FPHL is actually the most common cause of hair loss in females. Usually, FPHL begins when a woman is in her 40s. However, it can begin earlier for some women. FPHL is a progressive condition which means that women tend to continue losing hair. But unlike men, women do not lose all of their hair. Instead, the parting often gets wider. Hair near the temples may also recede in some cases. Without treatment, some women eventually develop widespread thinning.

Treatment can prevent hair loss in females from worsening and help women regrow their hair but the best results happen only when it is started at the first sign of hair loss.

Hair Shedding (also known as Telogen Effluvium) is more rapid wherein there is temporary hair loss due to the excessive shedding of telogen hair (hair in resting phase) after some illness, stress or deficiency. However, there may not be any visible bald spots and the hair tends to regrow in a few month’s time.

How can I tell if I have female pattern hair loss?

It’s best to make an appointment to see a dermatologist. Dermatologists are the experts in diagnosing the cause of hair fall and treating hair loss. A dermatologist can tell you whether it’s FPHL or something else that is causing your hair loss. Other causes of hair loss can look like FPHL, so it’s important to rule out those causes.

How can I tell if I have telogen effluvium or diffuse hair fall?

To know more about the most common causes of hair fall, check out Top 10 Causes of Hair Fall.

What causes female pattern hair loss?

FPHL is primarily a genetic condition that causes progressive hair loss in females. Click here to know about the causes of FPHL which is the type of Androgenic Alopecia.

How do dermatologists treat female pattern hair loss?

The most commonly prescribed medicine for FPHL is minoxidil which still remains the gold standard for treating hair loss in females. You can read about this hair growth medicine and how to use it in – All About Minoxidil.

If you want to know all the treatment options available for hair loss in females then check out the treatment of FPHL here.

When will I see results? Hair grows slowly, so it takes time to see results. You’ll need to use minoxidil continuously for at least 6 months to see the results. If this medication works for you, you’ll need to use it every day to continue getting results. When you stop applying minoxidil, the hair that grew because of minoxidil will gradually begin to fall out and your hair loss can continue.

Prescription medications: Your hair specialist can prescribe some medications which have proven to be effective in helping women with FPHL grow hair and prevent FPHL from worsening. These include:

• Spironolactone.
• Finasteride
• Flutamide
• Dutasteride

With any medication, side effects are possible. Ask your dermatologist about possible side effects that you might experience while taking one of these medications.

When will I see results? If your dermatologist prescribes one of these medications, you’ll need to take it for at least 6-12 months to see good results. Like minoxidil, once you stop taking a prescription medication, you may lose the hair which grew. This may happen in about three to four months.

Women who are pregnant or plan to become pregnant should not take prescription hair-loss medicines. Dermatologists recommend that all pre-menopausal women use birth control while taking one of these prescription medications.

Hair transplant: It has been used to treat hair loss in men for a long time and may be an option for some women with FPHL. Today, most hair transplants look completely natural. Not everyone is a good candidate for a hair transplant though. If the hair on your scalp is sparse all over, you may not have enough healthy hair to transplant. Consult your hair specialist to know more about hair transplant.

Are there other treatment options for FPHL? 

Women want innovative treatments for FPHL. To meet this need, researchers continue to look for new ways to stimulate hair growth and stop hair breakage. Other treatments that you may find for FPHL include the following.

Redensyl: This is a newer formulation that acts as regenerative medicine and targets the hair follicle stem cells, called the outer root sheath cells. Hair follicle stem cells play a big role in hair growth and are critical in initiating the anagen phase of the hair cycle (growth phase). And while it triggers the growing phase of hair growth, it also works to prevent the telogen phase (resting phase), meaning your hair has a longer period of growth before that follicle rests again. In this way, it helps your hair follicles favour growth over loss, helping to increase the overall number of hairs on your head, as well as the quality and length of those hairs.

Platelet-rich plasma therapy (PRP): This therapy uses your own blood. The blood is drawn and placed into a machine that separates the blood into its different components. The platelets, which are a type of blood cell containing various growth factors, are treated and injected into your scalp. This helps stimulate your cells to grow hair. 

Lasers: The FDA has approved laser combs, helmets, and other devices, which are available without a prescription, to treat hair loss at home. These devices emit a low level of laser light that may help stimulate new hair growth. A few studies show that this can be effective for treating FPHL. 

Stem cells: Using stem cells to treat FPHL is still in the experimental stages. 

Supplements: Many supplements, including biotin and folic acid, are said to help grow and thicken hair. In studying these different supplements, the findings have been mixed. In most studies, the supplements had no effect on hair growth and thickness. In one study, however, 120 healthy women had thicker hair and less hair loss after taking specific omega-3 fatty acids, omega-6 fatty acids, and antioxidants. They took this combination for six months. If these results can be repeated in other studies, we’ll have some evidence to recommend taking these supplements. 

You will find many supplements that promise to regrow hair. Before taking any of these, it’s best to check with your dermatologist. Some supplements can interact with medications. Your dermatologist can also tell you whether we have any evidence to show that the supplement helps regrow hair. 

Hair loss shampoos/oils/serums: These products tend to do one of the following.

• Help your hair hold moisture, which makes hair look fuller and thicker.
• Lessen breakage, which can reduce thinning.

While commercial hair loss products may do the above, they cannot regrow hair or prevent hair loss from worsening.

A dermatologist’s diagnosis is best before treating hair loss

You can find a dermatologist in your area by going to Find a Dermatologist.

Key points

• See a dermatologist to check if you have FPHL, and to rule out other conditions like diffuse hair fall and telogen effluvium, which may be causing your hair loss.
• Treatment works best when started at the first sign of hair loss.
• Minoxidil is the most recommended treatment for FPHL.

What is Dandruff? 

Dandruff, also known as pityriasis capitis or pityriasis sicca. Pityriasis means flaking (or scaling) of the skin which comes from the Greek word which stands for “bran”. This condition is usually isolated to the scalp with little or no inflammation and it is characterised by flaking from the scalp with or without itching.

The layers of the skin replace themselves constantly. The keratinocytes are pushed outward where they eventually die and flake off. Usually, these flakes very small and not visible. However, if the cell turnover becomes unusually rapid, especially in the scalp, it can lead to abnormal collections. It is thought that for people with dandruff, the keratinocytes may mature and be shed off in around 2–7 days compared to about a month in people without dandruff. This results in dead skin cells being shed in large, oily clumps, which appear as white or grayish flakes on the scalp, hair, skin and clothes. 

Increased secretion of lipases and phospholipases can lead to the formation of oleic acid, which impairs epidermal barrier function and causes desquamation of scalp skin as dandruff in susceptible individuals.

Why does it occur?

