What Hair Loss Does Jada Pinkett Smith Have?

Jada Pinkett Smith Shares her Hair Loss Story

You may have recently seen a news article about Jada Pinkett Smith and her update on hair loss.  

We are all very familiar with the term Alopecia and so many of us take the leap and think we have what Jada has but Alopecia is the general term for hair loss. Jada Pinkett's hair loss is actually called Alopecia Areata and it’s a bit more involved than general hair loss. 

Pinkett Smith first shared that she was experiencing hair loss in 2018 when she revealed that she was getting steroid injections, a common treatment for Alopecia Areata.  Since that time, Pinkett Smith has confirmed that she is experiencing Alopecia Areata, and in her most recent Instagram post, she shared a new bald spot on the top of her head.

Alopecia Areata is an “autoimmune” disease, meaning the body causes inflammation around the hair follicle preventing it from growing.  Most often it presents as a coin-shaped lesion or discrete patches of hair loss with sharp borders.  Less commonly it can be more diffuse.  Women with Alopecia Areata can have hair loss in other areas besides the scalp, including eyelashes and eyebrows. While considered a rare type of hair loss, Alopecia Areata still affects almost 7 million people in the US.  Alopecia Areata is one of the more difficult types of hair loss to treat, however, we have found success with many patients using a combination of treatments that may include steroid treatments, like the one that Pinkett Smith used.  However, not all patients respond to steroids, so we often utilize treatment plans that include minoxidil and Platelet Rich Plasma (PRP) Therapy.

Stories from celebrities like Pinkett Smith are so important as we try to normalize female hair loss.  While the type of hair loss that Pinkett Smith is experiencing is a more rare form of hair loss, hopefully, it will inspire more women experiencing all forms of hair loss to share their stories.  If you are experiencing hair loss, make sure to see a hair loss specialist that can diagnose the cause of the hair loss and provide an appropriate treatment plan to give you the best chance of success at treatment.   

Trichoscopy, what is it and why is it Important?

Patients are often surprised to hear that we schedule a full 60 minutes for our medical consultations.  However, to properly treat female hair loss, there is a lot that goes into evaluating and diagnosing the type of hair loss a patient is experiencing.  No step may be more important than trichoscopy, which is a method of evaluating the scalp and hair follicles at a higher magnification, often 30x to 60x magnification.  So why is trichoscopy so important?

Diagnosing the cause and type of female hair loss is often quite complex and to the naked eye many types of hair loss can present similarly, and the patient’s experience can even be similar.  It is not until an experienced practitioner reviews the hair and scalp using trichoscopy that important differences will become apparent.  A recent article in the December issue of the Journal of the American Academy of Dermatology (JAAD) titled Fibrosing alopecia in a pattern distribution provided a really great example of this problem.  The article reviewed a newly recognized form of scarring alopecia, known as fibrosing alopecia in a pattern distribution (FAPD).  One of the biggest issues with FAPD is that to the naked eye the hair loss occurs in almost exactly the same way as androgenic alopecia (AGA), also known as female pattern hair loss.  However, how we treat scarring alopecia is very different from AGA and that means if a patient has FAPD, but did not receive trichoscopy by an experienced hair loss specialist, there is a high likelihood they would be misdiagnosed with AGA and not receive the appropriate treatment plan.

When scheduling an appointment to be evaluated for hair loss, make sure that the practitioner will be performing trichoscopy so that you are receiving a thorough examination and can be confident in your diagnosis.  At Medi Tresse all of our consultations come with complimentary trichoscopy and our practitioners are highly trained on how to properly evaluate hair loss based on this extremely important diagnostic tool.

Chrissy Teigen Gets an Eyebrow Transplant. Is This Procedure Right For You?

Model Chrissy Teigen recently made headlines when she shared her experience receiving an eyebrow transplant.   You may be thinking to yourself, what is an eyebrow transplant?  Similar to a hair transplant for the top of your head, an eyebrow transplant is a small surgical procedure where hair follicles are removed from an area of the back of the head, known as the donor area, and transplanted to the eyebrows.  With any hair transplant, it is important to see an experienced surgeon that can combine the necessary artistry with their knowledge, to design a natural-looking eyebrow.  It sounds like Ms. Teigen decided to get an eyebrow transplant due to overplucking her eyebrows in the past, which is something we often hear as thicker eyebrows have come back into vogue.  An eyebrow transplant is a permanent option and takes 4-5 hours to complete.

