Webinar: How Hormones Affect Your Hair
Our webinar series is kicking back up next week Tuesday May 4th at 12:00PM and the topic is "How Hormones Affect Your Hair".
Hormones can have a significant impact on the health of our hair, both naturally and from medications and treatments now being offered. Women will often experience changes in their hair during pregnancy and menopause, when hormones are fluctuating naturally. However, many of the birth control options available today affect our hormones, which can have an impact on our hair, some positive and some negative. We have seen an increase in the use of hormone replacement therapy for various conditions, which can also directly affect our hair as well. During this webinar, we will look at how hormones affect our hair and how and why our hormone levels change and what we can do to protect our hair.
If you happened to miss any of our past webinars, they are all posted on our website and the button below will bring you to our Webinar Series page. Just a reminder that we do offer special discounts and give-a-ways to webinar attendees, so it is always best to attend the webinar if you can.
Posted by Dr. Mary Wendel
Researchers May Have Identified Why Stress Can Induce Hair Loss
Over the course of this past year, a number of times, we have touched on the importance of de-stressing, as we always knew that stress could cause hair loss. As April is Stress Awareness month, we are excited that there may be some good news when it comes to hair loss from stress. In a study released on March 31st, researchers from Harvard believe they have identified why hair loss occurs due to stress. While the study was conducted on mice, they hope it will provide greater understanding for why this phenomenon occurs in humans, with the goal to help with prevention in the future.
Hair loss caused by stress is known as Telogen Effluvium. Telogen Effluvium is the second most common form of hair loss. Telogen Effluvium typically presents as diffuse thinning, meaning coming from all parts of the scalp and most woman will experience an increase in shedding of their hair. While it is normal to shed between 50 and 100 hairs a day, during a Telogen Effluvium episode you can notice more excessive shedding. The telogen phase of the hair cycle is the resting phase, which is when shedding normally occurs, however, during a Telogen Effluvium either the telogen phase is extended or an abnormal number of hairs enter this phase. This can be caused by pregnancy, rapid weight loss, protein deficiency, physical illness, surgery, trauma, some medications, and of course stress. Fortunately, it is usually reversible and complete regrowth occurs in about 1-2 years.
So why does stress cause a Telogen Effluvium to occur? According to the researchers, they found that sustained exposure to stressors increased the amount of the stress hormone corticosterone in mice, which is the equivalent of cortisol in humans. The researchers found that an increase in the stress hormone led to a shortening of the growing phase and a lengthening of the resting phase, which is consistent with shedding and telogen effluvium. Initially the scientists thought the stress hormone was directly affecting the stem cells responsible for regenerating the follicle and hair. However, the scientists realized that instead, the increased levels of the stress hormone were preventing secretion of a certain molecule, called Gas6, which plays a key role in regenerating the follicle and the hair follicle cells. More importantly, the scientists found that manually increasing the molecule Gas6, could activate hair growth even when stress hormone levels were increased.[i]
While this study was only conducted on mice and research has a long way to go before we will know if there is potential to apply this to humans, it is important for us to better understand the mechanisms behind the causes of hair loss. Stress management is so important for many reasons and the health of your hair is one of them.
Posted by Your Medi Tresse Team
[i] Choi, S., Zhang, B., Ma, S. et al. Corticosterone inhibits GAS6 to govern hair follicle stem-cell quiescence. Nature 592, 428–432 (2021). https://doi.org/10.1038/s41586-021-03417-2
The “Skinification” of Hair Care – Good or Bad?
I recently read an article about the “skinification” of hair care. Essentially, the article was explaining how the concept of a multistep care routine that people have been utilizing for skin care is starting to catch hold with hair care. At one time, the focus of hair care was a good shampoo and conditioner, but over the last few years, there has been an explosion in different types of hair care products, like scalp cleaners, pre-shampoos, hair serums and much more. The question becomes is this a good thing or just a marketing ploy to get us to buy more products?