• Genetics: Certain individuals are predisposed to developing this condition and the role of genetics is thought to be the predominant factor.
• Environmental Factors: It tends to occur more commonly in the winter months and often improves in the summer.
• Fungus: It is often related to the presence of a lipophilic yeast known as Malassezia ovalis (Pityrosporum ovale). Although M. ovalis may be present abundantly on the scalps of many people, not all of them develop dandruff and the yeast may only be pathogenic (ability to cause dandruff) in predisposed individuals.
• Bacteria: According to a 2016 study, bacteria (mainly Propionibacterium and Staphylococcus) are important to the formation of dandruff. Bacterial presence is in turn influenced by water and sebum amount.
• As a part of another skin condition: It would be advised to consult a skin doctor if it is occurring as a part of another skin condition or concurrent medication.
• Use of inappropriate hair products: Sometimes using the wrong products for your hair can cause increased proliferation of the keratinocytes and lead to flaking from the scalp. If you are unsure about the products you are using then consult with a skin specialist to know which products will suit your hair.
• Stress: Stress can trigger dandruff in some people, so managing it better can reduce the symptoms.

Why consult a dermatologist?

Certain conditions can mimic dandruff, for example, scalp psoriasis or seborrhoeic dermatitis which some people consider to be a severe form of dandruff. To make a proper diagnosis and get the appropriate treatment, it is important to consult a dermatologist.

It can cause self-esteem problems so treating your condition can help in getting back your confidence.

FAQs

• Does dandruff occur due to poor hygiene?

Although washing your hair regularly and using a good shampoo, conditioner and hair serum is important to maintain strong and healthy hair, there is no evidence that having poor hygiene can lead to dandruff.

• Does dandruff occur due to dryness?

The condition is not caused due to dryness. In fact, it can increase if too much oil is applied. Malassezia yeast tends to feed on the excess oil and dead skin cells which can lead to shedding and clumping of the keratinocytes into flakes. 

• Is food related to dandruff and which foods should I take?
  • Zinc: It is an essential mineral when given as oral supplementation can help in decreasing flares. Zinc-rich foods include spinach, peanuts and dark chocolate.
  • Essential fatty acids (omega-3 and omega-6 fatty acids): They are good for the overall health of your skin and hair but studies with respect to the control of dandruff are lacking. Some common sources include salmon, tuna fish, peanut butter, flaxseeds, extra virgin olive oil, canola oil, avocado, walnuts, and fortified eggs.
  • Fruits and vegetables: The standard Indian diet is low in fiber and high in foods with a lot of sugar, salt, and fat. This leads to poor digestion. So it is recommended to eat lots of vegetables and fruits. However, direct studies related to dandruff are not available.
  • Sugar: Diets with a high glycemic index can lead to stimulation of hormone surges that can trigger the output of oil. Restriction in intake of fatty foods, fried foods, refined sugars and processed food may lead to a reduction in flaking.

How to manage dandruff?

Although there is no permanent cure for this condition, it can be easily controlled in some easy ways.

• Hair wash with medicated shampoos (Ketoconazole, Zinc Pyrithione)
• Avoid application of oil.
• Severe Dandruff: May require oral medicines and medicated lotions for overnight application for a few days. If you have severe flaking, then it would require a consultation with a dermatologist.
• Alternative Therapies:
  • Lemon
  • Vinegar
  • Tea Tree Oil

Dandruff doesn’t usually cause hair fall but if it occurs, check out Top 25 tips to prevent hair fall.

“PRP can strengthen the existing hair and thicken them. By thickening them, they take up more space and cover more of the scalp. Additionally, plasma has vitamins, nutrients and proteins which adds to the benefit. And because PRP has growth factors which helps stimulate collagen and generate new collagen to grow, I’ve been using it successfully for hair loss treatment.

It doesn’t work for everybody, but it works for a majority of people. We pick our patients carefully. I don’t recommend it to someone who has end-stage hair loss for example when hair transplant is the go-to option.”

Dr. Siddhartha Saikia

What is PRP therapy?

PRP (platelet-rich plasma) therapy for hair loss is a three-step medical treatment in which a person’s blood is drawn, processed, and then injected into the scalp. PRP injections stimulate natural hair growth and maintain it by increasing blood supply to the hair follicle and increasing the thickness of the hair shaft. This therapy is often combined with other hair loss treatments.

PRP therapy has been in use since the 1980s. It’s been used for problems such as healing injured tendons, ligaments, and muscles as well as dental surgery. To understand how PRP works, it is important to be aware of the role that platelets play in healing.

Platelets are a component of blood, along with red and white blood cells. When a person suffers a cut, the platelets are some of the body’s “first responders” that arrive to stop the bleeding and promote healing. PRP contains a range of growth factors and proteins that speed tissue repair. As some types of hair loss result from damage to hair follicles, researchers began to try PRP for regrowth of hair by reversing the process that occurs in androgenic alopecia (AGA).

Most PRP therapy requires three treatments 4–6 weeks apart. Beyond that, maintenance treatments are often done every 6 months.

Step 1

Blood is drawn, typically from the arm and put into a centrifuge machine (a machine that spins rapidly to separate fluids of different densities).

Step 2

After about 10 minutes in the centrifuge, your blood will have separated into in three layers:

• PPP: Platelet-poor plasma
• PRP: Platelet-rich plasma
• RBC: Red blood cells

Step 3

The PRP is drawn up into a syringe and then injected into various areas of the scalp for hair growth. Because PRP therapy involves injecting your own blood into your scalp, and with sterile equipment, you aren’t at risk for getting a reaction or communicable diseases.

However, any therapy that involves injections always carries a risk of side effects such as:

• Mild pain at the injection site
• Scalp tenderness
• Swelling
• Headache
• Itching
• Temporary bleeding at the injection site
• Injury to blood vessels or nerves
• Infection
• Scar tissue
• Negative reaction to the anesthetic used in the therapy. Notify your health care provider if you have any past allergy to anesthesia used.

Risks of PRP for hair loss

Be sure to report all medications you’re on before the procedure including supplements. When you go for your initial consultation, you may be advised against PRP if you:

• Are on blood thinners.
• Are a heavy smoker.
• Have a history of alcohol or drug misuse.
• Have any underlying medical condition which can interfere with the treatment.

Is PRP hair treatment a permanent solution?

PRP is not a cure for conditions that cause hair loss. A person would need to receive multiple PRP treatments to get the benefits of hair growth. It takes a few sittings to see the initial results. And after the results start to appear, you may require maintenance sittings once a year to maintain new hair regrowth.

How much does PRP for hair loss cost?

The price typically ranges from ₹2000-₹5000 per sitting. Pricing depends on a number of factors including:

• Your geographic location
• Quality of equipment
• The addition of nutritive components
• Additional micro-needling

Conclusion

If you’re concerned about hair loss, you have a number of options including medication like minoxidil and finasteride along with hair transplant surgery. Another consideration is PRP therapy. PRP is a safe and effective way of reversing hair loss and stimulating new hair growth.

Talk to your skin specialist to see which treatment or combination of treatments is the best choice for you.

Click here to read some FAQs about AGA and Baldness.

Hair fall can be a very stressful issue that takes a long time to fix. There can be various causes of hair fall (you can read this article to know more about the different causes of hair fall). However, here are the top 25 tips and tricks recommended by Dermatologists which you can use to prevent hair fall.

1. Be gentle with your hair.
   Use a wide-toothed comb while brushing and combing the hair initially. It will help to prevent pulling out of the hair. Limit the tension on hair from styles that use rubber bands, braids etc.
   
