The pull test helps to evaluate diffuse scalp hair loss. Gentle traction is exerted on a group of hairs (about 40–60) on three different areas of the scalp. The number of extracted hairs is counted and examined under a microscope. Normally, fewer than three hairs per area should come out with each pull. If more than ten hairs are obtained, the pull test is considered positive.[27]

Fashionista: What causes female hair to thin? Candace Hoffmann: There can be a number of reasons women lose hair. Female pattern hair loss (androgenetic alopecia) is the most common. How do you know if this might be the reason for your hair loss? Look around at your family. If you have parents, relatives with thinning hair or who are frankly bald --male or female--there is a good chance you could have the propensity as well. That being said, for women, it’s not so cut and dry. Men can easily discern such a connection, women can have multiple reasons for hair loss--sometimes, it's temporary hair loss (telogen effluvium). Here are some common reasons for hair loss in women that are not genetic:

Senescent thinning was indistinguishable from androgenetic alopecia in older males. Inflammatory changes were not a significant feature. Biochemical analysis for androgen receptors, 5 -reductase type 1 and 2, and aromatase, in scalp biopsies from older males showed nearly a two fold decrease in levels compared to levels in young males with Androgenetic Alopecia.


Less common causes of hair loss without inflammation or scarring include the pulling out of hair, certain medications including chemotherapy, HIV/AIDS, hypothyroidism, and malnutrition including iron deficiency.[2][3] Causes of hair loss that occurs with scarring or inflammation include fungal infection, lupus erythematosus, radiation therapy, and sarcoidosis.[2][3] Diagnosis of hair loss is partly based on the areas affected.[3]

Hair transplantation is usually carried out under local anaesthetic. A surgeon will move healthy hair from the back and sides of the head to areas of thinning. The procedure can take between four and eight hours, and additional sessions can be carried out to make hair even thicker. Transplanted hair falls out within a few weeks, but regrows permanently within months. Hair transplants, takes tiny plugs of skin, each which contains a few hairs, and implants the plugs into bald sections. The plugs are generally taken from the back or sides of the scalp. Several transplant sessions may be necessary.[33]


Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks.
The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.
In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus." 

Though not as common as the loss of hair on the head, chemotherapy, hormone imbalance, forms of hair loss, and other factors can also cause loss of hair in the eyebrows. Loss of growth in the outer one third of the eyebrow is often associated with hypothyroidism. Artificial eyebrows are available to replace missing eyebrows or to cover patchy eyebrows. Eyebrow embroidery is another option which involves the use of a blade to add pigment to the eyebrows. This gives a natural 3D look for those who are worried about an artificial look and it lasts for two years. Micropigmentation (permanent makeup tattooing) is also available for those who want the look to be permanent. 

Traction Alopecia causes hair loss by placing constant, excessive tension on the hair shafts, often due to overuse of hair extensions, tight braids or weaves. The hair follicles become damaged, leading to hair loss generally centred around the hairline and temples, with only fine or ‘fluffy’ hairs left behind. If the cause of the Traction Alopecia is concentrated in one specific location, for example a heavy hairpiece or ponytail extension, the condition can also cause patchy hair loss in those specific areas. Due to the nature of this condition being related to damage caused by hair styling, Traction Alopecia mainly affects women, although it is also common in men who wear their hair in cornrows.
It can be a horrible situation to be in, but sometimes, you can look at situations like this as a little trigger for change. I've known women who've had long hair all their life, it started to change as they go through the menopause, and they've ended up having their hair cut short. And sometimes, it can make them look so much younger. So, you know, look at these situations, too, and look at ways in which you can make yourself more comfortable with what's actually happening with you.  
Hi Will. I have a question regarding on my hair loss problem. Currently, I’m still on my 19 but I already have that M-shaped on my hairline which is really absurd and devastating for me. I met a doctor one month ago and he prescribed me with ketoconazole shampoo. The result is quite impressive as my hair didn’t feel itchy anymore. The thing is, the hair on my hairline is still not growing as much as the other parts of my head but the fine hair didn’t fall out. Is it going to be like that or is there anything that I should consider to make it grow back?
Hypothyroidism (an under-active thyroid) and the side effects of its related medications can cause hair loss, typically frontal, which is particularly associated with thinning of the outer third of the eyebrows (also seen with syphilis). Hyperthyroidism (an over-active thyroid) can also cause hair loss, which is parietal rather than frontal.[23][unreliable medical source?]

