Hair Loss Advice


Non-Medical Treatments for Hair Loss in Women


Non-Medical Treatments for Hair Loss in Women

Medically Reviewed On: December 06, 2000

Webcast Transcript:

LISA CLARK: Welcome, and thanks for tuning in to our webcast. I'm Lisa Clark. By the age of 50, approximately 50% of women will have to cope with hair loss. This is a natural part of aging, but it's a part that most women would prefer to skip. For many women, medications can provide a reliable solution to hair loss. For others, such things as clever hair styling or surgery might help overcome the problem of thinning hair.

Here to share some helpful hair care tips and treatment options for women who are experiencing hair loss, we have two experts. Dr. Marty Sawaya, adjunct professor at the University of Miami School of Medicine, and Dr. Michael Reed, assistant professor of clinical dermatology at the New York University School of Medicine. He's also in private practice here in Manhattan.

Now, it's true that although men have to endure a lot of bad jokes if they start to thin on top, it is socially acceptable for a man to have a little bit of hair or no hair. Some men even shave their heads to make a statement. But it is not socially acceptable for a woman to start losing her hair.

MICHAEL L. REED, MD: It's true. A man can choose or not to choose to suffer from baldness, but all women suffer from baldness, or hair loss or thinning or shedding, whatever it happens to be. It's because women have to have hair. It's an absolute requirement for them.

LISA CLARK: And she feels very stigmatized when this starts to happen, right?

MARTY SAWAYA, MD: Exactly. It's a very big social pressure for us to always look our best. We have to look like the models or the front of a magazine cover. So it's a very big pressure. And we lose about a fourth of our hair follicles by the time we're 50 years of age, so it's a natural aging process that we can't combat. Plus the fact of having more hair loss on top of that, for some people.

LISA CLARK: More good news about aging, right? When a women is at risk for losing her hair, are there things that she can do to slow or minimize the risk?

MARTY SAWAYA, MD: Definitely. And the sooner the better, that they seek help and do the proper things that they're supposed to do. Seeing their physician, making sure there's no underlying medical things we need to take care of. Excessive blood loss, medications, menstrual problems. A lot of things can happen as we get older. So making sure, health-wise, that we're really up to where we should be, is very, very important.

And the fact that we can have changes to our scalp with regards to age or hair loss problems, shedding problems, use of proper medications such as minoxidil, Rogaine for women can be very, very helpful. And properly using them is also advisable.

LISA CLARK: What are some of the mechanical things that women should be concerned about, in terms of taking care of their hair? Pulling it back too tight in a ponytail, cornrows, braids?

MICHAEL L. REED, MD: Any procedure, any product that chronically pulls for long periods of time on the hair shaft, will transmit that tension down into the living root, and will tend to cut off the blood supply or cause a low level degree of inflammation, and will actually cause the hair to use up its natural genetic allotment of hair growth and resting cycles, and it'll be gone prematurely, and it won't grow back after a long time. It will just be replaced by little fibrous tract.

Tight rollers, tight ponytail hairstyles, excessive brushing and combing, pulling, consciously or unconsciously, and cornrowing or braiding, those type of hairstyles, are all not advisable.

LISA CLARK: There's a myth that washing your hair is not a good thing. That is not true. But there is something that you can do to be proactive about how you wash your hair. Is that right?

MARTY SAWAYA, MD: We usually instigate shampooing on a daily basis. I usually recommend rotating shampoos, medicated shampoos and mild shampoos that are sensitive, for mild sensitive scalp. It's very advisable. People in the family usually end up liking these shampoos, and everybody uses them in the family. The zinc containing shampoos, depending on if you have any scale or inflammation.

The thing I tell women is, whatever you're doing to your scalp, if you have any itching, that's inflammation. Inflammation and the hair follicle do not like each other. That will start the whole process up with regards to shedding and hair loss. So be very careful what you do to yourself.

There is an institute for women's fine and thinning hair that the Pharmacia company has set up so women can call in and actually get advice with regards to styling techniques, medical questions, and psychosocial questions with regards to psychologists answering these questions. So women have a source to go for information now, which I think is just incredible.

LISA CLARK: A styling change can make a big difference in the appearance of thinning hair. Changing your part or cutting your hair shorter so that it's not hanging as limply as it might tend to want to do.

Dr. Reed, more and more women are opting for a technique that you're definitely familiar with, implants or follicle implants, microsurgery.

MICHAEL L. REED, MD: We're now in the age of the so-called follicular unit graft transplant. We have discovered, we should have seen this a long time ago, that hairs on the human scalp grow in naturally occurring, small anatomical clusters called follicular units, which have one, two, three, sometimes even four or five hairs in them.

Now we take these naturally occurring clusters from the back of the head, where they're genetically blessed and will have a long life. Maybe the entire life of the person. And we micro-dissect them under a dissecting microscope, and put hundreds and thousands of them into the thinning areas.