2. Avoid brushing wet hair.
   When your hair is wet, it is in its weakest state. One must avoid brushing wet hair as the possibility of hair loss increases. In case you cannot avoid must comb wet hair, use a very wide-toothed comb. Sometimes, you can use your fingers to undo tangles, not a comb or a brush.
   
3. Avoid brushing too frequently.
   Yes, continuously stroking the scalp will increase the blood flow (up to an extent) but you must avoid brushing hair too frequently as doing so can injure the hair and increase loss.
   
4. Hot water, warm water or cold water?
   Initially, begin with warm water (not boiling hot which damages the hair). That will help the pores open up and help you get rid of any dirt or build-up more effectively. Then, reduce the temperature of your shower to lukewarm water when you apply shampoo and finally to cool water when you apply conditioner. Rinse your hair with cold water for your final rinse to seal the hair’s moisture. Coldwater also closes the cuticles, which adds shine to your hair. If adjusting the temperature is not possible then using lukewarm or cold water is ideal.
   
5. A final rinse with soft water.
   Use special water as a finishing rinse (such as water treated by your RO water purifier) to maintain the pH balance of your scalp and remove the hardness. This is especially useful if you are living in a place where the tap water is hard.
   
6. Use a microfibre cloth to dry your hair (Gently).
   Investing in a microfibre towel is one of the best things you can do for your hair. It helps in soaking the water and drying the hair faster with minimum friction ensuring that the hair fall is lesser, as compared to when you are using a regular towel. 
   
7. De-stress – Lifestyle changes to reduce stress.
   Studies in the past have found medical evidence to link stress with hair loss. You must “de-stress” yourself. One of the ways of doing it is by practising meditation and yoga which not only reduces stress but restores hormonal balance too.
   
8. Have a nutritious, well Balanced diet.
   Eating a nutritious diet that includes proteins and certain vitamins and minerals is essential for good hair health. To know more about the best foods to consume for healthy hair, you can check out this article.
   
9. Keep yourself hydrated.
   One-fourth of the hair shaft is made up of water. Have at least eight glasses of water in a day to stay hydrated and for the growth of healthy hair.
   
10. Wash your scalp regularly.
    Washing your scalp regularly, three times a week and using a good dermatologist-recommended shampoo for cleansing the scalp is beneficial for healthy hair. Use a gentle shampoo and wash your scalp in gentle circular motions. If you have an oily or itchy scalp, you can consult your dermatologist who can recommend a proper hair care routine suited for you.
    
11. Rinse the shampoo off properly.
    Sometimes, when the scalp is not rinsed properly after shampooing, the leftover ingredients can cause irritation and damage to the hair so be sure to be thorough.
    
12. Use a good conditioner.
    You should use a good quality conditioner and apply a small quantity on the ends and centre of the wet hair (not sopping wet) while focussing on the oldest, most damaged sections. Using a conditioner on the scalp and roots can lead to over-conditioning. Keep it on for a few minutes and wash it off.
    
13. Use a good hair serum.
    Those with dry and damaged hair should use a small amount of hair serum. Towel dry the hair until it’s slightly wet and apply the serum on the hair – centre and ends gently.
    
14. Know what is bad for hair
    If you want to keep your hair healthy, you must know how to take care of them.
    • Avoid rubbing your hair dry with a towel.
      Rather, let hair dry naturally (air dry).
    • Avoid Thermal Damage by Hair Dryer.
      If you must use a hairdryer then it is better to use the cold air setting rather than hot air which can damage the hair.
    • Avoid Constant heating & drying
      Don’t subject your hair to frequent, constant heating and drying procedures. Heat weakens hair proteins, and constant heating and drying can lead to weakness and fragility that causes hair loss.
      
15. Keep your head sweat-free.
    Men with oily hair, experience dandruff during summer due to sweating and the chances of hair fall increases. Using medicated shampoos can keep the head cool and prevent dandruff. Men who wear helmet sometimes experience hair loss in summer as the sweat accumulates in the pores and weakens hair roots causing hair loss in men. So wearing a scarf/ bandanna over your hair or a headband can help by absorbing the sweat.
    
16. Change how you style your hair (for men with long hair).
    If you are losing your hair lately, you must loosen up your hair. Hairstyles such as ponytails, braids and artificial hairstyles pull hair or tug hair follicles, and can eventually cause baldness.
    
17. Avoid harsh chemicals.
    Harsh chemicals and permanent hair colour products could be damaging for your hair. When you are experiencing hair loss, it is advised not to colour your hair or undergo any chemical treatments.
    
18. Reduce alcoholic beverages.
    If you are experiencing hair loss then decrease your alcohol intake because drinking alcohol can impair the absorption of essential vitamins and thereby cause a reduction in hair growth.
    
19. Avoid smoking.
    Smoking cigarettes reduces the amount of blood that flows to the scalp and this may cause a reduction in hair growth. Some studies also show an association between smoking and baldness in men.
    
20. Regular physical activity.
    Make time for physical activity every day. Walk, swim or bike for 30 minutes every day if possible and alternate days at the least. This will help to balance the hormonal levels, reduce the stress levels and help in overall better health as well as reduce hair fall.
    
21. Protect your hair from sun damage.
    You can use a hat which will protect your hair as well as skin. You should also avoid other sources of ultraviolet light. To know more about sun protection, you can read this article here.
    
22. Do not tie your hair during monsoon.
    To avoid damage to the hair, wet hair should not be tied. Keeping that in mind, it is advisable that hair not be tied at all during monsoons. If the hair is tied when it gets wet in the rain, severe hair fall may occur as the hair is weakest then. Instead, one can use a clip to secure the hair if needed.
    
23. The minimalistic approach during monsoons.
    During monsoons, the humid atmosphere can interact with the hydrogen bonds of your hair and cause it to swell up and become frizzy, wavy and prone to breakage. It is advisable to keep your hair routine to a minimum. Do not use any hair products like gel, mousse etc. during the rainy season. Another thing to remember is to wash your hair if it gets wet in the rain, then shampoo it, cleanse your scalp and dry it nicely.
    
24. Oiling.
    Coconut oil is well suited for hair. Apply oil on the hair shafts and ends. People with oily scalp should not apply oil on the scalps. You can leave it on overnight and wash it off the next morning with a shampoo.
    
25. Schedule appointments with doctors regularly.
    There are many health conditions, particularly skin-related conditions, that causes changes in hormonal balances which in turn lead to hair loss. Make sure you see a doctor regularly for your underlying illnesses and conditions. Also, be sure to ask your doctor about medications and supplements you take that might cause hair loss.

Baldness Treatment

Currently, only 2 medicines have US Food and Drug Administration (FDA) approval for the treatment of androgenic alopecia:

Minoxidil: This medicine appears to lengthen the duration of the anagen phase (the active growth phase of hair follicles), and it may increase the blood supply to the follicles. Regrowth is better at the top of the head than in the front areas and is not noted for at least 3-4 months. It is usually used as a 2% solution for women or a 5% solution for men which is to be rubbed into the scalp. However, if the treatment is stopped, the baldness returns. It works better in patients who have just started having AGA and who have small areas of hair loss.

Finasteride: It is used in men and is better for balding at the top of the head. Again, if the treatment is stopped the baldness returns. It cannot be used in women who are still able to have children because it can result in defects in babies. The doses are about 1 mg daily by mouth.