Let’s start with the good! The fact that people are giving greater thought and attention to their hair care routine is very good. The truth is that a healthy scalp and follicles are essential to growing healthy hair. While poor scalp and follicle health are typically not the main cause of hair loss, they can definitely aggravate the condition for someone experiencing hair loss. Unfortunately, many of the styling routines, such as tight hair styles, applying lots of heat, or using chemicals in our hair can contribute to poor scalp and follicle health. While using a hair healthy shampoo and conditioner is essential, it is also important to incorporate products that can focus on cleansing the scalp and hydrating the hair. A good scalp cleanse will help to remove buildup around the follicles. A deep conditioner and hydrating serum also play vital roles in rehydrating and strengthening the hair.
So is there any downside to this “skinification” of hair? The biggest issue is just the sheer number of products now available for hair care. It can be difficult to determine which ones are actually worth using. Even as hair care professional, it can be overwhelming to evaluate new products with so many now available. We have a saying in our office whenever we look into a new treatment or product; “follow the science”, which just means make sure there is valid research behind it. All of the products we offer have been vetted by our staff to ensure that we are offering the best possible options for hair care routines.
The bottom line is that we needed to change how we thought about hair care, so we are happy to see that hair care routines have grown to include scalp and follicle health, but make sure you are using products that have actually been proven to benefit the hair.
Posted by Dr. Mary Wendel
What Does Female Hair Loss Look Like?
If we were to poll 10 random people and ask them what male hair loss looks like, they would probably all give similar answers about starting as receding in temples, with thinning in the crown, and eventually balding on top with a ring of hair around the head. If we then asked those same 10 people what female hair loss looks like, I am pretty confident we would get 10 different answers. This is one of the complexities about female hair loss. For many women, it is hard for them to realize if they are experiencing it since it can differ so much from person to person. It can even be hard for some medical practitioners to properly diagnose as its causes and presentation are so varied.
On our website there is a questionnaire that visitors can fill out that asks them various questions about their experience with hair loss. With over 1000 responses, it provides a pretty good snapshot of what our patients are experiencing. As expected, the experiences vary widely.
If people think they may be experiencing hair loss, often their first thought is to consider their family history. While the myths talk about different grandfathers, the truth is that genetic hair loss can come from anyone in your family. However, of the survey respondents only 55% felt there was a history of it in their family, which means that 45% did not believe that they had a family history of hair loss. While genetics can play a big role in causing hair loss, it is only one potential factor.
Often times our perception of hair loss is rapid sudden shedding happening over a short period of time. However, only 22% of the respondents felt their hair loss was sudden, while 78% felt that it had been gradual over time. Unfortunately, with gradual hair loss it has probably been happening longer than you thought, as it takes time to notice, which is why it is so important to seek treatment once you feel you are experiencing hair loss.
As we noted above, male hair loss is fairly consistent, but there was pretty big variation in how the respondents described their hair loss. The percentages below do not equal 100% as respondents were asked to select all that applied. Below is what patients felt they were experiencing, from most common to least common:
- 62% - Thinning All Over
- 48% - Excessive Shedding
- 40% - Thinner Ponytail
- 37% - Widening Part
- 27% - Temporal Loss
- 11% - Other
Lastly, 63% of the survey respondents had never received a diagnosis for their hair loss, while 37% had. If you think you are experiencing hair loss, it is so important to get a diagnosis from a practice that is trained in evaluating and treating female hair loss. If you have received a diagnosis from a dermatologist or primary care physician, make sure you meet with a hair loss specialist who can get you started on a treatment plan right away. Most important, if you think you are seeing any signs of hair loss, know you are not alone and there are great treatment options available.
Posted by Your Medi Tresse Team
Gender Inequalities in the Treatment of Hair Loss
Before Women’s History Month comes to a close, I wanted to touch on a subject that hits really close to home, both professionally and personally; the gender inequalities in healthcare and how these have impacted the treatment of hair loss in women. As a primary care physician for thirty years, I saw firsthand how these inequalities impacted my patients, especially as women are more likely to forego healthcare services due to cost while at the same time often having to pay higher insurance premiums.
