Tag Archives: HAIR LOSS CAUSES

Testosterone Replacement Therapy Linked to Hair Loss


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A recent study released in the May issue of The Journal of Sexual Medicine revealed the compliance rate for taking Testosterone Replacement therapy (TRT) is low in hypogonadal males. The study showed that by six (6) months of therapy only 35 % of male patients had continued on their medication. At twelve (12) months, the adherence rate had dropped to 15.4%. So what did we learn from this study ? Men are bad when it comes to taking medication.

Those numbers don’t surprise physicians who engage in hair loss and hair restoration procedures and treatments. Patients who fail to take physician prescribed medications, such as DHT blockers and TRT is a common problem.  Patients that have purchased and used illegal anabolic substances from nutrition sports stores are even more difficult to treat.  These patients often times present, unknowingly, with clinical findings of Anabolic Steroid abuse. Hair loss patients using anabolic steroids can also present with side effects including fatigued, erectile dysfunction,  poor libido, and low sex drive.

For the average medical doctor, the suspicion of underlying illegal anabolic steroid (AS) use as a cause for the patient’s subjective complaints often goes undetected. In patients who are no longer cycling on AS,  the development of  Anabolic Steroid Induced Hypogonadism (ASIH) is common unless the patient goes on another cycle of AS.

bald bb6Doctors often miss the correct diagnosis because they fail to ask the right questions, or patients are too embarrassed to offer this medical information during their office visit. The situation is only made worse because of inadequate training and knowledge of physicians in treating patients with ASIH from anabolic steroid use.

Most practicing physicians don’t understand  anabolic steroid use or the use of testosterone because physicians are taught early in medical school and residency to avoid these trouble causing and drug abusing patients. It is critical that patients be given direct instructions by healthcare providers about the serious side effects of steroid use.

Only a handful of physicians are engaged in evaluating the endocrine functions of their patients, and an even lesser amount of physicians have any idea of the side effects associated with steroid or non-physician prescribed testosterone. These side effects include hair loss, testicular atrophy, gynecomastia, lipid and liver abnormalities, and an increase in red blood cells called polycythemia.

Hair loss occurs for men and women who use testosterone or anabolic steroids because of the increase chemical conversion in the body of Testosterone to another hormone called, Dihydrotestosterone (DHT). During the metabolism or breakdown of  Testosterone, a equivalent increase in conversion to DHT occurs. This hormone has been known for over three(3) to four (4) decades to cause hair loss.

So what should a hair loss patient do when they have taken non-physician prescribed steroids?  Hair Restoration surgeon, Dr. Ken Williams of the Irvine Institute of Medicine and Cosmetic Surgery, states, “ Being honest with your doctor and obtaining medical care by a physician who is familiar with treating hair loss patients with hypogonadal symptoms is paramount.”

Williams adds,  “It is vital to have a comprehensive physical and endocrine evaluation. Baseline blood tests such as a PSA, Testosterone, CBC, and DHT are critical.  Routine office visits in time will eventually reestablish normal hormone levels, libido, and stabilize hair loss.

Patients with a history of steroid use and who suffer from hair loss can call Dr. Williams at his office at 949-333-2999 for a medical consultation and evaluation.

Using Fat Cells to Cure Hair Loss


Yale researchers have discovered the source of signals that trigger hair growth, an insight that may lead to new treatments for baldness. Researchers have identified stem cells within the skin’s fatty layer and showen that molecular signals from these cells were necessary to spur hair growth in mice, according to the data published in the Sept. 2 issue of the medical journal Cell.

“If we can get these fat cells in the skin to talk to the dormant stem cells at the base of hair follicles, we might be able to get hair to grow again,” said Valerie Horsley, assistant professor of molecular, cellular, and developmental biology and senior author of the paper.

Men with male pattern baldness still have stem cells in follicle roots but these stem cells have lost the ability to jump-start hair regeneration. Scientists have known that these follicle stem cells need signals from within the skin to grow hair, but the source of those signals has been unclear.

Horsley’s team observed that when hair dies, the layer of fat in the scalp which comprises most of the skin’s thickness shrinks. When hair growth begins, the fat layer expands in a process called adipogenesis. Researchers found that a type of stem cell involved in the creation of new fat cells, adipose precursor cells, was required for hair regeneration in mice. They also found these cells produce molecules called PDGF (platelet derived growth factors), which are necessary to produce hair growth.

Horsley’s lab is trying to find other signals produced by adipose precursor stem cells that may play a role in regulating hair growth. She also wants to know whether these same signals are required for human hair growth. Other authors from Yale are lead author Eric Festa, Jackie Fretz, Ryan Berry, Barbara Schmidt, Matthew Rodeheffer and Mark Horowitz.

The work was funded by the National Institutes of Health and the Connecticut Stem Cell Research Program.

