How Blood Tests Can Play a Role in Diagnosing the Cause of Your Hair Loss
The ultimate goal of our medical consultation is to determine the cause of your hair loss. Starting treatment without knowing the cause is really not helpful, and often is costly both in time and money. There are many types of hair loss that women can experience, and each of these types can have several different causes. During the physical exam of your scalp and hair, we will closely examine your hair follicles using a highly magnified camera called a trichoscope, which will allow us to look for signs like miniaturization of the hair follicles, inflammation, or other specific features of the follicle that are not visible to the naked eye. While the physical examination is a critical piece of the puzzle when it comes to diagnosing the cause of hair loss, it is only one piece of the puzzle. We still need to review the patient’s medical and hair loss history, and for some patients we may also ask for specific blood tests to be done. While some women have had blood tests completed in the past, we only consider it relevant if it has been completed within the previous 12 months.
So, when does blood work play a role in the evaluation?
Patients Suspected of Telogen Effluvium
According to the American Hair Loss Association, Telogen Effluvium (TE) is the second most common form of hair loss. It presents as excessive shedding which seems to occur very suddenly and can be very mild or aggressive. While Telogen Effluvium is common, the good news is that it is usually reversible and complete regrowth usually occurs in about a year. However, it is extremely important to do a thorough evaluation for this problem to determine the cause. Treating Telogen Effluvium is really a two-step process. The first step is determining what is causing the “shock” to your hair. It is possible there was a singular traumatic event like surgery or an infection. However, one of the most common causes of TE is a nutritional deficiency, like iron, Vitamin D, or the B vitamins like B12 or Folate. When we suspect that a patient is experiencing a Telogen Effluvium, we usually recommend blood work so that we can evaluate those results for potential causes.
Patients Under 45
Another common cause of hair loss in women is hormonal imbalances. The most common cause of hair loss in women is Androgenic Alopecia. We know that this is a genetic problem that is primarily driven mostly by testosterone in men and women, but we also know in women, any imbalance of the female hormones, estrogen, and progesterone, can accelerate hair loss. Just prior to menopause, as hormones change, we often see worsening loss. Therefore, in these cases it is very important to check testosterone, estrogen, and progesterone levels. And in women who are experiencing hair loss at a very young age, hormone levels are particularly important to evaluate.
Usually once a woman passes through menopause, there can be a stabilization of hormones and evaluation of these levels is not necessary. However, if a woman is on HRT or hormone replacement therapy, it becomes essential to know if the hormone levels are in balance for good hair growth, and blood testing is essential.
History of thyroid disease
Both hypothyroid and hyperthyroid diseases can cause hair loss. When a woman has a history of thyroid disease in herself or other family members, we always check blood tests. Once again, all hormones need to be in proper balance to create healthy, strong hair.
Treating female hair thinning or loss without knowing the cause will often lead to poor results, frustrating both the patient and the practitioner. Often, the only way to know the entire story is to check blood tests. If you are experiencing hair loss make sure to see a hair loss specialist that can complete a full evaluation and determine if blood work would be beneficial for you.
Posted by Your Medi Tresse Team
Medi Tresse Hair Care Products
When it comes to shampoos and conditioners, there are certainly many options available, and many will even make claims of regrowing hair. The truth is that shampoo and conditioners will not regrow hair as the ingredients are not on the scalp long enough to be absorbed, but good quality shampoo and conditioners combined with proper leave in products can really repair damaged hair and provide really healthy hair and scalp. With that, we are excited to announce the arrival of our Medi Tresse Hair Care line, which consists of two sets of shampoo and conditioners, a leave in conditioner, and a hydrating serum that are all paraben free and safe for color and chemically treated hair.
