Treatment of Female Pattern Hair Loss Case Report – Spironolactone and Minoxidil

by Y on October 17, 2007

Treatment of Female Pattern Hair Loss With A Combination of Spironolactone and Minoxidil I want to thank Kate for emailing me this Case Report about the use of spironolactone and minoxidil in treating female pattern hair loss. The Case Report appeared in the Australasian Journal of Dermatology Volume 48 Issue 1 Page 43-45, February 2007

CASE REPORT

Treatment of female pattern hair loss with a combination of spironolactone and minoxidil

Carlijn Hoedemaker, Sylvia van Egmond and Rodney Sinclair

Department of Dermatology, St Vincent’s Hospital, University of Melbourne, and Department of Medicine and Skin and Cancer Foundation, Melbourne, Victoria, Australia

Summary

A 53-year-old woman with clinical evidence of female pattern hair loss and histological evidence of androgenetic alopecia was initially treated with the oral antiandrogen spironolactone 200 mg daily. Serial scalp photography documented hair regrowth at 12 months; however, the hair regrowth plateaued, and at 24 months there had been no further improvement in hair density. Twice daily therapy with topical minoxidil 5% solution was then introduced and further regrowth documented, confirming the additive effect of combination therapy.

Introduction

Female pattern hair loss is a common, psychologically distressing, age-related, androgen-mediated condition that presents with increased hair shedding and reduction in hair volume over the mid-frontal scalp.1

Binding of dihydrotestosterone to cellular androgen receptors induces susceptible scalp hairs to undergo a progressive and orderly transition from terminal to vellus hairs to produce patterned baldness. Antiandrogen therapy with either spironolactone or cyproterone acetate is commonly used to treat FPHL, as is topical minoxidil.2 The mechanism of action of minoxidil is unknown, but does not involve androgen pathways.3 The use of topical minoxidil together with an oral antiandrogen might have an additive effect; however, combination therapy has not been previously reported. [click to continue…]

{ 19 comments }

Hair Loss Has Won Today

by Y on October 16, 2007

Hair Loss Has Won TodayIn the ever constant battle I have with my hair loss I strive to be victorious and triumph over all that it has seemed to take away from me. Some days I feel I am a clear winner and remain productive, pushing the obsessive hair loss thoughts aside, tying what’s left of my hair back, and walking out the door to get on with my life. Other days I feel like I got kicked in the head by godzilla’s foot. Obviously since I’m writing this today, it is clear that today is one of those kicked to the head days and my hair loss has got the best of me… for this moment anyways.

What frustrates me is that I try so hard to move on, but I’m constantly reminded that I have so little hair on my head. I just got done doing a pretty decent session of cardio. I ran on the treadmill for 60 minutes, hoping the run would clear my mind and help me to be more positive today. But… it’s hard to enjoy the run when the sweat rolls straight down my head and I can feel it all over, itching every part of my scalp. When I had all my hair this wasn’t a problem, the hair would just absorb the sweat. In the absence of my former tresses I now am confronted with pools of sweat soaking what’s left of my hair and rolling down into my eyes, into my ears…. everywhere. I manage to get through all of that, constantly patting my face and head with a towel. I then go to my room to change, and there in the mirror I see the reflection of disaster staring back. My soaked head has a million streaked gaps of bald scalp showing threw my very fine hair. It was just awful.

Sometimes it feels like no matter what I do, I end up getting pulled back down and receive a forceful reminder that I’m losing my hair and things will never be the same.

I’ve had these emotional ups and downs long enough to know that there will be better days ahead, I will not give up. I will continue to fight to reclaim myself because…

I am not my hair
I am not my hair
I am not my hair
I am not my hair

{ 10 comments }

Talking’ Bout Bald Girls – Article In Star Magazine

by Y on October 15, 2007

Talking' Bout Bald Girls - Article in Star MagazineI was at the grocery store yesterday when a magazine caught my eye. It is this month’s Star Magazine. It has a big title sprawled across the cover, “Hollywood Stylists Tell All!” and beneath it with a nice pink asterisk, it says “Who’s really bald.” Obviously I wasn’t going to make it out of the grocery store without this new item in tow, nor could I wait to paw through the pages until I came across the section it made reference to on the cover. It said “Talking’ Bout Bald Girls” and has 3 images of the heads of celebrities, Nichole Richie, Kate Beckinsale, and Lindsay Lohan.

