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

Hair Rejuvenation New Year’s Resolutions For 2021

Happy New Year’s and on to 2021! With the challenges that were presented to us this past year, I think we all get a pass for not keeping our 2020 New Year’s resolutions.  While the difficulties of this pandemic are not over, as the calendar flips to 2021, it does so with a great sense of hope for all of us.  With that, we wanted to offer everyone, regardless of where you are on your hair rejuvenation journey, a New Year’s resolution for the health of your hair.

Get on a hair loss supplement. 

If we learned anything in 2020 about hair loss, it is how much stress and external factors affect our hair.  Due to the increased stress of 2020, not only did we see an increase in complaints in excessive shedding from our patients, but there was significant news coverage related to this topic as this was seen everywhere.  A good hair loss supplement routine not only makes your hair healthier but can help minimize the impact when these stressful events occur.

If your last appointment with us was prior to this pandemic, schedule a follow up. 

The pandemic has now been going on for over 10 months.  It is recommended that you be seen every 6 to 12 months, just like going to the dentist.  As we have seen, a lot can change during that time and it is so important to follow up so that we can track your progress and make sure that no adjustments are needed to your treatment plan.  While we have significant safety protocols in place for the safety of our staff and patients, we know not everyone is comfortable coming in for an appointment right now.  In that case, we really recommend a video appointment so that we can at least check in and see how things are going.

If your treatment was interrupted or you stopped treatment, get back on that treatment plan.

As our lives were interrupted and put-on pause for various reasons during the pandemic, many patients had their treatment interrupted or stopped following their treatment plan.  It is important to remember that it is never to late to restart your treatments.  Whether you are overdue for an Optimal Platelet Concentration Therapy Booster or stopped using your laser cap, now is the time to get back on track.  If you have had any changes in your medical history (i.e., new medications) certainly let us know so that we can make sure that the treatment plan is still appropriate for you.

If you are currently following your treatment plan, keep at it!

If you started a treatment this past year or have been treating your hair loss for a while, keep at it! I am sure there have been some ups and downs, but you are doing all the right things, and being consistent with your treatments will give you the best chance for a successful outcome.  I know we all want immediate results, but it can sometimes take up to 12 months to see results so do not get discouraged and do not stop your treatments.

If you have never been seen by a hair loss specialist, schedule a consultation.

We cannot stress enough how important it is to be seen by a hair loss specialist as soon as you notice signs of hair loss.  The most common forms of hair loss are progressive, which means that without proper treatment the hair loss will continue.  It is important to remember that this does not mean you will go bald like men do, as women lose their hair differently than men.  It just means that the hair loss will get worse without treatment.  Female hair loss is quite complex with a variety of causes and it really takes a specialist to be able to diagnose the cause and determine an appropriate treatment plan.

Wherever you are on your hair rejuvenation journey, just know that the team at Medi Tresse is here to support you and help you keep your hair health New Year’s resolution.  Do not hesitate to reach out to our offices and have a safe and healthy 2021.

Posted by Your Medi Tresse Team

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

Medi Tresse Boston Female Hair Loss Seminar

We are excited to announce that on Thursday November 8th we will be hosting a free Female Hair Loss Seminar and Open House at our Wellesley office. Enjoy light fare and refreshments while learning about the latest advancements in female hair loss. Some highlights of the night include:

More details to come!

Interested in attending? Call our office at 774-314-3900 or email us at to RSVP.

Scarring Alopecia

When we first opened Medi Tresse and started seeing women experiencing hair loss, virtually all the patients who came in for evaluation were experiencing symptoms of Androgenic Alopecia, which is the most common type of hair loss in women. The hair loss occurred slowly over many years, sometimes decades, and many of them had family histories consistent with the genetic basis for Androgenic Alopecia. Research on the treatment for this type of hair loss is extensive and fortunately the treatment is usually very successful. These treatments include minoxidil (82M), LLLT (low level laser therapy) and PRP (platelet rich plasma), as well as supplements like Nutrafol and Viviscal. Sometimes hair transplant is an option as well.

