ALOPECIA IS A TREATABLE CONDITION.This disorder is in the news as a result of the infamous episode on the Oscars. Articles are being published, some promoting opinions rather than facts. As a hair loss expert, I welcome the public attention on this condition. Is shaving one’s head beneficial? Maybe. Shaving one’s head has no effect on hair growth but it may look better than not shaving the head. It is popular with many males as a masculine look, but infrequent for women. I don’t know why Jada Pinkett Smith elected to do it, but there are alternative medical therapies to regenerate hair follicles which could be tried before considering such a dramatic change.

What is alopecia? It simply means hair loss and is not a stand alone diagnosis. For men, the vast majority have a genetic condition; it is in the genes they inherit from their parents. For women, the situation is more complex. While many also inherit genetic alopecia, a sizable number are exposed to “triggers” that are at the root of the problem. For example, Covid is in the news as a trigger. Also many medications, lupus, childbirth, chemotherapy, thyroid issues, anemia, rapid weight loss, gastric surgery, and many other conditions including possibly stress may play a role. Some causes are self-induced such as traction alopecia (wearing very tight braids) or intentionally pulling out one’s hair (trichotillomania). Aerata alopecia (AA) stands alone as an auto-immune disorder that affects both men and women. There are new treatments for AA on the horizon using anti-arthritis medication.

Regardless of the underlying cause, there are a variety of effective treatments available. The mainstays of treatment to reduce shedding for both men and women with genetic alopecia are minoxidil (5%) and low level laser light therapy (LLLT). These FDA approved treatments help reduce significant shedding in about 70% of those that use them. Most oils, most supplements including biotin and fancy shampoos are generally of minimal or no benefit. Vitamin pills may be useful as B-12 and D3 deficiencies are very common.

So what is the smart approach? First, be proactive. If it has lasted over six months, it is not going away. It only gets worse. You need to figure out a few things then take action. Is it genetic or not? If there is a history of baldness in your family tree, odds are it is genetic. If so, you need to try minoxidil, LLLT, and a daily multi-vitamin for a minimum of four months.

If it is not genetic, get blood tests for common disorders: anemia, thyroid status, lupus, B-12 and D3. (Sex hormones likely play a role but blood tests for the sex hormones rarely show abnormalities). Scalp biopsies are usually vague and not informative. Check your medications on Google and see if they are associated with hair loss. If they are, ask your doctor to find an alternative.

Platelet rich plasma (PRP) is a popular but non-FDA approved treatment based on the healing powers of the body’s platelets. Their effect is to improve the blood flow to affected hair follicles. A healthy hair follicle does not fall out. All hair loss physicians - including me - have seen dramatic improvements from PRP treatment, which is very effective in stopping shedding (about 90% effective) and also reasonably effective (65-70%) in re-growing lost hair for most hair loss conditions. Take some pictures now. If the minoxidil and LLLT treatments discussed above after four months are not making an obvious visual improvement, or if your hair loss is not genetic, then you should investigate PRP treatment.

About Dr. Goldstein
Dr. Goldstein is a former NJ State Commissioner of Health and past-president of the Monmouth-Ocean County Medical Society. He has been practicing medical hair loss treatment and regeneration since 2016, most recently in Colts Neck, NJ.