I have to say that image of Kate Beckinsale isn’t new, I saw it a long time ago online. What the magazine is touting as “bald girls” is hardly the truth. Nichole Ritche may have some slight thinning on the hairline from the extensions, but even with a magnifying glass I couldn’t find the “noticeable bald spot” that the article stated existed and even had pointed to with a white arrow. Obviously I don’t know her and maybe there is truth to it, but you can’t tell from this image. Kate Beckinsale has a tiny little thin round area, very slight, very mild and again doesn’t warrant the title of “bald girl.” Lindsay Lohan got caught with her extensions showing, that’s how her head got landed on this page. An insider talked to Star and stated that she “is hiding her overprocessed hair” and that “the beautiful, shiny hair you see is not her own. It’s definitely extensions.”

On a different page there is an image of Jennifer Lopez with arrows pointing to different parts of her body. The one I found interesting is the arrow to the hair. I never knew that Jennifer Lopez wore hair, I just thought she was really lucky to be blessed with such gorgeous locks. The title is “Her Hair Does Cost A Thing.” It says “Don’t be fooled by the hair that she’s got! The source says that J.Lo sometimes wears wigs and that her actual hair barely touches her shoulders. And those big buns she wears? They’re add-ons!”

News to me. And yes, I’m guilty of buying Star magazine 🙂

{ 6 comments }

Jeni’s Hair Loss Story

by Y on October 14, 2007

Jeni runs a great blog on beauty and skincare called “Savvy Skin” and has contributed several comments on The Women’s Hair Loss Project. Now she is sharing her story. Here it is:

I’m 28, and I used to have really thick curly hair up until recently, and now I have probably half as much hair as before. I first started noticing that my part was really thinning back in September and I freaked out. After doing research, I first assumed that it was from the pill (ortho tri-cyclen) and I stopped taking it shortly after. I had been off and on it for over 10 years, but never really noticed any hair thinning before, or even the few times I went off it. I always lose a ton of hair (people always comment about my hair falling out all over the place), and I guess my hair has decreased over the years, but I never saw any baldness before Sept. My dad’s hair is thin on top, and my mom’s hair is thin now (but she has diabetes, is hypothyroid, takes a lot of medications, and eats terribly, so I don’t know if hers is AGA).

I first went to a dermatologist who said it could be AGA but couldn’t tell, and he just recommended Nizoral since he saw dandruff. Then I went to a general doctor who had no idea about anything, but she determined I was depressed, and suggested anti-depressants. I actually was really depressed (even before the hair loss), so I started taking anti-depressants, even though I was afraid it could make my hair worse. She claimed my hair loss was probably just because I was depressed and that it would grow back. I asked for all the various blood tests, and everything appeared normal. I started using Nioxin shampoo, Nizoral weekly, started taking a better multi-vitamin, attempted to eat better, including more iron and protein. For several months I‚ve also been taking Evening Primrose Oil, Vitamin C, Vitamin E, Iron, & Flaxseed on my food.

Things not getting better, I saw Dermatologist Dr. Richard Strick at UCLA in Los Angeles because he supposedly specializes in hair loss. He looked at my scalp and said I definitely have TE (telogen effluvium) and that things should just get better eventually. He said I could use Rogaine to speed up the regrowth, or just wait it out. He seemed pretty sure of himself and didn’t suggest anything else. The cause of the TE remained elusive.

A few months had passed and it was time for a visit to the endocrinologist because now I was sure I had a low thyroid [click to continue…]

{ 54 comments }

Just Noticed Hair Loss, Could It Be Nuva Ring Birth Control?

by Y on October 13, 2007

Hair Loss From Nuva RingI have noticed thinning of my hair around the crown over the past couple of months. I think I understand some or all of the contributing factors, but now I don’t know what to do to try and stop it. I had been on OrthoEvra (the patch birth control) for a few months, stopped it because it was giving me horrible anxiety, went on the Nuva Ring for the past three months, and finally decided today that the anxiety has returned as well as headaches, sleeplessness, and now hair loss. I didn’t know until I read things on this site that stopping the birth control might result in the hair loss getting worse, but I really don’t think I can continue on it because of the emotional/mood swing effects it has on me. I’m 30, and have had one child
(5+ years ago). I wonder if I can wait out the next 6 mos. while the birth control leaves my system and my hormones return to normal. I wonder if I should try Rogaine NOW, before it gets any worse (it’s really minor, but it’s starting to be noticeable enough that I try to style my hair over the thinning area or pull it back). I wonder if I should go back on birth control but I really shouldn’t do that. I wonder if this is permanent. HELP!