When we discuss gender inequalities in healthcare today, the discussion often revolves around access to healthcare, and that is certainly an important part of the discussion. However, one of the biggest issues is that for centuries, medical research was primarily conducted by male doctors and scientists on only male patients. The assumption was made that the results of these studies would be the same for females as males. Unfortunately, this meant that women were not receiving the same level of care, as the medical community did not fully understand what women were experiencing. This too is the history of the treatment of hair loss in women.
For far too long, female hair loss has been an afterthought for most medical practitioners, because its causes were not understood well enough, its impact was not understood well enough, and there were not great treatment options available. Female hair loss can be very complex to diagnose, as there are many potential causes and often multiple factors aggravating the condition. Due to the types of hair loss that women experience, they tend to respond best to medical treatments that focus on treating the causes and not masking the symptoms. For a long time, the only hair restoration option was a hair transplant, which work well for most men, but women are not always great candidates. The reason we, at Medi Tresse, offer hour-long consultations is because it takes that long to properly evaluate, diagnose, and create a customized treatment plan that addresses the needs of that specific patient. Unfortunately, this understanding of how to properly treat hair loss in women is still relatively new and many medical professionals still do not understand what it takes to properly treat or how difficult the experience can be for women. Hair loss has often been brushed aside as a cosmetic issue, but we at Medi Tresse understand the emotional toll that often comes with experiencing hair loss as a woman.
Thankfully, over the past 15 years we have seen progress as great treatment options have become available and more women are now seeking help. According to the International Society of the Hair Restoration Surgery (ISHRS), in 2005 women made up only 28% of the patients seeking non-surgical treatments, but in 2019 that increased to 40%. As one of the leading medical professionals in our industry, we understand that it is our responsibility to help normalize women's hair loss through education and creating a caring and supportive community for women. We still have a ways to go, and we hope to see even more progress over the next 15 years.
Posted by Dr. Mary Wendel
If you attended our webinar last week, “How Our Nutrition Impacts Our Hair”, you know how strongly I believe that a healthy diet can play an important role in the health of our hair. In this blog, I want to look at not just the vitamins and nutrients needed for healthy hair, but the overall types of diets.
The hair follicle is an extremely complex structure and made up of some of the most metabolically active cells in the body. Due to the complexity of the follicle and the fact it is made up of metabolically active cells, the hair follicle 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, so 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.
One of the biggest issues with the diets that most Americans consume, not only are they deficient in key vitamins and nutrients needed for hair health, the foods are also highly processed, high in sugar, and high in fat. While we know that these foods are not healthy, these foods are now known to be pro-inflammatory, which means they are activating our immune system to respond. Normally our immune system gets activated when it recognizes foreign substances like bacteria, viruses, chemicals, plant pollen, and then acts to neutralize them and protects us from harm. This is a good thing. However, if inflammation is chronic, it can lead to or aggravate disease. Alopecia Areata and Scarring Alopecia are two types of hair loss that are caused by immune disorders. Inflammation has also been noted on biopsy in the early stages of Androgenic Alopecia (Female Pattern Hair Loss).
This does not mean that eating junk food will automatically cause hair loss, but it is important to understand that unhealthy diets can impact our bodies in ways we may not realize. Research has repeatedly shown the negative impacts of a pro-inflammation diet and the positive impacts of anti-inflammatory diet. What is great about anti-inflammatory diets, is that when followed these diets also include many of the vitamins and nutrients that are important for hair health. Some of the best anti-inflammatory foods are:
- Olive Oil
- Green leafy vegetables
- Nuts- almonds, walnuts
- Fatty Fish- Salmon Tuna Sardines
- Fruits – All berries, cherries, oranges
- Curcurmin plus piperine (Curry, turmeric, black pepper)
The anti-inflammatory diet is very similar to the Mediterranean diet, which is consistently found to be the healthiest diet recommended by physicians. The focus is on limiting processed foods and red meats and making fruits and vegetables the foundation of your diet.
Lastly, it is important to remember, when it comes to hair health, it is important to be on a hair health supplement. The truth is that even when following a healthy anti-inflammatory diet, most people do not get enough of each of the necessary vitamins and nutrients needed that are key for the health of our hair. I strongly recommend that all of my patients get utilize a good hair loss supplement, like our Tresse Rx line.