Michelle Williams’ New Hair Cut: How To Grow Your Hair Out


rs_300x300-130410110511-600.MichelleWilliams.mh.041013While promoting her new movie, Oz the Great and Powerful, Michelle Williams admitted she was going to grow out her infamous pixie cut locks, “I think I’m ready. It’s on its way slowly but surely.  Her hairstylist, Chris McMillan, explained how he keeps Michelle looking gorgeous while she grows out her hair. “It’s getting long,” he said. “It’s growing out. We’re just cutting the underneath. It’s called an undercut haircut. That underneath hair is kept short and the top is growing longer so you can really see the extreme difference between the two. That is one way of growing a short pixie haircut out,” McMillan said. “You cut the underneath layers and keep the top longer.”

It is easy to get frustrated and discourage when attempting to grow out your hair.  Our society tends to be driven by instant gratification and growing out your hair can take months or even years…. enter hair extensions.  The problem with hair extensions though, is they cause even more damage and prolong the growing out process.  Many women even experience traction alopecia caused by the excess weight and pulling of the extensions.

The first thing you need to know is what influences healthy hair growth. There are many factors which influence healthy hair growth; these encompass a whole range of medical, emotional and lifestyle conditions which can prevent the body from effectively absorbing the essential nutrients it needs to support healthy hair.

  • Tppic131AGE– With aging nearly everyone has some hair loss with aging. The rate of hair growth begins to slow as we age. Hair strands become smaller and have less pigment. So the thick, coarse hair of a young adult eventually becomes thin, fine, light-colored hair. Many hair follicles stop producing new hairs.
  • STRESS– Believe it or not, the cliché about stress leading to hair problems is actually true. In extreme stress, the adrenal gland goes into overdrive, and the resultant increase in adrenaline sometimes leads to a consequent increase in the production of testosterone and dihydrotestosterone (DHT) which, without enough estrogen to counterbalance it, can lead to hair not being as healthy as it should be. For some people being stressed can seriously affect the condition of their hair and it can turn into a vicious circle: Stress affects the hair cycle and the impact of this can cause more stress for the sufferer. It can be difficult to pinpoint a specific stress episode as the reason hair becomes unhealthy but it is often acute and chronic stress that will bring on conditions such as telogen effuvium (hair shedding).
  • MEDICATION– In some instances medicine may have side effects which impact on healthy hair growth; they include cholesterol lowering agents, ulcer healing agents, anti-diabetic drugs, blood pressure medication and birth control pills.
  • POOR DIET– A diet rich in protein, vitamins and minerals is essential for healthy hair and hair growth. A diet low in protein is often the reason someone will experience hair loss, as a poor diet affects new growth. The hair follicle is a nonessential tissue and, therefore, one of the last tissues to receive nutritional substances, therefore any long-term deficiencies may lead to premature hair loss.
  • HORMONAL CHANGES– Hormonal changes associated with menopause can affect the healthy hair growth cycle. While this menopausal side effect is relatively rare, it has been known to occur in some cases. Other hormonal changes in the body– notably thyroid issues and hormonal responses to changes in the autoimmune system have been known to affect hair thinning and loss in some women. Women with Polycystic Ovary Syndrome can experience problems with their hair due to a hormone imbalance and increased sensitivity to the male hormones we all have.
  • POST PREGNANCY– While a beautiful and natural process, it is nonetheless a stressful process on the body. Consequently, it’s common for post-partum hair thinning or even bald patches to occur as the bodies’ hormone levels normalize. This is usually a temporary condition, however, and should reverse itself soon. If hair health is still an issue a few months after the pregnancy is over, chances are that the hair condition is attributed to something other than the pregnancy.
  • SMOKING– Smoking affects healthy hair growth. Cigarette smoking has been shown to cause poor circulation, which can affect the amount of blood flow available to the hair follicles of the scalp.
  • OVER-STYLING– Aerosol sprays, hair dyes, hair irons, and curlers might seem to be essential to hair beauty in the short term, but do keep in mind that excessive use of any of these items may result in damaging hair in the long run. Women who find their healthy hair is being affected may also want to consider what they’re putting into their hair and scalp on a daily basis and consider other nutritional supplements and cosmetic methods.

Now that we have identified the problem, lets talk about the solutions.  “There are non-prescription products available over the counter to help stimulate healthy hair growth,” says  Dr Ken Williams, a hair restoration physician at OC Hair Restoration Center in Irvine, CA., ” I like to recommend a nutritional supplement  called Viviscal, and always my favorite is Rogaine 5% foam to the scalp twice a day.”  For his patients that wish to be more pro-active with treatment Dr Williams offers Platelet Rich Plasma (PRP) and Low Level Laser Therapy to stimulate healthy hair growth.

