Alopecia (Hair Loss)

How to Treat Alopecia (Hair Loss)

Each hair follicle on your head grows 10-12mm per month during its growth or anagen phase. This lasts for about 5 years at which time this follicle enters a resting or telogen phase. The hair then sheds and the process begins anew. That’s all there is to it. It’s normal to lose up to 100 hairs daily, so expect to see some hair in the drain and on your pillow in the morning…that’s perfectly normal.


In men, the cause of hair loss is usually testosterone related, more specifically, the conversion of testosterone to a hair-losing compound 5-HT. 5-HT encourages hairs to shed without re-entering the growth phase. Most commonly, this loss will first be noticed at the front and crown (or top) of the scalp.

During your visit, we’ll first do a full screen to insure there are no other hormonal or medication-related causes for your hair loss, then we’ll get straight to treating and reversing the rate of hair loss you’re experiencing. Two-thirds of us will notice some degree of hair loss by the age of 60, but there’s lot’s to be done to insure this never becomes noticeable to anyone but you.

Treatment in men is straight-forward. Over the counter minoxidil, which retards the conversion of testosterone to 5HT, and an oral medication known as finasteride which blocks 5HT receptors that line every hair follicle. Patients often ask, “Will I take this for the rest of my life?” The short answer is, yes – in order to keep the new hair you grow or even retain the existing hair you have, continued therapy is required. Good news is, if you ever stop, you won’t lose all your hair, you’ll just go back to where you would have been had you never taken the medication in the first place.

One final option for male hair loss is the hair transplant. Hair is taken from the back of the scalp and mover forward, one follicle at a time. We’ve all seen some lousy rugs out there, so if you’re considering this option, let’s talk about finding you the right hair transplant surgeon with reproducible, consistent, beautiful results.


In women, aged 20-40, the leading causes of hair loss are birth control pills and low iron stores usually from heavy menstrual losses. Our evaluation of your scalp will begin with a battery of blood tests that will look into a vast array of potential causes, ranging from iron sufficiency to auto-immune conditions to hormonal imbalances within your body.

Female pattern loss is more diffuse, instead of the frontal-and-crown pattern seen in men. Women make up nearly half of all hair loss sufferers, so this is not a male only issue.

There are a number of medications we can use in women, that are off-limits in guys:

Topical Minoxidil. Blocks the conversion of testosterone to 5HT, the metabolite that retards hair growth.

Spironolactone. Initially invented as a diuretic to increase urination, this agent is now widely used for female pattern hair loss. Patients may notice one or two extra trips to the bathroom every week, but more importantly, this anti-androgen can markedly improve hair thickness in just a few months.

Biotin. 2mg of biotin daily is the only vitamin in the dermatologic literature base that has shown consistent results to regrow hair.

Ketoconazole Shampoo. While traditionally an anti-fungal agent, ketoconazole shampoo can block a step in estrogen metabolism at the level of the hair follicle, thereby encouraging hair growth.

B12 Shots. While not covered by traditional insurance, there is a preponderance of literature linking improved hair growth with optimized B12 levels.

Scalp Injections. We use a proprietary blend of anti-inflammatory agents, injected directly into the scalp, to decrease oxidants that may be interfering with hair growth.

No matter the cause of your hair loss, we’ll develop an intensive, customized regimen to regrow the hair you remember….safely and swiftly. Schedule an appointment today!