Hi Friend!
Have you ever looked at your brush filled with hair and felt like you’re losing a battle against your own body? Do you wear a hat every time you leave the house because you’re self-conscious about the thinning hair on your head?
You’re not alone in this struggle, I assure you. Hair loss is a common experience that many of us share.
On average, we lose between 50 and 150 hairs per day. That might seem like a lot, but it is a normal part of the hair growth cycle, and most of us have around 100,000 hairs in total. The unfortunate news is that time is not our friend when it comes to holding onto those hairs.
Studies have shown that more than 50% of women over 50 experience female pattern hair loss, the most common type of hair loss in women, which typically affects the crown of the head.
By the age of thirty-five, two-thirds of American men will experience some degree of noticeable hair loss. By age fifty, approximately 85% of men will have significant hair thinning. Around 25% of men with male pattern baldness begin losing hair before the age of twenty-one.
the stages.
Before diving into why hair loss occurs, it’s good to know about the stages of hair growth because the reasons for loss can happen at different points in this cycle. The hair growth cycle is a continuous process characterized by four phases: anagen, the growth phase; catagen, the regression phase; telogen, the resting phase; and exogen, the shedding phase. Each hair follicle cycles independently, undergoing ten to thirty cycles in a lifetime.1
Anagen
As the longest phase of the hair cycle, anagen typically lasts between two and eight years for scalp hair. Anagen is characterized by the production of an entire hair shaft from hair follicles; as such, hair length in the absence of cutting directly corresponds to anagen length. For example, whereas scalp hair follicles reside in anagen for two to eight years, eyebrow hair follicles reside in anagen for only two to three months. However, the length of the anagen phase decreases with age, resulting in weaker and thinner hair over time. Similarly, the proportion of follicles in the anagen phase declines with age. Importantly, anagen hair shedding resulting from premature termination of anagen growth or anagen arrest secondary to insult is never normal.2
Catagen
This phase lasts about two weeks. Throughout the catagen phase, hair follicles regress and detach from the dermal papilla, the population of mesenchymal cells within the hair follicle, resulting in epithelial cell apoptosis in the follicular bulb. Following catagen, the dermal papilla moves upward towards the hair follicle bulge. If the dermal papilla cannot reach the bulge during catagen, follicle cycling terminates, resulting in hair loss.
Telogen
Also called the resting phase, it lasts about two to three months. Approximately 9% of total scalp hair is in the telogen phase at any given time, compared to 40–50% of total hair on the trunk. While old hair is resting, new hair begins to develop at the base of the hair follicle, eventually pushing old hair out. However, if anagen enters the resting phase prematurely, excessive shedding and thinning can occur, known as telogen effluvium (TE). Conversely, reducing the percentage of hair follicles in the telogen phase can help manage hair loss.
Exogen
This phase is the termination of telogen and the initiation of anagen. During this period, newly developing hair continues to grow upward, pushing the old hair out, which ultimately results in its shedding.3
why are we losing it?
Several factors can influence the course of your aging and hair loss journey. While none of the factors listed below have been proven to be a definite cause of hair loss, data suggest that one (or more) may increase the likelihood of its occurrence. These factors include genetics, stress, medical conditions, medications, and certain treatments like chemotherapy.
Genetics – you can inherit hair traits from both parents. Humans have 23 pairs of chromosomes that carry their genetic information, including traits like eye color and toe length. Among these pairs, the “X” and “Y” chromosomes determine biological sex, with women having two “X” chromosomes and men having one “X” and one “Y” chromosome. The gene associated with baldness, called the AR gene, is found on the “X” chromosome. A study of 12,806 men of European ancestry revealed that those with the AR gene had more than twice the risk of developing MPB compared to those without it.
However, the AR gene is not the sole determinant of baldness. Further research in a 2017 review identified 63 genes that may play a role in male pattern baldness, with only six found on the “X” chromosome. Additionally, studies have shown that more than 80 percent of individuals experiencing noticeable balding had a father who also experienced hair loss.4
The exact genetics of hair loss in women are more complex than in men. Some women may experience genetic hair loss, even without a significant family history of the condition.
