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.

Post-Menopausal Women

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.

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

The Importance of A Virtual Consultation

We have heard from some patients about whether doing a virtual telehealth consultation is worth doing.  While our offices’ safety protocols meet, and in many instances exceed, all local and federal safety regulations, we understand that everyone’s comfort level is a little different at this point in time.  We also know that due to travel restrictions in different states, coming into the office is not an option for all patients.  With that said, for patients that are unable to or do not feel comfortable coming in for an in-office consultation, we would strongly recommend a virtual telehealth consultation for the following reasons.

Most types of hair loss are progressive and will continue to get worse without treatment.

First and foremost, many types of hair loss, including androgenic alopecia (Female Pattern Hair Loss), which is the most common type of hair loss are progressive.  That means that the hair loss will continue to get worse without proper evaluation and treatment.

Preventing hair loss is easier than re-growing what was lost.

Although we see many women who have already experienced quite a bit of loss and have successfully treated them, the importance of treating hair loss early is key.  It’s true that once the scalp is visible, up to 50% of your hair density has already been lost. As more and more hairs become “affected” they eventually go into hibernation, so to speak. In this dormant state, it is more difficult to fully restore a hair. The key is to start treatments early (before a significant amount of loss has already occurred) and nip hair loss in the bud.

A lot can be accomplished in a virtual telehealth consultation.

Back in the Spring when we started offering virtual consultations, our staff was honestly hesitant about them.  There was concern that we would miss something in our evaluation of the patient, however, we quickly realized that we are able to do a very thorough evaluation and get patients started on some sort of treatment that they would otherwise be holding off.  When these patients came in later for in-person follow-ups, we were very happy that they were able to effectively start treatments many months earlier than if they had not done the virtual visit.

There are many great at-home treatment options now available.

Thankfully, at home treatment options have come a long way and there are many clinically proven options that patients can start in the comfort of their home.  From low level laser therapy (LLLT) to supplements to topical micro-needling with growth factors, our staff will be able to customize an effective home treatment plan that you will be able to start immediately.  While many patients do take advantage of our in-office treatments, many of our patients only utilize at home treatments and with great success.

We understand that this has been a difficult year that has only gotten more difficult.  We also know that there are many things we have had to put off, but treating your hair loss does not need to be one of them.

If you are interested in scheduling an in-person or virtual consultation do not hesitate to reach out to our office today.


The Medi Tresse Online Store is Live

The Medi Tresse Online Store has officially launched to offer Medi Tresse patients a convenient way to reorder their favorite products and treatments.  The online store not only makes ordering easy, but you will get automatic updates and shipment tracking information on your order.  The online store will carry the following products:

You can visit the online store by clicking the link below:

Posted by Your Medi Tresse Team

**The Medi Tresse Online Store is independently owned and operated by Medi Tresse Management, LLC.**

How Tresse Rx Differs From Nutrafol and Viviscal

With the addition of our Tresse Rx supplement and vitamins, we have received a number of questions from patients regarding how these differ from Nutrafol or Viviscal.  First off, it is important to remember that the Tresse Rx healthy inside plan, is a comprehensive plan that consists of not just the Tresse Revitalizer and Tresse Fortifier supplements, but also the Tresse Prebiotic gut health powder.  When comparing to the Nutrafol or Viviscal, you really cannot include the Tresse Prebiotic gut health powder in the comparison, because that part of the plan is so different from what you get with Nutrafol or Viviscal, which is one of the reasons we love the Tresse Prebiotic.  Gut health plays such an important role in all aspects of our health, including our hair, the ingredients in the Tresse Prebiotic have been found to boost our immune system, soothe inflammation, and increase overall gut health.

What is great about the Tresse Revitalizer and Tresse Fortifier supplements is that they not only have many of the key ingredients found in Nutrafol and Viviscal, but they actually have even more ingredients that have been known to address the many causes of hair loss.

Ingredients Similar to Nutrafol
  • Ashwagandha Root Extract
  • Biotin
  • Marine Collagen
  • Resveratrol - Japanese Knotweed Root
  • Saw Palmetto
Ingredients Similar to Viviscal
  • Vitamin C
  • Biotin
  • Calcium
  • Marine Collagen
  • L-Cystine
  • L-Methionine

While Nutrafol and Viviscal are great supplements for hair health, there are still many important vitamins and nutrients that they do not have which have been incorporated into the Tresse Rx supplements. Below are some of the highlights:

Folic Acid

Folic acid can be found in the Tresse Revitalizer supplement. Folic acid is the synthetic form of folate, which is a type of B Vitamin. As folic acid is mainly responsible for healthy cell growth and can be found in your scalp tissue and hair, it is widely believed that folic acid is important for the generation of new healthy hairs.


Magnesium can be found in the Tresse Fortifier supplement. Magnesium plays a key role in protein synthesis in our bodies. As roughly 80% of our hair is made up of protein, magnesium plays an important role in the development of key cells for the hair. Therefore, magnesium deficiency can have a direct effect on our hair. Lastly, Magnesium is known to help reduce stress and anxiety, which we know can negatively impact our hair.