The Difference Between Male & Female Hair Loss


male-female2-300x227Many people believe female pattern hair loss is the same disease as male pattern hair loss, and  the hair loss pattern just looks different in women. In the last decades, though, the discussion between hair restoration surgeons in the International Society of Hair Restoration Surgery (ISHRS) has focused on the reality these two separate diseases or problems exists. Today many ISHRS physicians hypothesize  there are two different disease entities because their natural history (epidemiology) is so different.Many hair restoration surgery specialists think Female Androgenetic Alopecia is a misnomer and prefer the term Congenital Female Pattern Hair

PROMOTING PUBLIC AWARENESS-CARLOS PUIG

Promoting public awareness of female hair loss to the lay pubic and medical doctors is no easy matter. One particular physician, though, leading the effort is Carlos Puig , of Houston, Texas.  His tireless efforts to bring public attention to this medical condition is applauded and deeply appreciated. He is the founding member and current President of the ISHRS.  He is a world-renowned hair  restoration surgeon and probably the most knowledgeable hair specialist on female hair loss.

On a regular basis he leads an international effort to teach physicians about female hair loss and surgical restoration.  His hair restoration course, “Cowgirl Hair Loss Workshop,”  is an excellent compilation of his knowledge as well as featured hair surgeons from around the globe.   His below referenced chart comparison illustrates the differences between hair loss in men and women. We commend Dr. Puig for his efforts to bring hair surgical and medical restoration options to female hair loss suffers.

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**Chart adopted from Dr. Puig’s web site: www.hairrestorationhouston.com

HORMONE, STRESS, GENETICS ?

In some women with a genetic predisposition to hair loss, a group of hormones called androgens interferes with the growth cycle of the hair. These androgen hormones-testosterone, Androsteinedione, and Dihydrotestosterone (DHT)- are dominant hormones in men, but are present in women to a much lesser degree. In some women, hair loss may be due to the action of androgens on the hair follicles.

Hair grows at one-half inch per month and the growth phase can lasts two to six years. With yet-to-be discovered physiologic signals, the hair goes into a resting phase for a period of time, then the hair follicle falls out and a new follicle starts the process all over again.

In women who are genetically susceptible, when the testosterone comes in contact with enzymes residing in the hair cell, it is converted into the more potent androgen DHT, which then binds with receptors deep within the hair follicle. Over time, DHT in the hair follicle alters the natural resting and growth phases of the hair. Some of the hair follicles eventually die, while others stop continuing healthy hair growth.

webmd_rf_photo_of_hair_loss_chartThe term ‘androgenic alopecia’ in women is often referred to “female pattern hair loss.” It is a broader term that encompasses many possible causes of hair loss in women. Androgenic alopecia is caused by factors related to the actions of hormones, e.g., ovarian cysts, use of high androgen index birth control pills, pregnancy, and menopause. Just like in men, DHT and heredity plays a role in this disease.

In men, the pattern of hair loss is distinct whereas, women have a diffuse thinning of their hair. Female pattern balding affects circumferentially the whole top of the head with preservation of the frontal hairline. Men rarely have diffuse thinning and the frontal hair line is usually  loss to balding.

The science of female balding remains not entirely  understood.  Genetic codes and other factors plays a role in hair loss in women and remains a challenge to doctors and patients alike.

Heidi Klum & Seal Headed For Divorce?: Lupus Causes Hair Loss


On Sunday, January 22, 2012 Heidi Klum and Seal announced they are filing for divorce. The two wed on May 10, 2005 and have 3 children together.  Heidi’s statement to the press on what led to split, via her rep, was relatable and gracious.  “While we have enjoyed seven very loving, loyal and happy years of marriage, after much soul-searching we have decided to separate,” the duo says in a joint statement. “We have had the deepest respect for one another throughout our relationship and continue to love each other very much, but we have grown apart. This is an amicable process and protecting the well-being of our children remains our top priority, especially during this time of transition. We thank our family, friends, and fans for their kind words of support. And for our children’s sake, we appreciate you respecting our privacy.”

Jet magazine reported on June 10, 1996 that at age 23 Seal was diagnosed with Discoid Lupus Erythematosus (DLE). DLE is a rare form of Lupus causing scars of the face, ears, and scalp.  A majority of people with lupus experience some hair loss whether they have a form of lupus that affects several organs or a form that mainly affects the skin. Most of the time, though, lupus is unlikely to cause complete or permanent hair loss.

Hair loss can be an early sign of lupus,before the disease is actually  diagnosed. Lupus causes widespread inflammation, almost always involving the skin, particularly, on the face and scalp“, says Irvine hair transplant surgeon Dr. Ken Williams.  He adds,  “inflammation and other systemic medical factors, can cause the hair on the scalp to gradually thin out.  Patients may even lose their hair in clumps. or eyebrows, eyelashes, beard, and body hair is also possible.