At Medi Tresse, we are lucky to have one of the most experienced hair transplant surgeons in the world in Dr. Mark DiStefano, who has completed thousands of successful hair transplants, including eyebrow transplants.  Dr. DiStefano sees patients at our Wellesley, Worcester, and Scarsdale locations.

For patients interested in boosting their brows, but are looking for a non-surgical option, microblading is a great semi-permanent treatment.  Microblading is a procedure where a colored pigment is matched to your eyebrow color and applied to the dermal layer to create the illusion of hair.  It is amazing how natural and real an experienced microblading practitioner can make the brows appear.  It typically takes around 2 hours to complete the initial microblading treatment, but a 60-minute touchup is necessary a few weeks later.  The results from microblading usually last 12 to 18 months, when additional touch-up procedures will be necessary.   Microblading is available at both our Wellesley and Chattanooga locations.

The Scary Truth Behind These 4 Common Hair Styling Techniques

If you have had a consultation at Medi Tresse or have read our blogs, you probably know how strongly we feel about the importance of a hair-healthy hair care routine.  While this may seem obvious, the truth is that many of the most common styling techniques can actually cause damage to our hair.  When some of these styling techniques are used over and over, they can actually cause hair loss.  Today we will review 4 of the most common styling techniques that we see from patients in our office and why we have concerns about their overuse.     

Hair Extensions

For women experiencing hair loss, hair extensions often seem like a quick fix.  Extensions can be clipped, glued on hair strands, or sewn around other strands.  Extensions not only damage the hair itself, but if left in for a long period of time, they can actually damage the follicle leading to traction alopecia.  If you want to put in extensions for a single event or a few days and have them taken out, that should be fine, but they should never be left in for more than a week and should not be used repeatedly.  

Heat

We are all guilty of using heat to style our hair.  Whether it is a blow dryer that we turn up a little extra to dry faster or a straight iron to free us from all those frizzy hairs, we all have used heat.  The problem for our hair is that all of this heat actually damages the keratin making it more fragile.  The hair has no way to repair itself so continued use of heat with no repairing products will cause your hair to be brittle and lead to breakage.  While we strongly recommend turning down the heat, for those that do style with heat, it is so important to add moisture back to the hair with hydrating serums and deep conditioners.

Bleaching

It is estimated that 70% of women have their hair colored at some point.  Going from darker to lighter color requires bleaching which is hard on the strands leaving them brittle and dry. It strips the pigment from the shaft via “oxidation”, which opens up the cuticle so the chemicals can fully penetrate. The break in the cuticle leaves the hair more porous and therefore more prone to other things to damage it including styling, hot combs, dryers, straighteners, etc.  The results can be dry, brittle, stiff, split ends, and breakage.  While it is best not to bleach the hair, if you do, it is important to have a good conditioning routine to repair the hair.

Tight Ponytails

A tight ponytail is a very common hairstyle.  For those of us with young daughters, you know that a ponytail is sometimes the only way to keep their hair out of everything.  However, we need to be careful about utilizing this hairstyle every day, especially if it is a tight ponytail.  Over time, the constant pulling on the hair away from the follicle can actually damage the follicle and lead to hair loss.  It is usually seen initially along the frontal hairlines and margins or edges where the most pulling is exerted. Initially, the hair loss should be reversible if the styling method is changed. However, it can become permanent if not corrected as it causes atrophy or shrinkage of the follicle, and the hairs get smaller and then stop growing.  Wearing a tight ponytail once in a while is not a problem, but it is best to refrain from wearing one every day.

How to Recover?

For some of us, these hairstyling techniques are a necessary evil and we are not expecting anyone to get scared straight but there are some practices that can help your hair stay healthier and stronger.

Give your hair a break from time to time. We all need a little R&R and our hair is no different

Give your hair a little extra love and support. Hair that has been colored, or is styled often will love the extra hydration and moisture. Our Keratin Deep Conditioner or the Hydrating Serum is infused with natural ingredients that help your hair recover faster.