Stress – Yep, this one is a biggie. Emotional stress (like losing a loved one, significant life change, etc.) or physiological strain (rapid weight loss, major surgery, or severe medical condition) can both contribute to hair loss. While stress is not an immediate cause of loss, you will notice the change over several months during the natural hair cycle.
Medical Conditions – Thyroid disorders, PCOS, anemia, and nutrient deficiencies (specifically Vitamin D, iron, or protein) can contribute to hair loss. Infectious conditions like Ringworm, Folliculitis, Piedra (Trichomycosis Nodularis), Demodex folliculorum, and Seborrheic dermatitis also have a notable impact on hair health. Each condition exhibits distinct characteristics and uniquely affects the scalp and hair follicles.
Medications can disrupt hair growth at the telogen (short-term) and anagen (long-term). Most medications are associated with disruption at the telogen phase, whereas disruption during anagen is most associated with chemotherapy.
Vitamin A: In excessive doses, such as those found in some acne medications, including Accutane.
Monoclonal Antibodies: a biologic medication that may cause temporary hair loss. Remicade and Dupixent may cause alopecia areata, a condition characterized by patchy hair loss.
Anti-Clotting Drugs: Warfarin and Heparin may cause hair loss by interrupting the anagen phase. Noticeable loss may begin within 2 to 4 months after starting these medications.
Immunosuppressants: Certain medications used to treat autoimmune conditions, such as methotrexate, Arava, and Enbrel, may cause temporary hair loss.
Anti-Seizure Medications: According to a 2023 review5, hair loss is a commonly reported side effect of taking medications to prevent seizures. The three most prevalent medications associated with hair loss are Valproate, Lamictal, and Tegretol.
Blood Pressure Medication: Beta-blockers, such as metoprolol, timolol, propranolol, atenolol, and nadolol, may contribute to hair loss.
Antidepressants: SSRIs like Paxil, Zoloft, Prozac, Lexapro, and Celexa may cause hair loss after as little as two months of use. The good news, however, is that once the SSRI causing hair loss is stopped, about 63% of people will see hair recovery.
Weight-Loss Medication: Certain medications, such as Ozempic or Wegovy, may be associated with hair loss; however, this is not typically listed as a side effect. Patients who experience hair loss may also have nutrient deficiencies that affect hair growth and structure.
Rheumatoid Arthritis Medications: Some disease-modifying antirheumatic drugs (DMARDs) can cause hair loss. Methotrexate may cause hair loss in up to 3% of people, and Arava may cause hair loss in up to 1 in 10 people.6
Chemotherapy: Affects hair during the anagen phase. This type of hair loss can affect all hair, including the scalp, face, and body. Chemotherapy is designed to destroy rapidly growing cancer cells, but in the process, it also affects other rapidly growing cells, such as hair follicles.
Hormone Therapies: Certain therapies may trigger a hormone imbalance or significant hormonal changes, leading to hair loss. Birth control pills and hormone replacement therapies (HRT) with progesterone and estrogen can cause hair loss. In some cases, they may lead to female pattern baldness. The use of anabolic steroids for muscle-building can also cause hair loss.
Remember to keep in mind that just because you take one of the listed medications or have a familial history, there is no guarantee that you will experience any concerns related to hair loss. Conversely, you may not have any genetic predispositions or be prescribed any medications and still experience hair loss.
Now what?
Maybe you’re finding it more disconcerting to look in the mirror because all you notice is the thinning of your hair. Maybe you’re turning down social engagements because you don’t feel like yourself.
That’s understandable.
For many people, both men and women, hair is a significant part of our identity. While there may not be a cure for hair loss, my clinic does offer treatment that may help combat its progression.
Enter Platelet Rich Plasma (PRP).
