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How can I regrow hair that has been falling since my teenage years?

Hair Loss Skin, Hair & Nails

Hi, I am a female in my early twenties and have been losing hair on my crown ever since I was a teenager. My hair does not fall out in clumps, but I feel that new hair has not been growing out. I've tried minoxidil foam but my scalp itches after using it. Please advice me on what I should do, thank you very much and have a nice day.

DOCTOR’S ANSWER (1)

Thank you for your question and please bear with my lengthy reply.

PART 1: The likely diagnosis

What you are describing does sound like female pattern hair loss. This condition can typically start as early as puberty and is progressive in nature i.e. gets worse over time, unless treatment is initiated.

Internationally, there are a few ways to classify the severity of this pattern, the most common one being the Ludwig Scale.

ludwig scale

** Do note that the graphical representation of the Ludwig scale is done by analysing the scalp in a centre-parted hair style, so for comparison sake, center-part your hair to estimate your own stage of hair loss. Your hair restoration doctor would be able to give you a more accurate staging during the consultation

Part 2: Why this happens

Understanding female pattern hair loss is not easy as it involves multiple biochemical processes acting on a complex organ - the hair follicle.

To summarise, what is happening is

1) microinflammation at the level of the hair follicle, causing it to 'shrink' over time, resulting in shorter and finer hairs emerging from the scalp,

2) insufficient nutrition to the hair follicle, causing the hair shaft to grow out weaker and provide less coverage.

This process is medically called miniaturization.

hair miniaturization

There are also certain medications and medical conditions that can contribute to and accelerate this condition including thyroid disease and thyroid medication, autoimmune conditions etc. 

Part 3: What has to be done

The initial consultation will be done to establish a diagnosis of whether this is indeed female pattern hair loss (there are hundreds different hair loss diagnoses to consider). 

A genetic history of hair loss will be taken to determine further, to what degree of this hair loss is hereditary (genetic hair loss).

Other tests such as a 360 hair pull test to assess if you also have an on-going hair shedding condition called telogen effluvium, and a microscopic examination of the scalp (videotrichogram) will be performed to assess the scalp and hair condition.

Blood tests may be performed to rule out certain medical conditions (as mentioned above) as well as to ascertain any nutritional deficiencies. 

Part 4: What can be done to solve the problem

Target 1: STOP further hair loss - for you, this involves correcting any underlying medical conditions or nutritional deficiencies - commonly seen ones are iron deficiency or Vitamin D deficiency (96.6% of female pattern hair loss sufferers are Vitamin D deficient)

Target 2: OPTIMIZE existing hairs - the hairs that have miniaturized in your crown area can be salvaged to a certain degree, depending on how damaged the hair follicle is. There are various means to achieve target 2. A few examples would be to use medications (which carry potential side effects), clinically proven nutraceuticals such as Nutrafol for Women, botanical anti-hair loss sprays like CG210 from Abbott Pharmaceuticals, or a regenerative medicine procedure Regenera Activa. 

Target 3: RESTORE what has been lost - This involves filling up empty areas of scalp with strong hair extracted from the 'donor' area and is a surgical procedure called a hair transplantation.

** One should not skip steps in this process as results can be unsatisfying after a few years. Your hair restoration doctor would be able to show you example of unnatural hair restoration results if steps are skipped in logical treatment process.

In Summary:

Thank you for reading my lengthy reply, do speak to your hair restoration physician about the options available to you during a personal consultation. Do remember, seeking help early for hair loss is important as it helps to reduce the chances of requiring a large surgical hair restoration procedure in the future.

I hope this helps.

Yours Sincerely,

Dr Joshua Chong

847 views 15 Sep 2018
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