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12 female things
WAYS TO HALT AND REVERSE FEMALE PATTERN HAIR LOSS
hormonal. In women there can be more than one
Disclaimer: This document provides medical
information of a general nature for the purposes
contributing factor and needs to be tailored to each
of education. It should not be taken as specific
woman’s medical situation, age and life
individual medical advice as this cannot be
circumstances. Causes are divided into 3 groups.
supplied without a consultation and adjustments to suit an individuals own medical requirements.
1. Diffuse causes of hair loss. Most common.
Seek medical advice specific to you before
About 70% of sufferers will have hormonal or
embarking on a hair maintenance programme.
female pattern hair loss as the major cause of their problem. The second most common cause is telogen
It’s a scary moment when you discover that you are
effluvium, the hair loss caused by shock, stress, some
losing your hair. Maybe you have been losing your
medication,pregnancy and the contraceptive pill.
hair for a while and maybe your loss is more recent.
Charlotte Dawson admitted to suffering an attack of
Either way you need to be aware of 3 important
telogen effluvium. Telogen effluvium is usually brief
and the hair pretty much fully recovers but some women develop a more chronic form, which leads
1. Unlike men, it’s rare for a woman to lose all her
to a fluctuating level of hair loss lasting years. Thyroid
hair. You may get quite thin without treatment but
or other hormonal disorders as well as lack of iron
can contribute so a medical checkup is vital.
2. Effective treatment is available.
2. Patchy Hair Loss. Less common. These include alopecia areata (bald patches) as well as it’s rare
3. Covering up and your hairdresser can do
variants alopecia totalis (loss of all head hair) and
alopecia universalis (loss of all body hair). Also included in this group are traction alopecia due to
hairclips and rollers as well as trichotillomania (uncontrollable pulling out of hair due to stress and
You must get an accurate diagnosis. Find a doctor
3. Scarring alopecias. Rare and serious. These are
who will listen and take the problem seriously. Hair
medical emergencies that need prompt treatment.
loss is a condition where women are much more complicated than men. In men, the majority of hair
Whatever your cause and whatever treatment you
loss is due to androgenetic alopecia, which is
choose you need to be consistent as there is no
cure, only maintenance and slow regrowth. The
3. USE TOPICAL MINOXIDIL, a Pharmacy Only lotion
sooner you start treatment the better. It is easier to
applied to the scalp twice a day.
maintain a head of hair that has only just started
Minoxidil, marketed as Rogaine or Headway comes in either as 2%
down the road to hair loss than it is to resurrect a
standard solution or 5% extra strength. It is also possible to have a
compounding pharmacist mix a more effective 10% solution or combine minoxidil with retinoic acid to make it more effective. These options are quite pricey, however, at $150-$200 a month compared
Medical treatment of hormonal hair loss is a long
term process. Encouraging faster regrowth after a
Minoxidil works by causing very fine pale hairs (vellus hairs) to
bout of telogen effluvium is easy, similiar to taking a
thicken and darken into proper (terminal) scalp hairs. Studies show
course of antibiotics. Combatting the effects of the
that hair weight increases by 25% with 2% and 35% with 5%
androgenic hormones that cause female pattern hair
minoxidil. These effects occur over 6-12 months and then stabilise. Stop the Minoxidil and the hair falls out. Other studies show the
loss is a long term commitment, more like being on
effect of minoxidil together with finasteride is better than either
a blood pressure tablet. If you stop treatment you
treatment alone. Finasteride and minoxidil are the only medically registered proven treatments for hair loss.
The main side effect is occasional hair growth on the temple in some
It’s best to think about about hair loss treatment as
women. This is reversible once the minoxidil is stopped. It is pretty common with the use of the 5% strength so most women use the
like brushing your teeth,showering or your makeup
2%. Other side effects are related to either a skin reaction to the
routine: things that no-one did 100 years ago but
alcohol base of the lotion or to overdose of minoxidil. In tablet form minoxidil potently lowers blood pressure so overdose can affect the
you now do every day for your health and
heart. One man successfully committed suicide by drinking a whole
bottle of minoxidil 5% and another was admitted to hospital with palpitations after using way too much minoxidil on his body. There have been no major side effects reported in men at standard doses.
