What Doctor Should You See for Female Hair Loss? A Comprehensive Guide

Hair loss in women can be a distressing experience. Understanding the cause is the first step towards effective treatment. Board-certified dermatologists are the specialists with the expertise to diagnose and treat the many causes of hair loss in women. This guide will explain why a dermatologist is the best doctor to see for female hair loss and what you can expect during your appointment.

Effective treatment for hair loss starts with identifying the underlying cause. To get an accurate diagnosis, consulting a board-certified dermatologist is crucial. These doctors possess extensive knowledge of the numerous reasons behind hair loss and have significant experience in treating these diverse conditions.

How Dermatologists Diagnose the Cause of Female Hair Loss

When you see a dermatologist for hair loss, they will conduct a thorough examination to pinpoint the cause. This process typically involves:

Detailed Questioning: Your dermatologist will ask about your hair loss history, including when it started, how quickly it progressed, and any potential contributing factors like recent illnesses, medications, or lifestyle changes.
Scalp and Hair Examination: A close examination of your scalp, hair, and even nails provides vital clues. Dermatologists often use a dermatoscope, a handheld magnifying device with a light, to get a detailed view of the scalp and hair follicles. This helps them assess the pattern of hair loss and identify any scalp conditions.
Hair Pull Test: This simple test involves gently pulling on small sections of your hair to assess hair shedding and hair fragility. It helps determine the stage of hair growth and identify if hair is breaking easily.

In some cases, further testing may be necessary to determine the underlying cause of hair loss. If your dermatologist suspects an underlying medical condition, vitamin deficiency, hormonal imbalance, or infection, they may recommend:

Blood Tests: These can help identify vitamin deficiencies (like iron or biotin), hormonal imbalances (such as thyroid issues), or signs of underlying medical conditions that can contribute to hair loss.
Scalp Biopsy: In certain situations, a small scalp biopsy may be needed. This involves taking a tiny sample of scalp tissue to examine under a microscope. A scalp biopsy can help diagnose conditions like alopecia areata, lichen planopilaris, or rule out other scalp disorders.

After gathering this information, your dermatologist can often diagnose the cause of your hair loss and discuss appropriate treatment options. Sometimes, identifying the cause is more complex, especially if multiple factors are contributing to hair loss. For instance, a woman might be experiencing postpartum hair loss after childbirth, but also have early signs of hereditary hair loss (female pattern hair loss).

Understanding Hair Regrowth and When Treatment is Necessary

Once a dermatologist determines the cause of your female hair loss, they will advise you on whether treatment is recommended. In some instances, hair loss is temporary, and hair regrowth occurs naturally without intervention.

Situations Where Hair May Regrow Naturally

In certain situations, hair loss is often temporary, and you can expect natural regrowth. These situations include:

Postpartum Hair Loss (Telogen Effluvium): Many women experience hair shedding a few months after childbirth due to hormonal changes. This is typically temporary, and hair regrowth occurs within a few months to a year.
Hair Loss After Illness or Surgery (Telogen Effluvium): Significant physical stress on the body, such as major illness, surgery, or even rapid weight loss, can trigger temporary hair shedding. Hair usually regrows as the body recovers.
Hair Loss After Cancer Treatment (Chemotherapy-induced Alopecia): Chemotherapy can cause significant hair loss. However, hair regrowth is expected after the completion of cancer treatment.
Mild Alopecia Areata: Alopecia areata is an autoimmune condition that causes patchy hair loss. In mild cases, hair can regrow on its own, although recurrence is possible.
Scalp Psoriasis Management: Psoriasis on the scalp can sometimes lead to hair loss. Effective treatment of scalp psoriasis can allow for hair regrowth.

A dermatologist can assess your specific situation and determine if natural hair regrowth is likely. In other cases, intervention and treatment are necessary to encourage regrowth and prevent further hair loss.