Laser therapy is another option available to young men and women who are experiencing hair loss. A state-of-the-art helmet is worn on top of the head. Inside the helmet are 80 low-level lasers, which help stimulate hair growth. While this may seem like something straight out of a science-fiction novel, laser therapy is showing promising results for many hair loss patients.
Tightly pulling back your hair in ponytails, cornrows or braids can lead to traction alopecia, characterized by hair breakage along the hairline and temples. Women athletes who often wear their hair pulled back are particularly at risk. A change in hairstyle usually helps; however, hair loss may be permanent if the tight styling techniques have been used too long.
FPHL is very common and increases with age and varies across ethnic groups. Although it can happen at any age, the condition occurs most commonly following the menopause. This does not mean that hormones alone are to blame, although oestrogen may have a protective role, helping to keep hair in the ‘growing phase’. Age itself is a factor and whilst women can take care of their hair cosmetically, it is one aspect of the ageing process we cannot always control. Genetics are important too and you may notice a family link with both male and female hair loss. Occasionally times of acute stress on the body will influence hair growth, eg illness, emotional stresses and crash dieting. Some medications may have an influence too.

It's important that you keep a lookout for these signs so that you'll be able to spot hair loss before you lose most of your hair. The good news is that there are a number of treatment plans available that can stop and, in some cases, even reverse hair loss. Creating a regimen filled with healthy foods, biotin supplements, and clinically-tested medicines like minoxidil and finasteride could be your best bet for stopping hair loss.
Hair grows in three different cycles: anagen, catagen, and telogen. About 90% of the hair on the head is in the anagen, or growth phase, which lasts anywhere from two to eight years. The catagen, or transition phase, typically lasts 2-3 weeks, during which the hair follicle shrinks. During the telogen cycle, which lasts around two to four months, the hair rests.
One of the first signs of hair loss in women occurs at the parting; this may start to appear wider than usual, with more scalp becoming visible. Another frequently seen symptom is hair thinning at the temples, which can be especially noticeable when the hair is worn up or pushed back off the face. This does not cause a receding hairline in the same way that men often experience it, rather it causes thinning hair on one or both sides but without baldness developing.
The VS model discussed her ongoing struggle with the disorder via Instagram saying, 'Mine started when I was around 15yo! It started with me pulling on my eyelashes and almost quick after it went to me pulling in my eyebrow hair! I no longer pull on my eyelashes and have been pulling on my eyebrows ever since! The episodes are worse under a lot of stress or when I'm not doing anything like watching tv or reading a book!'
It’s important to keep your stress levels in check to prevent a hormonal imbalance. Reduced estrogen production can affect your brain chemistry and cause mood swings, anxiety, and depression. However, doing yoga and other breathing relaxation methods are especially effective in fighting menopausal symptoms. Exercising regularly can also help reduce stress.
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If follicles receive the necessary stimulus and nutrients from the body, it can stabilize hair loss during menopause and strengthen existing hair growth. This is why it’s important to nourish thinning hair follicles with the right nutrients, including marine extracts, vitamins (including B vitamins such as Biotin and Niacin) and minerals (such as Zinc), to promote hair growth during menopause. A good diet, as well as a nourishing shampoo and conditioner that is gentle on dry, aging hair, are top tips for how to treat menopause-related hair loss.

