Experiencing hair loss? Don’t panic!

Many great new treatments are now available

Hair loss can have a profound effect on a person’s self-esteem. Hair loss is a problem faced by many people of all ages, sexes and nationalities. To fully understand what it means to experience hair loss, one must first understand the types of loss, their causes, and the treatments available to help combat or reverse the condition.

Hair loss can be a challenging and frustrating experience for many people, mainly when it is noticeable or affects their appearance. In many cultures, a full head of hair is seen as a sign of youth, attractiveness and confidence. 

Hair loss can cause people to feel less confident and self-conscious, diminishing their self-esteem and impacting their emotional well-being. Hair loss can also have a severe psychological effect on individuals, potentially leading to depression and anxiety.

There are approximately 25 different things that can cause hair loss. Some are very common; others are extremely rare.

The most important thing to do when experiencing hair loss is to see a board-certified dermatologist. They will perform a series of tests, often including a small scalp biopsy to determine what exactly is causing the hair loss. 

Different causes have different treatments, and you want to be sure your treatment is the proper treatment. One of my professors in medical school would frequently state, “You can’t treat it for sure if you do not know what it is for sure.” 

Today we will focus on alopecia areata, but let’s briefly discuss the five most common causes of hair loss.

1. Androgenetic alopecia 

Also known as male- or female-pattern baldness. Your genetics determines androgenetic alopecia. The treatment is typically a combination of topical minoxidil, oral finasteride, and other medications.

2. Alopecia areata 

A disorder where the body’s immune system attacks the hair follicles, leading to patchy or complete hair loss. Treatment includes topical steroids, injected steroids, light therapy (narrowband-UVB phototherapy), and, as discussed here, new and exciting FDA-approved medications

 3. Telogen effluvium 

This type of hair loss occurs when there is a disturbance in the hair’s growth cycle. Telogen effluvium happens during stress like childbirth, surgery, automobile accidents, or losing a loved one. Treatment may involve medications to reduce inflammation, hormonal therapy, or the tincture of time. Telogen effluvium will also resolve on its own over time. 

4. Chemotherapy-induced hair loss 

This is also known as anagen effluvium, a type of hair loss caused by chemotherapy medications.

5. Seborrheic dermatitis hair loss 

Seborrheic dermatitis hair loss is one of the most common types of hair loss I see in my clinic. The common term for seborrheic dermatitis on the scalp is dandruff. Seborrheic dermatitis hair loss often mimics a “dry, itchy scalp.” For more information on dry, itchy scalp and how it affects hair loss, please see:

Let’s Talk about alopecia areata

Alopecia areata is an autoimmune disorder that affects hair follicles, leading to patchy and sudden hair loss on the scalp, face, and other body areas. It is one of the most common types of hair loss. 

For some unknown reason, your immune system gets confused and attacks your own hair and hair follicles, causing your hair to fall out. One connection is that stress can make alopecia areata worse. The sudden loss of large circles or patches of hair loss can be devastating.  

Great news: The FDA has approved a class of medications called Jak-inhibitors to treat alopecia areata. 

Jak inhibitors are a class of medications that block specific enzyme activity (called Janus kinases—Jak). These enzymes are involved in signaling pathways that control various cell functions, including inflammation. 

By inhibiting these enzymes, Jak inhibitors can help to reduce inflammation and promote normal hair growth in patients with alopecia areata. In the past we used injected steroids, topical steroids and phototherapy treatments.

Hair loss can be a devastating experience. Fortunately, for alopecia areata there is a tremendous new and effective treatment. The treatment is an oral pill called baricitinib (Olumiant). We have had great success with Olumiant. Most patients see results in 1-2 months. 

If you are experiencing hair loss, don’t panic. There are many great new treatments for hair loss, including alopecia areata. The most important thing you can do is to see a dermatologist to determine the cause. Once you have determined the cause, you can develop a treatment program to treat your hair loss.