Revive Shampoo and Conditioner
This stimulating, aromatic cleansing shampoo and moisturizing conditioner, includes Peppermint and Lavender Oils that revitalize both hair and scalp, while creating a calming, spa-like experience. The rich lather of the shampoo removes excess oils and product build-up and strengthens hair while improving body and shine. Vital vitamins and botanical extracts in the conditioner protect sensitive skin and scalp, while proteins strengthen the hair shaft. The shampoo and conditioner are safe for colored, straightened, and chemically treated hair.
The Revive Shampoo and Conditioner are great for all patients, except those with fine hair or who feel some shampoo or conditioners weigh their hair down too much. For those patients we would recommend the Volumizing Shampoo and Conditioner.
Volumizing Shampoo and Conditioner
A rich shampoo that infuses weightless volume while delicately freeing hair and scalp of surface impurities. ProVitamin B5 strengthens the hair while adding shine and thickness. Combined with a volumizing conditioner, infused with Keratin, that leaves hair nourished while maximizing volume and body. Safe for colored and chemically treated hair.
The Volumizing Shampoo and Conditioner are great for patients with fine hair or those looking for more volume.
Keratin Deep Conditioner
We recommend using a deep conditioner once a week and this Keratin-infused deep conditioning treatment, super-charged with proteins and extracts, restores moisture, strengthens, reduces breakage and stops frizz. Great for all hair types. Safe for colored, straightened & chemically-treated hair.
Many of the things we do to style our hair can dry out and damage the outer cuticle of the hair so it is so important to add moisture back into the hair. This hydrating serum enriched with Moroccan Argan Oil, is fast-absorbing, deep-penetrating and produces a luxurious shine and silky smooth texture with enduring results. Safe for colored, straightened & chemically-treated hair.
Reach out to our offices to learn more about the Medi Tresse Hair Care line.
Posted by your Medi Tresse Team
Keeping Up with Hair Loss and the Kardashians
You probably do not come to our website looking for the latest news about the reality TV star Kourtney Kardashian from Keeping Up with the Kardashians. To be totally honest, it is not a show that I typically watch, but a recent episode made headlines regarding hair loss and a well-known hair loss treatment, Platelet Rich Plasma (PRP) Therapy. For those that missed it, Kourtney Kardashian found a spot on the crown of her head that had significant hair loss. Kourtney blamed the hair loss on a recent tight ponytail she had worn and went to see a physician that diagnosed her with Traction Alopecia. Traction Alopecia is a type of hair loss that occurs from pulling the hair too tightly over an extended period of time. Ultimately, the doctor prescribed a treatment plan of three Platelet Rich Plasma (PRP) Therapy treatments over the course of three months to help heal the damaged follicles and regrow the hair she lost.
While it is difficult to asses someone strictly from TV, the idea of getting Traction Alopecia from over styling is very probable and very common. It is important to remember that it is unlikely that wearing your hair in a certain style for one night would cause so much damage to the follicles that hair loss occurs, however, if that hair style is continued often over a prolonged period of time it can absolutely cause hair loss. We see this all the time in women who consistently pull their hair back tight, wear tight ponytails, or have cornrows. For a woman diagnosed with Traction Alopecia, PRP Therapy is a great treatment option if the hair loss occurred in the past few years. However, if the hair style is continued, the hair loss will continue.
While I do not usually feel there is much to learn from Keeping Up with the Kardashians, the experience Kourtney had is an important one for many people to see. Unfortunately, hair loss can happen to any of us for various reasons, but it is so important to seek medical help as soon as you see signs of hair loss. Getting an appropriate diagnosis regarding your hair loss is key to starting the right treatments and treating your loss. If you think you are seeing signs of hair loss make sure you see hair loss specialist right away.
Posted by Mary Wendel, M.D.
Alopecia Areata Awareness Month
If you read our blogs last month, you would know that August was National Hair Loss Awareness Month and we tried to focus our blogs on providing important information on female hair loss as a whole. September is also an important month, as it is Alopecia Areata Awareness month. While considered a rare type of hair loss, Alopecia Areata still affects almost 7 million people in the US. Alopecia Areata is actually 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.