Recently we are seeing increasing numbers of women with Scarring Alopecia, which is an inflammatory cause of hair loss, and a much more challenging problem to treat. At a recent international conference on hair loss I heard the world’s experts debate the potential causes, but at this point we really don’t understand why this is happening more frequently. There is some evidence that certain harsh hair care practices may contribute to some forms of Scarring Alopecia, particularly in African American women that use chemical relaxers from a very young age. This type of hair loss is much more common in women than men, with some studies reporting as high as a 4:1 ratio of women to men. There is some evidence to suggest an autoimmune cause, and there may be a genetic component as well, but more research definitely needs to be done.

Scarring Alopecia results in permanent damage of the hair follicle if treatment isn’t started immediately. Unfortunately, in the early stages, it often looks very similar to Androgenic Alopecia and treatment may be delayed. However, the major difference is the rate of hair loss, which is much faster with Scarring Alopecia.

There are several types of Scarring Alopecia: Central Centrifugal Cicatricial Alopecia (CCCA), Lichen PlanoPilaris (LPP), and Frontal Fibrosing Alopecia (FFA). If a woman presents with a more rapid rate of hair loss, as well as evidence of inflammation around the base of the hair follicle on examination, then we become concerned with the possibility of Scarring Alopecia. The pattern of hair loss may be patchy, or as in FFA present as a band of loss along the frontal hairline with loss of eyebrows as well. A biopsy is essential to confirm the diagnosis.

Regardless of which type of Scarring Alopecia exists, the initial treatment is usually steroids, topical or injected. Strong consideration should be given to oral medication, which may include doxycycline, hydroxychloroquine, and dutasteride. Newer treatments like laser therapy and PRP have not been studied at length, and should be considered only after standard treatments have failed. We have had some success utilizing PRP in CCCA, especially in women with some underlying Androgenic Alopecia as well.

Patients with scarring alopecia need to be followed carefully and treated aggressively. At Medi Tresse we are fully capable to treat all types of hair loss in women, and early diagnosis and treatment is essential, especially in Scarring Alopecia in order to prevent permanent loss.

Posted by Dr. Mary Wendel

Medi Tresse Is Now Offering Nutrafol®

We are excited to now offer our patients Nutrafol®, one the top dietary supplements available for hair loss.  At Medi Tresse we have a very high standard for the treatments that we offer our patients, and all our treatments must have clinical studies that prove their benefit before we will give it our stamp of approval.  After careful review by our medical team it was determined that Nutrafol® is a great option for women experiencing all types of hair loss.

Nutrafol® is made with all-natural ingredients and is free of gluten, wheat, and shellfish, and binders.  Nutrafol® includes the following key ingredients for the treatment of hair loss:


Sensoril® Ashwagandha

BCM-95® Biocurcumin

Saw Palmetto

Cynatine® HNS


It takes at least three to six months before you will start to see the benefit of Nutrafol®, but for many patients it can take up to year.  While some patients experiencing short term hair loss like telogen effluvium, may only take Nutrafol® for a year, we would recommend taking it as long as you want to help maintain healthy hair.  For patients not currently on a vitamin or supplement we would recommend starting on a daily regimen of Nutrafol®.  However, if you are currently using another supplement, such as Viviscal®, and having success with it, we would recommend sticking with that as you do not want to rock the boat.  As Nutrafol® does contain Saw Palmetto we would not recommend to patients that are pregnant or breastfeeding.

If you are interested in learning more about Nutrafol® and how it can help you reach out to our offices today.

Posted by Your Medi Tresse Team

Hear From A Patient - Laura D. Shares Her Experience

Unfortunately, as a society we have decided that female hair loss is a taboo topic that is rarely discussed.  In reality, hair loss will affect up to 50% of women in their lifetime, but since we do not have honest discussions about it, many women feel forced to suffer in silence.  Today we are thankful to have a patient that is willing to share her experience so that more women can feel empowered to speak about their hair loss and learn about the treatment options available to them.  Laura D. is 31 years old and has been experiencing telogen effluvium over the past few months due to being post-partum.  In the upcoming months she will occasionally write blogs for us to let us know how her journey is going.