Every patient is unique and only the doctor can evaluate and determine the best baldness treatment. Some drugs that are not approved by the FDA but may be helpful in certain situations are:

• Spironalactone: In women with AGA.
• Oral contraceptives: In women.
• Dutasteride: Similar and more potent than finasteride.
• Latanoprost: This solution is currently used to treat glaucoma and using it results in an increase of eyelashes. Some studies have shown that this medication could be useful for stimulating hair follicle activity and baldness treatment.
• Follistatin: It is a human cell-derived medication which is being studied.
• Low-level laser light therapy: A red light hairbrush–like device has been used by some doctors with good results but more studies are required.
• Surgical treatment: This gives good cosmetic results in AGA. The main problem is covering the bald area with donor plugs (or follicles) in a sufficient number to be effective. Micrografting produces a more natural appearance than the old technique of transplanting plugs.

5AR Inhibitors

Finasteride is a 5 Alpha Reductase Inhibitor (5AR) that is approved by the FDA for AGA. The drug works by inhibiting the conversion of testosterone to a hormone known as dihydrotestosterone (DHT) by blocking type II 5AR. Dosing, side effects, and counselling points are given in the table below.

Some studies have been conducted comparing finasteride topical solution with oral finasteride 1 mg. The studies were small, but they found a similar improvement in hair growth with fewer side effects compared with the oral therapy group.

Dutasteride is also used off-label for the treatment of AGA and is an inhibitor of both type I and type II 5AR. In addition, dutasteride is a more potent inhibitor of both of these isoenzymes compared with finasteride. In several studies, Dutasteride 0.5 mg was found to be superior to finasteride 1 mg at the end of 3 and 6 months in increasing hair count and hair width.

Minoxidil

Minoxidil was the first drug approved by the FDA for the treatment of AGA topically. It is available in various formulations but the commonly used ones are 2% and 5% solution. There are several mechanisms by which minoxidil may promote hair growth; however, the exact mechanism of action is unclear. In addition, topical minoxidil may oppose calcium entry into the cells, which may increase epidermal growth factors to allow hair growth. In approximately 50% of men, hair loss is stopped, and for some, there was hair regrowth. The drug must be continued even after desired results are achieved or hair growth will subside. Dosing, side effects, and counselling points are included in the table below.

Ketoconazole, Spironolactone, and Prostaglandin F2 Analogues

Ketoconazole shampoo has been considered as an agent to aid in the treatment of AGA as combination therapy with oral finasteride. The mechanism is unclear; however, ketoconazole inhibits the DHT pathway, because of its antiandrogenic properties. In addition, it may reduce inflammation in the skin and help with baldness treatment.

Spironolactone is a potassium-sparing diuretic that has antiandrogenic properties; it blocks androgen receptors and decreases testosterone levels. Most of the clinical data using 50 to 200 mg/day of spironolactone have been in women with Female Pattern Hair Loss. It is especially effective if the woman with PCOS.

Prostaglandin F2 analogue latanoprost has been used in patients to treat glaucoma and the patients experienced the side effect of elongation of eyelashes and eyebrows. Studies have been done on latanoprost 0.1% daily to evaluate scalp hair growth. The 24-week study resulted in a significant increase in hair density from baseline when compared with placebo. Additional studies need to be conducted in a larger patient population for a longer period of time to determine the efficacy and safety of the therapy.

Low-level Laser Therapy

Low-level laser therapy has also been used for the treatment of AGA. It appears that these lasers can stimulate hair growth at certain wavelengths; however, the mechanism for this action has not been determined. There are several laser therapy devices, including a comb, a hood, and a helmet that fits on the head. More information is needed to determine the effectiveness as a baldness treatment.

Microneedling

Microneedling (with dermaroller or dermapen) has gained popularity and has been found to be beneficial in stimulating hair regrowth in alopecia. In micro-needling, multiple fine needles are used to create tiny punctures in the skin that stimulate the formation of new blood vessels, release growth factors, and promote the expression of certain proteins. Hair growth is a result of the release of certain growth factors and activation of the hair bulge, and Wnt proteins have been found to stimulate dermal papillae stem cells, leading to hair growth. Microneedling is generally used in conjunction with topical therapy such as minoxidil and it has been used with PRP.

Hair Transplantation

Hair transplantation is a commonly used treatment option for AGA. In hair transplantation, hair follicles are taken from areas of the scalp that are resistant to androgen and transplanted into areas that are androgen-dependent. Results are generally evident within 6 to 8 months after the transplant, and the use of pharmacologic agents such as minoxidil may be required to prevent progression of the condition.

Emerging Therapies

Several new therapies are emerging or being studied as treatment options for AGA, including PRP injections and JAK inhibitors.

Injecting autologous PRP into the scalp is a new therapy for the treatment of AGA. The platelets are gathered through a blood draw and then separated, concentrated, and prepared through several methods utilizing commercially available kits. Platelets release growth factors that are involved in the stimulation of endothelial and stem cells. Usually, it involves monthly sittings and may require 3-4 sittings to see the results. After 6-8 monthly sittings, patients can go for maintenance sittings every 6-12 months.

JAK inhibitors are under investigation as new drugs to treat alopecia areata; however, there is limited information about their use in AGA.

Conclusion

Over the past 30 years, there has been very little advancement in the treatment of AGA. As skin specialists consider options for treating this condition, pharmacologic products such as finasteride, minoxidil, and dutasteride, which have been widely studied and have provided positive outcomes, are available and should be considered as first-line therapies. In addition, PRP and microneedling are less common options that provide promising outcomes.

Healthcare providers should discuss options with patients and prescribe therapy based on actual outcomes in conjunction with patient preference while taking into consideration dosing schedules and cost.

Click here to read some of the FAQs about baldness and AGA.

The thing is, we don’t know of many efficient hair growth-promoting medications, and minoxidil is one of the very few successful ones. It’s very easy to tell results from placebo once you’ve been using regularly for a few months, whereas with essential oils and the likes you might notice healthier hair, but you really won’t be able to tell it apart from placebo.

You’ll find the basic information you need to know about Minoxidil. I still highly recommend you do your own independent research and learn more if you’re considering trying Minoxidil.

What is Minoxidil?

Minoxidil is a generic hair growth medication. It is the only other FDA approved medication for AGA (androgenic alopecia) along with Finasteride. It’s widely available as a topical solution in various strengths but the commonly used ones are 2%, 5%, and 10%.

Who could benefit from Minoxidil?

Both men and women with androgenic alopecia (thinning scalp hair/baldness) could benefit from minoxidil. It has been found that younger men and men whose hair is still thinning and haven’t yet gone completely bald are more likely to get satisfying results. Additionally, Men looking to grow facial hair could also benefit from it. People with receding hairlines will not benefit as much from Minoxidil.

What strength should I use?

A trial was done to compare the efficacy of 2% and 5% minoxidil solutions where it was found that 5% solution was significantly better. It’s generally recommended that women using it for androgenic alopecia try the 2% strength first and then if they didn’t get satisfying results in a few months to switch to the 5% strength (once daily). This is because minoxidil causes minor hair growth all over the body (read side effects below) because some of it gets absorbed to the bloodstream. It’s recommended for men who’re taking it for male pattern baldness or facial hair growth use the 5% strength (twice daily).