We have instrumentation now so we can go between the native hairs so we don't disturb them. We now are transplanting a large percentage of women who previously were unaware of this treatment, and it wasn't really for them, but now it is.

LISA CLARK: I want to ask you some specifics. If a woman comes to you to have this surgery done, is it a process? Are there several steps that you go through in doing sections, or do you do it all at once? How does that work?

MICHAEL L. REED, MD: It's done in many different ways, but most women, I find, like to get it over with as quickly as possible. Especially older women tend to have a sensitive scalp, and it's sore in the back afterwards, because it has to be sutured. Although when it heals, you don't miss the hair on the back. There's a pencil-line scar that usually disappears. And the top, there's a period of time where a person may have a little bit less hair, because it's a shock to the scalp, and even some of the native hairs will come out and grow back with the transplanted hairs. That takes two or three months to really get going. But it works in everybody. Everyone gets a good result nowadays with the techniques.

LISA CLARK: When do you recommend this option to a patient?

MICHAEL L. REED, MD: It can happen any time that they get to the point where their hair is noticeably thin, so that in normal circumstances, you can see through the hair and you can see scalp. You don't have to have a bald spot, you just have to have a thin spot. We can fill it up.

LISA CLARK: Dr. Sawaya, let's talk about some of the alternative therapies, and whether any of them actually work. People may see things advertised such as saw palmetto.

MARTY SAWAYA, MD: Correct. Saw palmetto is an herbal agent you can buy in the health food stores. Especially for men, because of prostate problems. They'll have advertisements that will also link it to hair growth. It's very disconcerting, because there have not been clinical studies showing that this actually helps men with hair loss, much less women.

But people can find it, it's readily available. They think it's a cheaper alternative than trying our two FDA-approved products, so they will opt because it's the easier choice, it's faster for them. I think there's a false hope. "I'm hoping that the unknown will work better than our known products." This is very difficult to try and convince patients, unless they've gone through years of searching with these products, and then realized it didn't do anything for me thousands of dollars later.

That's a product that men use for prostate hypertrophy, urinary retention, and it has made some medical claims on helping DHT, which is a problem with miniaturizing the hair follicle. But, again, there have been no proven efficacy or clinical studies to show that saw palmetto works with even men for male pattern hair loss, much less women.

LISA CLARK: Same story with B-vitamins? Now, those are much more common.

MARTY SAWAYA, MD: Right. All of the things, as we say, alternative treatments that you might find on the cable channels, internet, magazines, if they haven't had the FDA approval, be very careful in using them because, again, they have no proven clinical efficacy. And we have clinical studies down to a science today, where we really can show if they do grow hair. If the companies don't back these in clinical studies, we have to use them with some sense of caution in advising our patients.

LISA CLARK: Here's the championship Scrabble word: Electrotrichogenesis.

MARTY SAWAYA, MD: This is electrical waves that you can have in helmets or in devices set up in doctors' offices. It's supposed to have electrical stimulation that stimulates the hair follicles. And there have been some clinical studies in literature, but most of the outcomes of these studies have not shown any proven efficacy, and certainly do not outdo our two medical products that are approved by the FDA. So, again, skepticism with even the devices that are out there.

LISA CLARK: Dr. Reed, let's talk about some of the things that are being studied for possible future use, for men as well as women. Genetic technologies, and follicle cloning. What can you tell us about those?

MICHAEL L. REED, MD: Those are two science fiction fantasies at the present time. But usually today's science fiction becomes tomorrow's scientific fact, and I think both of them will come to pass, although probably two generations for gene therapy, and maybe a generation for cloning.

Cloning is basically a modification of the surgery we do now, where instead of taking a hair follicle from the back and moving it to the top, a one-to-one gain, would take a follicle and will take a portion of it, and will grow out the little stem cells, and inject maybe several hundred of them, and make several hundred new hairs in the new location.

The trouble is that, right now, we haven't really isolated the exact cells, and when they do get in tissue culture, they don't really behave properly, because it's not the right environment for them.

Gene therapy is very intriguing because it may be possible to attach, once we find out what gene to do, which we don't have, it may be very difficult. But once we get the right gene, we might be able to inject some type of a carrier or put it into a topical preparation that penetrates into the hair root cells, and it will add the genetic material that's missing in these doomed hair follicles that are destined to be lost prematurely, and make them into the genetically blessed hair follicles that live forever.

LISA CLARK: Those are far down the road, as you say, but we should remind women who are having hair loss issues, there are treatments available now, and you need to see your dermatologist.


MICHAEL L. REED, MD: They work.

LISA CLARK: They work, all right. Thank you both for joining us. We really appreciate it. And thank you for joining us for our webcast. Let me say thanks to Dr. Marty Sawaya, and Dr. Michael Reed.

MARTY SAWAYA, MD: Thank you.

LISA CLARK: I'm Lisa Clark