Being a new mother has been more wonderful than I had ever dreamed.  That being said, I will be the first to admit that I didn’t love most of the parts of being pregnant.  I am someone who likes to be in control of my own body, and it was challenging watching my body change in ways that were completely out of my control.  Despite having what most would consider a “fit pregnancy” where I continued running, doing yoga, and swimming up until delivery, I gained 50 lbs with my daughter!  Yet along with the less desirable body changes that included swollen ankles, a baseline waddle, and constant kicking of my ribs, I will say that my hair was more thick and vibrant than it had ever been. There were at least  some perks of being pregnant for sure! 

Now that my daughter is four months old, I feel as though I have finally gotten into a routine of daily life with a baby, and for the most part have my body back again.  Let me tell you what a victory it was to fit back into my pre-pregnancy jeans!  I finally feel like myself again and would be feeling very happy about my post-partum body if it wasn’t for one thing, my hair.  The one thing that I wasn’t expecting was how much hair I would start losing, and how drastic the change in my hairline would become.  At about 3 months post-partum, I started shedding hair excessively.  My shower drain would be clogged with a fistful of hair each time I washed my hair, and it became near impossible to keep up with vacuuming the rooms in our house where my hair seemed to collect in every corner.  I now dread washing my hair or even brushing my hair, because every time I do so my hair falls out in handfuls.  Although there is definitely overall thinning, I am thankful that I had very thick hair to begin with, so a thinner ponytail isn’t the worst thing.  However, what really bothers me is that I have significant hair loss along my temples and across the front of my hairline.   Instead of thick dark hair, there are patches where my hair is now so thin you can easily see through to my scalp.  I’ve started parting my hair differently and styling it differently to try to cover up these balding spots near my temples.  

It’s extremely frustrating how self-conscious I am about my hair loss, because I feel like this should be a time where I am so proud of all that my body has done for me in the past year.  It’s crazy to think that over this year my body has carried a tiny human from conception to birth, and now has been nourishing this tiny little human and allowing her to grow and thrive in this world.  I should feel empowered that this body has done all of that so well, yet I find myself focusing the negatives of my thinning hair when I look in the mirror and not the other beautiful parts of my body both outside and in.  

In March I decided to speak to the medical staff at Medi Tresse to try and figure out what was going on with my hair.  While it was not easy to talk about, my interactions with both Diana and Rosie have been beyond wonderful.  They are both such caring, compassionate, and dedicated practitioners.  They have assured me that I’m not alone in my post-partum hair loss, and they’ve helped me create a treatment plan that will fit into my life as a new mom.  They explained that I was experiencing telogen effluvium due to being post-partum.  After discussing my options, I decided to pursue treatment with a laser cap to hopefully slow down the shedding and reverse the hair loss. I am really excited to get started with treatments and see if I can regain some hair (and some confidence!) in these upcoming months.   I can’t wait to share this journey with you all and I am so thankful that Medi Tresse is here to help me! 

Note from Diana Gallerani, NP: Laura is experiencing telogen effluvium, which is a temporary hair loss typically caused by a stressor on the body.  For most patients, telogen effluvium is reversible and all loss should regrow, however, it is important to start treatment early to help mitigate the shedding and reverse the telogen effluvium.  Post-partum hair loss is extremely common, as during pregnancy most women experience less shedding and will see thicker hair as a result.  After the pregnancy women will shed hair and go back to their pre-pregnancy baseline.  Unfortunately, in some cases, and in the case of Laura, we do see some patients shed more hair than they started with before their pregnancy and actually see thinning throughout the scalp.  With telogen effluvium, it is important to be aggressive with the treatment and we typically recommend a multi-therapy approach of Low Level Laser Therapy, Formula 82M, and Viviscal.  However, since Laura is breastfeeding we do not recommend the Formula 82M or Viviscal, so we have started her on a laser cap.  Laura is currently not a candidate for Platelet Rich Plasma (PRP) Therapy as she is in an active shed, but once we stop the shedding she could try PRP, which will likely give her faster results than just waiting for her hair to grow back on its own.

Posted by Your Medi Tresse Team

No, McDonald’s Fries Do Not Regrow Hair

If you have watched or read the news lately you probably saw some headlines that read “McDonald’s French Fries Cure Hair Loss!”. While that headline is attention grabbing and sounds delicious, sadly, it is not true. So what is everyone talking about?