Types of Alopecia Areata
While we often speak of Alopecia Areata in general terms, there are actually a few different types of it. The most well known is Alopecia Areata, which presents as coin shaped lesions on the scalp, although the loss can occur on other areas of the body. Alopecia Totalis presents as total loss of the hair on the scalp. Alopecia Universalis presents as total loss of hair on the scalp, face, and body. Less common forms of Alopecia Areata are Diffuse Alopecia Areata, which is very sudden loss and thinning across the entire scalp, and Ophiasis Alopecia, which has unique pattern of loss on the sides and lower back of the scalp[i].
Why Does it Occur?
Alopecia Areata is an autoimmune disease, which means the body’s immune system is attacking the body. Much is still unknown about Alopecia Areata and why some people get it and what causes the flareups to occur. While stress was often thought to be a trigger for flareups, there is little scientific evidence to prove this.
Can we Cure Alopecia Areata?
Unfortunately, there is no cure for any type of Alopecia Areata. However, through treatment we try to stop the progression of the hair loss, and sometimes complete regrowth is possible. It is important to understand that even if the hair completely regrows, a flare up can re-occur at any time, which will cause the hair loss to occur again.
Treatments for Alopecia Areata
Up until recently, Alopecia Areata was treated solely with steroids – both through injections into the area of loss in addition to topical creams. Unfortunately, this still is not a cure and strong steroids are needed to illicit a positive response. Using these steroids long-term is never a favorable choice. Long-term use of steroids in the scalp can lead to thinning and weakening of the skin, as well as rebound irritation or skin reactions. Furthermore, because of the nature of the condition, most patients have to return multiple times a year to get more treatments. In recent years we have also seen some success with treating Alopecia Areata with Platelet Rich Plasma (PRP) Therapy and Low-Level Laser Therapy (LLLT).
If you think you are experiencing Alopecia Areata it is important to see a hair loss specialist that can diagnose the cause of your hair loss so that you can start an appropriate treatment plan as soon as possible.
Posted by Your Medi Tresse Team
[i] (Naaf.org, 2019)
Medi Tresse Named Best of Westchester
We are honored to announce that Medi Tresse Westchester is a 2019 Best of Westchester winner from Westchester Magazine in the category of Female Hair Loss Treatment. “We take great pride in offering our patients the best treatments available for female hair loss and we are truly humbled to be recognized for the work our great staff does every day,” said Dr. Mary Wendel, the National Medical Director of Medi Tresse.
At Medi Tresse we understand how difficult hair loss can be for women and we appreciate the trust all of our patients place in us when they choose to see us for treatment. We will continue to strive to provide the best possible treatments for female hair loss and provide women the chance to not only rejuvenate their hair, but restore their confidence!
Hair Transplants for Female Patients
One of the most well known hair restoration techniques, and one that many patients ask us about, is the hair transplant. Hair transplants are advertised as the only permanent solution for hair restoration, so they are a very intriguing option for patients. Unfortunately, women are typically not great candidates for hair transplants due to the type of hair loss that they have.
What is a hair transplant?
A hair transplant is a surgical procedure where hair follicles are surgically removed from the back of the scalp and planted into desired areas on the top of the scalp. There are two types, Follicular Unit Transplantation (FUT) or Strip Method and the Follicular Unit Extraction (FUE) method. With the FUT, a strip of grafts about 2 CMs wide and 15 to 20 CMs long in the back of the scalp (donor area) is extracted and then the individual follicles are cut up and planted on the top of the scalp. With the FUE, each follicle is extracted individually using a small punch and then planted. Typically hair transplants last anywhere from 5 to 8 hours and the patient is awake during the procedure, but does receive local anesthesia to numb the scalp. While everyone’s pain tolerance is different, the procedure can be painful and the recovery period is one to two weeks depending on the type of hair transplant. On average, a hair transplant will cost around $6,000 and often patients will need more than on surgery to get the desired density.