********************************

Hi, thanks for writing. I always say this at the beginning of my responses to emails so that there is no misunderstanding. I am not a doctor and cannot give medical advice, this is just my thoughts and opinions.

I did some searches in Google for “Nuva Ring and hair loss” and there are several cases of women who are experiencing the same thing as you. Since it is birth control, it does alter your own hormones, and anything that does that can cause hair loss. But you should realize everyone responds differently to the effects of the pill. For some women going on the pill can cause hair loss, which seems to be your case, and for others the hair loss begins when they discontinue the use. It sounds like you already made the choice to get off the pill and are currently not taking it due to the many unpleasant side effects you were experiencing. In my opinion that was definitely a good decision.

I think it is too early to tell whether or not your hair loss will simply be a temporary shedding or the onset of androgenetic alopecia. It would probably be a good idea to consult a knowledgeable physician in this matter. Experienced doctors can tell whether or not the hair follicle is miniturizing which is usually an indication of female pattern baldness. But it is very possible this will just be a temporary shedding (telogen effluvium) similar to the hair loss many women experience after having a baby. As mentioned in my response to Sarah’s story, I actually met a woman who had hair loss from going on the pill, she stopped taking it an told me eventually all her hair grew back. It all depends on the individual. [click to continue…]

{ 105 comments }

Purchased A Few Wigs On Ebay – What A Disaster!

by Y on October 12, 2007

Purchased A Few Wigs On Ebay - What A Disaster!So a few weeks back I purchased two wigs (synthetic) on ebay. A week after that I purchased another one (supposedly human hair). I was hesitant to make online purchases of wigs for obvious reasons. One, I didn’t have the ability to see the quality of hair or thickness of the cap, and Two, I wasn’t able to try the hair on first. But I went ahead anyways with eyes wide open, knowing that I may end up getting a bag or rocks in the mail… or worst nothing, or worse what I got in the mail… Horrible wigs. I should mention the wigs are quite photogenic and take a much better picture than they actually look like in person. I couldn’t help myself, I had to throw it on my dog and take a picture. He looks much better in it than I did.

My first set of wigs arrived promptly and I anxiously ran out the door to pick up the package like a little girl on Christmas morning…tearing at the box to get to the inside. I open it and was shocked at what stared back at me, it looked like rubber hair. I have no idea what the wigs were treated with, perhaps a preservative or maybe it was the dye used, but I was horribly allergic to it and instantly started sneezing, the watery eyes followed suit. There I was, standing with rubber hair on my head, a cap so thick it felt like 3 baseball caps and an allergy attack. What a disappointment! I would have preferred the bag of rocks. 🙂 My fiance was very sweet and didn’t make any initial reaction to my rubber hair cap, he was just silent. As soon as I screamed in horror after seeing my reflection in the mirror he was quick to jump in and casually mention that they weren’t very good quality. Not being good quality is an understatement. My childhood cabbage patch doll had better hair.

The next wig (human hair.. yeah right) arrived the following week. At least I wasn’t allergic to it, but still poorly made, so now I have 3 wigs that cannot be worn and will never see the light of day. Thank goodness for that. I am not discouraged though, it was a big step for me to order them and to try at least start thinking about wigs as a possibility. After this experience, I definitely think wigs are something that have to be seen and tried on in person. Very important. There are several large wig retailers in my area so perhaps I’ll get up the courage to visit one soon. I’ll keep you guys updated.

