About Hair Loss

“Androgenetic alopecia” is the medical term for genetic hair loss commonly seen in men and woman as they age. Both sides of an individual’s family play into the genetic and hormonal makeup of the individual hair and how one will experience hair loss. 

Androgenetic alopecia typically affects 50% of people — both men and women — by the age of 50. Male pattern alopecia is typically characterized by thinning hair in the temples and the crown, while female pattern alopecia typically affects the front and top of scalp.

Hair Loss Treatment 

All individuals will have some variability in their response to hair loss treatment. The best improvement is achieved using a combination of modalities: oral, topical, and lights. Combining hair loss treatments that help promote hair growth as well as to help decrease hair loss is also the best choice. For all treatments, improvement will be seen only while using them. This means that if you stop using them, your hair will gradually return to your genetically pre-determined state. Microneedling and injected treatments are typically done monthly over several months, then can be decreased to a maintenance program. However, oral and topical treatments will need to be used daily to maintain their effect.

Over-the-Counter Medications

Nutrafol® is a nutritional supplement designed to treat hair loss. It provides standard nutrients to encourage hair growth, as well as herbal-based ingredients to help fight inflammation and hormonal influences. Prenatal vitamins, B-complex, and Biotin are all nutrients that can help serve as building blocks for hair growth. In some studies, supplementing your diet with these has been shown to help increase hair growth. Supplements with iron will be better, but can cause constipation in some patients.

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Prescription Oral Medications

Minoxidil

Minoxidil* is used off-label for hair loss in men and women. Minoxidil works in multiple ways: 

  • Dilates blood vessels of the scalp to increase the availability of oxygen, nutrients, and growth factors to hair follicles
  • Reverses miniaturization of follicles 
  • Stimulates follicle movement from the resting to hair growth phase 

Propecia

Propecia® prevents the conversion of testosterone to dihydrotestosterone (DHT) in the body, thus blocking the hormonal effects on hair. It is used to treat men and post-menopausal women.

Viviscal Pro

Viviscal® Pro is a dietary supplement that nourishes thinning hair while also promoting existing hair growth from within. It focuses on restoring nutrients, vitamins, minerals, and protein to increase hair growth. Viviscal Pro increases the growing phase of hair follicles, promotes growth of existing hair that has slowed or stopped growing, and makes hair noticeably stronger, healthier, and more vibrant.

Spironolactone

Spironolactone is used off-label to decrease the process of female pattern hair loss. Spironolacton is a diuretic that was originally developed for the treatment of elevated blood pressure, but has antiandrogenic properties. This medication blocks the action of androgen by way of stopping dihydrotestosterone the form of testosterone that causes hair loss. Potassium levels need to be checked while taking this medication.

*Minoxidil was developed as a blood pressure medication. Because of this, we will need to check your baseline, and you will need to check your blood pressure each morning and night and then send it to us the first week. Minoxidil should not be combined with any other blood pressure or heart medications.

Over-the-Counter At-Home Topicals

Rogaine® is a topical version of minoxidil that was the first FDA-approved hair loss treatment brand for both men and women. It works by counteracting the effects of hereditary hair loss and revitalizing hair follicles. It increases the duration of the hair follicle growth phase, and will induce a new hair growth cycle, resulting in thicker and fuller hair.

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FAQ

When is the best time to begin hair loss treatment?

Can I use hair loss treatments while I’m pregnant?

When is the best time to begin hair loss treatment?

In general, at Grossman Dermatology in Santa Monica, hair loss treatment starting soon after hair loss has begun will get the best results. For men, beginning hair loss treatment as soon as hair loss is noticed is ideal. For women, the best time is when they enter menopause.

Can I use hair loss treatments while I’m pregnant?

The only medications and treatments that can be used while pregnant, trying to get to get pregnant, or breastfeeding are prenatal vitamins, B-vitamins/biotin, low lever-laser light (LLLT) therapy caps, and PRP treatments.

Prescription Topicals

KeraFactor® contains a proprietary KeraFactor peptide complex (KPC), which is unique in that it contains specifically selected proteins to help with hair and scalp health. These key ingredients help to promote stronger, smoother, thicker, and healthier hair growth. It can be applied directly to the scalp twice daily. Since minoxidil helps decrease hair loss and KeraFactor promotes healthy hair growth, the use of the two medications together is recommended.