Are women good candidates for hair transplants?
The reason a hair transplant is considered a permanent hair loss solution is because with male pattern hair loss the hair in the back of the scalp is typically stable hair. The vast majority of men never lose that hair even when they lose all the hair on the top of their head. This stable hair is considered the donor area and when transplanted to other areas of the head it will stay stable and typically will not be lost in the future. However, female pattern hair loss is more diffuse, meaning the hair loss occurs throughout the scalp, even the typical donor area. That means the transplanted hair could be lost in the future. Women also tend to be more susceptible to the phenomenon of shock loss, which is post-surgical hair loss. While this loss is typically temporary, there can be a significant amount of loss throughout the scalp after surgery.
Are any women good candidates for hair transplants?
Women that are experiencing scarring alopecia could be good candidates for a hair transplant, especially when the loss occurs with the frontal hair line. Since scarring tends to be in an isolated area the donor site should be unaffected. A patient with scarring alopecia would need the affected area to be stable for at least one year, and preferably longer, and they would likely need to continue medical therapy for the underlying scarring alopecia to keep it under control.
What options do women have if they do not get a hair transplant?
The good news is that even though women are not great candidates for hair transplants, there are still great treatment options available to them. For a patient with female pattern hair loss, a treatment plan consisting of Platelet Rich Plasma (PRP) Therapy, Low Level Laser Therapy (LLLT), and Formula 82M should not only stop further loss, but should make existing hair thicker and hopefully activate dormant follicles to regrow some hair.
If you are experiencing any signs of hair loss the first step is to meet with a hair loss specialist that can help you find the best treatment options for your unique needs.
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
How Often Should I See My Hair Loss Specialist?
Your follow up visits provide an opportunity to track your results, update your hair loss specialist on any changes in diet or medications, and to potentially change the treatment plan if necessary. So how often should you see your hair loss specialist? Just like visiting your dentist (although hopefully less painful!), at Medi Tresse we recommend follow up visits every six months.
Tracking your results is extremely important, and any hair loss specialist should be taking photos and doing trichoscopy (which is highly magnified photos where you measure the hair) to track your progress. As you see your hair every day, it is often difficult to notice changes, but in your follow ups you will easily be able to track your progress throughout treatment.
The follow up is an important time to update your hair loss specialist of any major changes in your diet or medications. A major diet change, like becoming a vegetarian, could affect your hair loss if you are not receiving enough vitamins and nutrients. Some medications have been found to induce hair loss, and your hair loss specialist can help guide you through if the medication could be problematic to your hair.
For most patients, hair loss is progressive, which means that it will continue to get worse if not treated correctly. By seeing your hair loss specialist every six months, you can ensure that if you need to make changes to your treatment plan, it is done in timely fashion. The earlier hair loss is treated, the better chance there is for re-thickening and re-growth during treatment.
Tricomin® Products Reformulated
We are excited to announce that one of our favorite products at Medi Tresse, the Tricomin® Clinical product line, has been reformulated to provide even better hair health. Tricomin®, which offers a follicle spray, shampoo, and conditioner, has long been the standard for hair loss shampoos and conditioners. Tricomin ® products are fortified with patented Triamino Copper Complex™, a proprietary peptide blend of copper and amino acids. Copper is not only important for the health of the hair, but copper peptides can help with healing in the body. Amino acids are key building blocks for protein, and hair is made of the protein keratin.
So how have the Tricomin® products been reformulated? The great part of about the reformulation is that it is a relatively minor change to the products, which is important because the products were already really beneficial for hair health. However, the product line now has Pinoxide, which is a micro-circulation booster for the hair follicle. This means increased blood flow around the follicle, which not only helps in repairing the follicle, but should keep the follicle healthy longer.
If you are interested in learning more about these products do not hesitate to reach out to one of the hair loss specialists at Medi Tresse.
Posted by Your Medi Tresse Team