While hair loss can happen for a wide variety of reasons, the most likely culprit is something called androgenic alopecia, better known as male pattern baldness. Contrary to the locker room tall tales you’ve probably heard, your hair won’t thin because you’ve worn a baseball cap everyday for a year straight, or because you use hair gel to style your hair. Male pattern baldness is solely due to genetics and male sex hormones.

Hey everyone, now I know “I am not my hair” (we all know how India sang it, lol), but I sure don’t want to lose it!  Some of us have issues with areas of thinning hair – I am no exception to that!  I have had thinner hair in my temple area for as long as I can remember having hair.  In my case, it’s hereditary (says the family dermatologist), however, I am sure that my lack of knowledge concerning the treatment and management of my hair over the years has contributed to this minor setback.  Many of us who have experienced hair loss in the temple area have reached this point due to a number of activities.  Thus the following list comes into play:
In men, finasteride (originally marketed as Proscar) is approved for hair loss associated with androgens. In one study, 62% of women also taking oral contraceptives containing the synthetic progestin drospirenone reported improvement. So it may be effective for female hair loss in the setting of increased androgen. But studies are limited and it is harmful to the male fetus so should not be used by women thinking about becoming pregnant or who are pregnant.
Female hair loss is one of those beauty topics that's swept under the carpet more often than not. Why? I'm not so sure, because I have lots of friends, acquaintances and family members that have dealt with it. An old colleague started losing her hair at age 22, only to be half-bald by 27, while another friend started losing big chunks of her locks when a close family member passed away.
Hair loss before, during or after menopause -- as well as after childbirth -- is commonly attributed to hormonal changes. And while most physicians agree that replacing these hormones can alleviate many of the other troubling symptoms of menopause, unfortunately, hormone replacement alone does not seem to radically alter a woman's "follicular fate," and can even sometimes make matters worse.
It's a massive self-esteem destroyer, I know I'm guilty of isolating myself from friends when I'm feeling especially vulnerable, turning down nights out and otherwise enjoyable social events. It's a vicious cycle, you feel depressed, you lose your hair. You've lost your hair, so you feel depressed. I've been suicidal over it before, no doubt about that.
Ahh this is so helpful and it makes a lot of sense! Thank you so much for this! I’ll definitely take all this on board! Honestly since my hair started thinning a few months ago I’ve been so panicked and confused as to why it was happening. I’m quite vain and I’ve always loved my hair so I’ve been really worried about keeping my curly locks! My friend actually recommended getting a wig made. Apparently you can have small pieces and extensions to cover up certain thinning parts of your hair without losing all your hair (and I’m definitely leaning towards this option). I read about a company called Optima Hair (they’re located near where I live), has anyone else used them? They look good but I don’t know much about it if I’m honest so I’d appreciate any advice or recommendations people could give me! x
Clearly, minoxidil is not a miracle drug. While it can produce some new growth of fine hair in some — not all — women, it can't restore the full density of the lost hair. It's not a quick fix, either for hair loss in women . You won't see results until you use the drug for at least two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you'll need to keep using it to maintain those results. If you stop, you'll start to lose hair again.
Fusco says that if your family has a history of androgenetic alopecia or thinning hair, you should make an appointment with your dermatologist and discuss the best prevention or treatment methods. Some of them will require routine check ins. Additionally, “maintain a healthy diet and proper hair and scalp hygiene to keep the existing hair healthy,” she says. (Try a hair-strengthening shampoo like Brickell for Men’s. Starting a supplement like Nutrafol for Men, plus annual visits to the dermatologist will be most beneficial in slowing or delaying the onset of alopecia.
However, both men and women are able to use the MHRA licensed and FDA-approved minoxidil – a dose-dependent drug which is applied topically to the scalp where needed to promote hair growth. Various formulations of high strength minoxidil are available for men and women and can form part of a targeted treatment course aimed at stopping shedding and encouraging regrowth.
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