Hair Loss Risk Factors as We Age

When we talk about the causes of hair loss in women, while there is typically a primary cause, we often talk about it being multi-factorial, as there can be many contributing factors.  Some of the most common contributing factors including stress, diet, postpartum, hormonal changes, and aging.  While these can happen at any time, there are certain age groups that are certainly at higher risk for each of these potential causes of hair loss.  Below we will look at different age groups and examine potential risk factors to be on the lookout for.

Ages 20 to 30 – Nutritional Deficiencies

What feeds your body feeds your hair and young women are at especially higher risk for nutritional deficiencies.  Nutrition plays a key role in hair health as the hair follicle is an extremely complex structure that requires specific vitamins and nutrients to grow healthy and vibrant hair.  Unfortunately, many of the vitamins and nutrients needed by the hair follicle are also needed by key organs in our body and when we are deficient in these, our body does not give them to our hair.  One study conducted in Australia in 2014 on 308 women between the ages of 18 and 35, found a high rate of iron, vitamin B12, and selenium deficiency, which are all known to play an important role in hair health.  

Ages 30 to 45 – Genetic Hair Loss

Androgenic alopecia, more commonly known as Female Pattern Hair Loss, is a genetic form of hair loss and is the most common form of hair loss affecting around 40 percent of women in their lifetime.  Typically, androgenic alopecia will start for women in their early thirties, but it can take many years before they really notice.  Over time, the hairs begin to thin in a process called miniaturization and over time the hair will disappear.  The key to treating androgenic alopecia is starting early as it is easier to prevent a further loss than it is to regrow what was already lost.

Ages 45 to 55 – Hormonal Changes

Women’s bodies go through tremendous hormonal changes during our lifetime and after age 45 as women start to get into those premenopausal years, the hormonal changes can be drastic.  The biggest issue becomes the ratio of estrogen (estradiol) to testosterone.  Testosterone is one of the biggest drivers of androgenic alopecia, but when the hormones are in balance and the estrogen and progesterone levels are normal, the testosterone does not have the same effect.  Right before menopause and during menopause, the levels of testosterone and estrogen decrease, but not at the same rate.  Your estrogen levels drop 75-80%, while testosterone only drops around 20-25%, which means the ratio of testosterone to estrogen increases and this is not good for your hair and can accelerate androgenic alopecia.

Age 55+ - Rejuvenation Slows 

Unfortunately, as we age, our body does not rejuvenate itself the way it did when we were younger.  Once we reach about 60, we definitely see this with our hair.  Our hairs are not only grey, but they are thinner and there will be less of them.  It is important to be careful with your hair as any damage we cause them, will not be repaired as efficiently, since our bodies are not able to rejuvenate in quite the same way it did before.

Whatever age you may be experiencing hair loss, you have options for treatment.  Schedule your consultation today to take back control of your hair loss and rewrite your hair story!

The 7 Leading Risk Factors for Female Hair Loss.

While genetics is certainly the most common cause of hair loss in both men and women, it is not the only cause.  The hair follicle is an extremely complex structure that needs constant nourishment to stay healthy and unfortunately, there are many factors that can affect the health of the hair follicle.  For most women, hair loss is a multifactorial condition, meaning it has multiple factors that could be causing or aggravating the condition.  Below are 7 of the leading risk factors for female hair loss.

  1. Genetics

Genetics certainly play a big role in whether we may or may not experience hair loss.  The truth is that if anyone in your family (siblings, parents, grandparents, etc.) has hair loss, it is possible that you have a genetic disposition to hair loss. As many as 30 million women in the United States are affected by this hereditary condition and the loss of hair can occur at any age although the most common age is between 50 and 60 years old.

  1. Stress

One of the biggest contributing factors to hair loss is stress.  When stress levels are consistently high or you have an extremely stressful event, this can cause a shock to your system. In terms of your hair, this can cause an unusually high number of hairs to move to the telogen phase, which is also known as the resting phase and no more growth occurs.  This is what causes increased shedding.  Incorporating stress-reducing activities like yoga, meditation, or exercise is extremely important.