COST - $45-70 A MONTH.
1. DON'T SMOKE or stop if you do. Smokers lose hair
faster and go grey quicker than nonsmokers.
4. USE 2% KETOCONAZOLE SHAMPOO as your daily
Either cut down then stop cold turkey or substitute nicotine gum for cigarettes. Free patches are available via QUITLINE 0800 778 778.
Ketoconazole is the active ingredient in Nizoral and Sebizole
Some people get inspiration from reading Allan Carr's "Easy Way to
shampoo. It is an antifungal and therefore active against dandruff.
Stop Smoking" available from major bookshops. He changes the way
Studies have also shown that it grows hair and the effect is additive
that you think about smoking so that you no longer crave a cigarette.
to minoxidil and hormonal treatment. Even if your current shampoo
was recommended by your hairdresser, is the only thing that gets your hair just right and you would never change, at least add 3 mls of 2% ketoconazole to your shampoo each day.
2. GET A PROPER CHECKUP. Hair loss can be due to
lack of iron or an underactive thyroid. Depending on
The 2% strength available only at chemists is more effective than the 1% strength you can get at the supermarket. Other antidandruff
your age and the length of time you have been
shampoos containing zinc pyrithione have also been shown to have
losing your hair you need to be checked out for the
slow hair loss but not as well as ketoconazole and only if you are not already on minoxidil. There has been no effect shown from selenium
effects of current or previous medication, PCOS, the
sulphide containing shampoos such as Selsun. COST - $25 A MONTH.
menopause or other hormonal conditions.
This point is number two for a reason. Your diagnosis and treatment
5. BLOCK AND REDUCE DHT, the final step of female
plan have to be right from the start or you will be like so many women
pattern hair loss
that I see or hear from. Shunted from a GP’s cursory examination, a dermatologist’s five minute consultation ($200 plus), a naturopath’s weak remedies or ONE OF THE CLINICS and their eight month,
In female pattern hair loss hair follicles shrink and die under the
$3-4000 regimes. And all the while the hair loss continues.
action of dihydrotestosterone, also known as DHT. Once it is dead the hair from that follicle falls out. No new hair grows again.
Make sure your diagnosis comes from a doctor. Sorry to sound arrogant but the facts are you will get the best advice this way. But
DHT is the breakdown product from testosterone. Levels in the body
make sure that the doctor you see is educated in female hair loss and
depend on testosterone levels (men have more, women produce
interested in taking the time to know you and your condition. If that is
more during puberty and after the menopause) and how quickly our
your GP then great, otherwise request a referral to a dermatologist or
bodies clear it away. If you are a slow clearer then levels build up and
endocrinologist with an interest. Or try me out.
lead to acne (DHT causes acne), excess body hair and hair loss.
Medication, iron levels, vitamins and minerals. What to take and what
You have options in your hormone blockage:
to avoid needs to be sorted out. Then you can decide how aggressive about treatment you want to be.
1. THE PILL
Not just any pill because some forms of the pill boost DHT levels. You
are better off with Diane 35 and Estelle 35 (very much the same) and
help in three ways. Firstly they are contraceptives. Secondly, they contain higher doses than other contraceptive pills of oestrogen.
CONTROL DHT BY CONTROLLING GI
If you are losing your hair you need to
Oestrogen raises the blood level of sex hormone binding globulin
know about the metabolic syndrome. The metabolic syndrome is
(SHBG). SHBG binds testosterone, reducing the amount able to
caused by insulin resistance, a condition where your body’s own
insulin does not work as well as it used to.
