the hair follicles to recover and regrow.

Immunomodulators (Topical and Oral): Immunomodulators (including Janus Kinase inhibitors) can help individuals with even severe alopecia areata regrow hair.

HydraFacial Keravive™: This in-office dermatology treatment cleanses and exfoliates the scalp and hair follicles, nourishes them with growth factors and proteins, and promotes a healthy scalp with fuller hair. Daily use of the HydraFacial Keravive Peptide Complex Spray enhances these results by delivering daily hydration and nourishment to the scalp and hair follicles.

PRP (Platelet-Rich Plasma): This treatment uses platelet-rich-plasma (extracted from your own blood), which is rich in growth factors, to stimulate hair regrowth on the scalp. PRP for hair loss is especially beneficial for individuals with early hair loss.

Vitamin and Nutritional Supplementation: Certain vitamins and minerals play a role in hair follicle development and cellular function. Evaluating and adjusting your diet to include appropriate supplements can assist in the prevention and treatment of hair loss.