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.
Posted by Your Medi Tresse Team
The Top Summer Activities That Wreak Havoc on Your Hair
With summer officially here, we are all excited to be outside at the beach or by the pool. For those of us that live in the northern part of the country, we know how important it is to squeeze out every last minute of this beautiful and warm weather. However, when it comes to our hair, summer is not the most friendly season. We are going to look at some of the top summer activities that wreak havoc on your hair and what you can do about it.
Swimming in Chlorine Water
Chlorinated water in swimming pools actually makes hair more vulnerable to summer stresses of heat and sun. Chlorine has an oxidizing effect, which weakens strands, removes natural oils, resulting in dry and damaged hair. To protect your hair from chlorine, the easiest option is to wear a swim cap when swimming. You can even use a leave in conditioner before putting on the cap, which creates a seal and doesn’t allow as much water into the cap. To repair damage from chlorine, always rinse hair immediately and don’t let the chlorine sit on the hair and use a deep conditioner, like the Medi Tresse Keratin Deep Conditioner, to add moisture back into the hair.
Swimming in Salt Water
Seawater leaves a layer of saline on the strand and when it dries the higher concentration of salt crystals will pull moisture out of the hair strand, making it more fragile and therefore, break easier. It is extremely important to rinse your hair immediately after swimming in salt water. Leave in conditioners or oil treatments, like the Medi Tresse Hydrating Serum are a must to add moisture back into the hair strands.
Excess Sun Exposure
Sunlight is essential for Vitamin D and has positive effects on our mood, but the ultraviolet radiation is responsible for both short-term and long-term damage to our hair and skin. Hair that is overexposed to the sun can become discolored, dry, and brittle. The easiest way to prevent sun damage to the hair is to wear a big hat and keep the hair moist so that it does not dry out. My favorite option is to apply a conditioner spray or oil and cover with a large-brimmed hat. If your hair does become dry or brittle from the sun, then adding back moisture with a hydrating serum and deep conditioner is a must.
If you noticed a common theme above, it is that summer activities tend to remove moisture from the hair strands, causing them to become dry and brittle. The truth is that all types of hair can be affected by these summer activities, and it is so important to add moisture back into hair strands. Our hair has limited ability to protect itself or repair itself when damaged.
The good news is by utilizing deep conditioners, oils, and hydrating serums, there are great ways to protect and repair your hair from drying out. So enjoy all of your planned summer activities, just make sure to protect your hair.
Posted by Dr. Mary Wendel
The Facts About Female Hair Loss
Did you know that August in National Hair Loss Awareness Month? This is a very important time to get the facts out about hair loss and female hair loss especially. Female hair loss tends to be very misunderstood, which only makes it more difficult for those women experiencing it. The American Hair Loss Association estimates that women make up 40% of the US population that is experiencing hair loss. Most people are often surprised to hear that it is so common, but it truly is and 50% of women will experience hair loss in their lifetime. We hope by creating more awareness that more women will seek treatment when they start to see signs of hair loss.
What is Alopecia?
Many patients will come to our office and say their primary care physician or dermatologist told them that they have alopecia, but there is a lot of confusion about what that means. Alopecia is the general medical term for hair loss. In reality, there are many types of alopecia, and before starting any treatment it is important to know which type of alopecia you have. Below are the most common types of alopecia in women.
The most common type of alopecia is Androgenic Alopecia, also known as Female Pattern Hair loss. It certainly is more common as women age, particularly after menopause, but it can start as early as the teenage years. Hormones play a role in this type of hair loss, especially the “androgenic” hormones such as testosterone.
Telogen Effluvium is a common and temporary cause of hair loss. It usually presents as a diffuse hair loss, meaning coming from all parts of the scalp. Most commonly a woman will see increased shedding of hair. Telogen Effluvium is due to a stressor on the body, which could be physical or emotional stress, a new medication, weight loss, or even deficiencies in key nutrients or vitamins. In order to reverse the hair loss we first must determine what stress on the body is causing it.
This type of hair loss occurs from pulling the hair too tightly over prolonged periods of time. This commonly occurs with use of dread locks, or tight ponytails. The constant pulling puts pressure on the hair follicle and can lead to permanent loss.
This is a rare type of hair loss, which is due to inflammation around the hair follicle. Unfortunately, we are seeing an increase in the incidence of Scarring Alopecia. There often are areas with white scales surrounding an area of inflammation, which then leads to scarring in that area. The hair follicles are actually destroyed and disappear.
This form of hair loss 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 beside the scalp, including eyelashes and eyebrows.
Will My Hair Grow Back?