The third way this treatment helps is they contain cyproterone as their form of progesterone. This drug has anti-testosterone effects. They
The hormone insulin is produced by the body to lower blood levels of
are excellent at reducing acne and excessive body hair as well as
glucose which comes from digested food. If you eat a high glucose
providing contraception but major side effect of Diane 35 and Estelle
meal or your insulin is not having enough of an effect the blood
35 is the risk of blood clots. They are unsafe in those at risk of blood
glucose level rises. To compensate the pancreas makes more insulin.
clots (deep vein thrombosis or DVT) or with liver disease. These
As well as reducing that blood glucose level by pushing the glucose
figures will help you understand their effect on DVT risk:
into cells high insulin levels also boost the production of testosterone.
All that extra testosterone is quickly converted into DHT which heads
• Risk of death from DVT - healthy young woman
straight to the scalp to kill off hair follicles as well as to areas like the
• Risk of death from DVT - pregnant woman
back, buttocks and forearms to cause hair growth and to the face to
• Risk of death from DVT - 2nd generation pill
cause acne. This same process occurs in PCOS or polycystic ovary
• Risk of death from DVT - 3rd generation pill
• Risk of death from DVT - Diane 35 or Estelle 35
So eat to keep blood glucose levels stable. No blood glucose surge
There is a new pill on the market called Yasmin. This contains
means no insulin spike and no DHT spike. The measure of how
drospirenone , a new form of progesterone similiar to spironolactone.
quickly different foods raise blood glucose levels is the Glycaemic
there are no studies to back up the use of Yasmin but it seems likely
Index. You should learn about this from available from a dietitian or
it would be helpful, especially for those requiring contraception
one of the many books the health section of any major bookseller.
anyway. COST - STANDARD PRESCRIPTION CHARGE, ADD $20 A
The two most popular series are the Zone Diet series from the USA
MONTH FOR YASMIN.
(keep your insulin levels in “the zone”) and the GI (Glycaemic Index) Factor books from Australia. Buy one.
This mild diuretic reduces testosterone and DHT levels so helps fight
acne and excessive hair growth. There is excellent evidence it helps
7. DRINK GREEN TEA, try to manage 3 cups a day.
excess body hair but the evidence for helping hair loss is weaker.
Occasionally it can raise the body’s potassium levels. COST -
Green tea contains compounds with anticancer properties which are
STANDARD PRESCRIPTION CHARGE.
currently also showing promise in treating hair loss lowering DHT. It is higher in caffeine than other tea so watch if you are sensitive to that.
3. CYPROTERONE AND FLUTAMIDE
Make it strong and try to drink 3 cups a day. COST - about $4 a packet.
These more powerful antiandrogen drugs are available through a specialist if necessary.
8. CONSIDER THE HERBAL REMEDIES SAW PALMETTO,
Known commonly as Propecia and Proscar, these are the only
BETA-SITOSTEROL AND PYGEUM in tablet form every day.
hormonal treatments available to men. It has also been shown to be of some use in female pattern hair loss at a dose of 2.5mg a day
May help some. More useful for men
($100 a month). It is very important not to become pregnant while taking this drug.
9. CONSIDER MELATONIN
5. HRT or PROGESTERONE CREAM
The body’s natural sleep hormone, melatonin, has been shown to be
You will need to decide if the risks are outweighed by the benefits in
important in boosting female hair growth. Melatonin tablets have
your case but topical and tablet oestrogen is effective hormonal
never really panned out to be that effective for sleep but topical
treatment. COST - STANDARD PRESCRIPTION CHARGE.
melatonin has been shown in trials to grow hair. Topical melatonin is not available in New Zealand. The same effect has not been shown yet with melatonin tablets but you could consider this.
6. CONTROL YOUR INSULIN LEVELS AND CONTROL DHT.
EAT TO SAVE YOUR HAIR (and maybe your life).
10. WEIGHT GAIN WILL ACCELERATE YOUR HAIR LOSS
Don’t underestimate this. Basically the low glycaemic index, slow
This is true because insulin resistance and the metabolic syndrome
raise insulin levels which causes abdominal fat cells to suck in calories and grow. These enlarged fat cells and the gut they grow
There are four good reasons why you should take control of your diet:
then worsen insulin resistance further in a vicious cycle. Have you found that you gain weight more easily than your siblings and friends
• A healthy diet low in saturated fat and processed carbohydrates
even though you eat and exercise much the same? That’s insulin
and packed with fresh fruit and vegetables is good for all of us.
resistance. Why does being overweight and bald seem to go together? Insulin level spikes accelerate hair loss (by raising DHT)
• Hair loss can be associated with the metabolic syndrome, a genetic
and promote fat gain. That fat gain then raises insulin levels further.
condition where insulin resistance causes hair loss, a fat gut, gout, high blood pressure and an early death from a heart attack or stroke.