Posted by Dr. Mary Wendel
How Blood Tests Can Play a Role in Diagnosing the Cause of Your Hair Loss
The ultimate goal of our medical consultation is to determine the cause of your hair loss. Starting treatment without knowing the cause is really not helpful, and often is costly both in time and money. There are many types of hair loss that women can experience, and each of these types can have several different causes. During the physical exam of your scalp and hair, we will closely examine your hair follicles using a highly magnified camera called a trichoscope, which will allow us to look for signs like miniaturization of the hair follicles, inflammation, or other specific features of the follicle that are not visible to the naked eye. While the physical examination is a critical piece of the puzzle when it comes to diagnosing the cause of hair loss, it is only one piece of the puzzle. We still need to review the patient’s medical and hair loss history, and for some patients we may also ask for specific blood tests to be done. While some women have had blood tests completed in the past, we only consider it relevant if it has been completed within the previous 12 months.
So, when does blood work play a role in the evaluation?
Patients Suspected of Telogen Effluvium
According to the American Hair Loss Association, Telogen Effluvium (TE) is the second most common form of hair loss. It presents as excessive shedding which seems to occur very suddenly and can be very mild or aggressive. While Telogen Effluvium is common, the good news is that it is usually reversible and complete regrowth usually occurs in about a year. However, it is extremely important to do a thorough evaluation for this problem to determine the cause. Treating Telogen Effluvium is really a two-step process. The first step is determining what is causing the “shock” to your hair. It is possible there was a singular traumatic event like surgery or an infection. However, one of the most common causes of TE is a nutritional deficiency, like iron, Vitamin D, or the B vitamins like B12 or Folate. When we suspect that a patient is experiencing a Telogen Effluvium, we usually recommend blood work so that we can evaluate those results for potential causes.
Patients Under 45
Another common cause of hair loss in women is hormonal imbalances. The most common cause of hair loss in women is Androgenic Alopecia. We know that this is a genetic problem that is primarily driven mostly by testosterone in men and women, but we also know in women, any imbalance of the female hormones, estrogen, and progesterone, can accelerate hair loss. Just prior to menopause, as hormones change, we often see worsening loss. Therefore, in these cases it is very important to check testosterone, estrogen, and progesterone levels. And in women who are experiencing hair loss at a very young age, hormone levels are particularly important to evaluate.
Usually once a woman passes through menopause, there can be a stabilization of hormones and evaluation of these levels is not necessary. However, if a woman is on HRT or hormone replacement therapy, it becomes essential to know if the hormone levels are in balance for good hair growth, and blood testing is essential.
History of thyroid disease
Both hypothyroid and hyperthyroid diseases can cause hair loss. When a woman has a history of thyroid disease in herself or other family members, we always check blood tests. Once again, all hormones need to be in proper balance to create healthy, strong hair.
Treating female hair thinning or loss without knowing the cause will often lead to poor results, frustrating both the patient and the practitioner. Often, the only way to know the entire story is to check blood tests. If you are experiencing hair loss make sure to see a hair loss specialist that can complete a full evaluation and determine if blood work would be beneficial for you.
Posted by Your Medi Tresse Team
Ingredient Highlight – Ashwagandha Root
If you watched our webinar “What is the Right Supplement for Me?” on January 27th, it can be found on our website here for those who missed it, you would have heard us talk about a number of important ingredients that you should look for in a hair loss supplement. One ingredient that we discussed that many patients may not be as familiar with is Ashwagandha Root. When thinking of important ingredients for hair loss supplements, Ashwagandha Root may not come to mind for most people, but it is actually quite important.
Ashwagandha is a small shrub that grows in India, the Middle East, and parts of Africa. It is an ancient medicinal herb that has been used for over 3,000 years[i]. Specifically, extracts of the plant’s root have been used to treat a variety of medical problems. Ashwagandha Root is known as an adaptogen, which means that it can help reduce stress in the body. In 2012, a double blind study was conducted over a 60 day period and found that the treatment group had a significant reduction in scores on the stress assessment scales compared to the placebo group[ii].