What about 10%, 12.5% and 15%?

10% does produce better results than 5%, but the relationship between concentration and efficacy isn’t linear. This means that 10% will not make your hair grow twice as fast as 5% will; rather, there will only be a 20-30% boost. But on the flip side, you’ll also be getting more of the side effects. Keep in mind that 10% is available only by prescription in many places, and 12.5% or 15% isn’t available in most places.

I started using minoxidil and now I’m losing more hair?

The efficacy of minoxidil is not in doubt. Numerous studies have been done showing that it results in significant improvement in hair growth, diameter and density. The rate at which hair will grow differ from person to person. In general, when used for AGA, users should expect a shedding phase that lasts about a month but can continue into the second month.

It’s important not to panic and stop treatment as this is an expected, and even positive sign. What’s happening is that the weaker hair that are in the ‘telogen phase’; A phase of the hair growth cycle in which a hair is not growing, start falling down to be replaced by new ‘anagen phase’ hair, the phase in which hair grows at a constant rate. You should start noticing growth by the 2nd or 3rd month, although it’ll only start being apparent by the 4th or 5th month.

How do I apply minoxidil, and how often?

Applying Minoxidil is simple. It is recommended that you wash the area first to clear your skin of dirt and oils for better absorption, but this isn’t necessary. First, make sure that your skin is completely dry before you apply minoxidil. Then either use the dropper or spray onto the area where you want to see growth, rub it in your skin and leave it to dry. Avoid washing that area for at least 3-4 hours (1ml in the dropper or 5-6 sprays). Twice a day application is recommended for males, roughly 8-12 hours apart. Females may begin with once a day application depending on tolerance and side-effects. More applications will not produce more results and will increase the side effects.

I’m happy with the results. So when can I stop?

If you’re using it for AGA, unfortunately, you’ll have to use it indefinitely. Since there’s a hormonal cause for scalp hair loss, you’ll lose the new hair when you discontinue minoxidil. However, if you’re using it for facial hair, Or hair on any other part of your body for that matter, the results are permanent for almost everyone.

Side effects?

Like any other medicine, minoxidil comes with a variety of side effects. Most common ones include redness, irritation and flaking. This is usually caused by the ingredients in the preparation and not minoxidil itself. Mostly the cause is propylene glycol or alcohol. Try other preparations if you experience this. People can rarely be allergic to minoxidil itself too. Unwanted body hair growth may occur but it is usually minimal if at all and usually falls off on its own. This is because some minoxidil passes to the bloodstream and it is more common when used for facial hair.

Less common side effects include weight gain, dizziness, headache, lightheadedness. Because Minoxidil is also a blood pressure medication, It might cause rapid or irregular heartbeat. If severe allergic symptoms are experienced, they should discontinue use and consult a professional.

Which brand should I get?

Minoxidil is a generic medication. I recommend that you try different brands and decide what’s best for you because some preparations get absorbed faster than others and some cause much less discomfort or dryness of hair. If you are unsure which one to get, then consult your dermatologist for an assessment and recommendation.

What other treatments are effective for baldness?

The US-FDA has approved only 2 drugs for Androgenic Alopecia. Namely, minoxidil and finasteride. Click the link to know more about the treatment of AGA. Another novel therapy which is being used with quite some success is PRP Therapy for hair loss.

Where can I find out more about Androgenic Alopecia?

You can find out by clicking the link – All About AGA. You can also go through some of the frequently asked questions regarding baldness.

What Are The Most Common Reasons For Hair Loss?

There are many possible reasons for hair loss, ranging from genetic to environmental. One of the most common hair loss causes is genetics, resulting in alopecia or male pattern baldness (which occurs in women as well as men). Although alopecia causes cannot be prevented, there are several possible approaches to addressing this cause of hair loss, including hair transplantation surgery, medications, and laser therapy.

In other cases, the reasons for hair loss may be related to an individual’s environment or lifestyle. Hair loss causes may include illness or disease (such as thyroid disease or anemia), certain medications (including chemotherapy), or lifestyle factors like smoking, stress, alcohol consumption or exposure to UV rays or chemicals. The best way to determine the cause of your hair loss is to see your dermatologist.

How can I prevent baldness?

You cannot prevent male pattern baldness or female pattern baldness, although there may be ways of slowing down the process or disguising the problem.

Isn’t hair loss just a cosmetic issue?

Male pattern hair loss can have a negative psychological impact. Studies have shown that hair loss can be associated with low self-esteem, depression, introversion, and feelings of unattractiveness. This is reinforced by attitudes in Western society, which place great value on youthful appearance and attractiveness. Some studies have shown that based on appearance alone, men with hair loss are seen as less attractive, less assertive, less likeable, and less successful than men without hair loss.

Is it such a big deal?

Since male pattern baldness is related to testosterone production, there is not much one can do to prevent it. But hair loss is primarily a cosmetic issue and some of the sexiest men on the planet – according to sources – have little or no hair. If you’re really struggling to come to terms with baldness, talk to someone. Hair loss may be a trigger to unhappiness and depression.

How common is male pattern hair loss?

Male pattern hair loss affects nearly all men at some point in their lives. It affects different populations at different rates, probably because of genetics. Up to half of male Caucasians will experience some degree of hair loss by age 50, and possibly as many as 80% by the age of 70 years, while other population groups such as Japanese and Chinese men are far less affected.

What role does heredity/genetics play in the male pattern hair loss?

Male pattern hair loss occurs in men who are genetically predisposed to be more sensitive to the effects of DHT. Researchers now believe that the condition can be inherited from either side of the family.

There is a strong history of baldness in my family. Can it be prevented in my case?

Yes. Even though male-pattern baldness is a genetic phenomenon, you can certainly be helped. The sooner you start with the treatment, the better are your chances of recovery. An integrated approach to the treatment as well as choosing the right combination of treatment will certainly be of help.

I have noticed excessive hair fall after changing my place of stay. Can hair loss be linked to the water?

Yes. A lot of people complain about hair fall after relocating their place of stay. However, this might not be the only reason for your hair loss. A video-microscopic test to examine your hair, along with the detailed analysis, will show us the exact cause or a combination of causes for your hair loss. The treatment will be accordingly which will be aimed at stopping the hair fall.

I have noticed hair fall after a lot of stress. Is hair fall related to stress?

Yes. Stress is known to increase hair loss. There, indeed, are links between male-pattern baldness and stress. While you may work your way through relaxation techniques such as yoga and meditation to control your stress level, homeopathic medicines can alter the reaction of the hair follicle to your stress, thereby preventing it from falling.

Where is DHT found in the body & what is the role of 5-alpha-reductase in the body??

• DHT is found in several tissues in the body including the prostate gland and skin.
• 5-alpha reductase is an enzyme that regulates the production of DHT. An enzyme is a protein that acts as a catalyst to speed up a chemical reaction. 5-alpha reductase can be inhibited by specially synthesised drugs (see below).

How Quickly Will I Lose My Hair?

Male hair loss starts at some point in the twenties, but it typically takes 15-25 years to go bald. Half of fifty year olds are quite bald. However, some men go bald in less than five years. It is almost impossible to predict how long the process will take.

