What Increases Your Risk
Factors that increase the risk of hair loss include:
- Genetics . If one or both of your parents have hair loss, it is likely that you will also.
- Disease or illness. Certain diseases or an illness can cause hair loss. The diseases may include ringworm of the scalp , thyroid diseases such as hyperthyroidism and hypothyroidism, or lupus. The illness may include a severe infection or high fever.
- Age. Many people have some hair loss by the age of 50.
- Medicines and medical treatments. Certain medicines or medical treatments can cause scalp problems and hair loss.
- Hair care and styling. Some methods of hair care or hair styles can damage hair and cause hair loss.
If you have alopecia areata, you are more likely to have permanent hair loss if:
- You have a family history of the condition.
- You have the condition at a young age.
- You have a lot of hair loss.
- You have abnormal colour, shape, texture, or thickness of the fingernails or toenails.
Patients Who Are Eligible To Be Scheduled For A Hair Loss Clinic Appointment Should Have One Of The Following Issues:
- Patients with a clinical diagnosis by a dermatologist OR biopsy-proven scarring alopecia:
- Lichen planopilaris
- Central centrifugal cicatricial alopecia
- Discoid Lupus Erythematosus
- Dissecting cellulitis of the scalp
- Scarring alopecia or scarring hair loss
- Patients with moderate to severe alopecia areata, affecting 30% or more of the scalp
- Patients with chemotherapy or cancer therapy induced alopecia
- Patients with alopecia due to graft versus host disease
If you meet eligibility, you must register as a Mass General patient to make an appointment.
It is required that patients provide one of the following to our office by faxing to 617-726-7768 Attn. Hair Loss Clinic:
2) A biopsy report confirming one of the following diagnoses:
- Lichen planopilaris
- Central centrifugal cicatricial alopecia
- Discoid Lupus Erythematosus
- Dissecting cellulitis of the scalp
- Scarring alopecia or scarring hair loss
- Chemotherapy induced hair loss
For less severe forms of hair loss or for patients who are not eligible for our Hair Loss Clinic appointments, you may request a consultation with one of our general dermatologists.
At Mass General Dermatologys Hair Loss Clinic, our board-certified dermatologists are highly specialized in the diagnosis, management and treatment of hair loss that affects both adolescents and adults. For most people, it is normal to shed 100-150 hairs a day however, if you are noticing bald spots or excessive hair loss, it may be a sign of alopecia.
How Do Dermatologists Treat Hair Loss
Just as there are many causes, there are many treatments for hair loss. Dermatologists recommend treating hair loss early, before you lose a lot of hair. Hair loss is harder to treat when a person has already lost an extreme amount of hair.
One or more of the following treatments may be part of your treatment plan.
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What Else Can Cause Hair Loss
Besides anemia and thyroid conditions, there are many other causes. These can include chemotherapy, certain medications, a severe illness or surgery, giving birth, menopause, low iron levels, polycystic ovary syndrome , extreme stress, physical trauma, dramatic weight loss, eating disorders, higher than normal vitamin A levels, hormones, and the list can go on and on. Further, hair loss can also be self-inflicted by using harsh products such as bleaches or dyes, frequent blow-drying, frequent flat ironing, tight braids, cornrows, tight rubber bands, etc.
The bottom line is: Take care of you and your hair. If you are asking yourself the question “Why is my hair falling out,” and you don’t know the reason for it, then make an appointment to see your doctor. Ask him/her to check all your blood levels to see if there is an underlying condition or deficiency. Tell him/her of all your other symptoms and possible stressors that may have contributed to this problem. Knowing the actual cause of your hair loss hopefully will enable your doctor to recommend a treatment plan.
It is also good to know that if you have hair loss, there are many options out there today. Many women, even those with healthy hair are wearing wigs and extensions every day. Here’s to you, your health and your hair!
How Is Hair Loss Treated
Talking about hair loss, there are some lifestyle changes that you can make in order to improve your hair loss. As for your dermatologist, he/she can prescribe drugs or recommend some over-the-counter drugs to help treat your case of hair loss. Scalp injections might be required as well. Scalp injections are one of the most commonly used treatments that dermatologists prescribe for hair loss. You and your doctor can also discuss the possibility of hair transplant if there is a severe hair loss going on.