Although lupus-related hair loss can be shocking, the hair will most likely grow back once the lupus is medically treated and controlled by a specialist, such as a rheumatologist. The signs and symptoms of lupus often go into remission for long periods of time, but the disease tends to flare back up unpredictably. If a lupus flare occurs the hair loss may start again.

If your hair is falling out, consult a hair loss specialist to find out why. Unless you’re already being treated for lupus or you have other signs and symptoms of the disease, your hair loss is probably caused by something else. Among the possibilities are genetics, medications, hormonal changes, thyroid disorders, nutritional deficiencies, and stress.

For more information on Lupus please visit the Lupus Foundation of America.

Saints defeat Lions, but Drew Brees is losing fight against hair loss


On Saturday, January 7, 2012 the New Orleans Saints defeated the Detroit Lions with a 45-28 NFC wild-card victory.  Drew Brees led an unstoppable offense by throwing for 466 yards, the most yards in a regulation playoff game.  “We were pulling out all the stops,” Brees said.  “We play aggressive. We’re not going to apologize for that. That gives guys in the huddle a lot of confidence. We’re not going to pull the reins back. It’s pedal to the metal.” That type of aggression has led to many victories for the New Orleans Saints, and if Brees would show that type of aggression with his hair he may have preserved his frontal hairline and overall hair density.

It is normal to shed hair everyday and the truth is we lose between 100-125 hairs on any given day.  However, some individuals may experience higher amounts of hairs being shed each day. Once a hair reaches the end of its growth cycle it will then shed from the scalp. At any given time 10% of our hair is in a “resting phase” and after 2-3 months resting, hair falls out and new hair grows in its place.

As we age, both men and women will experience some hair loss. This is a normal part of the aging process. Androgenetic Alopecia (AGA) accounts for 95% of hair loss, and it often times runs in families. In men this condition is usually referred to as Male Pattern Baldness (MPB). MPB is characterized by a receding hair-line and baldness on the top of head.  Women, on the other hand, don’t go entirely bald even if their hair loss is severe. Instead, hair loss is spread out evenly over their entire scalp while maintaining the frontal hairline.

Hair restoration surgeon, Dr. Ken Williams of the Irvine Institute of Medicine and Cosmetic Surgery adds, “Drew is one of the truly amazing football players in the NFL. But if he continues to lose hair, he will look much older than his chronological age if he does not intervene at this time in his life.  His hair loss is quite noticeable and I don’t want to see him lose any more.”

Hormones play a dominant role when talking about AGA. Simply put, both men and women produce testosterone and this testosterone is converted to dihydrotestosterone (DHT) with the aid of the enzyme 5-alpha-reductase. DHT miniaturizes the hair follicles causing the membranes in the scalp hair density to decrease.

Men naturally produce more testosterone than women and therefore men experience more hair loss. Both male and female AGA is very common and easily treated medicallyand surgically. For medical treatment,  minoxidil is recommended for both men and women to apply topically twice a day. For men, taking the oral medication finasteride, DHT blocker, is strongly recommended. Male and female AGA responds well to low-level laser therapy, and platelet rich plasma therapy is a therapy with a potential future as well.  For surgical treatment there is the older and more invasive linear strip method, or the latest FDA approved hair surgery called Automated FUE.

Tiger Woods Wins Chevron World Challenge & Reveals Hair Loss


On Sunday, December 4, 2011 Tiger Woods swung his way to victory at the Chevron World Challenge at Sherwood Country Club in Thousand Oaks, California.  Tiger birdied the final two holes and beat Zach Johnson by one stroke.  It has been two long years, 749 days to be exact, since Tiger has won either an official or unofficial tournament. After delivering a 10-foot downhill clutch birdie putt on the 18th hole Tiger gave an enthusiastic fist pump and the crowd erupted. After a quick celebration Tiger raised his cap in the air and revealed his receding frontal hairline and thinning temporal points.

It’s no secret that Tiger, currently  35 years old, has had a difficult 2 years both personally and professionally.  Has all that stress finally revealed itself through his hairline or is just unlucky genetics? Truthfully, it’s probably both. Most men have sometime of family history of hair thinning or hair loss, and emotional/physical stress can kick an existing condition into overdrive. Hair transplant surgeon Dr. Ken Williams of OC Hair Restoration Center located in Irvine, California treats men with this condition and appearance regularly and he has some advice. “Tiger is my favorite pro golfer, but he definitely has experienced hair loss and there is no better time like now to start a medical treatment before he loses more hair follicles, ” says Dr. Williams. “Outside of starting a medical stabilization program, hair surgery could be considered using FUE with NeoGraft or traditional Strip surgery to add density to his frontal hairline and re-establish his temporal points,” adds Williams.