  1. Poor Nutrition

The hair follicle is made up of some of the most metabolically active cells in the body, which means it requires proper nutrition to function properly and grow healthy hair.  The problem is that many of the nutrients that the hair follicle needs to be healthiest, vital organs of our body also need.  When we are deficient in these vitamins and nutrients, the body diverts them to places it feels are more important for survival, and our hair suffers.

  1. Illness

You may have heard reports of patients with COVID-19 experiencing hair loss.  The truth is that any illness, especially when it includes fever, has been known to cause shedding four to six months after the onset.  When you are sick it is a real shock to the body and the stress that it causes to the body is what actually induces hair loss.  It takes around 3 for the shedding to occur as the hairs need to transition from the growth (anagen) phase to the resting (telogen) phase, which is when the shedding occurs.

  1. Hormonal Imbalances

Hormones play a significant role in the health of our hair, both positive and negative.  Women experience natural hormonal fluctuations that can impact the health of the hair, but hormonal imbalances can also occur from thyroid disease, birth control, or hormone replacement therapy.  Over the last five years, we have seen an increase in the number of women utilizing hormone replacement therapy and some of these therapies can increase hair loss.  

  1. Age

Almost everyone will have some degree of hair loss as we age due to the shortening of the hair life cycle that happens over time.  Believe it or not, we are constantly losing hairs every day as old hairs fall out and that is normal as new ones grow in.  This life cycle for a single hair can be anywhere from two to eight years, but over time it shortens, which is why it is more difficult to grow your hair as long as you did when you were younger.  This shortened life cycle also means, the hairs are often not as thick and the density is less.  For those experiencing hair loss, they are often seeing fewer new hairs grow in and the hairs that grow in are not as healthy.  

  1. Scalp & Follicle Health

Women invest a lot of time into their hair care routine, but unfortunately, these styling techniques are often not the best options for scalp and follicle health.  Hairstyles that cause constant pulling, like extensions, tight ponytails, or corn rolls can be quite damaging to the follicles.  Permanent chemical straighteners, relaxers, or colors can result in brittle or dry hair.  Excessive heat from straighteners or blow dryers can not only dry out the hair but can cause burns on the scalp.

You may not be able to outrun your genes or your age, but you can take steps to give your hair a fighting chance against these risks as there are options to counteract or slow down hair loss caused by all of the risk factors listed above.  Take some time to evaluate your risk factors and make sure to schedule a consultation with a hair loss specialist that can customize a treatment plan for you. 

Ask Medi Tresse Anything – Is Hair Loss Reversible

Roughly 70% of our patient's list regrowth as one of their goals on their patient intake forms.

Now the short answer to this question is, it depends. Obviously, that is not helpful so let’s look at why it depends and how we set proper expectations with our patients. To answer this question, we need to look at two main variables, what is causing the hair loss and how long the hair loss has occurred.

Before we go further, it is important to set expectations about what we mean by reversible. We are never going to have the hair we had 20 years ago, but for many types of hair loss, we are able to see both thickening of existing hairs and regrowth of some of the hairs that were lost, however again it depends on the type of hair loss and when the loss occurred.

Diagnosing the type of hair loss is the most important step of any treatment plan because it helps us identify not just the best treatment options, but allows us to properly set expectations for what we can accomplish treatment. So, let’s look at each type of hair loss and what we can typically expect.

Androgenic Alopecia
The good news is that with the most common type of hair loss, androgenic alopecia (genetic hair loss), we can typically see some reversal of the hair loss, but how much depends on how long the loss has occurred.


Telogen Effluvium
The second most common type of hair loss, telogen effluvium (hair loss due to stressors) is almost always completely reversible. However, we must ensure that the stressor is also stopped. It could be a physical stressor on the body, like a medication, or it could be emotional stress.


Traction Alopecia
Traction alopecia, which is caused by tight hairstyles like tight ponytails, cornrows, or extensions, can be reversed if the hairstyle is stopped and the loss has not occurred for an extensive period of time.

Alopecia Areata
Alopecia areata has an auto-immune component to it and typically presents as patches of bald spots with sharp edges. While we can see significant regrowth with some types of alopecia areata, the problem is that even when that occurs, flare-ups are common, and the loss may occur again.