The main concern for patients is whether their hair will grow back and whether they will go bald. It is important to know that it is extremely rare for women to go bald the way men do. However, many types of hair loss are progressive, which means without treatment they will get worse, so it is important to start treatment to stop further loss. For many patients regrowth is certainly possible. For instance, we would expect patients with Telogen Effluvium to have almost complete regrowth once the stress on the body is identified and treated. Patients with Androgenic Alopecia can have regrowth, but it depends on how long the hair loss has occurred. If the follicle is completely gone it will no longer produce a hair. However, Androgenic Alopecia causes miniaturization of the hairs, which can be reversed causing their hairs to thicken and their hair look fuller. With Androgenic Alopecia it is also possible to reactivate recently dormant follicles to regrow hairs.
What are the Treatments for Female Hair Loss?
The good news is that over the past 5 to 10 years we have seen new and effective treatments for female hair loss. It is important to understand that the best treatment or treatments will depend on what type of hair loss you have and what stage of hair loss you are in.
Hair transplants have been around for decades, but over the past twenty years they have become extremely natural looking and with an experienced surgeon you would never know a transplant occurred. Not all women are great candidates for hair transplants as you need a strong donor area in the back of the head. Hair transplants are considered the only permanent solution for hair loss as you are not expected to lose the transplanted hairs, but you can continue to lose the native hairs without continued treatment.
Innovations like Optimal Platelet Concentration™ Therapy & Platelet Rich Plasma Therapy have changed how we treat female hair loss. These are great non-surgical options for patients with Androgenic Alopecia and Traction Alopecia. We have also begun to see positive results with the treatment of some Alopecia Areata and Scarring Alopecia patients.
Low Level Laser Therapy
Low Level Laser Therapy has been around for over 10 years and has proven extremely effective in the treatment of female hair loss. FDA Cleared at home devices like the LaserCap® Flex300 and LCPro224 are great for patients with Androgenic Alopecia, Traction Alopecia, and Telogen Effluvium.
Minoxidil is the only FDA Approved treatment for female hair loss, specifically those with Androgenic Alopecia, and can be a great supportive treatment. While patients sometimes complain about the over the counter options, as they can be greasy or irritating to some, we have found that compounded options, like Formula 82M can work even better without being greasy or irritating.
Vitamins & Supplements
Vitamins and supplements should be a part of any hair loss treatment plan. Deficiencies in our diets may not cause hair loss, but they can certainly affect hair health. Options like Nutrafol® and Viviscal® have been clinically proven to improve hair health.
I Think I Have Hair Loss, What Should I Do?
If you think you are experiencing hair loss, it is extremely important to see a medical professional that specializes in female hair loss. Common signs of hair loss are:
More visible scalp
The first step in treatment is getting a diagnosis to find our what type of hair loss you have, as that will determine which treatments will be effective. A medical professional should complete the following to diagnose your hair loss:
Physical evaluation of hair and scalp
Trichoscopy – High magnified photos of scalp and hair
In some cases bloodwork and/or a biopsy may be required
If you think you are experiencing hair loss, do not wait and do not suffer in silence. Know that you are not alone and that there are great treatment options available.
Posted by Your Medi Tresse Team
Increasing Incidence of Hair Loss in Women
Hair loss certainly isn’t as prevalent in women as men, but it is still a very common problem with significant accompanying emotional distress. The incidence varies according to the type of hair loss, but the statistics are as follows: Between the ages of 15 and 29 about 12 % of women have thinning hair from all causes. By the time a woman reaches 65, up to 50% of women have thinning hair.
Traction alopecia is caused by continuous pulling of hair seen in certain hair styles like a tight bun, dreadlocks, or tight ponytails. It is especially common in certain ethnic groups, especially Hispanic and African American women. In these cultures, studies have shown that up to 17 % of teens already have noticeable thinning along the temples, and up to 32% of adult women experience traction alopecia. Professional women athletes who leave their hair in tight ponytails for prolonged periods of time also experience traction alopecia with thinning along the frontal hair line.
Scarring alopecia is a less common type of hair loss that results in permanent damage to the hair follicles. It is widely accepted that the incidence of scarring alopecia is increasing. While this is most common in post menopausal women, it has been reported in women as young as the late teens. Hair loss experts don’t have good evidence as to why this is increasing. There is some evidence that some of the cosmetic products may be to blame, but further research is needed.
Another increasing cause of hair loss in women is post chemotherapy. Fortunately more women are experiencing long term remission and cure of their cancers as treatment improves. However, the latest statistics have shown that up to 30 % of chemotherapy patients experience some degree of permanent hair loss.
Telogen effluvium is the most common cause of temporary hair loss and it occurs in all ages. This can be caused by both physical and emotional stress. Both acute and chronic stress cause elevated levels of the stress hormone cortisol which can cause shedding. In severe chronic stress there are also increased levels of androgen hormones which can accelerate genetic hair loss as well. Increasing levels of stress are becoming more problematic in our society and may account for why hair loss in women is increasing.
Fortunately, all types of hair can be treated if diagnosed early. If you notices any signs of hair loss it is important to see a hair loss specialist as soon as possible.