Niacin can be found in the Tresse Revitalizer supplement.  Niacin is a B vitamin that is known to improve blood circulation, which is so important to hair health.  Increased blood circulation in the scalp allows for increased oxygen and nutrients to the hair follicle, which can extend the growth phase of the hair.

Vitamin B2

Vitamin B2, also known as riboflavin, can be found in the Tresse Revitalizer supplement.  Riboflavin plays an important role in hair growth by activating Vitamin B6 and niacin, which are two important vitamins for healthy hair development. The body stores only small amounts of riboflavin and riboflavin deficiency is known to cause hair loss.

Vitamin B6
Vitamin B6 can be found in the Tresse Revitalizer supplement.  Vitamin B6 helps our hair in two ways.  First, Vitamin B6 plays a key role in protein synthesis, which is important for hair as protein makes up roughly 80% of our hair.  Secondly, Vitamin B6 plays an important role in the creation of neurotransmitters that regulate emotions, and it is widely believed that Vitamin B6 can help us manage stress and anxiety, which can negatively impact the health of your hair.
Vitamin E
Vitamin E can be found in the Tresse Fortifier supplement. Vitamin E is a well-known antioxidant, which protect cells from the damaging effects of oxidative stress. Oxidative stress is known to play a role in premature hair loss. One study on the use of Vitamin E as a supplement for hair loss found that people with hair loss experienced a 34.5% increase in hair growth after supplementing with vitamin E for 8 months, while the placebo group had only a 0.1% increase.
To learn more about the Tresse Rx Healthy Inside plan schedule a consultation or contact our offices today.

Posted by Your Medi Tresse Team

Hair Loss Awareness Month - Dr. Wendel's Hair Loss Story

Like most years, August is National Hair Loss Awareness Month. Fortunately, awareness for hair loss in women is increasing, and with that awareness comes improved evaluation and treatments.  Up until about 10 years ago, there wasn’t much to offer women except minoxidil.  But things are rapidly changing.

I believe many of you know that I also suffer from Female Androgenic Alopecia, or FAGA. I always tell my patients, if you’re not sure if it runs in your family, take a close look at whoever is sitting at your family’s holiday dinner table.  Well, around my table was my immediate family, including my parents and two brothers.  Both my parents had a full head of hair, as did both my brothers.  But also at my table was my maternal grandfather who had thinning hair, as well as my paternal grandmother who sadly, wore a wig because her hair was so thin.  So there it was.  I always had fine hair, but enough to cover completely. But when I was pre-menopausal I started to notice some “see through” areas right in the front.  When it seemed to be getting worse, after a couple of years I started myself on minoxidil, first 2%, then 5%.  I was able to use it for a couple of years, but then my scalp became so inflamed I had to stop it.  After awhile I tried again, but unfortunately, the burning, itching, and scabbing happened again.  So I stopped and had nothing else to try at the time.

Fast forward about 15 years and fortunately now there are 5% minoxidil products like Formula PM which don’t contain the alcohol which had caused my irritation in the past.   I also use a Laser Cap faithfully every other day, as well as my  daily hair supplement Nutrofol and Lock RX to keep my scalp healthy, decrease shedding and help grow newer, stronger hair. I also know that our newest PRP treatment, known as Optimal Platelet Concentration (OPC) therapy is available if I decide I need that extra stimulation to grow stronger, thicker hair.   And while I presently don’t need it, we also offer micro-pigmentation, which uses a semi-permanent dying technique to gently color the scalp to fill in the areas that look thin.

So, have these treatments helped me?  Absolutely, YES.  I know that our Tresse Rejuvenation Therapy works. We see improvement in our patients every day. When I look at my own photos from ten years ago, my hair is healthier and fuller now.  My hair will always be fine, and I know that I will need to continue these treatments, but I am confident that I will never need that wig that my poor grandmother used so many years ago!

So let’s celebrate Hair Loss Awareness Month, knowing that because of improved awareness newer treatments are being studied, not just for Androgenic Alopecia, but for Alopecia Areata and Scarring Alopecia as well.

If you think you would benefit from an evaluation, or want to hear more about our Tresse Rejuvenation Therapy, give us a call.  We presently  are doing both in person consults as well as video consultations, for those not quite ready to venture out.

Stay safe and enjoy the rest of your summer!

Posted by Dr. Mary Wendel

Psoriasis and Gut Health

I recently came across some research in the Journal of Family Medicine and Primary Care called “The Role of Gut Microbiodome in the Pathogenesis of Psoriasis and the Therapeutic Effects of Probiotics” that I felt was quite interesting and pertinent for our patients for a two reasons.  First, we see a number of patients with psoriasis of the scalp, which leads to temporary hair loss.  I myself suffer from psoriasis.  Secondly, it really reinforced the importance of taking a systemic treatment approach, which I will expand on shortly.