{ 22 comments }

Hair Loss at The Age of 20 – Veronica’s Hair Loss Story

by Y on October 11, 2007

Hair Loss At The Age Of 20 - Veronica's Hair Loss StoryWow, I’m so happy I just found this site…I’m 20 years old, have had been genetic hair loss for four years now. About 2 years ago I had a biopsy done and my derm told me it was probably genetic, he put me on Rogaine, Spiro and Yasmin. I was on those meds for about a year… and they did absolutely nothing. Last year in the fall my hair loss was getting really bad and I was getting so desperate for something, so I spent over $1000 on getting Invisible Hair extensions. I was assured by so many people that they would be safe, and definitely the perfect solution. The extensions were great! I loved having so much hair and planned on having the extensions put back in. Well when I got them removed for the first time I was SO devastated, more than half of my already thin hair was gone.

Its been since January now since I’ve had them out and I feel like I’ve hit the bottom. I’m in college and can’t concentrate on anything. I’m always way too focused on everyone else’s hair and I feel like I’ll never feel normal again…I haven’t been able to wear my hair down since I got the extensions taken out. My poor hair is
still falling out like crazy… it’s so thin I can’t even wear it in a ponytail, I feel like I will be bald soon.

I’m so scared, nobody seems to understand. My best friend and my family just tells me to cope with it like its no big deal. I feel like I have no where to turn. That’s why I was so glad I found this forum…I really sometimes feel like I’m the only one experiencing this and it’s comforting to hear everyone’s story. I’m not sure what to do with myself, I hate going out, even going to school because I just feel so ashamed…I don’t even know where to start looking for a wig around here (I’m from Portland, OR). And I feel like seeing another doctor would also be pointless. Anyways, Thanks a lot for listening to my story.

~Veronica

*******************************************************

Dear Veronica,

Thank you for writing and sharing your story, I’m so sorry you are having to go through this. It probably is of mild comfort, but know you definitely are not alone and there are A LOT of women who start to lose their hair at young age. Who knew? I definitely didn’t until I started going through it. Here comes my usual disclaimer I provide on every question I respond to. I am not a doctor and cannot provide medical advice or treatment, this is just my opinion. Ok…

After reading your story I have so many questions. Did your dermatologist put you on Rogaine, Spiro and Yasmin all at the same time? You said you are 20 and have been experiencing hair loss for 4 years, so you started losing your hair at 16 and saw your doctor at 18. Did he provide any explanation as to what might have trigged your hair loss at such a young age? You stated that after a year the medications did nothing, but you didn’t say whether or not you stayed on them or took yourself off. I’m curious because if you took yourself off after a year and the following year noticed a rapid decline in your hair, then perhaps the drugs were doing more than you thought. Sometimes all the drugs can do is slow the hair loss process down and help you maintain the hair you have,. Not all women experience a phenomenal regrowth after treatment. Even after I started treatment, I never regained the hair I had and was pretty convinced the treatments weren’t working so I eventually took myself off of aldactone around 2003… I think. The dates get fuzzy. Anyways, my hair loss increased dramatically. That could have just been from getting off the drug and it may have re-stablized eventually, but that scared me enough to get back on. Not only did I get back on aldactone, but when I got back on, I had my dose increased from 100mg to 200mg a day.

If you would have asked me then about my hair, I would have complained about the hair I once had and that it was so thin and continuing to fall out. But looking back it was doing fairly well after the 200mg increase. [click to continue…]

{ 49 comments }

Know Of a Great Women’s Hair Loss Doctor? Fave Them!

by Y on October 10, 2007

Know Of A Great Women's Hair Loss Doctor? Fave Them!I have received numerous emails from women who want to know if I know of any good hair loss doctors in their area. Unfortunately I don’t, but I think there are probably plenty of women who have found doctors they trust and believe are truly helping and listening to them. So I’ve decided to give women the opportunity to recommend their doctor should they wish to do so. I’m calling it “Fave Your Doctor” and you’ll notice I added a little button in the side bar.

What makes a good hair loss doctor? In my opinion I’d start with a doctor that doesn’t dismiss your complaints of hair loss and doesn’t demean the emotional implications it is having on your life. What else? Let’s see, a doctor that routinely treats women’s hair loss and has a lot of experience with the causes and appropriate treatments. A doctor that listens to your concerns about the recommended treatments and answers all your questions, providing you all your feasible options as well as explaining any possible side effect of those options. In my opinion the doctor should definitely order the necessary bloodwork to help diagnosis the cause of your hair loss.

