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Resources for Hair Care and Hair Loss Prevention

These books, websites, and reports may prove helpful to you if you wish to read further about MPB or androgenetic alopecia and its prevention.

Alopecia Areata: Understanding and Coping with Hair Loss by Wendy Thompson, M.A. and Jerry Shapiro, M.D. John Hopkins University Press, Baltimore 1996.

Hair Loss Prevention Through Natural Remedies: A Prescription for Healthier Hair by Ken Peters, David Stuss, and Nick Waddell. Apple Publishing Company, Ltd., Vancouver, British Columbia, Canada, 1994.

The Hair Replacement Revolution: A Consumer’s Guide to Effective Hair Replacement Techniques by James Harris and Emanuel Marritt. Square One Publishers.

Bald No More by Morton Walker. Kensington Publishing Corporation.

Your Hair: Helping to Keep It: Treatment and Prevention by Neil Sadick and Donald Charles Richardson. St. Martin’s Press.

The Bald Truth by Spencer David Kobren, Diane B. Eisman, and Eugene H. Eisman. Pocket Books.

Healing Psoriasis: The Natural Alternative by Dr. John O.A. Pagano. The Pagano Organization, Englewood Cliffs, NJ, 2nd Printing, 1995.

Propecia: The Hair-Growth Breakthrough by Othneil J. Seiden, M.D. Prima Health Publishers, Rocklin, CA, 1998.

The National Alopecia Areata Foundation (NAAF), P.O. Box 150760, San Rafael, CA 94915-0760, (415) 472-3780

The National Psoriasis Foundation at 6600 SW 92nd Ave., Suite 300, Portland, OR 97223-7195, (503) 244-7404 or (800) 723-9166

Hair Loss Summary

Hair is a living protein, and as with any living part of our bodies we must be sure to maintain proper health to optimize our chances of maintaining a healthy head of hair. Proper nutrition is vital to maintaining healthy hair, since the hair is a living and growing part of the body’s system. Viewing it in this manner can help us to treat our bodies different and raise expectations through proper care. A healthy balanced diet, occasionally with the help of vitamin and mineral supplements and exercise are all key components to a healthy regimen of maintaining healthy hair.
Male Pattern Baldness (MPB) or androgenetic alopecia is the condition that over 95% of persons that suffer hair loss have, and it is caused by a rise in DHT, a direct component of testosterone. The scientific developments of the past two decades have brought hope and promise to many who suffer with this type of hair loss. Treatments like Rogaine®, Rogaine® for Women, Propecia, and improved surgical treatments have brought relief to many who would have previously had to settle for gradual hair loss, wigs, or hairpieces. The discovery of the role of DHT in preventing hair loss has even opened the doors to possible herbal solutions to hair loss prevention, such as saw palmetto, nettles, rosemary and horsetail. Even more promising is the fact that the hair loss commonly known as androgenetic alopecia is found to occur mainly in Western civilization or those who have adopted the ways of Western civilization, meaning that there may be dietary practices that contribute to hair loss and therefore giving hope to the possibility that diet could control not only temporary hair loss, but androgenetic alopecia as well.
Doctors and scientists are studying DHT production in the body to understand it more thoroughly. There is an obvious link to hair loss and prostatic health and this only increases the pace of hair loss discoveries. Most treatments for prostatic diseases such as benign prostatic hyperplasia (BPH) also have the pleasant side affect of growing hair on the heads of those taking it. With the pace of research and discoveries today, there is a great deal of optimism in the field of hair loss prevention. Hair is an important part of our dress and appearance, therefore a large part of our self-esteem. It is likely that there are answers for your situation presently or coming in the near future.
Remember, the restoration of hair growth is not an overnight process. The process takes time regardless of the method chosen. Be patient and follow as much of the advice given by professionals as possible. Keep in mind that the body is a system, and it is the abuse of this system by food intake and environmental causes that lead to most common hair loss. Through returning the body back to its natural state, hair growth can be restored. Good health to you!

