Common Hair Disorders and What You Can Do About Them

By Katie Regan Lenehan

Ancient Egyptians soaked their heads in the fats of lions, hippos, and geese. Hippocrates, father of medicine himself, rubbed pigeon guano into his scalp. “Professor” Alexander Barry sold bottles of Tricopherous to gullible, balding nineteenth-century New Yorkers. Renaissance farmers' rub of choice? Cow saliva. So if you're despairing over hair loss, don't feel alone; the history books are littered with stories of people who've endured it.

Balding is a concern for many men, women, and sometimes children. While Hollywood 's ideal body-type fluctuates—shapely is in one year, stick-thin the next—it seems that the “beautiful people” always have full heads of hair. There are a few manly exceptions: can you picture Bruce Willis, Michael Jordan, and Andre Agassi without their trademark hairless heads? But for women, role models are few. Though your views may be untainted by popular taste, you do live in a larger culture that has certain ideas about beauty. And that affects us.

Surprisingly, balding is not a hair-loss problem. It's a matter of hair not growing back fast enough to replace the strands we normally lose. Most of us shed about 100 hairs a day. With age, many people's hair growth rate (among other things!) slows, and hair falls out faster than the rate at which it's replaced. Those of us who are balding are losing more hair than we grow it.

According to the American Academy of Dermatology (AAD), there are three common types of hair disorders.

•  Androgenetic alopecia (al-uh-pee-shee-uh), better known as pattern hair loss, is a hereditary condition that affects half of all men under the age of 50. Shrinking hair follicles cause shorter growth cycles; hair becomes thinner and shorter, until growth eventually stops. It's rarer in women, affecting 25 percent of pre-menopausal women and 38 percent of those post-menopausal.

•  Alopecia areata is a complete absence of hair that afflicts 2 percent of the United States population (4.5 million people). Both the cause and the cure of this condition are unknown, though there are treatments for it. For mild cases, Minoxidil or an anthrolin cream may grow hair in 8 to 12 weeks. A monthly cortisone injection can also be used for mild cases. Cortisone in pill form is sometimes prescribed for more serious instances.

•  Telogen effluvium is a slow shedding of hair that often goes unrecognized until half of the hair is gone. Increased hair loss when brushing, combing, or washing because could be a symptom of any one of 30 health conditions that can cause permanent or long-term hair loss, including eating disorders, thyroid disease, and hormonal imbalances. Dr. Renfro stresses the importance of getting a diagnosis for any kind of hair loss condition because the "treatment is based on the cause." Telogen effluvium, it may be a clue to something underlying like cancer, or a drug needing to be discontinued. It is important for the patient's sake to understand why there is hair loss, and seeing a doctor is the first step.

At age 5, local woman Shelbi Miles began to lose spots of hair in episodes that continued for several years. She correctly assumed there was a link between the ridges in her fingernails and the hair loss, but didn't learn the name of her condition, alopecia areata, until she was 17 years old. "I went to a dermatologist,” she says, “who said it was a severe case linked to stress and diet." Doctors prescribed Prednisone, but Miles stopped taking it because of negative side effects involving her skin and mood. "It was horrible! I was on it briefly."

For several years, Miles opted for steroids shot directly into her scalp. But now, Miles relies on positive thinking and meditation for remedies. In high school, she read a magazine article about a boy who had a tumor. Each night he imagined rocket ships blasting away his tumor. His attitude changed, and when he went back to the doctor, his cancer was gone. The story inspired Miles to think positively, and to this day, she credits that article for changing her mindset, which proved to be her remedy. After college, Miles lived abroad where steroid shots were unavailable, so she relied solely on positive thinking, meditating, eating well, reducing caffeine, and managing stress.

She keeps things in perspective. She felt uncomfortable when people expressed sympathy for her condition. "I thought, I am losing my hair, but I am lucky. I am healthy." Hormonal changes still have an effect: no surprise that pregnancy and childbirth wreaked havoc on her immune system! Her experiences with such challenges have influenced her life's work, and she has made it her career to help others. She co-owns Severna Park Yoga Studio, and she's a yoga instructor and a massage therapist. "Think about what you can do. How do you want to live? I can only speak for myself, but, don't become a victim of it. Look at what you can do to make changes. Look to doctors; look within." Yoga, meditation, and positive thinking about the attributes you do have-sound advice for us all.

Bald is Beautiful

According to Consumer Report s, "Hair plays a huge role in our sense of physical beauty, and losing it can be devastating." It can be. There is no diminishing that fact. There are people out there, however, who view hair loss differently.

California restaurant owner Gary Arnold, made news in 2004 by charging customers according to the amount of hair on their heads. On Wednesday nights, those with less than 50 percent of the hair on their head were charged half-price, and the completely bald received free meals.

John T. Capps, II, founded Bald Headed Men of America (www.members.aol.com/baldusa), an organization based in Morehead City , North Carolina , and coined the motto: "The world's only organization that grows because of a lack of growth.” The organization holds an annual convention and offers subscriptions to the "Chrome Dome Bulletin," along with bumper stickers and gift catalogues. Despite its name, the BHMA welcomes everyone: women, children, and the hairless of any nation.

