How to Spot, Diagnose and Treat Hair Loss
By Dr. Alan J. Bauman
Roughly 80 million men and women in the U.S. suffer from hair loss. This may sound like a daunting figure, but in reality most hair loss cases today are treatable - thanks to several decades of advanced medical research and high-tech treatment development.
However, the most important weapon in the battle against baldness is a relatively simple one - early detection.
By the time hair loss becomes noticeable to the naked eye, science tells us that about 50% of the hair follicles responsible for producing hair have already shut down. The earlier patients can get started on preventive or restorative therapies, the better their odds are for retaining a full and healthy-looking head of hair.
Since August is National Hair Loss Awareness Month, it’s a good opportunity for all of us - men and women, old and young - to learn more about the early signs of hair loss and the treatment options available.
Detecting Hair Loss
A common mistake with detecting hair loss is to rely on the “mirror test” before taking action. That is, most people wait until their hair loss becomes readily noticeable - perhaps it’s diffuse thinning up top for men and women, or a receding hairline.
However, relying on this type of visual cue puts you at a disadvantage because as noted above, by the time hair loss is visible half of your hair in that area may be already gone.
Some people think that a better way to check for early signs of hair loss is to examine how much hair is being shed each day. This also can by tricky because a typical healthy head of hair will lose approximately 100 hair strands per day due to natural hair follicle cycling. If you’re noticing an excessive number of hairs on the pillow in the morning, at the bottom of the shower or in the comb, you may be in the active stages of hereditary hair loss. What’s tricky about that? Well, excessive shedding doesn’t always mean you have male or female pattern hair loss--it could be a sign of an underlying health problem or even a scalp issue, which results in temporary shedding of hair called telogen effluvium.
Further, patients put themselves at another disadvantage when they tell themselves that their hair loss has stopped. Studies show us that left untreated, hair loss will always get worse over time even though visually it appears to have stopped.
For these reasons, it is important to schedule a visit with an experienced, board-certified hair restoration physician when these symptoms are observed. He or she will be able to run the proper tests to determine the true cause of your hair loss, and what types of treatments might be needed. A hair restoration physician can also run tests that will help predict the likelihood of future hair loss.
Diagnosing the Problem
Aside from blood work and other traditional tests, Hair restoration physicians have several tools at their disposal to gauge a person’s risk of hair loss, and the rate at which active hair loss is progressing.
- Genetic tests - While the results are a little more complicated than a “yes” or “no”, a new genetic test by HairDX can accurately determine a man’s (and woman’s) risk for losing their hair, so they can begin preventive treatments early. The test uses a simple cheek swab and can determine the genetic risk of developing male and female pattern hair loss. There are also genetic tests that can determine how well you are likely to respond to certain medical treatments. For example, the HairDX Genetic Test for androgen sensitivity can help predict your response to certain types of medical treatment (such as finasteride or Propecia). This information helps the physician tailor a treatment regimen specific to the patient’s genetics and therefore patients avoid spending hundreds or thousands of dollars on a treatment that may not be effective for them.
- Hair density measurements - The HairCheck® device is a highly sensitive hand-held ‘trichometer,’ which measures hair caliber and hair density together, and expresses them as a single number known as the Hair Mass Index (HMI), or "Hair Number.” Doctors can use this number to accurately assess hair loss, growth and breakage on any area of the scalp. By tracking these numbers, a physician can determine the extent and rate of the patient's hair loss and/or breakage, and inform them of any changes over time. This information also helps monitor and track the efficacy of their treatment regimen in case modifications are needed. This type of testing works for both men and women.
- Scalp exams - Newly developed “Trico-Tests” are highly effective at determining if an underlying problem with the scalp is the root cause of a hair disorder. Patients are evaluated with non-invasive, pain-free skin diagnostic tests that check the scalp’s pH, sebum and hydration levels to determine if there are any abnormalities. A magnified videoscopic examination of the scalp is also performed to examine any signs of scalp flaking or dandruff, excess sebum production, identify bacterial or fungal colonies and assess overall hair follicle health and function. Depending on the patient’s symptoms, hair strand cortisol level testing may also be administered (for example: Bauman Medical’s “sTRESS Test”). Scalp testing is available for both men and women.
Effective Treatment Options
Once the cause of the hair loss has been determined, an effective treatment program can be developed. This is likely to include a multi-therapy approach, and certain lifestyle changes may also be recommended.
Today, there are a variety of effective treatment options available for both men and women:
Topical and Oral Treatments: In addition to the over-the-counter minoxidil-containing Rogaine, and Rogaine for Women, topical treatments include compounded topical minoxidil Formula 82M and Latisse/Bimatoprost or other prostaglandin analogs. Currently, there is only one FDA-approved oral medication, (finasteride, brand name Propecia).
