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You Empowered: An approach to managing hair loss

As I continue to treat more and more patients with hair disorders, I find that there are specific principles that apply to all those afflicted with hair loss conditions or a patient's perceived hair loss ( when clinical and histological findings are otherwise normal). Whether it is a scarring process resulting in permanent hair loss or the hormonal/genetic-related pattern changes that affect many aging adults, it is possible to monitor your hair to determine whether there are changes happening that are negatively impacting it's health. If someone does find themselves dealing with a hair problem or has concerns about changes that are resulting in thinning hair or abnormal hair loss, these are the FOUR questions to ask:

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1. Is there worsening hair loss?

2. Are there symptoms (pain, burning, itch, tightness, soreness...)?

3. Are there noticeable scalp or hair changes (redness, dryness, breakage, rash, pimples...)?

4. Are there side effects to treatments or medications?

 

The Breakdown:

1. Is there worsening hair loss?

We all shed everyday, hair cycles take months to normalize once disrupted or once treatment has begun, not all hair strands seen in the shower implies a disease state. The point is to make sure that whatever the hair loss or normal state is, there is no worsening of the hair loss ( increased shedding or continuously worsening thinning over time) that could  be better treated or prevented. Hair loss should not "get worse before it gets better," worst case is that things remain stable or unchanged for a period of time as hair cycles change.

2. Are there symptoms (pain, burning, itch, tightness, soreness...)?

Symptoms of the scalp and hair could indicate that there is an inflammatory process or other negative aggravator at play. Do not tolerate ongoing pain, itch, or scalp discomfort. Make sure to bring this to the attention of your care provider.

3. Are there noticeable scalp or hair changes (redness, dryness, breakage, rash, pimples...)?

A healthy scalp is needed to grow hair and to maintain hair health. If growths, texture changes, redness, rashes, breakage, or other findings are observed, have them evaluated as soon as possible. They could indicate worsening disease or the manifestation of an underlying hair problem. 

4. Are there side effects to treatments or medications?

While certain medications, such as topical minoxidil or corticosteroids to oral spironolactone and finasteride are used to treat hair diseases, these medications are not without side effects. If quality of life is impaired by the use of these treatments for hair loss or you find yourself dealing with side effects that are resulting in a YES to questions 1 through 3, discuss this with your care provider to make sure that the benefits of the treatment outweigh the risks. While hair is important to us all, your health should not be made worse by medicinal intervention and more appropriate treatment options should be explored. 

 

The takeaway

If you cannot answer NO to all four questions above, follow up with your care provider and make sure that concerns and issues are addressed to prevent further or irreversible hair loss. 

Margareth Pierre-Louis