Help for Hair Loss
September 2009
by Molly M. Ginty
It all started with one small spot for Maureen McGettigan.
“When I was 16 and working as a hair model for a local salon, a hairdresser noticed a quarter-sized bald patch on the back of my head,” says McGettigan, of Flourtown, Pa. “When I saw it, I wondered how something so strange could ever happen to me.”
As the years progressed, it happened more and more. Bald patches spread through McGettigan’s auburn locks, and by age 24, she’d lost most of the hair on her head—along with her eyelashes and eyebrows. To avoid strangers’ stares, she started wearing a wig and had fake eyebrows tattooed on her skin.
McGettigan was diagnosed with alopecia areata, an autoimmune disorder that causes hair loss and affects about 2 percent of the population. But while her condition is rare, the shame and embarrassment it causes are not. Roughly half of women suffer from hair loss at some stage of life, reports the American Academy of Dermatology.
“Our surveys show that when asked whether they would rather have more hair, more money, or more friends, 64 percent of women chose more hair,” says Dr. William M. Parsley, president of the International Society of Hair Restoration Surgery.
While losing up to eight hairs with a single stroke of your brush is normal, dropping more than 100 strands a day could signal alopecia areata, anemia, a hormonal imbalance, or other underlying health problems. How can you tell when hair loss (alopecia) signals serious trouble? And what are your best bets for treating it? During September or Alopecia Awareness Month, here’s help.
Hair is its lushest from puberty through our 20s, and continues to thrive afterward on a protein- and iron-rich diet. Healthy hair grows at the rate of about half an inch per month, with each of the 100,000 strands on the scalp going through a growth phase (anagen, lasting two to three years); a resting stage (catagen, taking three to four months); and a shedding phase (telogen, when the strand falls out and a new one sprouts).
When this growth cycle is disrupted, several types of hair loss can occur:
Female pattern baldness (androgenic alopecia) affects a third of women and is usually permanent, with hair thinning on the front, sides, and crown of the scalp. A genetic predisposition can sometimes trigger it, as can hormonal shifts related to ovarian cysts, pregnancy, taking birth control pills, and entering menopause (when androgenic or “male” hormones, which women have in trace amounts, become more predominant as estrogen wanes).
Telogen effluvium is temporary hair loss caused by trauma (such as childbirth, physical illness, or emotional upset) that disrupts hair’s normal growth cycle. Up to 30 percent of hairs prematurely enter the shedding phase. Thinning is overall, and can occur between six weeks and six months of the triggering event.
Traction alopecia is localized and caused by tight hairstyles: braiding, cornrows, extensions, or taut ponytails that cause only temporary damage if addressed early.
Though strand shedding can be alarming, quick fixes often stop the fallout. Simply easing up on your ponytail holder—or getting your diabetes or thyroid problem under control—can kick-start growth. You can switch to new medications instead of using ones known to cause hair loss (certain drugs for arthritis, depression, heart disease, and high blood pressure). You can try low-androgen index birth control pills (such as Desogen or Ortho-Cept) instead of high-androgen index ones (such as Ovral or Loestrin 1/20).
If hair loss continues, your doctor may recommend heavier-duty help:
Rogaine (minoxidil) is a drug approved by the Food and Drug Administration to treat androgenic alopecia in women at a concentration of 2 percent (though some doctors will prescribe it at 5 percent, the same concentration used for men).
Other hair loss drugs include steroid injections or creams, drugs to inhibit your body’s production of male hormones, potassium-sparing diuretics, and histamine blockers.
Hair transplant surgery involves taking tiny hair follicle plugs from the nape of the neck or the back of the head (where their removal may go unnoticed) and implanting them in bald or thinning areas. Surgery costs $3,000 to $8,000 and is rarely covered by insurance.
Still thinning on top? Joining a hair loss support group can bring emotional relief (as it did for McGettigan, who found one through the National Areata Alopecia Foundation).
There are grooming tricks that can maximize your mane. To build volume, you can part your hair on a different side or blow-dry your hair with your head flipped upside down. To minimize the contrast between your scalp and thinning hair, you can color your hair to better match your skin tone (lightening it if you’re fair-skinned and darkening it if you have a dark complexion). “Also of great help are hair extensions and wigs,” says McGettigan, who wears a custom-made auburn wig every day. “Mine is so convincing that strangers no longer notice my hair loss and could easily mistake me for the hair model I was more than 30 years ago.”
Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.