Prescription Drug Treatments

While topical solutions such as Rogaine® brand monoxidil have been used to treat hair loss, Propecia® brand Finasteride by Merck & Company, Inc. is the only FDA approved pill approved for the prevention of hair loss and possible hair re-growth. Like Rogaine®, Propecia® was discovered when its generic equivalent being used for another purpose was found to have beneficial side effects. Finasteride is the generic name for the drug, which was already in existence for quite some time and had been produced under the name Proscar® by Merck & Company and used for treatment of enlarged prostates, a syndrome medically called benign prostatic hyperplasia (BPH). BPH is caused by an overproduction of DHT, which causes the prostate to grow. Many BHP patients were also suffering with MPB, and when patients began taking Proscar®, they noticed the re-growth of hair also. This sparked new testing and the birth of Propecia® as a hair restoration drug. The approval of Propecia® by the FDA was easy to achieve, since it was merely marketing already approved Finasteride as a hair restoration drug, with a much smaller dosage than that required for BPH.
Propecia® is being prescribed by doctors to some patients as an oral treatment to internally block the production of DHT. Propecia is an androgen hormone inhibitor only approved for men, and has been clinically proven to grow hair on a significant percentage of men who suffer with Male Pattern Baldness (MPB) or more properly androgenetic alopecia. Unfortunately, the drug has not been approved for use by women at this time. This is especially true for women who are pregnant or can become pregnant, because the process of inhibiting testosterone from being converted to DHT can affect secondary sex characteristics of unborn fetuses.
Propecia® works by reversing the shrinkage of hair follicles that are in the telogen phase, or last phase of the normal hair cycle. Propecia® works best in combination with topical treatments of Monoxidil such as Rogaine®. Participants in studies have seen hair grow in as little as six months, whereas those who have seen no results in a year’s time are reported not likely to see any results from the drug. One round of testing of over 2,000 men with androgenetic alopecia over a four-year period showed half with reported new hair growth.
Side effects of Propecia® in a few persons studied include diminished sex drive, difficulty in achieving an erection, and a decreased sperm production. Side effects were found in less than three percent of participants in clinical studies. Fortunately when the drug’s use was discontinued, the side effects went away and normal functions resumed. Of course there are some who say that the growth of new hair is worth the cost of a drop in libido. Only you can decide whether this side effect is worth the personal cost to you. Finasteride is metabolized primarily by the liver, and therefore anyone suffering with liver disease may not be able to take the drug, and should consult a physician. Additionally, as with Monoxidil, it can mask PSA levels, thus caution should be used if used by patients with elevated PSA levels, as it may be difficult to read levels properly when diagnosing potential prostate cancer. Of course proper consultation with your physician will help determine if taking Finasteride treatments such as Propecia® is right for you.
An interesting phenomena concerning Propecia® is the dramatic rise in price it caused for Finasteride when it entered the market as a hair restoration drug. Propecia® is simply a 1mg version of Finasteride, a drug that was already being marketed as Proscar® for BPH by the same company that markets Propecia®, Merck & Company, Inc. Therefore there should not be an increase of any kind in the cost of production of Finasteride, since it was simply being marketed under a new name at a much smaller dosage. Merck & Company therefore was prepared to introduce Propecia at the price of $1.25 per pill or $37.50 for a 30-day supply in 1998. However, after reconsiderations it was decided that Propecia would be introduced at $50 for a one-month supply. This is compared to a 30-day supply of Proscar® which is 5mg Finasteride being marketed at $55-60.00 for a 30-day supply. The price was adjusted to be in the range of Rogaine® Extra Strength. The price of Propecia® today in 2004 is in the range of $130 for a 30-day supply, while Proscar® prices have risen at a much slower pace, and is now less expensive than the same Finasteride drug that is 1/5th the dosage. Doctors of course are discouraged by pharmaceutical companies to prescribe Proscar for cosmetic treatment of androgenetic alopecia. Of course there are always going to be those who find ways to circumvent this. Therefore, many have been driven to find ways to purchase Proscar® and divide the pill into fourths or fifths instead of paying the exorbitant prices for the very same Finasteride.