So why is this important? Hair loss in women is typically a multifactorial condition, meaning it has more than one cause. One of the biggest contributing factors 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 actually 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. Supplements that contain Ashwagandha Root have been known to help combat stress, which gives you a better chance for healthier hair. Ashwagandha Root can be found in the Tresse Fortifier supplement, which is part of the TresseRx supplement plan.
Before starting any hair loss supplement, we recommend meeting with a hair loss specialist and medical practitioner that can ensure that it is the right supplement for you.
Posted by Your Medi Tresse Team
[i] Mirjalili MH, Moyano E, Bonfill M, Cusido RM, Palazón J. Steroidal lactones from Withania somnifera, an ancient plant for novel medicine. Molecules. 2009 Jul 3;14(7):2373-93. doi: 10.3390/molecules14072373. PMID: 19633611; PMCID: PMC6255378.
[ii] Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577.
Overcoming Our Own Perceptions of Female Hair Loss
When Medi Tresse opened 2015, our mission was two-fold. First, we wanted to help all women experiencing hair loss feel empowered by their options and reclaim their confidence. Secondly, as the leading medical professionals in our industry, we wanted to normalize women's hair loss through education while creating a caring and supportive community for women. That second part is the hardest, but most important part of our mission.
The reason I am sharing this, is due to a recent patient interaction that I had during a consultation. During the consultation I made a comment about the patient’s hair loss and the patient was slightly taken aback and stated that they did not suffer from hair loss. The patient went on to state that she only has some thinning hair, but not hair loss. This is actually something that is not that uncommon to hear from patients at Medi Tresse.
While hair loss may seem fairly objective, either you have it or you don’t, in reality, that is not how people feel about hair loss. The truth is that everybody has different perceptions about what counts as hair loss. We have some patients that come in with what appear to be full heads of hair, but they are noticing changes in their hair and feel they have hair loss that needs to be treated. We have other patients that come in with what we would consider advanced female hair loss, but they feel like they have just started to notice hair loss or they have always had fine hair so it really is not that advanced to them. It is important not to minimize anyone’s feelings about what they are experiencing.
It is just as important to break through the negative connotations of words and phrases like “hair loss”, ”thinning hair”, or “alopecia”. Thankfully, with the patient I alluded to above, even though this patient did not think they had hair loss, they were still seeking treatment. Unfortunately, many women are unable to take the next step to see a specialist, because doing so would be an admission that they are experiencing hair loss. Hopefully, through greater awareness of how common hair loss is in women and the treatments available, we will be able to break free of our negative perceptions of female hair loss.
We know it is not easy, but important work never is. When you are ready to take that next step, please know that staff at Medi Tresse is here for you.
Posted by Dr. Mary Wendel
Argan Oil for Hair Health
Unfortunately, many of the popular hair styling techniques are actually detrimental to our hair. The problem is that many people want something they don’t have and utilize styling techniques that damage the hair. Over styling, and especially techniques that use excessive heat, can actually dry out and damage the outer hair cuticle, so it is important to add that moisture back. Leave in conditioners, masks, and oils can help to condition and moisturize the hair strand. We especially recommend those products with oils like argan, avocado, coconut, which help offset the dryness and help keep hair shiny.
Today we are going to look further into argan oil, which has become an increasingly popular product for hair health. Argan oil is made from the fruit of the argan tree in Morocco. Argan oil has been found to be beneficial for both the hair and the scalp. Rich in fatty acids, argan oil is also known to lubricate and add moisture back into the hair. Argan oil is also rich in Vitamin E, which has been known to help prevent dryness in both the scalp and hair.
At Medi Tresse, we recently started offering a Hydrating Serum that is enriched with Moroccan argan oil. This fast-absorbing, deep-penetrating serum helps to moisturize the hair and scalp, while also providing luxurious shine and silky-smooth texture. Used daily, this hydrating serum is safe for colored, straightened, and chemically treated hair.
Whether you add our Hydrating Serum or another argan oil product, we would strongly recommend argan oil for any hair care regiment to help provide healthier more rejuvenated hair.
Posted by Your Medi Tresse Team