Alopecia is defined by Merriam-Webster as “loss of hair, wool, or feathers”. We think of it as baldness. Alopecia affects men and women, young and old, and has many causes. Thanks to advances in medicine, alopecia is treatable and cures can be achieved. One of the most important factors in treating hair loss is understanding why hair loss occurs. Below we will discuss the 2 of the most common variants of hair loss and therapy options for each. Later blogs will cover other causes of alopecia and their treatments.
Alopecia Areata is an autoimmune disease that typically appears during childhood and adolescence. It classically appears as sharply defined, circular patches of hair loss on the scalp and face. Typically it does not involve the entire scalp but there are several variants that affect the entire scalp or body. In most cases alopecia areata resolves on its own and is not associated with other conditions. Rarely alopecia areata is associated with thyroid disease or anemia, these are seen more frequently in patients that are older when the disease first appears.
Alopecia areata can be cosmetically devastating to those it affects, making treatment quite important. Traditional therapy options include topical and injectable steroids, oral immune suppressive medications, and topical irritant therapy. Recently several oral medications have shown promise in treating alopecia areata, Xeljanz and Vytorin. They are both well tolerated and can produce great results. The only draw back is cost, they are expensive and can be difficult to get covered by insurance.
Androgenetic Alopecia is the most common form of hair loss. It affects both men and women and can appear as early as our late teens and early 20s. Andogenetic alopecia is commonly known as male pattern baldness and female pattern baldness.
Androgenetic alopecia is caused by the effects of testosterone byproducts on the hair growth cycle. Testosterone is converted to dihydrotestosterone(DHT) and dehydroepiandrosterone(DHEAS) by 5-alpha-reductase, a normal enzyme found in our skin and hair follicles. DHT and DHEAS interfere with the normal hair growth cycle resulting in decreased hair growth and eventual hair loss.
Although there is no cure for hair loss, there are many highly effective therapies. Topical minoxidil, best known as Rogaine, has long been shown to be effective in slowing down hair loss from androgenetic alopecia. It is safe to use in both men and women and is very affordable. Alternate topical therapies are available and in small studies have been shown to be helpful in male and female pattern baldness; however, they lack large, well designed studies showing there effectiveness.
Finasteride is an oral medication that inhibits the function of 5-alpha-reductase and has been proven in numerous studies to decrease hair loss and also induce hair growth. It is very safe in both men and women when appropriately prescribed. Spironolactone is an oral medication that inhibits testosterone’s function and can also be useful in controlling hair loss from androgenetic alopecia. It is only used in women and is very well tolerated. There are numerous oral supplements that can also be used to help with hair restoration. They are generally considered safe but often lack good evidence that shows real benefit.
Platelet-rich plasma injections are a new and exciting therapy in hair restoration. The technique involves using growth factors in your own blood to stimulate hair growth. Its like fertilizing your hair. Injections are performed monthly for 3 months and then repeated every 6-12 months. The treatment sessions only take 10-15 minutes and are very well tolerated. Numerous studies have shown it to be effective at restoring hair loss in male and female pattern baldness.
Hair transplant provides a permanent solution to hair loss caused by androgenetic alopecia. Hair transplantation has evolved over the last 50 years from hair plugs to strip harvesting to manual follicular unit excision(fue) to state of the art robotic hair transplant. When performed properly all modern hair transplants looks great. The ARTAS® Hair Restoration Robot delivers the most state-of-the-art, precise, accurate, and reproducible results available.The advanced technology in the ARTAS® Robot allows more individuals to get amazing results, far exceeding traditional methods.
Dermatology and Cosmetic Physicians, S.C. is proud to offer the ARTAS® Robot for hair transplantation. I am the exclusive provider of hair transplantation in Wisconsin, Minnesota, and the Dakotas with the ARTAS® Robot. With the ARTAS® Robot and our highly skilled, professional team you can be assured an excellent result.
To schedule an appointment to discuss your hair loss treatments, please call Dermatology and Cosmetic Physicians, S.C. at 262-558-4367.