Can Home Remedies Cure Baldness?

You may be wondering if you can use home remedies for hair growth or if there are any effective natural hair growth remedies. A healthy, nutritious diet is a great place to start; vitamin and iron deficiencies can be detrimental, so eating a variety of vitamin-rich foods is one of the best home remedies for hair loss.

If your hair loss is genetic, home remedies for hair growth are unlikely to be an effective treatment for baldness (you are more likely to have success with approaches such as medication, laser therapy, or hair transplantation surgery). It is a good idea to ensure you have a healthy lifestyle (for example, by reducing stress, smoking, and alcohol consumption, which can all cause or exacerbate hair loss). Avoid websites offering miracle cures, since they are rarely effective.

Is There Anything I Can Do to Stop My Hair from Falling out Naturally?

Everyone loses hair naturally and it is normal for hair to thin somewhat when you get older. But the truth is that male pattern hair loss is a genetic condition that cannot be stopped entirely.

Is Baldness Caused by Emotional Stress or Sexual Frustration?

Some hair loss is associated with stress although male pattern baldness is a genetic condition found in many men. If you find your hair is falling out in clumps or at unpredictable times, it is most likely to be the symptom of something else. This could be stress related but is unlikely to be caused by sexual frustration. The best thing to do is to see your dermatologist for a check up.

How Do I Stop Hair Loss?

Many people experiencing hair loss want to find out how to stop losing their hair, or whether hair loss solutions are available. However, it is important to remember that the most effective remedies for hair loss will depend on its root cause. In some cases, stopping hair loss may simply require a change in lifestyle, such as reducing stress levels, quitting smoking, or cutting down on alcohol. In other cases, the best hair loss solutions may be medical, with the use of drugs like Minoxidil (for example, Rogaine) and Finasteride. And still others find success using laser therapy or laser combs.

In all cases, if you are wondering how to stop losing hair, the best place to start is to see a dermatologist to determine what is causing the hair loss and which option is likely to work best for your situation.

How do I know if my hair loss is due to male pattern baldness?

Going bald is a slow process which might take a significant time to become visible. Identifying the first phase of hair loss that leads to baldness is tricky and sometimes difficult to determine. You should watch for signs of an M shaped or horseshoe-shaped hairline.  Along with either of these signs of hair thinning, excessive hair loss during a shower or while brushing is also a strong indicator of balding times approaching.

Should I see a doctor?

• To get advice and treatment for hair loss, you should always start with either your family doctor or a professionally qualified trichologist.
• Until very recently, male pattern balding was seen as a natural process and you may find your doctor to be neither sympathetic nor helpful if you consult him/her about it. But things may be changing. An increasing number of doctors realise that hair loss can have psychological consequences that significantly diminish quality of life, especially for younger men, and they may be more willing to take the problem seriously.

It is best to consult a reliable trichologist.

A trichologist, is a hair specialist whose training covers both the cosmetic and the medical aspects of the subject. They have a degree in dermatology. The Institute of Trichologists keeps a register of properly qualified people: look for the letters AIT (Associate), MIT (Member) or FIT (Fellow) after their name.

Other types of hair loss, such as alopecia areata, are taken seriously as medical conditions and you should seek your dermatologist’s advice as you would for any other medical problem.

What treatments are available for male pattern hair loss?

Current treatment options include:

• Minoxidil solution
• Finasteride tablets (type II 5-alpha-reductase inhibitor)
• Dutasteride
• PRP Therapy
• Micropigmentation (cosmetic tattoo)
• Hairpieces
• Ketoconazole shampoo
• Low-dose oral minoxidil (off label)
• Hair Transplantation
• Cosmetics

Check out treatment of AGA.

How Do I Regrow Hair?

Men and women experiencing hair loss will often wonder about hair regrowth options. Hair regrowth treatment will vary depending on the cause of your hair loss. Because the reasons for thinning hair vary widely, the solution may range from making lifestyle changes (such as reducing stress or eating a more healthy, nutritious diet) to treating existing medical problems (such as thyroid disorders or anemia) or seeing a physician to discuss medical treatments like Minoxidil or Finasteride.

Hair regrowth for men and women can be stimulated using hair regrowth treatments such as laser therapy or laser combs. If none of these treatments are effective, surgical options such as follicular unit extraction (FUE) are also available. Hair regrowth for women may also be affected by pregnancy, so if you are a pregnant woman experiencing thinning hair, know that this problem will resolve itself in time.

How Do I Make Thin Hair Thicker?

Many people with thinning hair wonder how to make hair thicker. Thinning hair remedies range from actions you can easily take in the comfort of your own home to medical and surgical thinning hair treatment. The best option will typically depend on the cause of the hair loss, so it is important to consult your physician.

Here are some steps to consider for how to make your hair grow thicker. First, determine whether your stress level or dietary habits may be affecting your health. Second, ensure that you are not suffering from any illnesses, such as a thyroid disorder or iron deficiency. Next, you may consider using medical thinning hair remedies such as Minoxidil or Finasteride. Finally, if these options prove insufficient and you are still left wondering how to make hair thicker, you may consider laser therapy or hair transplantation surgery.

One of the newest treatments for making hair grow thicker is PRP therapy. It consists of injecting platelet-rich plasma into the areas of the scalp which require hair growth. Find out more about PRP therapy.

In men, hair is usually lost in a well-defined pattern, beginning above both temples and is usually referred to as male-pattern baldness. Over time, the hairline recedes to form a characteristic ‘M’ shape. Hair also thins near the top of the head, often progressing to partial or complete baldness.

The pattern of hair loss in women differs from men (female pattern hair loss). Women with this condition, don’t experience noticeable thinning as early and they tend to develop a general thinning over the entire scalp, widening of the midline partition and extensive hair loss at the crown. Androgenic alopecia in women rarely leads to total baldness. A variety of genetic and environmental factors likely play a role in causing this condition.

Frequency

AGA is a common disorder that affects roughly 50% of men and perhaps as many women older than 40 years. The incidence of AGA increases greatly in women following menopause.

Race

The incidence and the severity of AGA tend to be highest in whites, second highest in Asians and African Americans, and lowest in Native Americans and Eskimos.

Age

Almost all patients with AGA begin to develop it before the age of 40 years.

Causes

A variety of genetic and environmental factors play a role in causing androgenic alopecia. Many factors still remain unknown to this date.

DHT Hormone

Researchers have determined that AGA is related to hormones called androgens, particularly an androgen called dihydrotestosterone (DHT). DHT is believed to shorten the growth phase (anagen) of the hair cycle, from a usual duration of 3–6 years to just weeks or months. This occurs together with the miniaturisation of hair follicles and progressively produces fewer and finer hair. The production of DHT is regulated by an enzyme called 5-alpha reductase. Androgens are important for normal male sexual development before birth and during puberty. Androgens also have other important functions in both males and females, such as regulating hair growth and sex drive.

There are three types of alpha-reductase receptor isoenzymes, and type I and type II are significant in the treatment of AGA. Type I is located in the skin, including the sebaceous glands and hair follicles, and type II is located in the inner root sheath of hair follicles in the scalp, face, chest, genitals, and prostate gland. Some of the hair follicles are smaller and more sensitive to androgen. The pattern in which the hair loss occurs is genetically predetermined by the distribution of these smaller hair follicles.

