Hair loss or hair thinning affects men and women, adults and children. Yet no matter the person and the cause, it is an incredibly sensitive issue for all. The Dermatologists at NorthShore, recently sat down to answer questions on hair loss, from causes to treatment options:

Do hormones contribute to hair loss?
It really depends on which hormone you are specifically referring to, because some can help hair grow and others can contribute to thinning. 

It's important to mention that any hormonal shift in your body is enough to cause telogen effluvium, or massive hair shedding. This is typically seen after childbirth, but can also be seen when starting or discontinuing birth control, hormone replacement therapy or during thyroid hormone fluctuations. Hair loss can also be an effect of anabolic (muscle building) steroid use and glucocorticoid (e.g. Prednisone or Medrol) steroid use. 

DHEA is a supplement that is available over the counter without a prescription. This medication tends to be anabolic and can contribute to hair thinning as well. It is important if you are taking protein powder/muscle-building supplements to look for the DHEA in the ingredients to know whether or not you are consuming this product. By the way, anabolic steroids and DHEA can also cause acne. 

Would using birth control help/harm a woman with thinning hair? 
It’s well known that no two birth control pills are the same nor do they produce the same reactions in different people. Certain anti-androgen birth control pills, such as those the FDA approved for the treatment of acne, could be helpful in androgenic alopecia, or pattern hair loss.  FDA-approved acne medications include the following progestins: norgestimate, norethindrone, and/or drospirenone. Androgenic alopecia can affect women (and men) early in life— as early as late teens and early 20s—and is usually caused by a hypersensitivity to male or “androgen” hormones. Birth control pills, especially those formulations that are “anti-androgenic” could be helpful in minimizing this interaction in androgenic alopecia. While it may not give a complete cosmetic benefit, it certainly could be a good, inexpensive and relatively safe start.

Conversely, some birth control pills could worsen this condition, particularly if they are more androgenic. It’s important to discuss the androgenicity of your birth control medication as well as potential side effects with your prescriber.  As I mentioned earlier, it’s also important to note that any hormonal shift in your body is enough to cause a telogen effluvium, or massive hair shedding. This is typically seen after childbirth, but can also be seen with starting or discontinuing birth control. 

How do you prevent hair loss due to hypothyroidism? 
The best way to prevent hair loss due to hypothyroidism is to keep your thyroid levels normal. The thyroid really is in control of this process; however, regularly seeing the doctor managing your thyroid medication, and taking your medication as directed, is helpful. Natural thyroid replacement hormone is much less reliable and can contribute to increased hair loss as the amount of hormone frequently changes and is nearly impossible to regulate. 

When taking thyroid medication prescribed by a doctor, it’s also important to follow the doctor’s instructions very carefully. This medication is usually best absorbed on an empty stomach and without any other medications, vitamins or supplements because they can interfere with the proper absorption of a prescription thyroid medication.

Is there any connection between vitamin D and thinning hair?
There is growing evidence that vitamin D does play a role in hair growth. This exact role has yet to be clarified. What is known is that when comparing women with thinning hair to women without, the vitamin D levels were significantly lower in the women with thin hair. It is not clear if this is the cause of the thinning or a result of something else going on with the body that may also lead to hair loss. Additionally, it is not yet clear whether supplementation of vitamin D to normal levels would help with hair regrowth.  

How does diet affect hair loss or thinning? 
Diet can directly impact hair loss because hair loss can be the result of a nutritional deficiency. Hair needs iron, protein and the consumption of sufficient calories to grow.  Vegetarians, for instance, can still achieve adequate protein levels but they have to pay careful attention to their diets to ensure they are achieving those levels each day. A well-balanced diet with sufficient calories (1200+) and a healthy mix of whole grains, fruits, vegetables and protein is generally sufficient and supplementation is seldom required if this is followed. 

Would losing or gaining weight have a positive/negative effect on hair?
There is no research that demonstrates an “ideal weight” in regard to your hair. However, if someone is far underweight or overweight, their overall health may be compromised. It’s important to mention that those who are greatly underweight and overweight are both nutrient poor. Well-balanced, normal caloric diets and healthy weights are important for maintaining overall health as well as hair health. Weight loss or gain for health must be done at a safe speed as large shifts in body weight can instigate hair loss.

Does washing your hair every day have any effect on hair loss or thinning?
It’s important to think of the hair and scalp separately. Typically, what’s good for the scalp is not necessarily ideal for the hair and vice versa. The scalp loves to be clean. For oily scalp/hair types, daily cleansing is important to prevent excess oil build-up, which if left uncontrolled could lead to scalp inflammation (seborrheic dermatitis) and further hair loss. Curly hair or dry scalps may be able to get by with less-frequent washing. 

If you have dandruff, it’s a sign that you need to cleanse your scalp more frequently. Also, if your hair is massively shedding, dandruff typically makes this worse. So, although, it’s scary to see so much hair coming out when washing, washing your scalp less frequently can make the problem worse.

Are handheld laser lights like the HairMax Advanced Laser Comb effective tools for stimulating hair growth? 
The HairMax hair laser comb is a low-level laser device that is approved by the FDA for androgenic alopecia, or pattern/hereditary hair loss. This device stimulates hair follicle energy cells to be more active through a process called photobiostimulation.  It also stimulates improved blood flow to the scalp and increased delivery of nutrients to the hair follicle. This device has significant research data that demonstrates that it works for androgenic alopecia; however, it does not work for everyone.  It may also work for other types of hair loss but this has not been proven yet. The best thing about this device is that it has a money-back guarantee, although it costs about $400-600. You also need to use this device three times a week for 16 weeks before you determine results.  

How do Minoxidil and Rogaine work? Are they for both men and women?
Minoxidil, the generic for Rogaine™, is FDA approved for androgenic alopecia, which is pattern or hereditary hair loss. It’s available in men’s strength (5%) and women’s strength (2%). Research studies have found that the 5% strength foam is safe and effective for women, and only needs to be applied once daily. 

Minoxidil helps to reset the normal hair growth cycle. This is important for androgenic alopecia as well as many other hair loss disorders. Although it is only FDA approved for androgenic alopecia, it’s utilized in practice by dermatologists, especially hair loss specialists, for other forms of hair loss as well. 

It “wakes up” hair follicles that are in the resting phase of the hair cycle, and stimulates them to grow. Occasionally these follicles are just under the scalp, so it does appear as though new hair follicles are forming. It can also prevent further hair loss in androgenic alopecia.

It’s important to apply this product to the scalp and not the hair. It’s also important that the hair is dry before applying. Give it a chance to work! It may be only after four months of consistent use that you finally see improvement.  If you are using this medication consistently for longer than six months with no improvement or continued hair loss, you will need to consult with a medical professional or hair loss specialist as you may have other underlying medical issues or a scarring (potentially permanent) type of hair loss.

Do you have an opinion on Ovation Cell Therapy?  
There are literally thousands of “miracle hair products” which offer much but deliver little. The Ovation product line utilizes many herbal ingredients that have limited data on efficacy, but likely do support healthy hair growth.  Saw palmetto (dried berry extract) is probably the most effective ingredient in the Ovation product line. This has been demonstrated to block DHT (dihydrotestosterone) in a very similar mechanism as finasteride, Propecia™, which will help with androgenic alopecia. Saw palmetto is sold over the counter as a supplement for “prostate health,” but you can find it much cheaper than the Ovations product line in topical and oral formulations.