Aug 142012
 

Hair loss is usually associated with men, but women can also lose their hair. It’s even worse for women because going bald just isn’t an option. But we’re lucky that we live now instead of decades ago, when the only options were toupees or wigs.

Today men and women can stop hair loss pretty easily. There are chemicals that have been proven to be effective at hair regrowth. These chemicals are minoxidil and finasteride. They’re quite different however. Finasteride can only be used by men and you need a prescription to buy it. Some people think that finasteride is the best hair loss treatment for men.

But what’s the best hair loss treatment for women? A couple of products come to mind. They both use minoxidil. One is called Scalp Med, which you can read about here. If you’re a woman who’s losing hair you might want to try this product. But it’s a bit expensive.

A slightly cheaper option is Provillus. to find reviews and other information). This is a very popular topical hair loss treatment for both men and women. It also comes with vitamins that help prevent hair loss from inside your body.

provillus

You must apply Provillus every day to stop hair loss. If you stop using it your hair will begin to fall out again. Also, be sure to start using a receding hairline treatment as early as you can. Don’t wait until you are bald. Dead hair follicles can’t be brought back to life. If you make an effort and get the best hair loss treatment, you can keep a beautiful head of hair.

Until recently, at least, the search for a systemic or topical medication with proved effectiveness against androgenetic alopecia has been in vain. When minoxidil (Loniten) was introduces as an oral antihypertensive agent five years ago, some patients receiving the drug started growing hair as a side effect. But because minoxidil given systemically may induce tachycardia and pericardial effusion unless accompanied by a [beta]-blocker and a diuretic, using the drug systemically in an attempt to induce hair growth in the normotensive patient is not feasible.

If you see a woman with a pronounced male pattern of baldness, suspect an endocrinopathy characterized by excess androgen production rather than a normal androgenetic tendency. In addition to examining the patient for signs of virilization, take a complete menstrual history. Adrenal hyperfunction or tumor, ovarian tumor, or Cushing’s disease may cause virilization as well as hair loss. Rule out other causes of hair loss that may have unmasked androgenetic alopecia by exacerbating losses, such as anemia, thyroid problems, or medications.

 Posted by at 3:18 pm
Aug 142012
 

“Doctor, my hair is falling out.” This is the complaint you will hear, regardless of whether the patient with alopecia has increased shedding, decreased growth, breakage, or patchy hair loss. Careful questioning to distinguish among these possibilities will narrow your differential diagnosis.

When did the patient first notice hair loss? Was it gradual or sudden? Has the patient noticed hair loss in certain locations or all over the head? If you do not see defined patches of baldness, assume that the problem is diffuse thinning. Ask whether the patient has noticed a sudden increase in the amount of hair left on his or her comb, brush, pillow, shoulders, or bathroom sink. Ask about whether the patient is interested in various receding hairline treatments. The amount of hair lost in the basin or shower after shampooing always seems excessive to a patient concerned about possible hair loss and is not a reliable indicator, but don’t ignore this observation if the patient reports other hair loss.

The healthy person loses approximately 100 hairs in brushing, shampooing, and random shedding. Normally, follicles at different stages of the growing cycle are distributed randomly over the scalp, so the shedding of hairs does not result in visible areas of baldness. A person must shed 50% of his hair before any noticeable thinning results, although the patient may become concerned about increased shedding long before this point.

A woman with thinning hair who does not have increased shedding is most likely experiencing the gradual expression of androgenetic alopecia, which in a man causes the typical pattern of receding hairline and balding crown. Ask about hereditary factors that might indicate a predisposition to androgenetic alopecia: Was the patient’s father or an uncle on either side of the family bald? Did the patient’s mother or aunt have thin hair? Can a product like Scalp Med help?

Ask if the hair is coming out by the roots or breaking. While you will make this distinction during the physical examination, the patient’s answer can be important. Often the patient with trichotillomania is not a reliable reporter; also, a parent may report finding hair that appears to have come out by the roots but actually was broken by pulling. Determine if the patient has been pulling out his hair or “fooling with it.” The problem may be trichotillomania, or it may be a reaction to the discomfort of a scalp disorder. An adult with traction alopecia, as a result of a childhood hairstyle such as multi-braiding, may say the hair loss has stopped, but replacement hair will not grow.

Since trauma to the scalp is a common cause of hair loss, find out how the patient takes care of his or her hair. Frequent trips to the hairdresser; nightly roller-setting; backcombing; use of a hot comb, a chemical hair straightener, bleach, or permanent wave solution may explain the presence of trichorrhexis nodosa. Suspect the condition if the patient reports that his hair “won’t grow” beyond a short length.

When scaling and redness in a round or irregular patch of stubbled hair loss lead you to suspect a fungal infection, you may try shining a Wood’s lamp on the patch. If it fluoresces, you can make the diagnosis of tinea capitis due to Microsporum audouini, Microsporum canis, or Microsporum gypseum. In as many as 90% of cases of tinea capitis, however, the infectious agent is Trichophyton tonsurans, which does not fluoresce. In some cases of tinea capitis you may see a kerion–a boggy, inflamed lesion that usually resolves without treatment–as well as black dots, which are broken hairs. Even if hair loss is minimal and diffuse, suspect tinea capitis when you see scaling.

 Posted by at 3:08 pm