You know when you see a doctor whether or not they are good, and you know when you have the itching urge to run out of the office screaming your head off because you simply can’t be heard. There are a bunch or qualities that make up a good doctor. I place a high importance on a good bedside manner because when you suffer with hair loss you feel so vulnerable and are reaching out for help, I want that vulnerability to be received with care and not with a stern “well it’s just hair loss, it’s not going to kill you.”

How does fave your doctor work?

It’s pretty simple. If you’ve had a good experience with a particular physician and think that he/she would be a great resource to recommend to another woman, please fill out the form here. Or click on this button from the sidebar Fave Your Doctor?Hopefully I’ll be able to compile a good size list of different doctors who treat women’s hair loss located throughout the county and in other countries as well.

I’d like to take it one step further, so in the form I’m asking if you would allow for another woman from our site to contact you via email to learn more about your experience. Either way, your email will not be published, and I completely respect your privacy should you not wish to be contacted. [click to continue…]

{ 1 comment }

Beauty Behind The Hair – Video of Women Who Shaved Their Head

by Y on October 9, 2007

This is a short one minute video I found on youtube of a few different women who have shaved their head. I don’t think they did it for hair loss, but still they all look great with their new bare scalps. I often look online for images of other women who’ve taken the plunge for whatever reason, to hopefully get the strength and motivation to do it myself.

Check it out:

{ 1 comment }

Female Pattern Balding – Hair Loss Story

by Y on October 8, 2007

I did not notice hair falling out, it just stopped growing and the dermatologist said it was female patter baldness and nothing could be done. I had take Prempro for 11 years without a missed day – per GYN to stop my periods. I was 50 at the time. Went through an extremely stressful divorce and work situation. I noticed the balding when I was about 59, and it has gotten worse…..my scalp showed through no matter how I tried to cover it. Since I was told I was not a good candidate for transplants, I got an epiphany. I went to a women who does permanent make-up and had her tattoo the areas (with a sort of light brown – I am blond) that aways showed through. It works quite well, but is very expensive and takes a long time to do. I had about 5 sessions of 1 – 2 hours. I was able to get novacaine after the first two-hour session, so the pain was managed. I still have some areas to cover, but it is a great improvement.There is no hair loss like this on either side of my family. I have taken some of the medications listed that cause hair loss, but what can you do if you need them? I am now 70 and hate my very thin hair, which used to be one of my best features.

*************

Hi –

Thanks for writing, I realize hair loss at any age is distressing, but I have to say you are so fortunate to have spent the majority of your life with hair and not dealing with the massive shedding and hair loss that many very young women experience today. For myself, I basically spent my entire 20’s in partial seclusion, feeling very sad and depressed, feeling like I’ve lost who I was… my identity. I wrote in the past post, “Hair Loss, Hair Loss Everywhere – What’s in the water?” that I would seal that deal immediately if I was told I could have all my hair back and then at 50 it would all fall out and I’d definitely do it for 60, even better. That would mean I’d get to have 31 more years of peace, of happiness, being out there and enjoying my youth. I feel I’m letting that slip away, losing my hair 8 years ago did that to me, but I work on myself all the time and trying to get past the whole idea of ” I am not my hair” and just trying to be positive.

Please understand I am not at all dismissing your concerns and I really do understand hair loss and how it would affect anyone who becomes afflicted with it, but I thought I would point out how fortunate you have been. Your tattoo idea was extremely creative, and I’m glad to hear you are happy with the results, but there also are less invasive ways to conceal the scalp. There are several products are on the market today that are actually a sort head make up that serve as a scalp cosmetic concealer. Two that I am aware of our DermMatch and Toppik. DermMatch and Toppik Scalp Cosmetic Concealer

Also, you are right when you talk about some of the drugs listed on the “drugs that cause hair loss” list, what can one really do when they have to take a certain medication? It is also important to note that while these drugs can cause hair loss, they are not necessarily the cause of hair loss for a lot of women. I am sure there are plenty of women and men who take these medications without experiencing hair loss as a side effect. So it doesn’t necessarily mean that since you took some of the drugs listed that that is what spawned your female pattern baldness.

A lot of women begin to experience hair loss for the first time post menopause. [click to continue…]

{ 6 comments }

← Previous Entries

Next Entries →