Lifestyle Adjustments and Hair Care for Hair Loss

Sometimes, simple changes to your hair care routine or hairstyle can make a difference in addressing hair loss. Certain hairstyles that pull tightly on the hair, like tight braids or ponytails, and harsh hair treatments can damage hair follicles and contribute to hair loss known as traction alopecia. Dermatologists can identify if these factors are contributing to your hair loss and recommend gentler hair care practices.

When Dermatologists Recommend Hair Loss Treatment

While natural regrowth is possible in some cases, dermatologists often recommend treatment to expedite hair regrowth, prevent further hair loss, and address underlying conditions. Treatment plans are tailored to the specific cause of hair loss and may include a combination of approaches.

At-Home Hair Loss Treatments Recommended by Dermatologists

Dermatologists frequently recommend at-home treatments as part of a comprehensive hair loss management plan. These treatments offer convenience and can be readily incorporated into your daily routine.

Minoxidil (Rogaine®): Minoxidil is an over-the-counter topical medication FDA-approved for hair loss. It is available in liquid or foam form and is applied directly to the scalp. Minoxidil can be effective for various types of hair loss, particularly early-stage female pattern hair loss. It works by stimulating hair follicles and prolonging the hair growth cycle. It’s important to use minoxidil consistently as directed, usually once or twice daily, to see results. It typically takes 6 to 12 months to observe noticeable hair regrowth. Continued use is necessary to maintain results, as stopping minoxidil will lead to a gradual loss of any regrown hair.
At-Home Laser Therapy: Laser devices, such as laser caps and combs, are available for home use to treat hair loss. These devices utilize low-level laser therapy (LLLT) to stimulate hair follicles. While research is ongoing, some studies suggest that LLLT can be beneficial for hereditary hair loss. However, results vary, and more research is needed to determine the long-term efficacy and ideal candidates for this treatment.
Microneedling: Microneedling devices, equipped with tiny needles, are gaining attention as a potential at-home hair loss treatment. Studies suggest that microneedling can stimulate hair growth by creating micro-injuries on the scalp, triggering the body’s natural healing response and promoting hair follicle regeneration. Microneedling is often used in conjunction with other treatments like minoxidil to enhance results. It’s advisable to consult with a dermatologist before starting microneedling at home to ensure it’s appropriate for your condition and to receive guidance on proper device selection and technique.

In-Office Procedures for Hair Regrowth by Dermatologists

For more significant hair loss or when at-home treatments are insufficient, dermatologists offer in-office procedures that can provide more effective results.

Corticosteroid Injections: For localized hair loss conditions like alopecia areata, corticosteroid injections into the bald patches are a highly effective treatment. Corticosteroids reduce inflammation around the hair follicles, allowing hair to regrow. Injections are typically administered every 4 to 8 weeks as needed. Studies have shown significant hair regrowth in a majority of patients with patchy alopecia areata treated with corticosteroid injections.
Hair Transplant: Hair transplantation is a surgical procedure that offers a permanent solution for hair loss, particularly for female pattern hair loss. It involves transplanting hair follicles from a donor area (usually the back of the scalp) to the thinning or balding areas. Hair transplants can provide natural-looking and lasting results. Dermatologists specializing in hair restoration can perform hair transplants or recommend qualified surgeons.
Laser Therapy (In-Office): In-office laser therapy, also known as low-level laser therapy (LLLT), utilizes more powerful laser devices compared to at-home devices. It is a non-invasive treatment that stimulates hair follicles and promotes hair growth. In-office laser therapy requires multiple sessions over several months to achieve noticeable results. It can be used for various types of hair loss, including hereditary hair loss and alopecia areata, and to promote healing after hair transplants.
Platelet-Rich Plasma (PRP) Therapy: PRP therapy is an innovative treatment that uses the patient’s own blood to stimulate hair growth. A small blood sample is drawn, processed to concentrate platelets (which contain growth factors), and then injected into the scalp in areas of hair loss. PRP therapy has shown promising results in treating various types of hair loss, including female pattern hair loss and alopecia areata. It is generally considered safe and requires repeat treatments, typically monthly for the first three months and then less frequently for maintenance.