Scarring Alopecia
We are seeing an increase in the incidence of scarring alopecia, which is much harder to treat, and see some regrowth, but not impossible. The issue with scarring alopecia is the hair follicle is actually damaged and once that occurs it most likely will not produce hair again, which is why we need to treat it early and aggressively to have any chance to see regrowth.


One common thread in the ability to see regrowth for any type of hair loss is the amount of time that has passed since the hair loss occurred. While there is no magic timetable, this is why we stress the importance of seeing a hair loss specialist as soon as you think you are experiencing thinning hair or hair loss, especially as it is easier to prevent a further loss than restore what is lost. Most types of hair loss are progressive, which means they will most likely get worse without treatment, so if you think you are experiencing hair loss or thinning, meet with a hair loss specialist to diagnose the cause of your hair loss and start appropriate treatments.

Scalp Exfoliations - Our Newest Treatment to Promote Healthy Hair

When it comes to hair, we talk about many factors that can contribute to poor hair health and poor growth.  We usually focus on causes like genetics or nutrition or even styling issues, however, one important area that is often left out is scalp health.  Just like a flower garden needs good soil to grow healthy, our hair and follicles need a nourishing environment to prosper.  When it comes to the skin on our face, many of us have multistep routines to keep it clean and fresh, but we often neglect the skin on our head, because it is out of sight and out of mind.  Excessive build-up on the scalp can cause clogged pores and follicles, which leads to dandruff and inflammation around the follicles.  This could be due to not washing our hair enough, using lots of products on our hair, or just natural build-up over time.  Thankfully, we have options to address this extremely important hair health issue and we are excited about a new treatment that we are now offering in our Wellesley office, the scalp facial. 

The scalp facial exfoliates and infuses the scalp with a unique detox solution that not only cleanses the scalp but feels amazing while it happens. The high-pressure exfoliation of the scalp removes all of the build-ups and this detox solution includes three important ingredients that work in different ways to improve scalp health: aloe vera, silver oxide, and hyaluronic acid.  The aloe vera helps to cleanse and detoxify with antimicrobial, antibacterial, antifungal, and anti-inflammatory properties.  Studies have shown silver oxide to have benefits in wound healing.  While hyaluronic acid has been known to improve hydration. 

The summer is an especially important time to consider getting a scalp facial.  As some of our previous blogs have touched on, the summer can be particularly harsh on our hair and scalp due to the elements, specifically the sun, saltwater, and chlorine, which can burn and dry out the scalp causing flaking and build-up.  However, exposure to summer weather is not the only reason to consider a scalp facial and most people should consider monthly treatments to optimize scalp health.

We would recommend monthly scalp facials to the following patients:

We hope to be rolling out this scalp facial treatment at our other locations in the coming months, but for those that are not able to make it to our Wellesley office for this great new treatment, our Tresse Root Cleanse shampoo is a great at-home option that should be used to cleanse the scalp.  So make today the day you stop neglecting scalp health and provide a nurturing environment for your hair to grow.

Can Sunscreen Cause Hair Loss?

Sunscreens are a hot topic in the news after the major aerosol sunscreen recall due to traces of carcinogens.  

Now the ingredient that caused the recall was not listed on the sunscreens, but this highlights why it is so important to know what is in the products we are using.  

Unfortunately, if you read the ingredient list of most facial products, including sunscreens, they have a laundry list of hard to pronounce words that you have most likely never heard of.  It can be difficult to know which of the products can have side effects or not.

When it comes to our hair, recent research has shown that we should really be more conscientious about the products we are using.  We have been seeing an increased incidence in scarring alopecia in women and current research is showing that the products we are using may play a role in this.  

Scarring alopecia is still rare, but it is more difficult to treat and with this type of hair loss, once the follicle is damaged and the scarring occurs, you cannot bring that hair back, which makes it very difficult to treat.  While the research on the rise of scarring alopecia is still ongoing and not definitive, some of it is pointing to some of the common ingredients found in popular sunscreens, titanium dioxide.  

Now I need to make two important points, especially as I put sunscreen on my face every day.  First, sunscreens are life-saving products, and I am in no way advocating not using them.  We just want to make sure that we are using the right ones and using them properly.  Secondly, just because someone uses a product that contains an ingredient that we believe may play a role in the increase in scarring alopecia does not mean they will get scarring alopecia.  There is believed to be a genetic component to this, where a small group of people are genetically predisposed to react to these ingredients.