PRP is a non-surgical option for treating hair loss that involves injecting platelets, extracted from your blood, into your scalp to help restore thinning hair. Platelets promote growth and regeneration, and, as the term ‘platelet-rich plasma’ implies, platelets are about five times more concentrated in PRP than in regular whole blood.
it’s all in the blood.
PRP is considered a safe, less invasive treatment option than transplant surgery. Platelets in your blood contain growth factors, or the cell-signaling proteins that orchestrate the body’s tissue rejuvenation and healing systems. Plasma is the fluid component of blood that carries platelets, along with red blood cells and white blood cells.
Your blood is drawn at the beginning of your appointment. Then, it undergoes centrifugation to separate the plasma from the red blood cells. Simply put, your blood is placed on a device that spins it at a high speed until the components separate. Once separated, the plasma is collected and then injected into your scalp.
Upon injection, PRP increases blood flow to the surrounding hair follicles and can stimulate new hair growth and lengthen the anagen (active) growth phase of existing hair, helping to slow hair loss. A 2019 review of studies on PRP for hair loss found that both men and women have shown positive results related to increased hair density, thickness, and regrowth.7 However, it is essential to note that every patient’s results may vary, and success with new growth will differ from one patient to another.
Most patients require several sessions to achieve noticeable changes in their hair. There is no hard and fast number of sessions you will need; however, patients typically see results after three or four, with four to six weeks between each. Maintenance treatments are suggested every six to twelve months.
Remember that results are highly individualized, and factors such as age, health, and the underlying cause of hair loss can influence the likelihood and degree of successful regrowth.
PRP is considered a low-risk procedure; however, potential side effects should be considered. Research from 2022 suggests that some patients may experience mild discomfort at the injection site, headache, itching, and temporary swelling. Additionally, underlying health conditions like low platelet count or sepsis, some types of cancer, smoking, recent injections of certain steroids, fever, and anemia may increase the risk of those side effects.8
In 2019, a study published in the International Journal of Trichology compared the effects of platelet-rich plasma (PRP) treatment with those of topical minoxidil (Rogaine). The study demonstrated that PRP was more effective at preventing hair loss than Rogaine and had fewer side effects. Compared with other treatments, such as topical minoxidil and oral finasteride (Propecia), PRP frequently performs better and is not associated with the same frustrating side effects.
For men, such medications can often lead to side effects, such as erectile dysfunction. For women, side effects can include facial hair growth and low blood pressure. For that reason, PRP is quite often the best option for combating hair loss.9
Like any other treatment, before proceeding with PRP, we need to review your health history to ensure this is the best course of treatment for you.
next steps.
I want you to feel confident.
And beautiful.
And handsome.
And like yourself.
If you are concerned about hair loss, please know you have options.
I’ve seen the difference that just a few PRP sessions can make in someone’s confidence. I’ve seen before-and-after photos and real-life, in-person results for people I love dearly.
With its lower risk of side effects, encouraging results after treatment, minimal downtime, and utilizing your blood to heal another part of your body, PRP may answer a question you weren’t even sure how to ask.
I would love to discuss whether PRP (or any other treatment we offer) would be a good fit for you.
Please call the clinic at 405-701-6717 to schedule a visit!
With Love,
Dr. Ronni Farris
- Harrison S., Bergfeld W. Diffuse hair loss: Its triggers and management. Clevel. Clin. J. Med. 2009;76:361–367.
↩︎ - Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss – PMC
↩︎ - Paus R., Cotsarelis G. The Biology of Hair Follicles. N. Engl. J. Med. 1999; 341:491–497
↩︎ - Causes – American Hair Loss Association ↩︎
- https://pubmed.ncbi.nlm.nih.gov/37367730/ ↩︎
- Medications That Cause Hair Loss: List, What You Can Do, and More ↩︎
- Stevens J, Khetarpal S. Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol. Int J Womens Dermatol. 2018 Sep 21;5(1):46-51 ↩︎
- Paichitrojjana A, Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Devel Ther. 2022 Mar 10; 16:635-645. ↩︎
- How Effective Is PRP For Hair Loss? – Dr. Michele Green M.D. ↩︎
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