More than 80% of men and women experience some form of patterned hair loss in their lifetime, according to NYU Langone. While complete reversal of genetic or age-related hair loss may not always be possible, a dermatologist outlined key strategies for managing the condition.
Dr. Kseniya Kobets, director of cosmetic dermatology at Montefiore Einstein Advanced Care, emphasizes that hair loss is often multifactorial, meaning it can stem from various causes and requires a combination of treatments. "One of the biggest things I tell my patients is that hair loss usually isn’t from just one thing, especially as we get older and in peri- and postmenopausal women," Kobets stated.
Potential contributing factors include tight hairstyles that cause traction alopecia, physical or emotional stress leading to telogen effluvium, and the exacerbation of underlying genetic hair loss due to menopause or weight gain. Kobets noted that treatments such as minoxidil, platelet-rich plasma (PRP) injections, nutraceuticals, serums, or LED therapy can be effective when used in combination.
Kobets also highlighted the importance of internal health, comparing hair follicles to a garden that requires good soil. Nutritional deficiencies, particularly low iron, vitamin D, or thyroid issues, can significantly impact hair growth. She advises patients to consult a doctor about optimizing nutrient levels and thyroid function rather than solely relying on topical products.
Overall health, including adequate sleep, exercise, sufficient protein intake, and reduced consumption of processed foods, plays a crucial role. However, Kobets cautioned that these lifestyle factors may not resolve hair loss in individuals with conditions like insulin resistance, diabetes, or high stress levels, as genetic sensitivity of hair follicles also plays a part. Decreasing stressors can help maximize hair growth potential.
When considering treatments, Kobets recommends prioritizing those with FDA approval and scientific backing. The only two FDA-approved medications for hair loss are topical minoxidil and oral finasteride. She advises against relying on trendy, unproven cures often found on social media.
It is also important not to assume that hair loss is solely genetic. Kobets stressed that symptoms like significant itching, burning, tenderness, redness, or scaling should prompt a visit to a dermatologist, as these can indicate inflammatory or scarring alopecias that can permanently damage hair follicles. "If you’re losing hair and also have significant itching, burning, tenderness, redness or scale, see a dermatologist," she warned.
Patients should be wary of expensive, unproven "regenerative" or "cutting-edge" treatments. Kobets expressed particular caution regarding injectable exosomes for hair loss, noting they are not FDA-approved for this purpose, lack standardization, and require more robust studies on efficacy and long-term safety.
Before investing in supplements, Kobets suggests checking for true nutritional deficiencies and ensuring adequate protein intake. She added that excessive intake of certain supplements can sometimes contribute to hair loss.
For individuals using GLP-1 weight loss drugs, hair loss can be a side effect, but it is often temporary. Kobets recommends maintaining adequate protein intake, avoiding rapid weight loss when possible, and ruling out underlying genetic causes.
Treating hair loss is a slow process, with individual hairs growing about 1 centimeter per month on average. Kobets advises patients to give treatments at least three to six months before evaluating their effectiveness. Using standardized photos can be more helpful for tracking progress than daily mirror observations.
Major shedding events, such as telogen effluvium, can sometimes reveal or unmask underlying genetic hair loss that was already progressing. This can explain why hair may not fully return to its previous state even after the initial stressor is resolved, according to Kobets.