Here are my recommendations when it comes to sunscreen:

  1. Always use a zinc-based sunscreen. The best sunscreens to use are physical sunscreens, which include either zinc oxide or titanium dioxide.  In terms of hair, my big concern is titanium dioxide, so make sure to use a zinc-based physical sunscreen.  Many zinc-based sunscreens include some amount of chemical sunscreen ingredients and that should be OK, but the main active ingredient should be zinc oxide.
  2. Do not put sunscreen on your scalp and wear a UV protectant hat instead. As our research is still ongoing, I personally do not recommend putting sunscreen on your scalp.  The scalp still needs protection and unfortunately, for those with thinning or fine hair, your hair is not going to provide enough coverage, so it is important to wear a hat to protect your scalp.
  3. If you do not have a hat to protect your scalp, wear sunscreen on your scalp. I know this is the opposite of what I just said, but any protection is better than no protection.  If you are going out in the hot sun and do not have a hat, then I would recommend using sunscreen on your scalp, especially your part lines.  I would strongly recommend that you use a zinc-based sunscreen.
  4. Do not put sunscreen into the hair line.  I use sunscreen every day and I used to blend it up into my hair line. However, with the current research I now leave about an inch between the sunscreen and my hairline. I still recommend wearing a hat to ensure complete coverage of the face when out in the sun.

With summer still going strong, make sure to grab the sunscreen to protect your skin and make sure to grab the right one to protect your hair.

Posted by Dr. Mary Wendel    

How to Brush Your Hair Without Causing Damage

Haircare routines can be simple or complex, but no matter what they always include a brush or a comb or both.  We have all been brushing and combing our hair since we were kids and have probably gone through hundreds of brushes and combs in your lifetime.  Healthy hair is something we all strive for and oftentimes our hair care routines include practices that negatively impact our lovely locks.  However, what can seem like such a simple part of our hair care routine, can actually impact the health of your hair.  While using the wrong brush or comb or using the wrong technique shouldn’t lead to hair loss, it can certainly lead to breakage and cause extra tension on the hairs that can damage the follicles. So here are some hair-friendly tips for brushing or combing.   

Keep brushing to a minimum. We have all heard the myth that brushing 100 times a day can lead to healthier-looking hair, but this myth is not true and is unfortunately bad advice.  There is no need to overbrush, in fact, increased brushing can lead to split ends.  Limiting the brushing is especially true for African American hair, as it is particularly fragile and more susceptible to damage.

Tip: If you have African American hair, use a soft brush with widely spaced and coated bristles.  Another good option is a wooden comb with wide teeth.

Handle wet hair as little as possible.  We have all done it.  You jump out of the shower and in a rush, you don’t have time to dry your hair so you just style it right away.  When brushing or combing your hair, it is best to allow the hair to partially dry first.  Hair is most fragile when wet and will be more vulnerable to damage. 

Tip: don’t rub your hair dry with a towel, dry hair by wrapping in a towel or let air dry for at least 10 minutes.

If you have to style wet hair, use a comb instead of a brush.  If your hair is wet, we still recommend waiting at least 10 minutes to dry some, but use a comb instead of a brush.  This will help to avoid some of the tugging that can cause breakage.  Definitely use small strokes and use your fingers instead of the comb to loosen any knots.  If your hair is tangled or knotted, consider using a detangler or leave-in conditioner.

Tip: Keep a wide-toothed comb in the shower and gently use it immediately after conditioning.  The conditioner will help protect the hair as you gentler comb through and detangle your hair.

Don’t start brushing from the roots.  One of the biggest concerns when brushing and combing is tugging on tangles and causing tension on the follicles.  This is more likely to occur if you start brushing from the roots.  Start brushing from the bottom, ideally a few inches up and brush down working in a small section.

Tip: Once all of the hair is brushed, take a few gentle strokes from the roots, which will help distribute your body’s natural oils along the hair shaft. This serves as protection from harsh elements, as well as a built-in moisturizer for the hair.

Brushing and combing your hair is something we do to our hair every day, which makes utilizing the right tool and technique so important.   Keep your hair health in mind whenever you are styling your hair.