Remember It all comes back to the reason that has been causing you to lose hair rapidly. If it is stress that has been causing your hair loss, managing your stress levels will do some good. If it is a thyroid issue, treating it usually results with an improvement in your hair loss. As soon as that reason is discovered, you can proceed to exercise, improve your diet, and use all of the tips and treatments that your dermatologist has recommended.
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Other Concerns With Hair Loss
Treating the cause often stops hair loss, and hair grows back. In some cases, other treatment is needed.
Hair care for cancer treatment
Hair loss caused by cancer treatment requires special care: Use mild shampoos. Do not use a hair-dryer.
Alopecia areata
Alopecia areata occurs when the immune system attacks hair follicles, where hair growth begins. Because hair often grows back within a year, you may decide not to have treatment. Understanding the come-and-go nature of hair loss with this condition can help you make the best treatment decision. Children and teenagers may need counselling to help them adjust to the hair loss.
Medicines, such as corticosteroids, can be used to treat alopecia areata.
Women taking birth control pills
Women with inherited hair loss who wish to take birth control pills should use a pill type that does not add to hair loss, such as a norgestimate or desogestrel.footnote 2
Factors To Inform A Diagnosis Of Female Pattern Hair Loss
A differential diagnosis should be conducted to rule out other common causes of hair loss such as chronic telogen effluvium, central centrifugal cicatricial alopecia, frontal fibrosing alopecia, and patterned fibrosing alopecia.
In evaluating a patient for female pattern hair loss, Dr. Carmina mentioned a few key recommendations:2
- Assessment of female pattern hair loss is clinical so healthcare providers should look for two common patterns:
- Isolated hair loss with androgen levels at 4 ng/dl would not be considered a form of hyperandrogenism.
- Seek a dermatoscopic exam and/or dermatologic biopsy to assess hair density that will vary by ethnicity
- Evaluation for possible androgen excess should be done routinely while assessing for vitamin D, iron, zinc, thyroid panel, and prolactin is recommended.
- First-line treatment with minoxidil with adjunctive therapy as needed
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Should I See A Dermatologist For Hair Loss
Of course, you can ask for advice from your dermatologist online, but we would recommend seeing him/her personally. Do not make the mistake of thinking that a dermatologist is only trained to take care of any skin issues. Your dermatologist is able to recognize and treat any issues that are linked, not only to your skin but also to your nails and hair. That is why, during your visit at the dermatologist, you will be asked to take away most of your clothes, so that your doctor can inspect the whole skin, your scalp and hair, and your nails to look for any irregularities.
Of course, your dermatologist will also ask you about your medical history and perform a physical exam. Other tests such as a blood test or a hormone test might be required as well. For example, if your dermatologist discovers that it is really a serious hair loss case that you are dealing with, he/she would naturally want to investigate further and discover the reason behind it. You might be instructed to expand your visit to an endocrinologist or even another dermatologist due to the importance of a second opinion.
Treatment For Other Causes Of Hair Loss
If a disease, medicine, or stress is the cause of hair loss, then treating the disease, changing medicines, or managing stress may stop the hair loss. And your hair is likely to grow back. For example, if an underactive thyroid is causing the problem, taking thyroid medicine may help. And most hair lost during chemotherapy will grow back after the treatment ends.
If alopecia areata is the cause of hair loss, medicines such as corticosteroids can be used to treat it. But because hair often grows back within a year, you may decide not to have treatment. Understanding the come-and-go nature of hair loss with this condition can help you make the best treatment decision. Children and teens may need counseling to help them adjust to the hair loss.
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How Do Dermatologists Diagnose Hair Loss
Because so many things can cause hair loss, a dermatologist acts like a detective and begins by asking questions. The dermatologist will want to know whether your hair loss happened suddenly or gradually. Knowing this helps to determine the cause.