Role of Genetics

Several genes play a role in AGA. One gene, in particular, The AR gene has been confirmed in scientific studies to play a part in AGA. The AR gene provides instructions for making a protein called an androgen receptor. Androgen receptors allow the body to respond appropriately to DHT and other androgens. Studies suggest that variations in the AR gene lead to increased activity of androgen receptors in hair follicles.

Recently, two more genes have been identified including PAX1/FOXA2 and HDAC9.

Polycystic Ovarian Syndrome

A few women present with male pattern hair loss because they have excessive levels of androgens as well as genetic predisposition. These women also tend to suffer from acne, irregular menses and excessive facial and body hair. These symptoms are characteristic of polycystic ovarian syndrome (PCOS) although the majority of women with PCOS may not experience this kind of hair loss. Less often, congenital adrenal hyperplasia may be responsible.

Role of other medical conditions

Researchers continue to investigate the connection between AGA and other medical conditions, such as coronary heart disease and prostate cancer in men and polycystic ovary syndrome in women. They believe that some of these disorders may be associated with elevated androgen levels, which may help explain why they tend to occur with androgen-related hair loss.

Other hormonal, environmental, and genetic factors that have not been identified also may be involved.

Role of vitamin D receptors

Some studies have shown that there is a lack in functional vitamin D receptors which may lead to a defect in the cyclic regeneration of hair follicles, leading to the development of AGA although further studies are required.

Role of Oxidative Stress

The study, on males aged 18 to 30 years, found higher total oxidant levels and oxidative stress index values in patients, all of whom had early-onset AGA, than in healthy controls.

Inheritance

The inheritance pattern of AGA is unclear because multiple genetic and environmental factors are likely to be involved. This condition tends to cluster in families, and having a close relative with patterned hair loss appears to be a risk factor for developing the condition.

Features

Signs of androgenic alopecia include the following:

• Gradual onset.
• Increased hair shedding.
• Hair Miniaturisation: Transition in the involved areas from large, thick, pigmented terminal hair to thinner, shorter, indeterminate hair and finally to short, wispy, non-pigmented vellus hair
• End result can be an area of total baldness; this area varies from patient to patient and is usually most marked at the vertex

Hair miniaturisation

Unlike other areas of the body, hair on the scalp to grow in tufts of 3–4. In AGA, the tufts progressively lose hair. Eventually, when all the hair in the tuft are gone, bald scalp appears between the hair.

Males

• Men note a gradual recession of the frontal hairline early in the process.
• Hair is lost in a well-defined pattern, beginning above both temples. Over time, the hairline recedes to form a characteristic “M” shape.
• Hair also thins at the crown (near the top of the head), often progressing to partial or complete baldness.

Females

• Hair generally is lost diffusely over the crown; this produces a gradual thinning of the hair rather than an area of marked baldness; the part is widest anteriorly
• The frontal hairline is usually preserved in women
• A bitemporal recession occurs rarely in women.

Prognosis

The prognosis of AGA is unknown. Some patients progress to the point where they lose almost all of the hair on the scalp. Others have a patterned or nonpatterned thinning but retain a considerable number of scalp hair. Women with AGA usually show thinning of the crown rather than developing truly bald areas.

An increase in benign prostatic hypertrophy has also been associated with androgenic alopecia.

A study by Sanke et al indicated that early androgenic alopecia (i.e. prior to age 30 years) in males is the phenotypic equivalent of polycystic ovarian syndrome (PCOS) and that these males may be at risk of developing complications found in association with PCOS, such as obesity, metabolic syndrome, insulin resistance, cardiovascular disease, and infertility.

When to consult a skin specialist

Consult a skin specialist if you notice shedding of hair, receding hairline or thinning of hair. Starting treatment early can help in preventing extensive hair loss. Usually, a person suffering from AGA tends to try various home remedies and other natural treatments and the hairline recedes permanently due to lack of proper diagnosis and treatment so it is important to start the appropriate treatment as soon as possible for the best outcome.

Treatment

Only 2 drugs have been approved by the US-FDA (US Food and Drug Administration) for treatment of androgenic alopecia. They are minoxidil and finasteride. To know more about the treatment of AGA, check out Treating AGA for Men and Women.

Check out some FAQs about baldness.

Can hair fall & hair loss be treated?

Hair fall and hair loss may be due to various different reasons. Effective treatments for some types of hair loss are available. You might be able to least slow it down and sometimes, even reverse it upto an extent. With some conditions, such as alopecia areata and telogen effluvium, hair may regrow without treatment within a few months to a year or so.

Sometimes, hair fall can be prevented (you can read more about how to prevent hair fall here). However, if the hair loss is due to certain causes, there is no option but to treat it. Treatments for hair loss include medications and surgery. Let’s review some of the best options available.

Medications

If your hair loss is caused by an underlying disease, it is necessary to treat that disease. If a certain medication is causing the hair loss, you may need to stop using it for a few months after consulting your doctor. Ultimately, the treatment will depend on the cause which can be variable. To know more about the various causes of hair loss, click here.

The most common type of hair loss is androgenetic alopecia. It is a poly-genetic pattern of baldness but the most common options to treat it are listed below.

1. Minoxidil.
   • Minoxidil and Finasteride are the only 2 medicines approved by the US-FDA for the treatment of male-pattern baldness
   • Minoxidil comes in liquid, foam and shampoo forms. The most effective is the solution form, however, there is a chance that it causes dryness due to the alcohol content in the solution.
   • Apply the product onto the scalp skin (once daily for women and twice daily for men). Your doctor can explain how to apply the solution in a detailed manner.
   • Products with minoxidil help many people regrow their hair or slow the rate of hair loss or both. It’ll take at least six months of treatment to prevent further hair loss and to start hair regrowth.
   • It may take a few more months to tell whether the treatment is working for you. If it is helping, you’ll need to continue using the medicine indefinitely or at least for a long time Once the medicine is stopped, the hair shedding may occur in the next 2-3 months.
   • Possible side effects include scalp irritation and unwanted hair growth on the adjacent skin of the face and hands if the solution is not applied properly. Some people also complain of headache. To know more about minoxidil, contact your dermatologist today.
     
     
2. Finasteride.
   • This is a prescription drug used for men (and rarely women). It is to be taken daily as a pill.
   • Most men who take finasteride experience a slowing of hair loss and some men even have regrowth of hair up to an extent.
   • It takes a few months to give optimal results so again, patience is key. Like Minoxidil, this medicine is also to be taken for a long duration and has to be continued to retain the benefits. Finasteride may not work effectively for men over 60 as far as hair loss is concerned.
   • Although it is rare, one of the important side effects of finasteride are diminished sex drive and sexual function. You must also remember to consult your doctor in case you have any prostate cancer as it can interact with the detection of certain antigens.
   • Women who are in childbearing age or pregnant need to avoid taking finasteride tablets as well as touching crushed or broken tablets.
     
