Hair Loss

Hair Loss

Winning over Thinning

Your hairstylist has been able to hide it so far. Those short, frizzy 'dos keep your locks looking full, and no one can tell the difference.

Still, it's getting hard to deny that just like 20 million other American women, you're starting to lose your hair. Now you're worried sick, checking the mirror constantly--and feeling older by the minute.

"Hair is very much part of a woman's body image," says Dominic A. Brandy, M.D., medical director of Dominic A. Brandy, M.D., and Associates, a permanent hair restoration practice in Pittsburgh. "Losing it can cause a great deal of stress and, in some cases, can make women lose a certain amount of respect for themselves."

It doesn't help that hair loss typically begins between ages 25 and 40, before you even reach middle age. "That doesn't seem quite fair," Dr. Brandy says. "You're supposed to be at your peak, and something's already happening that makes you feel old. It can make some women worry that their youth is slipping away fast."

Not for Men Only

Heredity plays a role in as much as 85 percent of hair loss in women. If your mother, grandmother or aunt had thinning hair, you might, too, says Marty Sawaya, M.D., Ph.D., assistant professor of dermatology at the University of Florida Health Sciences Center in Gainesville.

Unlike men, who first lose their hair on the crown and at the hairline, women are more likely to lose hair evenly over the entire scalp. Where a woman once had five hairs, she may now have only two. She may also develop a widow's peak, with a slightly receding hairline and more noticeable hair loss around her temples.

No one is quite sure what causes hair to stop growing. Research shows that women with high levels of male sex hormones--and those with scalps that are sensitive to even normal hormone levels--are more likely to lose their hair. Whatever the cause, individual hair strands thin gradually, and follicles eventually stop producing them altogether.

The sad truth is that short of prescription drugs or hair transplants, there's really not much you can do to stop your hair from thinning. Ken Hashimoto, M.D., professor of dermatology at Wayne State University School of Medicine in Detroit, stresses that miracle hair treatments--massages, topical creams, megavitamins and the rest--do absolutely no good.

But don't give up just yet. You have some options.

It's Not All in Your Head

You can tackle a number of nonhereditary factors that can cause women to lose their hair, Dr. Sawaya says. She lists:

* Fad and crash diets. Diets deficient in protein (such as grapefruit-only schemes or plans that leave out beans, lean meats and other protein sources) can rob the body of a vital building block for hair.

* Anemia.

* Childbirth.

* Drugs, including birth control pills, anabolic steroids, beta-blocker blood pressure drugs and drugs derived from vitamin A.

* Conditions such as arthritis, lupus (a skin disease characterized by lesions) and polycystic ovarian syndrome, which causes ovaries to fill with small cysts.

* Major stress events, such as a divorce or the death of a loved one. Poor diet can also stress your body.

Dr. Sawaya says some of these nonhereditary causes may result in temporary hair loss. A thorough medical exam, better diet, stress management and medical treatment might spur regrowth in some cases, she says.

Short Cuts to Thicker Hair

There's no reason why you have to put up with hair that's too thin or too limp, no matter what the cause. You can put body back into your thinning hair. Here's how.

Do the wave. The fastest way to hide thinning hair is with a curly perm, according to David Cannell, Ph.D., corporate vice president of technology with the Redken Product Laboratory in Canoga Park, California.

"With a wavy pattern, individual hairs push against each other," Dr. Cannell says. "The overall effect is that they push up and out, making your hair look fuller.''

Dr. Cannell also advises women to avoid hairstyles that require small curlers or tightly pulled hair. The more pressure you put on your hair, the more likely it is to pull out.

Get in condition. Avoid oily hair dressings and other products that advertise "creamy-rich" results. Dr. Cannell says these tend to weigh down and flatten hair, which can make your hair look thin.

He suggests trying a lighter, leave-in conditioner that may add a microscopic amount of thickness to individual hairs.

Give yourself a pat on the head. After showering, dry your hair carefully. Pat it lightly with a towel instead of rubbing.

Comb with care. Dr. Cannell says to be gentle with brushes and combs. Never brush your hair when it's wet (pulling on a tangle is always a no-no). Try using a comb with widely spaced teeth instead.

And forget the 100-stroke gospel your great-aunt used to preach. Dr. Cannell says you should brush your hair only as long as it takes to get it styled the way you want it.

Lighten up. Choose a new, lighter hair color. Shades that closely match your skin tone are best, Dr. Cannell says, since they blend with your scalp.

"The worst thing you can do is dye your hair jet-black," Dr. Cannell says. "That really shows your scalp, which is the last thing you want to do."

Keep your hands off. Drop nervous habits such as tugging on your hair or curling it with your fingers. You may be pulling on it more than you realize, since you're conscious of how it looks.

"Even when a hair is ready to fall out, it will stick around for quite a while--if you leave it be," Dr. Cannell says. "The more you manipulate it, the faster it will go."

Know you're not alone. More than anything else, Dr. Brandy says, you should try to remember that other women are facing the same problems as you.

"Millions of women have thinning hair," he says. "You shouldn't feel singled out, and you shouldn't feel like you don't have options for dealing with it."

The Surgical Route

If your problem is hereditary and there's no chance your hair will bounce back to its youthful look by itself, you might want to consider hair replacement surgery. Years ago, hair transplants were easy to spot and often not worth the expense. But technology and technique have improved dramatically, Dr. Brandy says. And yes, women are having them done, even though the majority of patients are still men.

"When done properly now, you don't see the artificial cornrow or 'doll's hair' look anymore," Dr. Brandy says. "The process may be expensive for some, but the results look quite good."

Doctors are performing three main types of cosmetic surgery on women, Dr. Brandy says.

Hair transplants. They've been around for about 35 years. The old practice involved moving large plugs of hair follicles (8 to 20 at a time) from the back of a patient's head, then embedding them in a balding area. This often resulted in uneven, unnatural hairlines.

Dr. Brandy says new micrografting surgical techniques allow doctors to transplant as few as one hair at a time. Dr. Brandy says this procedure is especially good for women, who usually don't have large bald spots to cover.

Total costs can range from $3,500 to $10,000.

Hair-lifts. These aren't often used for women, since they are designed to cover large bald spots. The procedure involves cutting away bald scalp, then stretching hair-covered scalp from the sides and back of the head over the woman's crown. The procedure can cost between $3,500 and $5,000, Dr. Brandy says.

Scalp reduction. This is a scaled-down version of the hair-lift. It involves removing smaller bald spots by stretching hair-covered scalp over the bald areas. Cost is about $2,500 to $3,000.

Hair weaves. These are cosmetic treatments, not surgical procedures, in which technicians splice natural or synthetic extensions to existing hair to make it look fuller. While they may be cheaper than surgery in the short run, Dr. Brandy says they must be adjusted every four to six weeks as hair grows.