All About Hair Loss- Elizabeth Velez, PA-C

Hair loss is a very common complaint, and something we see a lot of at NBDPS. It can present as overall thinning, shedding, receding hairline, annular patches of loss, itchy/flaking scalp, and more. It is often extremely distressing to patients and causes emotional turmoil. There are several different types of hair loss and many different treatment options based on each case of hair loss. If you think you are experiencing hair loss of any kind, it is best to make an appointment so one of the providers at NBDPS can fully evaluate you and come up with a personalized treatment plan to get your hair to a better place. In this visit it is important to know the history of the problem including the timeline of changes, family history, lifestyle factors, changes to your health/medications, stress levels, and any symptoms associated with the loss. Your provider will take a thorough history and then do a physical examination of the scalp. Labwork is often ordered which can test for problems that may be an underlying issue to the loss, and important lab values to ensure that your body is in a good place to start growing healthy hair. This often includes, but is not limited to, a CBC, iron labs, TSH, vitamin D, and more depending on your history. Let’s break down some common therapies for hair loss and the evidence behind their use.

Topical medications are often first line therapies as they are well tolerated with minimal side effects, do not require intensive monitoring, and avoid systemic side effects. Minoxidil (commonly known as Rogaine) is a medication that is used for hair loss both as a topical compound and an oral medication. As a topical it is available over the counter. Minoxidil acts as a vasodilator bringing blood to the hair follicle. It is thought to prolong the growth phase of the hair cycle, which helps with longer and thicker hair over time. We can also compound this medication as a prescription with other topical medications such as finasteride or spironolactone as well.

Oral therapies are often the next step in treatment if a patient has failed topical therapies. These could include oral minoxidil or oral finasteride. When properly prescribed and managed by your dermatologist, these are safe treatments with a long history in the treatment of hair loss. What about hair loss vitamins or supplements? Patients often have tried these at some point, and want to take them as an additional therapy to their plan. There are several supplement companies geared toward hair loss on the market. These are thought to work by addressing possible nutritional deficiencies. Many on the market also have adaptogens in them which are aiming to calm down sympathetic nervous system and alleviate the stress response on the body. In our office we currently carry Nutrafol, which we have seen great results with.

Injection therapy with platelet rich plasma (PRP) has also been studied to show improvement to hair growth and many of our patients see a benefit with adding this into their treatment protocol. These injections are often used alongside topical and oral therapies to boost growth factors to the scalp giving your hair follicles the extra boost they need to grow healthy hair. This would be performed in a series of 4 treatments spaced one month apart. Injections are mildly painful, but often are quick and pain can be managed with the use of a chilled air that can be blown on the scalp during the injections.

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