For those that are not familiar with psoriasis, psoriasis is an autoimmune disease that affects up to 7.5 million Americans.  Psoriasis is a chronic disease that most commonly presents as red scaly patches on the skin and psoriasis flare ups come and go.  Unfortunately, there is no cure, but there are ways to manage the flareups when they occur and decrease their likely hood of experiencing them through lifestyle changes.  While psoriasis can occur on all parts of the body, psoriasis of the scalp is one of the most common, with a 2016 paper estimating that 80% of those with psoriasis will have a flareup on the scalp[i].  Psoriasis itself does not cause hair loss, however, it can be quite itchy and when you itch the scalp you can damage the follicle and hair leading to loss.

What the “The Role of Gut Microbiodome in the Pathogenesis of Psoriasis and the Therapeutic Effects of Probiotics” found was there may be link between our gut health and the immune response that causes psoriasis.  When the bacteria in the gut is out of balance, it can cause a condition known as bacterial dysbiosis, which is known to cause chronic inflammatory conditions in the skin.  While we often use treatments that specifically target the affected area, the researchers felt that we should consider treating systemically as well, which in this case would be through targeting the bacteria in the gut with probiotics.

Anyone that has been treated at Medi Tresse knowns that we are strong believers in utilizing a multi-therapy approach that also include systemic treatments that focus on nutrition and gut health.  The health of our scalp and hair are directly affected by the total health of our bodies.  While utilizing treatments like Optimal Platelet Concentration Therapy and Low Level Laser Therapy that directly target the scalp, it is important to support these treatments with a systemic approach through the use nutritional and gut health supplements.  Our bodies are complex and extremely intertwined.  While we are only scratching the surface on the importance of gut health, it is becoming more clear that it plays a strong role in the health of our hair.

Posted by Dr. Mary Wendel

[i] Blakely, Kim and Melinda Gooderham. “Management of scalp psoriasis: current perspectives” Psoriasis (Auckland, N.Z.) vol. 6 33-40. 29 Mar. 2016, doi:10.2147/PTT.S85330

Ketoconazole Shampoo

We receive a lot of questions from patients about shampoos and there is one in particular that comes up often, ketoconazole shampoo.  It is important to understand that most shampoos are not going to significantly regrow hair, regardless of what they advertise.  Many of these products will have ingredients that are known to help with hair loss, like DHT blockers or proteins, but it is not known how much of this is really absorbed in scalp.  This does not mean that there is no benefit to these shampoos.  While they will most likely not regrow hair, there is the potential to get healthier hair, less dry hair, or even increased volume.  In terms of what should be in the shampoo, ones that have panthenol and proteins can make hair appear thicker. Some shampoos have dihydrotestosterone (DHT) blockers in them, which brings us to ketoconazole shampoo.

Ketoconazole shampoo is a potent DHT blocker and is sold under the brand Nizoral. Excessive DHT has been found to be one the causes of androgenic alopecia.  It is important to note, that you would not want to use ketoconazole shampoo every day, and most people would only use it once or twice a week. Ketoconazole shampoos come in two strengths, over the counter, which is 1% strength and prescription, which is 2%.  When would we recommend these types of shampoos?  The over the counter Nizoral can be a good option for anyone with androgenic alopecia, also known as Female Pattern Hair Loss.  It is believed that ketoconazole shampoos may also have anti-inflammatory benefit, which could possibly help with other types of hair loss.  The over the counter strength can also be used for patients with a dry scalp or dandruff.  We often prescribe the 2% strength ketoconazole shampoo to patients experiencing severe dryness or seborrheic dermatitis.  Ketoconazole shampoos have been known to dry out hair, so it is really important to use a good conditioner with it.

In short, ketoconazole shampoo with an added conditioner once or twice a week is a good choice for any woman with known androgenic alopecia.  As always if you have any questions, we recommend consulting with a female hair loss specialist.

Posted by Your Medi Tresse Team

 The content contained herein is for education only and should not be considered medical advice.  Medical advice may only be given through a one-on-one, private consultation with an appropriate licensed medical provider.

Alphaeon Eyelash Serum is Back!

Patients that have been with our practice for a few years may be familiar with Alpheaon Eyelash Serum, which was discontinued in 2018 due to some restructuring withing the Alpheaon organization.  The Alphaeon Eyelash Serum was a big hit with our patient’s and staff, and we were all very sad to see it go.  Well we have some great news; the product is back under a new brand name AlphaLash™ and new company Almond Blossom!

AlphaLash™ was developed to hydrate, condition and strengthen lashes, resulting in the appearance of longer, fuller eyelashes.  AlphaLash™ is fortified with peptides to help stimulate hair growth, plus biotin to encourage growth and prevent lashes from becoming dry and losing volume.  Pumpkin seed extract, rich in fatty acids and essential minerals, helps to nourish, while sodium hyaluronate, a form of hyaluronic acid, helps to condition and moisturize.  Also, unlike Latisse®, AlphaLash™ will not cause lashes to grow in irregular and crooked directions or cause discoloration of the eyelid.

AlphaLash™ is a great treatment for both the eyelashes or eyebrows.  If you are interested in learning more about AlphaLash™ please contact our offices today!

Posted by Your Medi Tresse Team