Over The Counter Treatments

The most popular over-the-counter hair restoration drug today is Rogaine®, a brand of topical monoxidil solution by Pfizer Corporation, approved for over the counter sale in 1997 by the Food and Drug Administration (FDA). Monoxidil was originally used as a blood pressure medication, and then doctors found that it produced the side effect of increased scalp hair growth. Today monoxidil remains the only FDA approved pharmaceutical topical solution proven to grow hair. In the preliminary studies held in 1985, 55% of men tested were able to re-grow hair with extra strength Rogaine® (5% topical monoxidil treatment), although the best results came from those who had been balding for less than 10 years and were bald in a section of four inches across or less. Another test study compared the results of regular strength Rogaine® (2% topical monoxidil solution) with the extra strength version, and found that subjects grew 45% more hair with the extra strength Rogaine® than with the regular strength Rogaine®, and users of both solutions outgrew the users of the placebo. Only 6% of those tested experienced any type of irritation. Rogaine® works by blocking the production of DHT. Of course there are generic brands of topical monoxidil solution also on the market. Rogaine® was originally made only for men’s use, and then a women’s version of the drug was produced. Similar results were achieved with the women’s version. As with both men’s and women’s versions, users must take note that continuous use of the drug is necessary to maintain the newly grown hair, as it is a usual reaction for newly growing hair to stop growing and fall out when one ceases to use the drug. As with any drug, follow all directions and cease to use if irritation or discomfort persists.
Of course many people choose not to use drugs to treat conditions, because they want to avoid the use of chemicals and their possible side effects. In this case, there are several treatments in existence that have been found to block the production of DHT and thus work similarly to topical monoxidil products. As mentioned earlier, Saw Palmetto has been used effectively to block DHT in the treatment of prostatic disease, and is now being explored for its effectiveness in stimulating hair growth. Traditionally it has been used by herbalists to stimulate hair growth effectively. Nettles, usually taken in the form of Nettle Root Extract has shown itself to be effective in preventing hair loss as well. More information on these was covered in the section called Natural Hair Remedies.

Hair Replacement and Restoration Techniques

There has been a great deal of progress in the field of hair replacement and restoration in the past few years. Surgical techniques have improved greatly from the days when hair replacement first began. All hair replacement techniques involve the use of your own hair; therefore, hair replacement candidates must have some healthy hair, usually at the back and sides of the head. The process is a relatively safe procedure when performed by a qualified surgeon, however as with any surgery there are risks. Candidates must be checked for uncontrolled high blood pressure, blood-clotting problems, or skin that scars excessively, as these conditions may make healing difficult. Small pieces of hair growing scalp grafts are removed from areas of the scalp with healthy hair and are placed where hair is thinning. There are three major types of grafts: punch grafts, mini-grafts, and micro-grafts. Punch grafting takes about 10-15 hairs and places them in the scalp. This was the first type of technique to be developed, and when first developed caused a patchy look in many candidates. The technique has been improved since the first days of being developed, and the new mini-graft technique has also been added as an option. Mini-grafts contain only 2-4 hairs per graft, and therefore look much more natural. Micro-grafts are still smaller grafts that contain one to two hairs each. To maintain healthy circulation of the scalp, grafts are placed 1/8th of an inch apart. Local anesthesia is usually sufficient for these procedures, and several procedures are usually required to achieve the desired result. Post-surgery, a period of approximately 10 days of no sexual or strenuous activity is recommended, as strenuous activity may cause bleeding from the graft areas.
Of course surgery is a serious option, and often an expensive one as well. For those not wishing to undergo surgery for either reason, the option of non-surgical hair additions is often explored. Many professionals have developed techniques to add hair to existing hair on your scalp that look very natural. Weaves, fusions, bonding, cabling and micro linking are some of the techniques used to bond hair to the existing hair or scalp non-surgically.
Many jokes were made in the past about wigs and toupees, and they have gained an unfavorable light amongst many people because they were so obvious on the wearer. Today’s toupees and wigs are often made of real hair and are very well styled, causing them to look more natural on the wearer. These hairpieces are held in place by affixing adhesive to the scalp and stay in place through vigorous exercise. Of course you will need to seek a professionally made toupee in order to make it worth your while, and you should purchase at least two so that you can maintain them properly, servicing one while wearing the other. A professionally styled and fitted toupee is expected to cost upward of $600 to $1000 in today’s market. Of course no one wants to go through the embarrassment of wearing the obvious “rug” on top of your head, so if you are not willing to spend the money it takes to purchase a professional toupee then it is probably best to not wear any hairpiece at all.
Structured hairpieces as they are called are a semi-surgical approach that permanently attaches hair to the scalp by stitching the hair to the bald scalp. This procedure is not recommended, as it is a process that involves introducing a foreign material to the scalp. Most ethical surgeons do not perform this procedure any longer as they are generally deemed to be ethically inappropriate. If this procedure is recommended to you, get a second opinion from a trusted physician.
A much safer procedure is hair weaving, yet this can only be used if hair is thinning and large balding areas are not present. The process is also called hair intensification or hair integration. Strands of synthetic or real hair are braided or weaved into your own existing hair giving an appearance of a full head of hair. This procedure does have its drawbacks, because it can make the scalp difficult to access, interfering with proper hair and scalp maintenance necessary for the health of your remaining natural hair, and this method can also stress existing hair since the artificial hair introduced through weaving is attached to it. This method is usually expensive, costing several thousand dollars per application, and being that because of the aforementioned drawbacks it can only be left in for a few weeks at a time it is usually impractical for the average person.
It is highly recommended that one seek professional assistance with these procedures from licensed beauticians or barbers, and have a patch test done to the skin if using adhesives to test for skin sensitivities. Extra care must be taken to maintain cleanliness of the hair and scalp when wearing added hair in order to maintain the health of existing hair and the scalp in general. Of course, if you are undergoing chemotherapy or are in the early stages of diagnosed alopecia areata then these procedures should be avoided as the hair they are connected to is likely to fall out as well. Either waiting for a period of time or obtaining a full prosthesis is recommended in these cases.
Yet still there is another type of treatment which is a spray of micro fibers made up of the same substance that hair is made of: keratin. If your hair is simply thinning, while you are investigating a more permanent solution to your hair loss problems or in the process of employing a particular process that takes some time, you can use these substances to cosmetically produce the appearance of thicker and fuller hair. The substance is marketed under several different names, one such being Topik®. Being a temporary solution it is relatively inexpensive, and can provide some immediate aesthetic results to bolster confidence and optimism as you work on more permanent solutions.