Low Level Laser Therapy: In recent years, low-level laser therapy has become a key element of the multi-therapy hair restoration regimen. Thanks to continued device approvals from the FDA specifically for hair regrowth, and a wide array of devices, including in-office laser ‘hoods’, at-home handheld units, hats, and brushes, more patients and doctors are utilizing phototherapy as an effective treatment option.
Nutritionals: Many hair loss patients benefit from the addition of nutritional supplementation in their treatment regimen. Hair vitamins and supplements, like Viviscal Pro and “SuperBiotin” are specially-formulated to nourish thinning hair, while also creating a healthy environment for existing hair and hair follicles.
Scalp Makeover: During a scalp makeover, the patient undergoes a simple skin diagnostic test to see if their sebum, pH, hydration, toxin and cortisol levels are imbalanced, and then depending on the results, a variety of scalp therapies are provided. Treatments for the scalp range from sebum-regulating topical serums (as well as hydration, anti-DHT and blood microcirculation stimulants) to scalp steaming, scalp massage, electrotherapy stimulation, hair boosting dermal patches and laser therapy. A scalp makeover can help overcome common hair problems, including hair thinning, excessive shedding and breakage.
Platelet Rich Plasma Therapy, or PRP: The use of autologous PRP (platelet rich plasma) for wound healing after hair transplants and as a stand-alone treatment for enhancing hair growth has become a promising new treatment for both men and women. The application of PRP to the scalp requires short outpatient visits which can normally be done over a lunch hour.
Hair Transplant Robotics: The first robot designed to perform part of the hair transplant recently became available. Called the ARTAS System, it’s an image-guided robot that harvests up to 1,000 hair grafts in a single hour – which has made hair transplant surgery even more accurate and efficient and leaves no linear scar.
NeoGraft FUE: Less invasive hair transplants allow for the transplantation of hair without the ‘telltale’ signs of old-style hair transplantation such as the linear scar on the back of the head. The NeoGraft device helps the surgeon extracts hair follicles from the donor area of the scalp individually without the need for scalpel or stitches, leaving no linear scar. Recovery is faster, more comfortable and less restrictive. Artistic hairline design and single-follicle transplantation techniques create hair transplant results that truly defy detection.
3D Printed Hair: For male or female hair loss patients suffering from severe or extensive hair loss, or those looking for an alternative to hair transplantation, “3D-Printed Hair” is the latest breakthrough in hair replacement. New non-surgical medical-grade hair and scalp prosthesis, like the CNC Hair Replacement System, offers a customized, natural hair replacement option for a complete return to an active lifestyle, without compromise! The 3D printed hair system can be shampooed, dried and styled as your own hair. With monthly maintenance and proper care, the prosthesis can last up to 4-5 years - much longer than traditional wigs or hairpieces.
Visit http://www.baumanmedical.com for an overview of these treatment options.
Seeing It Through
Treatment programs should be customized for the individual patient, and based on a full examination of the person’s genetic factors, health history, hair loss progression and lifestyle issues. Routine follow-ups are also important in order to determine how well the follicles are responding to the treatments, and to see if changes should be made in the therapy regimen.
One of the hardest parts of treating hair loss is helping the patient understand that it is a long-term investment and process. Just like hair loss, initial changes in hair regrowth take time and can be subtle before they are noticeable to the naked eye.
When one starts to actually treat their hair loss, it is important to keep in mind that it can take more than a year to see the full, final results from treatment. This is longer than many other treatments or procedures that patients have experience with so many patients are tempted to end their hair treatments too soon. Ending treatment prematurely disrupts any progress that had been made. Regular follow-ups should be performed every 90 days as this helps to reconfirm to the patient that they are responding to their treatment regimen and getting the best results possible. If they are not responding, adjustments to treatments can be made expeditiously.
Hair loss is a treatable condition, but the earlier the problem is detected and treatment started, the better your chances are of keeping your hair and re-growing what has been diminished.
Tips on Finding a Hair Restoration Physician
- A hair restoration physician is someone who specializes exclusively in the medical diagnosis, treatment and tracking of hair loss and its treatment.
- Look for physicians who are board-certified in hair restoration by the American Board of Hair Restoration Surgery, accepted members of the International Alliance of Hair Restoration Surgeons and recommended by the American Hair Loss Association.
- Due to the limited number of board-certified hair restoration physicians worldwide, prospective patients should be prepared to travel and consult long-distance.
- Before choosing your doctor, visit the clinic, read reviews, ask for before-and-after pictures and, most importantly, ask questions.
- Medical doctors who do not specialize in hair restoration (general practitioners, dermatologists, etc.) may not be up to date on the latest treatment methods and technologies. This can lead to subpar results and, in some cases, treatment complications.
Visit http://www.baumanmedical.com to start a consultation with hair loss expert and board-certified hair restoration physician, Dr. Alan J. Bauman.