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Understanding the causes of hair loss can help you detect its beginning stages. Unfortunately, hair loss affects people at any point in their life, sometimes beginning in their 20s.

According to the Mayo Clinic, the most common cause of hair loss is a hereditary condition called male pattern baldness and female pattern baldness. The genetic predisposition causes the individual to be more sensitive to specific sex hormones which trigger hair loss.

The sensitivity to hormones causes the hair follicles to shrink, which leads to thinning hair and eventual loss of hair. The medical term for this type of hair loss is called Androgenetic Alopecia.

Androgen is a term used to describe any hormone that promotes male characteristics, testosterone being the most well-known. Hair loss can also result from another type of hormone disorder including hypo/hyperthyroid and adrenal imbalance.

  • FACT: Most people normally shed 50 to 100 hairs a day. But with about 100,000 hairs in the scalp, this amount of hair loss shouldn't cause noticeable thinning of the scalp hair. 

  • FACT: Almost half of all people have inherited hair loss by about 50 years of age.

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The Most Common Type of Hair Loss
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Male and Female Pattern Baldness, also known as “Androgenic Alopecia”, is the most common cause of hair loss and will affect up to 70% of men and 40% of women at some point in their lifetime.

Men typically present with hairline recession at the temples and hair loss on the upper surface of the head, also known as vertex balding. Women typically present diffuse, or scattered, thinning of the hair over the top of their scalps.

People who suffer from this type of hair-loss have an underlying sensitivity to “hair follicle miniaturization” due to androgenic hormones. Miniaturization refers to the shrinking of the hair follicle which results in the thinning or loss of hair.

Dihydrotestosterone (DHT) is the primary hormone associated with the miniaturization of hair follicles. DHT is a by-product of the hormone Testosterone, found in both men and women, although typically much higher in men. Testosterone naturally converts to DHT through a hormonal pathway called 5 Alpha Reductase.

Certain hairs on your head may genetically susceptible to thin if exposed to excess levels of DHT. DHT can attach to the hair follicle which causes it to be prematurely shed while also shrinking the follicle and preventing hair re-growth.

Instead of normal, healthy hair re-growing in its place, a thinner, finer hair replaces it. According to the Foundation for Hair Restoration, the onset of miniaturization from androgenic alopecia is due to three factors.

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Miniaturization of hair is genetic, and the genes come from either parent or both.
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The presence of and sensitivity to Dihydrotestosterone (DHT) is a factor in hair loss.
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The older you are, the more likely you are to experience miniaturization of your hair.

Causes of Hair Loss

There are other causes of hair loss such as poor nutrition, particularly lack of protein or iron in the diet. Hair returns after you change your diet to get enough of these nutrients. Other causes include certain diseases, chemical exposure, or drug use.

More than 95% of hair loss in men is due to this condition. Women can also be affected by this common type of hair loss.

Usually poor nutrition doesn't cause complete baldness; thinning of the hair is more common. Studies show that limited food intake and deficiencies in certain nutrients can cause thinning. These include deficiencies of biotin, amino-acids (protein), zinc, and iron. Consuming a diet high in animal fat, such in fast food, can also have a negative effect on hair loss.

Stress has been shown to restrict the blood supply to capillaries, which prevents oxygen and nutrients from reaching the hair follicle. This can prevent hair growth in an effect that is similar to having poor circulation.

Some medications can cause hair loss, especially medications which affect hormone levels. These medications include contraceptive pills, some forms of hormone replacement therapy, anabolic steroids, and acne medication. Other medications that can have an effect on hair loss include those for blood pressure problems, diabetes, heart disease, and cholesterol.

FDA Approved Treatments for Hair Loss
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There are currently two treatments approved by the FDA for the miniaturization of hair-follicles from androgenic alopecia: 

  • Finasteride (Propecia) - The American Hair Loss Association notes finasteride is a prescription oral treatment for male pattern baldness. It reportedly reduces the active levels of DHT in your body to prevent miniaturization of hair follicles. Women should not take oral finasteride due to its risks. In addition, many men who are prescribed Finasteride to be taken orally by tablet experience significant side effects which reduce life quality. These side effects include loss of libido, erectile dysfunction, hypogonadism, gynecomastia, and sexual dysfunction. 

  • Minoxidil - An over the counter topical treatment that has been used since the 1990’s to treat baldness in men and women. It reportedly promotes new hair growth by increasing cutaneous blood flow to shrinking hair follicles. It is generally safe and can be effective by itself if used during the early onset of alopecia.

    • Topical minoxidil fortified with finasteride - An account of maintenance of hair density after replacing oral finasteride. Finasteride acts by reducing dihydrotestosterone levels, thereby inhibiting miniaturization of hair follicles in patients with androgenetic alopecia (AGA). Oral finasteride is associated with side effects such as decreased libido, sexual dysfunction, and gynecomastia. Topical finasteride can be considered for hair density maintenance after initial improvement with oral finasteride, thereby obviating the indefinite use of oral finasteride. Topical finasteride may absorb less systematically than oral finasteride, therefore reducing the side effects associated with oral finasteride. 