Women’s Hair Issues

The term Male Pattern Baldness (MPB) tends to lay credence to the thought that hair loss is primarily a male problem. While males do lose hair more readily and tend to lose hair in sections, women suffer baldness and hair thinning also, except the thinning is more uniform throughout the head. With this is mind, women are better candidates for surgical hair replacement and weaving treatments, because large portions of the scalp are highly unlikely to be bald on a woman suffering with androgenetic alopecia.
Because a great deal more emphasis is put on the beauty of a woman’s hair, this is becoming a great concern for today’s woman. While the general information covered thus far is good for all persons in general, there are a few things specific to women concerning hair loss.
Many women suffer hair loss and an increase of facial hair after the onset of menopause. This is because of the drop in estrogen production, changing the ratio of estrogen to testosterone in a woman’s body. Prior to menopause, a woman’s body is constantly producing estrogen, which binds excess testosterone to proteins called globulins. Therefore, there is little excess testosterone in a woman’s body. After the onset of menopause this estrogen is no longer present, thereby exposing it to a similar although milder type of syndrome that males go through concerning the overproduction of DHT. An interesting note is that once again, the syndrome of menopause and its unique effects are not as common in the Eastern world, but are specific to Western civilization. The key differences are the consumption of less red meat and fatty foods in Eastern lands than in the West and less daily stressors in most Eastern lands as compared to Western civilization.
Anorexia is an eating disorder that is becoming more prevalent among women in the past few decades and is psychologically driven in Western society due to the emphasis put on slender women being the ideal in Western civilization. Needless to say, if you or a loved one is suffering with this disorder, a qualified physician should treat any cases of anorexia. However, some of the side effects of anorexia can be hair loss due to the malnutrition the syndrome caused. In this case, it is vital to carefully follow the advice given in the sections Nutrition, Diet, and Hair Loss, and Natural Hair Remedies.
It is of course recommended in all cases that you reduce your intake of red meats, fatty foods, and reduce stress, however due to your profession and engrained habits there may be a limit to how much you can change this part of your lifestyle. There is another factor in Eastern civilizations that may cause a stark difference in their women not suffering through typical menopausal symptoms here in the West. The consumption of soybeans and soybean products is much higher in the East. This is significant because soy contains estrogen-like substances and work in the body similarly to estrogen. Therefore there is not an extreme drop in estrogen levels in women who consume soybean products, thus reducing the symptoms of menopause typically suffered in the West.
Some women who suffer hair loss tend to have gastrointestinal problems that do not allow them to absorb proteins and zinc that are necessary to maintain a healthy head of hair. If you think that you have problems with your gastrointestinal system and are experiencing unusual hair loss, of course see your doctor. You may be able to take some natural non-dairy acidophilus after meals for a couple of months in order to increase your digestion of these nutrients.
There are a number of myths associated with hair loss in women particularly. Many were told that brushing the hair 100 strokes each night will promote healthy hair growth. As mentioned earlier, extreme brushing of the hair can cause stress on the hair which can cause breakage and hair loss. Also, just as hats have been rumored to cause hair loss, wearing wigs has also been rumored to cause hair loss. This is very untrue, especially if the scalp is given sufficient time to breathe at night and hair is washed regularly to avoid buildup. Although stress can cause temporary hair loss, permanent hair loss is usually unconnected to stress. Last but not least, the belief that there are cosmetic products that are out on the market that grow hair is simply unfounded. There is only one product on the market that has been proven to grow hair on women safely, and that is women’s Rogaine® discussed later in the section Over The Counter Treatments.
During pregnancy hair growth increases dramatically in most women. This increases the usual percentage of hair normally growing on the head. Therefore, after childbirth there may be an increase in hair loss due to more hair follicles than usual entering the rest phase. The temporary excessive loss of hair usually occurs between one and three months after childbirth and is quite normal; it should balance out a few months after childbirth at most. Similar syndromes occur after ceasing birth control pills or switching types of birth control pills.

