androgenetic alopecia

Helpful Hair Loss Abbreviations For Newcomers

by admin on February 21, 2008

Helpful Hair Loss Abbreviations For NewcomersA Blog Post By Dottie

Hey y’all,

I noticed that we use a lot of abbreviations when we talk about our histories & diagnoses here. I thought a simple index might help alleviate some confusion for the newbies. I included some basic information because I know that it took me awhile to figure some of this out, and I’m an RN! So here it goes…

AGA – Androgenetic Alopecia (AKA Androgenic Alopecia) is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness. The pattern of hair loss in women differs from male-pattern baldness. In women, the hair becomes thinner all over the head, and the hairline does not recede. Androgenetic alopecia in women rarely leads to total baldness. A variety of genetic and environmental factors likely play a role in causing androgenetic alopecia. Although researchers are studying risk factors that may contribute to this condition, most of these factors remain unknown. Researchers have determined that this form of hair loss is related to hormones called androgens.

Spiro – Spironolactone is a diuretic commonly prescribed for treatment of high blood pressure, but due to its anti-androgen properties may also be prescribed for hair loss.

AA– Alopecia Areata is a form of hair loss from areas of the body, usually from the scalp. Because it causes bald spots on the head, especially in the first stages, it is sometimes called spot baldness. In 1%–2% of cases, the condition can spread to the entire scalp (AAT-Alopecia totalis) or to the entire body (AAU- Alopecia universalis). Alopecia Areata occurs more frequently in people who have affected family members, suggesting that heredity may be a factor. In addition, it is slightly more likely to occur in people who have relatives with autoimmune diseases.

TE– Telogen effluvium is characterized by sudden, diffuse hair loss caused by an interruption in the normal hair growth cycle. A typical example of telogen effluvium is seen after pregnancy. In this condition women lose a significant amount of hair a few months after delivery when the protective effect of estrogen is removed. This shedding usually stops spontaneously and these patients will (generally) re-grow hair after 3 months.

Basics of hair cycles: In a normal healthy person’s scalp about 85% of the hair follicles are actively growing hair (anagen hair) and 15% are resting hair (telogen hair). A hair follicle usually grows anagen hair for 4 years or so, then rests for about 4 months. The resting or telogen hair has a club or bulb at the tip. A new anagen hair begins to grow under the resting telogen hair and pushes it out. Thus, it is normal to lose up to about 100 hairs a day on one’s comb, brush, in the basin or on the pillow, as a result of the normal scalp hair cycle.

PCOS– Polycystic Ovarian Syndrome is an endocrine disorder that affects approximately one in ten women. It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The principal features are weight problems, lack of regular ovulation and/or menstruation, and excessive amounts or effects of androgenic (masculinizing) hormones. The symptoms and severity of the syndrome vary greatly between women. While the causes are unknown, insulin resistance, diabetes and obesity are all strongly correlated with PCOS. Common symptoms of PCOS include irregular, few, or absent menstrual periods, infertility, unwanted body hair, acne, and androgenetic alopecia.

I am not a physician, nor do I claim to know everything about female hair loss… I just hope that someone might find this helpful! I wish that there had been an easy “one stop” place for me to look for answers 20 years ago when I started loosing my hair. Maybe this information can help someone out there find answers.

About the author: Dottie is a community member of the Women’s Hair loss Project. To learn more about her and read her other blog posts, visit her profile: http://community.womenshairlossproject.com/Dottie/

