Dermatologist Specializing in Hair Loss in NYC

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Hair is an appendage of the skin. Although not a vital organ, its absence can have a tremendous psychosocial impact and suboptimal health function. In addition to providing social signals about our age, fertility, and health status, hair helps regulate our temperature, protects us from infection, and filters out external allergens, pollutants, and irritants.

Although many would categorize the absence of hair where it is normally present as a cosmetic concern, hair loss can be a signal that someone has a very serious underlying health condition.

In the Media:

Mary Calvi of CBS News New York Channel 2 interviews Dr. Strachan on alopecia

What is Hair Loss or Alopecia?

Hair loss, also known as alopecia, is a common problem that can represent a variety of diseases and conditions. It can be a problem with the hair and scalp itself, a reflection of the underlying health state, a side effect of a medication, the result of grooming practices, or the manifestation of a systemic disease.

Our patients who experience hair loss tend to notice symptoms like gradually thinning hair, hair that falls out over time or abruptly, a widening part, a receding hairline, or areas of baldness. Paying attention to your scalp can offer valuable insights. You may be able to spot thinning hair or hair loss in the early stages. However, areas of baldness will be the most apparent. See our dermatologist for a proper evaluation.

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Perimenopausal hair loss treated with Revian Red

What is the Anagen Hair Growth Phase?

The hair growth cycle is comprised of four distinct phases. The anagen phase, also known as the growth phase, occurs when hair is actively growing and being pushed out of the follicle.

Most of the hair on your scalp should be in the anagen phase at any given time, and it can stay in this phase for years. However, some types of hair loss shorten the anagen hair growth period. Other types of hair loss trigger other phases of the hair cycle to start prematurely.

Factors known to disrupt the natural cycle of hair growth include certain medicines, stress, poor nutrition, hormone changes, and some underlying conditions.

Where do people get Hair Loss or Alopecia?

Although we are more familiar with the idea of hair loss on the head, people can also develop alopecia on any part of the body that normally grows hair such as eyebrows, eyelashes, beard, and under the arms.

Is Hair Loss an “Inside or Outside” problem?

When evaluating a person for hair loss it is important to determine whether the hair is breaking or falling out by the roots. Hair breakage is most commonly caused by grooming practices that change the color or texture of the hair, such as, blow drying, chemical relaxing, or dying. There are some scalp disorders and genetic hair shaft disorders; however, which predispose a person to hair breakage.

People with curly or kinky hair are more likely to experience hair breakage. Curly or kinky hair is naturally drier and has weak spots that are more likely to snap with tension. Straight hair is the least likely to break.

In the Media:

What is the difference between Scarring (Cicatricial) and Non-Scarring Hair Loss?

  • Non-scarring hair loss (alopecia): Non-scarring hair loss refers to types of alopecia in which there is the possibility that the hair can grow back. The hair follicles are still present and potentially functional. Non-scarring hair thinning can also happen with age, and it is referred to as senescent alopecia.
  • Scarring (cicatricial) hair loss (alopecia): In scarring or cicatricial alopecia some of the hair loss is permanent because of the absence of, or severe damage to, the hair follicle. It is often worth it to treat scarring alopecia even when some of the loss is permanent in order to prevent further loss and attempt to restore function to injured hair follicles.

How Does One Diagnose Hair Loss or Alopecia?

Hair loss is diagnosed by taking a patient history, doing a physical examination, and sometimes with other tests such as skin biopsies and blood studies. A board-certified dermatologist is usually the most expert doctor to diagnose your hair loss.

The diagnosis of hair loss can be challenging even for doctors, and even some dermatologists without intense training in this area. There is more involved in figuring out why someone’s hair falls out than exploring just their thyroid function or their diet.

In the Media:

Is Hair Loss Genetic?

Yes, some types are. Male pattern baldness and female pattern baldness both have a common genetic cause. Patients sometimes have difficulty identifying that the condition runs in the family because of the different ways it may present. Additionally, it is hard to know if you have a family history of hair loss because some people experience shame and conceal their alopecia even from their closest relatives.

How Do I Know If I’m Losing Too Much Hair?

Hair loss is a normal part of the hair growth cycle. There is nothing unusual about shedding between 50 and 100 hairs a day. However, shedding more than 125 hairs a day might indicate hair loss, and you should visit a dermatologist for an evaluation. Similarly, you should visit a dermatologist if you find new areas of baldness, your part is widening, or your hairline is receding. Remember, significant hair loss can be an indicator of more serious health concerns, and seeking an effective hair loss treatment plan is not purely cosmetic.

