Alopecia (Hair Loss) Patient Education

Doctors Who Treat Alopecia

As your alopecia is diagnosed, treated and managed, you may encounter the following team of doctors and specialists listed in this hair loss patient education guide.

• Dermatologist - A doctor who specializes in conditions and diseases affecting the skin, hair, and nails. A dermatologist diagnoses, treats, and monitors patients with alopecia thinning hair.
• Internist or Family Physician - Doctors who provide general medical care for adults. Adults with alopecia may initially see an internist or family physician before being referred to a dermatologist.
• Pediatrician - A doctor who specializes in the medical care of children. Children experiencing alopecia hair loss may initially see a pediatrician before being referred to a dermatologist.

 

Written by Laurie LaRusso, MS, ELS

How to Prepare for Your Alopecia Doctor Visit

Having made your appointment with a healthcare provider, there are certain actions you can take to maximize the benefit of your doctor visit for alopecia. Read about them in this hair loss patient education guide.

• Write down when you first noticed your hair loss and for how long it has been happening.
• Write down a list of any symptoms or changes in your health, other than hair loss, and when they tend to occur.
• Make a list of all medications, vitamins and supplements that you are taking. Include the dosage you are taking of each.
• Write down key personal information, including prior and recent illnesses, diet and exercise habits, and any major stresses or recent life changes.
• Be prepared to answer many questions about your diet, hair care, personal habits, stressors, and medical history and to take an active role in managing your thinning hair condition.

 

Written by Laurie LaRusso, MS, ELS

Questions to Ask Your Doctor About Alopecia

From your initial diagnosis throughout your treatment and care, you will have questions about your thinning hair. Listed below in this hair loss patient education guide are questions to discuss with your doctor so you can make informed decisions about your condition and your care.

 

Questions About My Alopecia Diagnosis

• How can you tell what is causing my alopecia?
• Are there tests to determine the cause of my thinning hair alopecia?
• Could a medication be causing my alopecia?
• Does having alopecia put me at risk for other medical conditions?
• Is alopecia contagious?
• Will my hair ever grow back?

 

Questions About My Alopecia Treatment

• What types of medications are used to treat alopecia? Are there side effects?
• Will I have to take medication for the rest of my life?
• Will other medications I take interact with my alopecia medication?
• Are there other treatments for alopecia?
• Do I need a hair transplant?

 

Questions About My Lifestyle & Family

• Are there changes to my diet or hair care regimen that would help stop or reverse my hair loss?
• Will my children have alopecia?
• How long will it take for my hair to grow back?
• How can I hide the bald patches or missing lashes or eyebrows?
• Is there a support group you can recommend for people with alopecia?
• Can you recommend a stress relief program to help reduce my stress levels?

 

Written by Laurie LaRusso, MS, ELS

Common Tests or Labs to Diagnose Alopecia

Doctors diagnose alopecia by examining the head hair, scalp, and possibly hair on other areas of the body, asking many questions to determine the cause of the hair loss, and sometimes testing blood, hair, or skin cells. Listed in the table below are the most common tests and labs ordered for alopecia or thinning hair, why you need them, and what they can tell you about your condition.

The doctor will likely ask questions about the following questions in this hair loss patient education guide (link to main overview page with anchor text “hair loss patient education guide”):

• Whether the hair loss happened gradually or suddenly
• Your medical history
• Family history of hair loss
• Your diet
• Medications
• Allergies
• Recent illnesses
• For women: periods, pregnancies, and menopause

 

Test	Why Test?	What Happens?	Normal Result
Blood test	To check for anemia, thyroid disorder, or indicators of another autoimmune disorder or medical cause of hair loss	Blood is drawn with a syringe, typically from the arm.	The test will give information about whether the hair loss is caused by a medical condition, such as anemia, liver or kidney disease, thyroid disorder, or another autoimmune disorder
Hair analysis	To study the hair cells to determine the type or cause of hair loss	A few pieces of hair are pulled out for analysis.	The test results will help identify or confirm the type or cause of alopecia.
Scalp biopsy	To study the scalp cells to determine the type or cause of alopecia	After pain medication is injected at the site, a sharp instrument is used to remove a small piece of scalp for analysis.	The test results will help identify or confirm the type or cause of alopecia.
Skin biopsy	To study the skin cells to determine the type or cause of alopecia	After pain medication is injected at the site, a sharp instrument is used to remove a small piece of skin for analysis.	The test results will help identify or confirm the type or cause of alopecia.