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So Sorry That I Took My Hair For Granted - Amber's Hair Loss StoryHello Everyone. I am so happy to know that I am not alone in my hair loss devastation. I am a 28 year old mother of four. I’ve been experiencing heavy hair loss and extreme changes in the texture of my hair since the pregnancy with my daughter 5 years ago. Much to my dismay, my doctors were telling me that I was pulling my hair back too often or that my hormones just needed to get back to normal or that the straightening process I had done had caused the loss. So for five years I have watched my very thick, very curly hair become thin and straight thinking that one day it would magically reappear. It was two weeks ago that I had a scalp biopsy and was diagnosed with andogenetic alopecia. To boot, I am losing it from all over my head, not just the top. My dermatologist is pretty cruel and just chuckled and said “There’s nothing you can really do. Use Rogaine.” I am devastated. My daughter has hair just like mine used to be and I’m actually jealous of her. I’m debating whether to have the fifth child that my husband and I wanted but I don’t want to spark any excess shedding episodes. I have started Rogaine as it is the only FDA approved medication for women but I am feeling very lightheaded and somewhat dizzy so I’ll probably have to stop. I realize like many of you that this has quickly become an obsession. I know that I am not my hair. But let me tell you, after four children, my body is beat. My hair is the only attribute I have left and I’m losing that now too. I’m at an incredible loss. I can’t imagine what it will look like when I’m 40. Please give me any feedback you can and I hope this post helps someone feel not so alone as this site has helped me tremendously.
Thank you,
Amber

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Dear Amber,

You are not alone in your feelings and struggles. I wish I knew why most doctors are so insensitive and callus toward the women who seek out help for their hair loss. I can’t explain why they do it, but it is an unfortunate very common occurrence. Was your dermatologist by any chance a man? They seem to be the least understanding.Just like the birth control pills can somethings kick in the onset of androgenetic alopecia early so can the hormone shift of having children, sometimes there is just no rhyme or reason, but undoubtedly we are never prepared. There are other “treatments” used to treat women’s hair loss such as low androgen index birth control pills and aldactone (spironolactone). All hair loss treatments carry the risk of possibly igniting some extra shedding at first. It’s the whole, “has to get worse better it gets better type thing.” It’s all a very personal decision what a woman chooses to use to treat herself, and she has to fully understand the postives vs. the negatives. Hopefully in time there will be more studies done to figure out what exactly causes women’s hair loss and then with any luck a real solution for women’s hair loss will follow. [click to continue…]

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Losing Hair At 27, My Hair Loss Story By SarahI started to notice a loss of hair density when I was 19 years old. At first, I thought it was because I moved to a dry climate, but after time passed, I realized that this was not the case. I had thick, natural curly, wavy hair when I was young. My hair loss has been very gradual, but I feel as though it has accelerated in the last three years. I don’t notice my part getting bigger I just feel loss of density all over my head. I’ve been to three dermatologists and have taken all the tests. Everything comes back normal except for my iron. (Side note: I was diagnosed with anemia back in 2002 and went on iron supplements back then.) My dermatologist advised me to go on iron supplements and spirnolactone. She said I won’t notice a difference in hair density for at least a year after taking the supplements. So far, it has been almost 4 months since I started taking the iron supplements and I haven’t noticed a difference. I don’t shed as much during the day or while I take a shower. However, I lose a lot of hair when I brush. I’d say 150+ hairs. She said that if the iron doesn’t work, that I probably have androgenetic alopecia and because I’m losing hair all over my head, hair replacement surgery is not an option. I haven’t had a scalp biopsy done. I’d like to, but my dermatologist didn’t think it was necessary.

I feel I should also mention my family history. My mother has a full head of hair and she is 63. My dad is just now at age 62, losing his hair, but it could be due to his thyroid condition. My bother is losing hair and he is 33. My grandmother on my mom’s side has hair, my grandfather, however had hair loss. My grandmother on my dad’s side had thin, fine hair, but my dad said he couldn’t recall seeing her scalp. My other grandfather had a full head of hair. So, hair loss is in my family.

With all this said, I’ve gone through a wave of emotions. [click to continue…]

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Hair Biopsy Results _ Diagnosed With Telogen Effluvium and Androgenetic AlopeciaWell, in my situation, my family doctor first ordered blood work to look for an underying hair loss cause and found nothing. So she referred me to a dermatologist and on my own I sought out an endocrinologist because I have other symptoms. An endocrinologist is now looking into a possible underactive adrenal gland now because my cortisol level was borderline low. At the same time, my dermatologist did a biopsy of my scalp and found telogen effluvium AND androgenetic alopecia. SHOCK! No women in my family have this problem. So, I am wondering if you’ve heard of any possibility that this could be a false -positive for the androgenetic alopecia. Can anything else mimic alopecia? There’s no way to tell how much of my hair loss is due to TE or how much is due to AA, but as a result I have been advised to start using Rogaine for Women. I was told Men’s Rogaine is too strong while not helping any more than the women’s Rogaine. I also am going to use Nizoral 1%(doctor suggested) for dandruff that I already have and that may get worse with Rogaine. I just pray the Rogaine works. I don’t want to waste time and hair.

