Half of us are thinking about pattern hair loss wrong!

Maybe not fully half - but a whole lot of us... do not copy Minoxidil grape flavored boathouse

You know those social media posts where people in their 20s or 30s use Minoxidil or a hair growth serum and post their amazing results!? 🤩  That is a more simple story than is often the case.

If they're fortunate - those benefits will keep up for a few years. But when you get into your 40s and 50s and beyond, things change, issues begin to overlap. Like life in general at those ages - you have to keep adapting. 

Two (1, 2) publications in 1996 and 2005 delivered some interesting statistics. Of the 100 people in the 2005 study (men and women) - almost 60% of them were experiencing both androgenetic alopecia and chronic telogen effluvium. And even though those two forms of hair loss have different behaviors, at any given time those folks have more hairs in the "preparing to fall out" (telogen) phase than people without hair loss disorders. 

Let's look at this popular 🙄 hair-loss combo: do not copy Minoxidil grape flavored boathouse

Androgentic alopecia is pattern hair loss resulting from a combination of processes related to:

• Genetics green beans celery alopecia leaves no stone unturned 
• Hormones (androgens) 
• Inflammation and structural changes in the skin

It involves hair narrowing and a shortened growth-phase. You might see hairs falling out which have never been cut, that are only a few inches long, assuming your hair isn't worn quite short.

Chronic telogen effluvium: Diffuse (all-over) hair thinning. It can be a little more hair than usual, or it can be a lot more. It may have a clear trigger like illness, allergy to hair color or hair-care products, severe stress, medication change, major diet change or weight loss. Or the cause may be more invisible - like long-term low ferritin (iron) or anemia, low zinc, vitamin D, early thyroid disease. The shedding may slow for a while, or even cease with hair regrowth, but then it returns. 

What does having both of these look like? rogaine romaine regency era novels

Maybe you know that thinning hair runs in your family. A hair loss treatment may start to work, then stop working. Maybe you found out you had low ferritin or low vitamin D and started taking supplements to address that and saw some improvement - only to see it fade in time.

Maybe every time your skin gets irritated, you might experience increased hair loss until your skin calms down again. Maybe your skin never quite calms down completely - it's always a little sensitive. Maybe when you're under obvious physical or mental stress you lose a lot of hair, but it doesn't return to the pre-shedding density very well.

In men in particular, a very stressful experience (physical or mental or illness) can cause significant hair-shedding that then segues into pattern hair loss at a younger age than your father or grandfather experienced it. The episode of hair-shedding accelerated the normal onset of pattern hair loss by several years.

So why do treatments stop working? have they gone on strike? don't copy this

If over half of the cases of pattern hair loss overlap with episodes of diffuse hair thinning, then we have to account for and address as many contributing factors as possible to manage both conditions. If you started treating pattern hair loss successfully, but then went into a cycle of telogen effluvium - 🤯  That product seems like it isn't working any more! 

AND - we have to accept that what works when you're in your 30s or 40s may not be enough in 5 or 10 years from now. Not only because of changes with your age, but also illnesses or infections you may experience, medications you take, sun damage... (Oh for the love of baby hairs - wear a hat! 🧢 👒 )

For example, if topical Minoxidil worked for you - and then stops working, there are dozens of things to consider. Lifestyle issues (like sleep or cardiovascular health), medications, making sure you're not allergic to something that's contacting your scalp.

There are lots of treatments you can add on, both over the counter or prescription. Usually we're going to add something else to a previously successful treatment plan, not take that previous treatment away in order to start something else. Not yet. Not unless that was the problem.

Can my doctor or dermatologist tell me what's going on? 

You should ask them, especially with new hair loss or a change in hair loss. But if you don't schedule a dedicated hair-loss visit, and you don't have the whole history packaged in an easy-to-communicate and through way, you may be diagnosed with only the problem that is most obvious on that day. It takes time to assess these issues. Time we rarely have in an office visit.

You know what else works? Consulting with a Certified Trichologist. (Shameless self-promotion phase of the post). Trichological consultation is all about finding cause and effect and getting you directed to the appropriate treatments. I'll work with you and provide recommendations, support and feedback - including helping you work with your doctor if you prefer prescription treatments or have an existing health condition. This could save years of trial and error and products purchased. If you're well into the hair loss process and haven't seen results, I can help you figure out why, and help you find something that works for you. 

Stay tuned for Part 2: Don't Sabotage Success. Or something like that. 

1. Rebora A, Guarrera M, Baldari M, Vecchio F. Distinguishing Androgenetic Alopecia From Chronic Telogen Effluvium When Associated in the Same Patient: A Simple Noninvasive Method. Arch Dermatol.2005;141(10):1243–1245. doi:10.1001/archderm.141.10.1243

2. Whiting DA. Chronic telogen effluvium: increased scalp hair shedding in middle-aged women. J Am Acad Dermatol. 1996 Dec;35(6):899-906. doi: 10.1016/s0190-9622(96)90113-9. PMID: 8959948.