A dermatologist also will ask what medicines you take, what allergies you have, and whether you have been dieting. It is important to give the dermatologist accurate information. Like a murder mystery, the slightest clue can solve the case. Women may be asked about their menstrual cycles, pregnancies, and menopause.
The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
Sometimes the evidence lies in your scalp. The dermatologist may remove a small piece of the scalp. This is called a scalp biopsy. A dermatologist can quickly and safely perform a scalp biopsy during an office visit. A scalp biopsy can be essential to solving the case. Sometimes, a blood test is necessary.
Because so many things can cause hair loss, it can take time to find the cause.
How To Prepare For A Visit To A Hair Loss Specialist
They key is to make sure the doctor has specific expertise and knowledge in hair loss.
The most suitable doctors to assess your hair loss concerns are a dermatologist , hair loss clinic or a medical professional who specialises in diagnosing and treating scalp and hair disorders .
Tips to assist your doctor
- Make a list of important personal information, especially any recent life changes or major stresses youve experienced
- List all the medications including supplements/vitamins you are currently taking
- List any medical conditions you are affected by
- Jot down some questions youd like to ask your doctor about hair loss
Questions your doctor might ask you
- When did you first begin experiencing hair loss?
- Do you lose hair continually or just occasionally?
- Have you noticed any of the following: hair breakage, shedding or poor hair growth?
- Have you lost hair overall or in patches?
- Have you found anything that seems to improve or worsen your hair loss?
- Is this the first time you have experienced hair loss or has it occurred previously?
- Is anyone in your immediate family affected by hair loss?
- What medication or supplements do your take regularly?
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A Trichologist Is Not Medically Trained
A trichologist can of course help in some cases but can only give patients topical treatment for hair loss, as they are not medically trained. Unlike a dermatologist, they cannot perform tests that help with the diagnosis and evaluation of the condition and inform the best course of treatment these require special training.
For example, a dermatologist can perform a trichoscopy with a video dermatoscopy, a non-invasive technique that allows a rapid and magnified observation of the skins surface enabling the evaluation of hair thickness, presence of regrowing hairs and scalp inflammation. We can also perform a trigonometry, which involves an instrument that provides a numeric value of the hair quality. All of which are vital to in-depth diagnosis.
Dermatologists can also carry out a scalp biopsy, where a sample from the scalp is taken under local anaesthetic and tested under the microscope by a histopathologist. These tests are often necessary to evaluate cases of hair loss.
Only a dermatologist is qualified to carry out these tests, without which a full and thorough evaluation and diagnosis is not possible. Getting to the cause of your condition leads to better treatment. Furthermore, there are a variety of oral treatments available for hair disorders which a trichologist cannot prescribe but a dermatologist can so these are some reasons why you need a dermatologist for hair loss and not a Trichologist.
What Doctor Should You See For Hair Loss
September 25th, 2018
Great news! There are hair loss doctors that specialize in treating just women. Choosing which one to go see can be tricky. Hopefully, our insight can help make that a bit easier. We must state that were not doctors and therefore we can not provide medical advice. This post is based upon opinions and reviews from our own experiences and those of family and close friends.
Many conditions can sometimes be diagnosed and treated within the care of one doctor. Others may not be able it may take a few different doctors to truly diagnosis the issue, and then also the care of a few doctors to see what is the best course of treatment. This may be due to there being more than one underlying issue or the reason behind the problem.
Like many people, we also find comfort in more than just one opinion. Personally, I like to speak to a few different doctors if I have been told there is something serious going in my health which requires a form of treatment. I like to know if there are other options as well. I would suggest going to speak to a few different doctors personally. This is true also with hair loss doctors.
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What Kind Of Doctor Do I See For Thinning Hair
My hair has always been thin but now it is very noticeable. Ive been humiliated and called names. I cant live like this anymore, people are to hateful. I don’t know if there is anything that can be done but I need help and I just dont know where to turn. I went to my regular doctor who coldly told me it was male pattern baldness and there was nothing could be done. Im not a male and I dont want to be treated like this is no big deal. It is on the crown of my head just like most males though.