Alopecia, Race, and Gender

Genetic, hormonal, and grooming habits seem to cause certain types of hair loss to be found more commonly or severely in certain racial and gender groups. Androgenetic alopecia, or familial hair loss, commonly affects both men and women; however, it is often more severe and noticeable in men. Frontal fibrosis alopecia (FFA) tends to occur predominantly in postmenopausal caucasian women, where as central centrifugal cicatricial alopecia (CCCA) is more common in African American women and acne keloidal nuchae (AKN) is more common in African American Men

Women often complain of new onset hair loss after childbirth and during perimenopause. Women with polycystic ovarian syndrome sometimes present with more severe cases of female pattern hair loss.

Hair Loss Before & After

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femalehairloss after c1

African Americans and Hair Loss

Although hair loss affects people of all ethnic backgrounds, African Americans experience certain types of hair loss more commonly for the following reasons:

  • Hair Texture: Curly and kinky hair is more fragile and prone to breakage with grooming. In addition, people with curly or kinky hair are more prone to developing in grown hair, which can cause inflammation, scarring, and hair loss.
  • Grooming Practices:  Market research indicates that style is very important to African American consumers. Some grooming practices required to achieve certain hair styles traumatize the hair and scalp resulting in damage and hair loss.
  • Genetics: Some types of hair loss, such as central centrifugal cicatricial alopecia (CCCA), which predominantly affects African American women, is thought to be caused by a genetic predisposition to develop chronic inflammation in the scalp as a result of traumatic hair styling practices such as tight braids, tight weaves, or heavy dreadlocks.

In the Media:

Hair Loss and Mental Health

Sometimes hair loss is caused by a compulsion to pull out one’s own hair. This is called trichotillomania, which is a body focused repetitive behavior (BFRB). BFRBs are thought to be abnormal grooming behaviors and have a genetic predisposition. Other BFRBs include nail biting and skin picking. Treatment for BFRBs not only need to address the damage caused to the hair but involve a behavior intervention.

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Hair Loss and Diet

Certain nutritional deficiencies are associated with hair loss. These include protein malnutrition, biotin, zinc, and iron deficiencies. Although it is more controversial, some believe that vitamin D deficiency contributes. Vegetarians and vegans, as well as people with bowel problems that affect their ability to asorb nutrients are also at an increased risk of hair loss.

Hair Loss and General Health

As mentioned earlier, hair loss can be a sign of an underlying health problem. These include hormonal disorders, such as thyroid disease or polycystic ovarian syndrome or disease, autoimmune diseases such as lupus, and serious infections, such as syphilis. Hair loss sometimes occurs after surgery, childbirth, life-threatening stress, and as a side effect of some medications.

Alopecia and Skin Disorders

When a skin disorder such as eczema, seborrhic dermatitis, or an infection causes severe inflammation on the scalp this can result in secondary hair loss. If scarring hasn’t occurred, treating the skin problem can suffice to treat the hair loss.

Treating Alopecia and Improving Hair Growth

How one treats hair loss or alopecia largely depends on what is causing it. It may require a change in grooming practice, a change in diet, treatment of a medical problem or condition, elimination of an offending drug, topical, oral, or injected medication, light therapy, surgery, or just patience. Many times a combination of therapies is required to achieve the best possible degree of hair regrowth.

There are both medical and surgical techniques to address hair loss. Recommendations are based on the specific problem. We also offer hair restoration with the Alma TED.  If you are experiencing hair loss, we recommend you get evaluated and diagnosed by a board-certified dermatologist with expertise in hair loss and success in promoting healthy new hair growth.

How Can I Stop Hair Fall Immediately?

There are some steps you can take immediately upon discovering hair loss or thinning that may offer some improvement. For example, if you aren’t getting enough protein, increasing your consumption might have a positive effect on your hair growth.

Some other easy steps to address alopecia include:

  • Taking certain vitamin and mineral supplements to fill gaps in your diet
  • Using over-the-counter hair loss medications
  • Maintain good hair and scalp care
  • Exploring stress reduction techniques
  • Avoiding perms and bleaching
  • Wearing relaxed hairstyles that don’t pull on your scalp

Of course, the interventions listed above won’t work for everyone. Dr. Strachan tailors her hair growth plans to fit the individual patient. Schedule a consultation to learn what is best for your situation. She will thoroughly examine your scalp and hair, ask you questions about your lifestyle, dive into your relevant family history, and listen patiently to your questions and concerns.

When You Visit the Doctor

When you visit the dermatologist about hair loss it is helpful to be prepared for your visit. You hair and scalp needs to be available for examination. Ideally, your hair should be loose, not in braids or a weave. If you wear a wig, expected to remove it.

Additional Reading:

If you feel you need a dermatologist hair loss consultation, please feel free to contact us.

Learn More About Dermatologist Hair Loss

For more information about Dermatologist Hair Loss treatments we offer at Aglow Dermatology in New York City, please call us at 212-627-1004 or fill out the consultation request form from our contact page. Dr. Dina Strachan and her professional staff serve patients in New York City and the surrounding areas.

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