Prescription Medications for Female Hair Loss

Dermatologists may prescribe medications to address underlying hormonal imbalances or specific conditions contributing to hair loss in women.

Spironolactone: Spironolactone is an oral medication often prescribed for female pattern hair loss, particularly when hormonal factors are suspected. It works by blocking the effects of androgens (male hormones) that can contribute to hair thinning in women. Studies indicate that spironolactone can be effective in slowing down hair loss and increasing hair thickness in a significant percentage of women with female pattern hair loss. It is crucial to avoid pregnancy while taking spironolactone due to potential birth defects, and birth control is typically prescribed concurrently for women who can become pregnant.
Finasteride (Propecia®): While primarily approved for male pattern hair loss, finasteride may be prescribed off-label for women with hereditary hair loss who are not of childbearing potential. Finasteride is an oral medication that blocks the conversion of testosterone to dihydrotestosterone (DHT), a hormone implicated in hair loss. It can help slow down hair loss and stimulate new hair growth. However, it is contraindicated in women who are pregnant or may become pregnant.
Other Medications: For hair loss caused by infections like scalp ringworm (fungal infection) or inflammatory conditions like frontal fibrosing alopecia (FFA), dermatologists will prescribe appropriate medications to treat the underlying condition. Antifungal medications are used for scalp ringworm, while antibiotics and anti-inflammatory medications may be used for FFA.

Vitamins, Minerals, and Supplements for Hair Health

Nutritional deficiencies can sometimes contribute to hair loss. Dermatologists may recommend blood tests to check for deficiencies in vitamins and minerals like iron, biotin, and zinc.

Addressing Deficiencies: If a deficiency is identified, your dermatologist may recommend specific supplements to replenish these nutrients. However, it’s crucial to only take supplements when a deficiency is confirmed by blood tests, as excessive intake of certain nutrients can be harmful.
Multivitamins: For overall hair health, a balanced diet and a multivitamin are often recommended. While specific hair supplements are marketed, many dermatologists advise against high doses of single nutrients unless a deficiency is present.

Wigs and Hair Concealers for Managing Hair Loss

For some women, medical treatments may not be desired or feasible. Wigs and hair concealers offer immediate and effective ways to manage the appearance of hair loss and boost self-esteem.

Wigs: A wide variety of wigs are available, including custom-made options, offering different styles, colors, and hair types. Wigs provide full coverage and can be a comfortable and convenient solution.
Hair Concealers: Hair concealers, such as sprays and powders, are cosmetic products that can camouflage thinning areas and create the appearance of fuller hair. They are readily available online and in beauty stores.

Your dermatologist can provide guidance on selecting wigs and concealers that best suit your needs and preferences.

Expected Outcomes and the Importance of Early Intervention

With an accurate diagnosis from a dermatologist and appropriate treatment, many women experiencing hair loss can achieve hair regrowth or effectively manage their condition. Early intervention is often key to maximizing treatment success.

It’s important to remember that:

Not all types of hair loss are treatable, but a dermatologist can often prevent further hair loss progression.
Hair regrowth treatments take time, and noticeable results may not be evident for several months.
Treatment effectiveness varies from person to person, even with the same type of hair loss.
Finding the right treatment approach may require patience and trying different options under the guidance of your dermatologist.

Self-care practices, such as gentle hair care and stress management, also play a vital role in supporting hair health and treatment outcomes. Consulting a dermatologist is the crucial first step in understanding and addressing female hair loss effectively.

Images Images 1 and 2: Getty Images

Image 3: Property of the American Academy of Dermatology, A to Z Video Series

Image 4: Image used with permission of Journal of the American Academy of Dermatology: J Am Acad Dermatol. 1998; 39:578-89.

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Last updated: 12/13/22