Hair and Scalp Diseases 2

In addition to the dietary suggestions given earlier, it is suggested that those suffering with psoriasis should eat fish, poultry and lamb regularly, maintain a high alkaline diet and consume low fat milk or buttermilk. Fish, especially fresh or canned salmon, sardines and solid white albacore tuna contains Omega-3 fatty acids that are vital for skin and scalp health. Although most fish are recommended, avoid dark-fleshed fishes such as mackerel or bluefish, sushi or shellfish. Poultry such as chicken, turkey, Cornish Hens and other non-fatty fowl are excellent foods for those with psoriasis when not fried. To avoid excess fat, remove the skin before eating and avoid fowl that has high fat content like goose and duck. Lamb is the only recommended red meat for those suffering with psoriasis, being that it is easy to digest and still a great source of protein. Of course it should be prepared any way except by frying. Dairy products should be consumed sparingly, and only low-fat or non-fat dairy products Those suffering with psoriasis can obtain their calcium from sources mentioned earlier in the section on Diet, Nutrition and Hair Loss, such as soybean products, celery, lettuce and greens. White bread should be avoided. And a limited amount of whole grain bread and whole grain products can be substituted, but should be consumed with caution because all grains except millet are acid forming. Additionally, one should eliminate alcohol consumption entirely, except for perhaps a small glass of red wine with dinner to promote rich blood and digestion. For cleansing suggestions, see the earlier section on Natural Hair Loss Remedies.
Lecithin is beneficial for psoriasis, and can be taken in its granular form in the dosage of one tablespoon three times a day, five days a week, either plain or added to water, juice, sprinkled on salad or cereal. After the condition clears, reduce the dosage to one tablespoon taken once per day, five days a week. Lecithin can be obtained at any health food store, and although it can be obtained in liquid or tablet form in addition to granular form, it is best used in granular form due to the high phosphatide content when consumed as such. These doses should not be exceeded, as the over consumption of lecithin can cause a blockage in the absorption of calcium
Eczema is another non-contagious skin disease that mimics psoriasis very closely. Eczema produces scales, reddened inflamed skin that periodically ooze, and the familiar itch that is of supreme annoyance to those that suffer with it. These are however two different diseases that usually require different treatments. However, there are certain treatments that work for psoriasis that work for eczema also. Eczema causes extreme buildup and sores on the scalp, and can cause severe scarring. The buildup caused by eczema can cause temporary hair loss, however the scarring that can occur especially if one scratches the painfully itchy lesions can cause permanent damage to the hair follicles.
Eczema is an illness caused by toxemia as well. And although one can use the various medicated shampoos and creams on the market to control its symptoms, permanent relief is only going to come from removing the cause of the toxemia. Therefore once again cleansing and drinking plenty of purified water are keys to fighting eczema. Many of the dietary recommendations are the same for one who suffers from eczema, except there is usually an increased sensitivity to fish-therefore it should be eaten in a limited amount. Also, there is usually a high intolerance of cow’s milk, since eczema is highly associated with allergies. Therefore, one should use soymilk or goat’s milk instead.
Hair loss due to chemotherapy treatments is a common side effect of the treatment. Chemotherapy kills rapidly reproducing cancer cells, however the side effect of this treatment is that chemotherapy also destroys the rapidly reproducing cells that promote the growth of hair and nails. Hair is lost rapidly and in large quantities in most instances. During this process, no prescription, herbal or over the counter treatments of any kind have been found to assist in maintaining the hair. Fortunately, hair normally returns within six months to a year after treatments cease. Patients have found that hair re-grown after chemotherapy is finer in texture and lighter in color at first. These are usually temporary conditions that improve with time. Those recovering from chemotherapy should avoid chemical processes such as perms, relaxers, bleaching and coloring in the hair until it grows at least three inches and not until at least one year after the last treatment. Chemotherapy can cause skin sensitivity and these chemicals can be extremely irritating to the scalp.