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Hi, welcome to the site! I’m not a doctor and I don’t have a lot of first hand experience with scalp biopsies so I’m hoping that perhaps Andrea or another women who has actually had this test performed, can help in providing greater insight. I’m also sending your question over to The American Hair Loss Association so that it can be answered by an actual physician because I want to make sure you get the right information. I wish I could answer your question about whether or not scalp biopsies can return results that are false positives for androgenetic alopecia. Logically I think that it is always possible in any test. I am curious to know if any other women have received the same results as you, being diagnosed with both telogen effluvium and androgenetic alopecia. If I was concerned about the resulting diagnosis I probably would consider having the test be redone by a different physician. Doctors are people too and they do make mistakes.

When I was first diagnosed with androgenetic alopecia back when I as 21/22 years of age I was told to take the Mens Rogaine and that it was perfectly safe and would be more effective. I know that a lot of doctors do tell their female patients to go ahead with the stronger dose as well, but you have to do what you feel comfortable with. You can always go for the higher strength Men’s Rogaine at a later time should you choose to do so. Also, a few women on this blog have been saying that the Rogaine Foam is easier to use and eliminates some of the problems that the regular Rogaine can sometimes cause, such as greasiness and itchiness, since it doesn’t have the propylene glycol. Although currently the Rogaine Foam is only available in the 5% minoxidil Men’s version. You can read the comment Gretchen wrote about it here.

I used to use Nizoral myself because I read somewhere that the active ingredient Ketoconazole actually had some mild anti-androgen properties that would help in hair loss. [click to continue…]

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Disorders of Hair: Androgenetic Alopecia

by admin on November 8, 2007

Disorders of Hair: Androgenetic AlopeciaI came across this article today while doing some hair loss research on the internet, and I thought it covered a lot of questions that women have about hair loss. The article is about both male and female pattern hair loss and provides a good overview. It was published on medscape from ACP Medicine Online. Here it is:

David A. Whiting, M.D.

Androgenetic alopecia is the common type of nonscarring hair loss affecting the crown. It results from a genetically determined end-organ sensitivity to androgens. It is often referred to as common baldness, male-pattern alopecia, and female-pattern alopecia.

Epidemiology and Pathogenesis

Androgenetic alopecia affects at least 50% of men by 50 years of age and 50% of women by 60 years of age.6,7 Males have more androgen than females and therefore are usually affected earlier and more severely. Male-pattern alopecia often starts between 15 and 25 years of age. Male-pattern alopecia has two characteristic components, bitemporal recession and vertex balding [see Figure 1 — omitted], which in pronounced cases can progress to complete balding of the crown.6,7 Female-pattern alopecia is more likely to start between 25 and 30 years of age (or sometimes later, after menopause). It is characterized by an intact frontal hairline and an oval area of diffuse thinning over the crown [see Figure 2 — omitted]. Bitemporal recession in women is much less obvious than it typically is in men, or it can be nonexistent. In general, androgenetic alopecia in women progresses to mild, moderate, or severe thinning but not to complete baldness. The best predictor of outcome is the degree of progression in affected relatives.

Androgenetic alopecia is an autosomal dominant disorder with variable penetrance. Susceptible hairs on the crown are predisposed to miniaturize under the influence of androgens, notably dihydrotestosterone. In both sexes, miniaturization results from a shortening of the anagen cycle, from years to months or weeks. Miniaturized hairs are characterized by reduced length and diameter; this accounts for the appearance of hair loss.8 Androgenetic alopecia largely spares the back and sides of the scalp.

Diagnosis

The diagnosis of androgenetic alopecia is usually obvious from the clinical pattern of hair loss from the top of the head.9 In some men, a female pattern of alopecia (see above) causes diagnostic confusion but has no other significance. In women, a male pattern of alopecia (i.e., bitemporal recession and vertex balding) occurring with menstrual irregularities, acne, hirsutism, and a deep voice is significant. The virilism indicates significant hyperandrogenism, the cause of which must be identified and treated [see 3:IV The Adrenal — omitted].