 

Written by Laurie LaRusso, MS, ELS

Common Medications and Treatments for Alopecia

Treatment for alopecia depends on the cause or factors contributing to the hair loss. For people with temporary hair loss caused by factors such as underlying illness, diet, medications, or hormonal conditions, the hair typically re-grows on its own once those issues have been resolved. Many people with alopecia areata will also re-grow their hair without treatment, but treatment can help re-grow hair more quickly. Hereditary hair loss requires treatment to re-grow hair.

In general, it is helpful to seek treatment before a lot of hair is lost, because treatment is often easier when there is less hair loss. Cicatricial (scarring) alopecia, in particular, needs to be treated before scarring of the hair follicles occurs, because after scarring develops the hair cannot re-grow.

The two tables listed below in this hair loss patient education guide (link to main overview page with anchor text “hair loss patient education”) contain descriptions of the common medications and procedures used to treat alopecia.

 

Drug Category	How it works
Minoxidil	Stops hairs from getting thinner and stimulates hair growth on the top of the scalp Applied to the affected scalp areas Approved by the FDA for use in men and women
Finasteride	Stops the body from making the male hormone dihydrotestosterone (DHT) Helps slow thinning hair in most men and helps stimulate hair re-growth in many men Taken in pill form Approved by the FDA for use in men only
Corticosteroids	Helps stop inflammation that causes the hair loss in people with alopecia areata Given as an injection into the scalp or applied as a cream, lotion, or ointment on the scalp Typically not given in pill form, due to side effects
Anthralin	A tar-like substance that alters the skin’s immune system function Applied topically to the affected skin Also used to treat psoriasis
Diphencyprone (DPCP)	Works by causing a small allergic reaction in the affected area, which is believed to trick the immune system into sending white blood cells to the scalp to fight the inflammation that is causing hair loss Applied topically to the bald skin Also prevents hair follicles from going to sleep and causing hair loss

 

Type of Procedure	How it works
Hair transplantation	Scalp areas with good hair growth are removed and transplanted to scalp areas that need hair.
Scalp reduction	Bald scalp is surgically removed and hair-bearing scalp is pulled closer together to reduce bald areas. Can be performed alone or together with a hair transplant.
Scalp expansion	Devices are inserted under the scalp for about 3 to 4 weeks to stretch the skin. May be performed before a scalp reduction procedure to make the scalp more lax or performed only to stretch hair-bearing areas.
Scalp flaps	A hair-bearing piece of scalp is surgically removed and placed in a bald area.
Laser devices	Brushes, combs, and other hand-held devices that emit laser light intended to stimulate hair growth. Clinical studies have shown low-level laser to be safe and effective in promoting growth and treating hair loss in both men and women. Currently, there are only a couple of devices on the market that have been granted FDA approval.

 

 Self-care tips during periods of hair loss

• Apply sunscreen to the exposed, bald areas.
• Wear eyeglasses or sunglasses to protect the eyes from excessive sun and from dust and debris when eyebrows or eyelashes are missing.
• Wear wigs, caps, or scarves to protect the scalp from sun exposure and keep the head warm.
• When nostril hair is missing, apply antibiotic ointment inside the nostrils to keep them moisturized and protect against germs entering the nose.
• Apply hair-colored powder, cream, or crayon to small patches of hair loss to make the hair loss less obvious.
• Apply eyebrow pencil to replace missing eyebrows.

 

Written by Laurie LaRusso, MS, ELS