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.
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!
NECN Speaks to Dr. Wendel About Female Hair Loss for National Hair Loss Awareness Month
As a part of their coverage for National Hair Loss Awareness Month, Medi Tresse Medical Director Dr. Mary Wendel was a guest on the NECN segment Your Health for a piece on Female Hair Loss. During the interview, Dr. Wendel discussed the various causes and treatments for female hair loss, as well as what steps women can take to help reduce their risks of experiencing hair loss. Check out the interview below.
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:
Patients that only wash their hair a couple of times a week or less, as more build up will occur on their scalp
Patients with seborrheic dermatitis or eczema
Patients with psoriasis on the scalp
Patients that use a lot of hair products
Patients that use hair fibers
Patients with dandruff
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:
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.
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.
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.
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.
5 Ways to Keep Your Hair Healthy This Summer
If you read our blog last week, you know the summer can be an especially difficult season for our hair. Unfortunately, the hair strand has limited ability to protect itself or heal itself from damage. Once a hair strand leaves the area of the follicle, it no longer gets further nourishment. There is no blood supply or blood vessels to bring liquid to the strand and during the summer, many of our activities can really dry out or damage the hair. It is incumbent on us to repair it from any damage it goes through. During the summertime, that means adding moisture back to our hair. It is important to remember that the type of damage that occurs to our hair during the summer does not typically lead to hair loss, but it can lead to dry and brittle hair that can be more susceptible to breakage and more difficult to style.
Let’s take a look at 5 ways to keep your hair healthy this summer.
Become best friends with a hydrating serum and healthy oils for the hair. The sun, chlorine, and salt water all dry your hair and scalp and can weaken the hair. Using a hydrating serum, especially one with coconut oil or argan oil, will help protect the hair. These can be used preventatively, like under a swim cap or hat, or after you have rinsed off from a fun summer day. The Medi Tresse Hydrating Serum is a great option as it is enriched with Argan oil and is safe for colored, straightened, and chemically treated hair.
Limit the use of hot flat irons, hot rollers, and hair lightening products. These styling techniques can damage the keratin in our hair, which allows the sun and heat to penetrate the hair more easily and making it more fragile.
Use a deep conditioner treatment after swimming in the ocean or pool. Salt water and chlorine can have similar drying effects, but for different reasons. The excess salt in salt water will pull moisture from the hair, while the chlorine will remove natural oils. Using a deep conditioner, and leaving it in overnight, will help add moisture back into the hair. The Medi Tresse Keratin Deep Conditioner is great for all hair types and safe for colored, straightened, and chemically treated hair.
Use a big hat with Ultraviolet Protection Factor (UPF). A big hat not only will protect your face, neck, and scalp from harmful ultraviolet rays, but it will protect your hair. Sun damaged hair looks dry and is often unmanageable and won’t hold a curl or style. Woven hats are better than straw hats.
Try a DIY Hair Mask. Hair masks are becoming more popular and you don’t need to buy a fancy one at the store. You can DIY one at home with warm honey and buttermilk to help soothe the hair and scalp.
How to make your at home DIY hair mask:
Ingredients: 3 tablespoons of buttermilk, 1 egg, 1 banana, 2 tablespoons of honey, and 3 tablespoons of extra virgin olive oil
Add all ingredients in a blender and blend until you get a smooth texture.
Apply this smooth hair mask all over the hair and scalp and wrap it with a plastic shower cap.
Keep it on for 20 minutes.
Shampoo as usual.
When that hot summer breeze is blowing through your hair, use these tips to make sure it is healthy hair blowing in the wind!
Posted by Dr. Mary Wendel
The Latest Advancement in Platelet Rich Plasma: Painless Injections
Since we opened Medi Tresse in 2015, we have prided ourselves on not only being leaders in our field, but being innovators as well. This led us to the creation of Optimal Platelet Concentration (OPC) Therapy in 2019, which is one of the only truly customized PRP therapy treatments available. We are now excited to have the capability to inject the PRP treatment into the scalp in a completely painless fashion utilizing a technology that was developed by rocket scientists. This offering is currently only available at our Wellesley, MA location, we are hoping to offer this at all locations in the coming months.
Our new device not only injects the PRP solution painlessly, but without needles by utilizing pressurized oxygen and a process known as hydroporation in a three step process.
Pressurized oxygen accelerates the PRP solution and breaks down the liquid into micro droplets.
The powerful jet stream of micro-droplets stretches the skin at the point of contact creating tiny microchannels in the skin.
These tiny microchannels in the skin allow for delivery of the PRP down to the dermis level, where the follicle sits.
One of the best parts of the treatment, is before we administer the treatment, we will exfoliate and cleanse the scalp with a proprietary detox water. This is not only a soothing and relaxing part of the treatment, but a healthy scalp is key to healthy hair.
While normal PRP treatments are very well tolerated by most patients, this new delivery system is a great option for patients that may be scared of needles or concerned about any pain from PRP injections. When utilizing this new delivery system, the treatment course still requires one treatment a month for three months followed by a booster treatment every six to twelve months.
Keep an eye out for some videos of this new delivery system in the coming weeks.