Scalp biopsies are rarely necessary to diagnose androgenetic alopecia. Biopsies cut horizontally are sometimes useful, however, in differentiating female-pattern alopecia from chronic telogen effluvium (see below). [click to continue…]

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Low Iron Stores: A Risk Factor For Excessive Hair Loss In Non-Menopausal WomenI found this study really interesting as it cites low iron stores as a possible contributing cause of women’s hair loss. I know one of the first things that usually gets tested when a woman complains of hair loss is the iron levels. Of course there is such a huge range of what is considered normal its hard to tell the optimal level for our body.

Here it is:

European Journal of Dermatology. Volume 17, Number 6, 507-12, November-December 2007, Investigative report

*Abstract

Author(s) : Claire Deloche, Philippe Bastien, Stéphanie Chadoutaud, Pilar Galan, Sandrine Bertrais, Serge Hercberg, Olivier de Lacharrière

Summary : Iron deficiency has been suspected to represent one of the possible causes of excessive hair loss in women. The aim of our study was to assess this relationship in a very large population of 5110 women aged between 35 and 60 years. Hair loss was evaluated using a standardized questionnaire sent to all volunteers. The iron status was assessed by a serum ferritin assay carried out in each volunteer. Multivariate analysis allowed us to identify three categories: “absence of hair loss” (43%), “moderate hair loss” (48%) and “excessive hair loss” (9%). Among the women affected by excessive hair loss, a larger proportion of women (59%) had low iron stores (<\; 40 µg/L) compared to the remainder of the population (48%). Analysis of variance and logistic regression show that a low iron store represents a risk factor for hair loss in non-menopausal women.

The article is broken down into the following areas

Introduction

Materials and Methods

  • Volunteers
  • Hair Loss Assessment
  • Biochemical Measurements
  • Statistical Analysis

Results

  • Hair Loss Quantification
  • Link Between Hair Loss And Serum Ferritin Levels

Discussion

This study, carried out for the first time on a very large cohort of women, provides strong arguments in favor of an association between depleted iron stores and hair loss, particularly excessive hair loss in women before menopause. [click to continue…]

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Creating Women’s Hair Loss Awareness

by admin on September 26, 2007

Creating Women's Hair Loss AwarenessSeeing so many women walking around with hair loss is agonizing. I just want to run up to them all and give them a big hug, let them know that I know exactly how they are feeling about their hair. I notice all the little things that probably no one else does, the frequent touching to the head, eyes down, general display of uneasiness. I look at all those women, and I see myself. Do they see me? I do those same things as well. I wrote a past post talking about the high prevalence of hair loss in women today, called “Hair Loss, Hair Loss Everywhere – What’s In The Water?

Shouldn’t there be a universal sign all women hair loss sufferer’s should have to acknowledge from afar that we are one of the same. I feel like jumping up and down and waving my hands in frustration that there is so little women’s hair loss awareness. It is a life upsetting disorder, it has robbed me of being the person I really am. Feeling self conscious has thrust me into the gates my home and made me a prisoner for years. I am working on improving that, improving my situation, improving my life. Realizing I am more than my hair and if other people judge me because it, then shame on them.

How do we create more women’s hair loss awareness? It’s hardly ever taken serious by the media, it is frequently not taken serious by doctors. Several of the doctors I visited early on in my hair loss either brushed me off saying that they didn’t see any hair loss or stating that it was probably “just” telogen effluvium that would stop on it’s own. Hello doc, that was 8 years ago. Where has the bedside manner of physicians gone? When they do tell you it’s androgenetic alopecia (female pattern hair loss) they frequently like to allay any of your fears by letting you know “hair loss isn’t going to kill you.” Maybe not, but it has killed a part of me, a part of me I haven’t seen or known for the last 8 years. I have made myself sick over this, and it has caused tremendous feelings of hopelessness and despair.

So I guess that’ll be my universal sign to other women suffering with hair loss, I’ll jump up and down like a crazed lunatic, flailing my hands wildly above my head, at least that would make you smile :)

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