seems inevitable with age. By 70 years of age, approximately 80% of
Caucasian men have some balding and nearly 40% of Caucasian women
have noticeably thinning hair. For many, visible hair loss begins
years earlier. The cause of this hair loss is often hereditary. That
is, we inherit genes from our parents that cause hair loss. When
hereditary hair loss occurs, it is possible to treat it. Treatment
can give men and women of all ethnic backgrounds a more youthful
Hereditary hair loss
Women Concerned About Hair Loss
A woman who is concerned about hair loss should see her
dermatologist, who can evaluate her for many causes of
hair loss, including hormonal changes. Fluctuating
hormones, such as those that occur during menopause, can
cause hair loss.
How Dermatologists Treat
Before recommending treatment, a dermatologist will first diagnose
the cause of the hair loss. Once the cause is known, treatment can
be discussed. Options for hereditary hair loss include:
Surgical Procedures for Hair Restoration
Hair transplantation – Skin on the scalp that has good hair
growth is removed and transplanted to areas of the scalp that
Scalp reduction - Bald scalp is surgically removed and
hair-bearing scalp is brought closer together to reduce balding.
Scalp reduction surgery can be performed alone or in conjunction
with a hair transplant.
Scalp expansion - Devices are inserted under the scalp
for about 3 to 4 weeks to stretch the skin. This procedure may
be performed before a scalp reduction to make the scalp more
lax. It also can be performed solely to stretch hair-bearing
areas, which reduces balding.
Scalp flaps - A hair-bearing segment of scalp is
surgically moved and placed where hair is needed.
Medication for Hair Restoration
Finasteride – Approved by the U.S. Food and Drug
Administration (FDA) for treatment hair loss in men, this pill
helps slow hair loss in approximately 88% of men and stimulate
hair re-growth in about 66% of men. Finasteride works by
blocking the formation of the active male hormone,
dihydrotestosterone (DHT). It is available by prescription.
Over-the-Counter Treatment for Hair Restoration
Minoxidil - This topical solution works on hair follicles to
reverse the shrinking process and stimulate new growth on the
top of the scalp. Minoxidil is approved by the FDA for use by
men and women. It is the only hair re-growth ingredient approved
by the FDA for use by women. A dermatologist may combine topical
minoxidil with another topical treatment such as a topical
corticosteroid or topical tretinoin to enhance hair growth.
Laser devices – Brushes, combs, and other hand-held
devices that emit low laser light may stimulate hair growth or
make hair look more youthful in some people.
It is important to know that the FDA requirements for approval
of a medical device are not as stringent as those needed for
approval of a medication. Additionally, long-term effectiveness
and safety of these devices are not known.
When to be Concerned
Any person who feels that hair loss is a problem should consult a
dermatologist. While hair loss is often a sign of aging, it also can
be the first sign of an underlying medical condition. A
dermatologist can diagnose the cause of your hair loss. An accurate
diagnosis is essential for effective treatment.
Hair Restoration (more
information about the surgical procedures)
Hair Loss (AAD pamphlet)
What Causes Hair Loss?
Paus R, Olsen EA,
Messenger AG. “Hair Growth Disorders.” In: Wolff K, Goldsmith LA,
Katz SI et al. Fitzpatrick’s Dermatology in General Medicine, 7th
edition. USA. McGraw Hill Medical; 2008. p. 766-9.
Satino JL, Markou M. “Hair regrowth
and increased hair tensile strength using the HairMax LaserComb for
low-level laser therapy.” Int J Cosm Surg and Aesthetic Derm
2003; 5(2): 113-7.
All content solely
developed by the American Academy of Dermatology