     
3. PRP Therapy.
   • This is a novel therapy that involves separating the plasma rich in platelets which contains various growth factors.
   • On injecting the growth factors onto the scalp, either with needles or with mesotherapy, the growth factors boost the hair growth and increase the density and strength of the hair.
   • Because the blood is the person’s own blood, it is natural and there is no chance of allergy to the PRP.
   • To avoid pain, the doctor may apply a numbing cream.
   • In itself, it is effective but usually, a combination approach is preferred by the doctors.
     
     
4. Other medications.
   • Other medicines like spironolactone and oral dutasteride are used in certain scenarios. Be sure to consult a specialist to know more about which option is best for you.

Cosmetic Options

There are many options and alternative cosmetic treatments for hair loss if you want a quick response or the medicines are contraindicated for some reason. Some of these are listed here and include hair-fibre powders, hairpieces, synthetic wigs, human hair wigs, hair extensions, hair weaves as well as laser and surgery.

• Hair-fibre powders:
  Coloured, powdery fibre sprinkles are commercially available and may work to camouflage balding areas. They have special properties allowing them to attach to the hair and give a fuller appearance. These products are available without a prescription and some of the products are good as well as cost-effective and quite safe with minimal risk. Often these may be used in addition to medical treatments like Minoxidil, Finasteride and hair transplants, and they are a great temporary measure to tide one over for special occasions.
  
  
• Hairpieces:
  One of the ways to add hair temporarily are hairpieces or hair weaving, in which a mesh is attached to the remaining hair and artificial or human hair of similar colour and texture is woven with existing hair. Quality varies considerably with the price. The hairpieces and weaves may stretch, oxidize, and loosen.
  
  
• Laser Therapy:
  The Food and Drug Administration has approved a low-level laser device as a treatment for hereditary hair loss in men and women. A few small studies have shown that it improves hair density. More studies are needed to show long-term effects.
  
  
• Hair Styling:
  You may try various hair care methods to find one that makes you feel better about how you look. For example, use styling products that add volume and choose a hairstyle that makes the hair loss areas less noticeable. Use wigs or extensions, or shave your head. Talk with a hairstylist for ideas. These approaches can be used to address permanent or temporary hair loss.
  
  
• Scalp Micropigmentation:
  It is a type of cosmetic camouflage technique where the specialist will make cosmetic tattoos which last for up to a year or more. This technique is often used when hair transplant is not viable or sometimes even in combination with hair transplant if the donor area is less. It is also commonly used for designing better eyebrows after colour matching. Contact your dermatologist to know more about this technique.

Hair Transplant Surgery

Sometimes, the pattern baldness progresses to a stage at which very few hair follicles are remaining and there are areas of permanent hair loss which cannot be preserved or treated with medical methods. In that case, hair transplant is the best surgical modality.

During a hair transplant procedure, a dermatologist or cosmetic surgeon removes hair follicles from a part of the head that has hair (usually the back of the head) and transplants it to the areas of balding. Each patch of hair has one to several hairs (micro-grafts and mini-grafts). This procedure doesn’t require hospitalization, but it is painful so you’ll be given local anaesthesia to ease any discomfort wherein you will be awake and alert but the area will become numb.

Possible risks include bleeding, bruising, swelling and infection. You may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery so the medical management will need to be started in addition to the surgery for longer-lasting results.

Surgical procedures to treat baldness are not usually covered by insurance.

The Cons!

• It is a long process: A session of laser hair removal on the upper lips takes less than a minute. However, it takes multiple sessions to see real results and you generally have to wait 4-6 weeks in between treatments. Different parts of the body have different growth rates and therefore could take longer or shorter depending on the area being treated.
• You need to attend every session: You have to be consistent with treatments to get the best results.
• The cost factor: Laser hair removal is costly.
• Less effective in dark-skinned individuals: LHR works best on fair skin with dark hair because the contrast between the skin tone and the hair colour allows the laser to easily pick up the target areas. In patients with darker skin tones, the pigment-rich skin competes with the hair follicle for the laser energy absorption. Certain lasers, like the Nd:YAG, are better in such cases so discuss with your skin specialist about which laser is to be used in your case.
• Epidermal Burns: If done by non-certified personnel, laser hair removal could leave burns or scars on the skin. Unfortunately, licensing procedures vary from state to state, and sometimes there are no requirements at all. Make sure that the procedure is being done by a dermatologist or under the supervision of a certified doctor.
• There are a few risks: There is a risk of burning which was discussed above. some of the other risks include blistering, discolouration, redness, and scarring. There’s also the possibility that your hair could grow back and may require yearly treatments to keep new hair growth at bay.
• Risk of pigmentation: There is a chance of increase or decreased pigmentation in the treated areas. To overcome this, you will need to apply a sunscreen with SPF30 regularly before and after the procedure is done, regularly.
• Reduced effectiveness if there is hormonal imbalance: Sometimes, hirsutism (unwanted hairs growing in females) can be a result of PCOD or other hormonal imbalance. In that case, your doctor will investigate you for the same and suggest medicines depending on the condition. Sometimes, additional medicines are required to control these hormonal imbalances in addition to laser therapy or as an alternative to it.
• Not available everywhere: Some of the skin care clinics may not be having the laser services due to high cost and upkeep of the machines.
• COVID19 Era: While treating areas such as the upper lips, the mask has to be removed. Make sure that the clinic where you are taking the LHR services are using the national guidelines of COVID19 prevention in their laser room.

The Pros!

• Best hair removal option: Yes, laser hair removal doesn’t get rid of hair forever (see the cons) but it does drastically reduce hair growth — to the point that you can stop shaving altogether and remains the most effective treatment for unwanted hair.
• Can be done for any area: You can get it done anywhere on the body, and the machine can cover large areas quickly. You can target the face, neck, underarms, back, arms & legs, bikini line, stomach etc.
• Excellent results: While laser hair removal can work on any body part, it is especially effective on the lips, chin, and underarm areas, especially if the hair is dark and the skin is fair.
• It shouldn’t be painful: When it comes to pain level, laser hair removal falls somewhere between shaving (painless) and waxing (painful). The skin specialist will usually use a cooling system to numb the area before and after the laser treatment. It also gets progressively less painful as treatments continue and the hair becomes finer.
• Precision – Lasers can selectively target dark, coarse hairs while leaving the surrounding skin undamaged.
• Speed. Each pulse of the laser takes a fraction of a second and can treat many hairs at the same time. Small areas such as the upper lip can be treated in a few minutes.
• Predictability. Most patients have great results after an average of 4-6 sessions.
• Diode Laser: The diode laser is very effective for light and dark skin and it is the most commonly used laser for hair removal in our country.
• Don’t worry if you’re on your period. Unlike getting a bikini wax, you should not cancel your treatment due to your period. It’s very important to stay consistent with treatments.
• The cost factor: Yes, it was mentioned as a con. But if you see the cost of regularly buying razors and waxing, those costs also add up to pretty much the same amount. So in some situations, it can be considered as a “beauty investment”. At our skin care clinic, we are doing LHR at very affordable rates to make sure that the cost is not an issue.

Although laser hair removal is not without its fair share of cons, it is a very beneficial procedure to be done especially if it is being done by a certified dermatologist. Read more about the frequently asked questions related to LHR.