Tony Snesko, "The Bald Guy," is based in DC, and runs www.baldrus.com , a Web site encouraging "men to get rid of rugs, drugs, and plugs." He is "fighting the industry"-everyone who profits from hair growth products and services. His Web site is loaded with letters from men who have experienced failed hair replacement surgeries, who have tried different products unsuccessfully, and who are proudly accepting their baldness. Snesko himself said, "There are millions who've tried all the potions. When I worked at LAPD, my barber at Hollywood and Vine told me to rub olive oil on my head to slow down the balding process. I looked like a tossed salad for two years." Through his Website, Snesko says, "Men have lost their covers, had plugs lasered and removed, and we've saved lots of others from starting the process." Though Snesko's Web site claims he's fighting a $2 billion industry, when we spoke, he was sure that number was outdated and entirely too low. However, he claims, "It's not a money issue as much as a psychological issue. A young man recently wrote in that he'd been contemplating suicide before coming across our website. Yes, young men and women write in-it's a support for all."

Sharon Blynn, an ovarian cancer survivor, temporarily lost her hair undergoing four rounds of chemotherapy. Blynn won her 3-year battle against cancer, and one of her discoveries, was the "many women along (her) path that were overwhelmed and beaten down by hair loss." Blynn writes on her Web site, "We simply cannot afford any negative energy in the form of self-doubt, low self-esteem, and insecurity when we are fighting for our lives!" Through Blynn's work (www.baldisbeautiful.org), she is now fighting a different battle: she is expanding and redefining social notions of beauty and femininity as a writer, a spokesperson, an actor, and a model. Once a self-proclaimed longhaired hippie chick, Blynn is now a bald hippie-chick, who feels more in touch with who she is, and who loves herself in ways she "couldn't imagine without having lost (her) hair and both of (her) ovaries."

Blynn urges all women facing hair loss issues to embrace the journey-whether an abrupt, often temporary cancer/chemotherapy experience or a more prolonged struggle with alopecia or pattern baldness. "All too often women judge themselves (and each other), and we are holding ourselves to an arbitrary and narrow standard of beauty and attractiveness. We need to reclaim the power to define our own beauty and femininity for ourselves on our own terms." She is working hard to get the image of a bald woman into the mainstream consciousness in positive, powerful, significant ways. "No matter what choice a woman makes about her hair—covering it with hat, scarf, wig, or flying au natural—it is more important to examine what's underneath (pardon the pun) that choice." Blynn is embracing the journey, hoping to influence other women to appreciate what is beautiful and strong within. "I had to lose my hair to find myself, and I am healthier now in mind-body-spirit than I ever was!"

Whatever the age or era, few would argue against feeling healthy in mind, body, and spirit. If you're experiencing any kind of hair loss that's causing a loss of self-esteem, feelings of being less attractive, or an increased amount of tension in public places, you may want to consult your primary care doctor or a dermatologist as soon as you recognize a hair loss issue Oftentimes, you can do something about it, and early treatment is usually the most effective. There is much to gain if you make the choice to accept the condition rather than be overcome by it. Even Hippocrates—though he was a little off with the pigeon droppings—knew that in order for a body to be healthy, it needs to be in balance.

Pattern Hair Loss Treatments

A doctor may recommend Minoxidil, Finasteride, or hair transplant surgery, depending on the affected individual's needs.

•  Minoxidil (Rogaine) is an over-the-counter topical solution known to reverse hair-follicle shrinking. It's approved for use by both men and women, and it must be used indefinitely to be effective.

•  Finasteride is FDA-approved for use by men only and is available by prescription. It blocks the formation of DHT (dihydrotestosterone), the hormone responsible for shrinking hair follicles. Finasteride needs to be taken indefinitely to work.

•  Hair transplant surgery involves moving healthy hair follicles from one area of the scalp and to a bald area. Dr. Lisa Renfro, a dermatologist at Anne Arundel Medical Center believes that this surgery can be highly effective for the right candidate: "Androgenetic Alopecia is the only type of hair loss appropriate for transplants, but in the right hands and with the right candidates, it's fantastic. Men have to have a thick enough donor site. It's extremely expensive and laborious." But, Dr. Renfro says, there's "nothing better for some."

The Opposite Problem

The third most common hair complaint is not hair loss; rather, it is excessive hair growth on the female face and body. Also known as hirsutism (Latin for shaggy), this condition bugs women more than men. Genetics and some medical conditions can trigger excessive hair growth on the chin, upper lip, or other parts of their body. Prescription treatments include birth control pills, hormonal suppression, and a topical cream. Some women choose over-the-counter bleaching creams and waxes or good old-fashioned tweezers; while others prefer electrolysis and laser removal. Dr. Renfro encourages laser removal because it's "miraculous; it changes lives," and she recommends Bob Adrian, whose office is located on West Street : The Center for Laser Surgery. Of course, laser removal is not covered by most health insurance.