There was a recent study conducted in Japan where a research team was able to regrow hair on mice by creating hair follicle germs, which are the reproductive source of hair follicles, and seeded them into the mouse’s body. Amazingly, the hair follicles generated hairs on the back of the mice. The hope is this may one day lead to similar success with humans, but there is still much testing to be done.

So you are probably still asking what this has to do with McDonald’s french fries? Dimethylpolysiloxane is a silicone compound that McDonald’s uses in its french fries to prevent the oil from foaming. The research team also used Dimethylpolysiloxane in this study. In order to produce the hair follicle germs in a lab, the research team needed “oxygen-permeable dimethylpolysiloxane (PDMS) at the bottom of the culture vessel”. Therefore, while it is true that this ingredient in McDonald’s french fries was used in a successful hair loss study, it was not a contributing factor to the hair growth, but rather was necessary for conducting the study.

Unfortunately, this type of breakthrough treatment is still a ways off from becoming a reality, however, there are still lots of great treatments available for hair loss, even if eating french fries is not one of them!

Posted by Your Medi Tresse Team

2018 New Year’s Resolution For Healthy Hair

Sometimes it feels like New Year’s resolutions are made to be broken.  You start telling yourself you are going to exercise outside more, while looking at a thermometer that reads 5 degrees right now or you assure yourself you will eat better, but you have a house full of left over holiday treats! This year we thought we would help you with a New Year’s resolution for your hair health that should hopefully not be too hard to keep.

For Those That Have Never Seen A Hair Loss Specialist

For Those That Have Not Been Back to Their Hair Loss Specialist

For Those Currently Treating Their Hair Loss

For Everyone

We hope you have a safe and exciting New Year!

Posted by Your Medi Tresse Team

Comparing Hair Restoration Treatments - Hair Transplant vs Platelet Rich Plasma Therapy

Today’s blog post is the first in a series that we will be writing that compares different hair restoration treatments.  Thankfully, there are lots of great hair restoration treatments available today, however, with all of the options available, patients often are concerned they are not choosing the right one.  This series will give you the information you need to make the right choice for your hair restoration treatment.  Today we will compare one of the best known hair restoration techniques with one of the more recent non-surgical hair restoration techniques, hair transplants versus platelet rich plasma (PRP) therapy.

Hair Transplants

In their current form, hair transplants look extremely natural and are the only permanent hair restoration solution, as your hair follicles are surgically being removed from the back of the head (the donor area) to the desired part of the scalp (the recipient area).  However, hair transplants can be painful as it is a surgical procedure and the recovery is typically 7 to 14 days.  Also, hair transplants are not always the best option for patients with female pattern hair loss (FPHL). Female pattern hair loss (FPHL) typically presents as diffuse thinning throughout the scalp, which means your hair is thinning everywhere.  Therefore, patients with female pattern hair loss (FPHL) may not have the required hair density in the donor area for a hair transplant.  Lastly, some women may be prone to shock loss from the surgery, which causes further loss, which may not recover.

Platelet Rich Plasma Therapy

PRP Therapy is a minimally invasive non-surgical hair restoration treatment that has been shown to strengthen and thicken hair and reactivate dormant follicles.  Recent studies have shown up to 85% of patients will receive benefit from PRP therapy.  PRP Therapy uses your own blood and takes only 45 minutes to complete the session, and there is no real down time.  While PRP Therapy is not permanent solution, you can maintain results with booster treatments every 6 to 12 months after the first year.


For patients experiencing female pattern hair loss, that are looking to increase the thickness of their hair, decrease shedding, and re-activate dormant follicles, PRP Therapy is a great option.  If you have significant scalp showing in a certain area then you may want to look into a hair transplant, as PRP will not regrow hair in areas of scalp with no hair.  However, just remember, you need the required donor area and need to be able to tolerate moderate pain to have the hair transplant.  It is always important to see a hair loss specialist who will guide you through this process and insure you are choosing the best possible treatment for you.

Posted by Your Medi Tresse Team