MinoxiKare™ is a prescription-strength topical compound utilizing minoxidil and other hormones that can be used daily to decrease hair loss. It speeds up the hair growth cycle by prematurely putting your hair follicles into the anagen phase, causing hair follicles to quickly go through the resting and shedding phases before they start to regrow.

Cetirizine is an antihistamine medication that blocks the formation and accumulation of inflammation that occurs with different stressors and contributes to hair loss. By inhibiting the formation of inflammation with Cetrizine, we can decrease hair loss and help facilitate hair growth. Cetrizine is applied topically to the scalp daily and is shown to increase total hair density, especially of the thicker hairs on the scalp.

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“I have had a lot of doctors, and I have to tell you, Dr. Grossman is the best doctor I’ve ever had, heard of, or known in my entire life. That comes from my heart. She is thorough, she knows the best of everything, she is constantly learning, and is always at the top of her game. Rare indeed. And her attention to her patients is beyond. Just beyond.” 

Penelope B.

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Laser Cap

Laser Cap®’s low level LED light therapy (LLLT) is beneficial for hair loss in several different ways. LLLT causes vasodilatation, which in turn increases blood circulation. This delivers more oxygen and nutrients to the hair bulb, resulting in improved hair quality. In addition, LLLT stimulates the growth phase of the hair cycle to promote longer, healthier hair. LLLT can help decrease progression of hair loss if one begins treatment during the earlier stages of hair loss. There are several companies offering these devices. All devices require daily use, and will take 4-6 months to see improvement. The following devices all use 650nm diode lights:

  • KeraCap: 272 individual 650nm laser diodes allow for excellent coverage of the scalp; use for six minutes each day.
  • Illumiflow: 272 laser diodes; use for six minutes a day.
  • Capillus®: Three different laser caps available. the 272 laser diode cap is recommended to ensure the most scalp coverage. Use for six minutes each day. 
  • HairMax® / HairPro™: LLLT hair comb or brush that works similarly to the caps. Individuals must comb or brush their hair in the needed areas for 10-15 minutes each day. 

In-Office Topical Treatments

Platelet-rich plasma (PRP) hair loss treatment is performed by using your own blood. Your blood will be drawn and then spun in a centrifuge which separates the plasma from the red blood cells. The plasma is full of platelets, which is why it is called “platelet-rich plasma”. These platelets revive hair follicles. The plasma is injected into the scalp, and the nutrients target the hair follicles directly to stimulate new hair growth. Platelet-rich plasma also stimulates dormant hair follicles that have stopped growing, and helps result in overall new hair growth and better hair health.

KeraFactor treatments (listed above under Prescription Topicals) can also be used as an in-office treatment with an advanced delivery mechanism. One of our highly trained aestheticians will perform microneedling on the scalp, and the tiny punctures that are created in the skin will be used to introduce the KeraFactor, which causes increased absorption and better results. This can also be combined with PRP injections at the site to produce more effective results.

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Surgical Hair Transplants

A hair transplant is a surgical procedure that involves removing hair from one part of the body (usually the lower scalp) and transplanting it where hair growth is needed. This procedure is performed in a medical office with the patient under local anesthesia.

The number of hair grafts needed — and the size of them — depend on your hair type and its quality, color, and the size of the area that the hair is being transplanted to. You will likely have to wear bandages on your head for 1-3 days, and you will be able to return to work in 2-5 days.

Dr. Karyn Grossman, MD
Karyn

Why Choose Grossman Dermatology for Hair Loss Treatment?

Our team at Grossman Dermatology proudly serves patients from Santa Monica, California and New York, New York. Our founder, Dr. Karyn Grossman, is a board-certified dermatologist who is a respected author, instructor, and presenter. Her long-established, high-end boutique cosmetic dermatology center is a place of relaxation and privacy where you will receive exceptional care. Dr. Grossman is well known for her dedicated attention to each unique patient, her thoroughness, and her passion for getting the best results possible in a safe and effective manner. If you’re in the Santa Monica or NYC area and you’re interested in hair loss treatment, we welcome you to contact us.

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