WARNING: Oral Finasteride (Propecia) is commonly prescribed to men with male pattern baldness with the intent to block the production of the hormone Dihydrotestosterone (DHT). The problem with taking Finasteride is that it may cause a condition called hypogonadism in men resulting in side effects including impotence, low sperm count, depression, anxiety and many other significant side effects which can last long after the drug is discontinued. We recommend that men do not take Finasteride orally to treat MPB and to try other available options first. 

 

Hormone Testing & Treatment for Hair Loss

The most common type of hair loss experienced by men and women is caused by a sensitivity to androgenic hormones like Dihydrotestosterone (DHT).

Dihydrotestosterone (DHT) is the primary hormone associated with the miniaturization of hair follicles. DHT is a by-product of the hormone Testosterone and is found in both men and women, although typically much higher in men. Testosterone converts naturally to DHT through a hormonal pathway called 5 Alpha Reductase.

Finasteride is an FDA approved medication commonly prescribed to block 5-Alpha Reductase therefore significantly reducing DHT production. Although this method may slow hair loss, reducing DHT can lead to unpleasant symptoms and side effects leading to a decreased quality of life. DHT is an important hormone that plays a role in the regulation of libido, body composition, bone density, cardiovascular function, and positive mood. Therefore it is optimal to reduce DHT activity directly on the hair follicle while preserving a healthy level of this important hormone in the body. Other hormones can influence hair health and regeneration including hormones produced in the thyroid and adrenal glands.

A simple blood test can help determine androgen levels including testosterone and dihydrotestosterone (DHT). Thyroid and adrenal hormones will also be analyzed along with other important biomarkers so that treatment can be customized to restore any hormone imbalance while protecting hair follicles and preserving the quality of life.

Compounded thyroid restoration is available for patients diagnosed with hypo or hyperthyroid. We also offer bio-identical hormone restoration for aging men and women who have a deficiency or imbalance of sex, adrenal, thyroid, and pituitary hormones.

 

Effective Compounded Topical Medications

There are medications available that have shown to be effective for the treatment of alopecia when applied topically. These medications are available at compounding pharmacies who specialize in making custom medication formulas.

Doctors who specialize in hair loss have partnered with various compounding pharmacies to design topical formulas that effectively treat, prevent, and reverse hair thinning and loss depending on the cause. These formulas are available a Defy Medical and can be customized based on your condition, and the cause of that condition. A prescription is required to purchase these formulas.

Here is a list of ingredients which can be included in your custom formula:

Latanaprost

A double-blind scientific study published in the May 2012 issue of the Journal of the American Academy of Dermatology has found that latanoprost, a drug that mimics naturally-derived compound molecules called prostaglandins, significantly increases hair density on the scalp after 24 weeks of treatment in young men with mild hair loss. Latanoprost, like the eyelash restoration drug bimatoprost (better-known by its brand name Latisse), has been used to treat glaucoma. And like bimatoprost, latanoprost has been used to treat eyelash alopecia. The scientists who conducted the study sought to determine if latanoprost could stimulate hair growth when applied topically on the scalp.

Ketoconazole

Ketoconazole, an anti-fungal medication, can also be effective in stimulating new hair growth if you suffer from androgenetic alopecia. Androgenetic alopecia, also called male and female pattern baldness. Dihydrotestosterone is the hormone responsible for shrinking hair follicles in people who have this condition. In addition to killing fungi, ketoconazole is also helpful in countering the effects of Dihydrotestosterone.

Spironolactone

If you have female pattern baldness caused by excessive androgens and do not respond well to minoxidil, Defy’s physician will also prescribe spironolactone. Spironolactone is usually prescribed as a tablet which helps reduce water retention (edema). It will also lower testosterone and androgen levels produced in the ovaries and adrenal glands. Typically this would be a therapy specific for woman who experience pattern baldness. Spironolactone can be also used in a topical scalp solution in combination with other ingredients designed to treat hair loss. Men can also use Spironolactone topically for the same objective, to reduce the effect of androgen hormones on the scalp. This is a great option for men who do not want to take any risk using Finasteride.

Azelaic Acid

A naturally occurring substance found in whole grains that contains a mild antibiotic designed to reduce harmful bacteria from the skin. It is also said to be a potential inhibitor of 5-alpha-reductase in human skin. A reduction of this enzyme reduces the amount DHT (Dihydrotestosterone) in the body and therefore, have a similar effect to finasteride; the active ingredient in FDA approved oral hair loss solution Propecia (finasteride).

Minoxidil

The number one treatment prescribed for male and female pattern baldness. It helps to increase blood flow bringing more nutrients and oxygen to the hair follicle. Minoxidil is best applied topically

 

Platelet-Rich Plasma for Hair Restoration

 

Platelet-Rich Plasma (PRP) injections can stimulate hair growth by delivering platelets and growth factors directly to the follicles. In this treatment, we use your own blood sample, processing it to create the highest concentration of platelets and growth factors. Then we inject it directly into the scalp in different areas and at different depths for a comprehensive scalp treatment.  PRP injections are best suited for those who experience thinning hair, because the treatment can help stimulate thin hairs to grow thicker.  

Learn more about the PRP Hair Restoration process.