Insulin resistance makes it harder but more important to control that
Combating this condition with diet may save your life.
gut. A six pack and a fit body will slow your hair loss as well as decrease your risk of an early death.
• Controlling insulin levels through controlling the glycaemic index of your food will reduce DHT levels and therefore slow hair loss.
11. GOOD FATS MAY GROW HAIR
• Boosting the level of omega 3 fatty acids from fish or some plant sources may boost hair growth.
The latest news about diet and hair loss is related to fat intake. And the story starts with eye drops for glaucoma! Eye drops containing
the prostaglandin Latanoprost have been shown to make eyelashes
are required.There are no easy answers, just a group of drugs,
grow longer. Studies show it will also grow scalp hair but the good
supplements and cosmetic and lifestyle measures to be getting on
news is we can cause the same effect through diet. Latanoprost is a
with every day. Treatments don't work straight away and it may take
synthetic (and therefore patentable) form of the class of hormones
six months before you can say for sure whether they work for you or
known as prostaglandins. There are two different classes of
prostaglandins, the hair losing, arthritis and stomach ulcer class and the hair saving, arthritis and stomach ulcer preventing class. And your
BUT it’s the best we have. And if you don’t have that focus and belief
diet influences the balance between them.
in your regime chances are you will stop and start your treatment, panic when the inevitable bad days come and chop and change from
Fats in the diet are either saturated (don’t eat them),
one regime to the other. And remember there is always a clinic out
monounsaturated (safe, mainly from olive oil) or polyunsaturated.
there waiting for you to pay for a $4000 treatment at a weak moment.
Polyunsaturated fats are further divided into omega 3 and omega 6 fats and these are the building blocks for the two different classes of
Remember what Susan Devoy says - success comes from
prostaglandins. Omega 6 fats make inflammation boosting, hair
discovering the right thing to do and then doing it every day. At
losing prostaglandins and omega 3 fats make inflammation settling,
present I think the above advice is the best thing you can do.
Modern western diets contain too many omega 6 fats and this is implicated in the rise in arthritis, heart disease and hair loss, all
WHAT ABOUT OTHER TREATMENTS?
caused by inflammation. The reason is that omega 3 fats are mostly present in fish and wild game while omega 6 fats are mostly present
The above treatments are the most effective, proven treatments.
in farmed grains such as wheat. Our modern processed diets contain
Other treatments fall into two categories, minimally effective and
an imbalance, too much grain and not enough fish and wild
outright fraud. The fraudulent treatments are too numerous to list
mammoth. To restore the balance eat more omega 3 fats. These are
here (I’ll only mention one - Nioxin), just be careful about what you
present in fish, especially tuna, salmon, kahawai and mullet, as well
buy. My website has links to information about scam artists.
as in flaxseed oil and nuts. Have some at least three times a week, preferably every day.
There are also many treatments with some weak evidence of a small effect on hair. These include azelaic acid, emu oil, copper peptides, zinc, squalene, biotin, pyridoxine (B6), Revivogen and low level
12. COMBINATION TREATMENT IS THE WAY TO GO - get
lasers. Sure they may have a small additional effect but they cost a lot and at best they would be used in addition to the top treatments
with a programme.
above. Any extra benefit you may get would be like buying Creme de la Mer at $200 a jar for your skin. You may notice a slight difference
Studies show that combination treatments are always more effective
but it’s a lot of money to spend for a small benefit. If you do want to
than the same treatments used alone. Knowledgeable people agree,
go down this road then Revivogen is your best bet. Dermatologist -
from Spencer Kobren to us, that an organised programme, followed
developed, Revivogen is packed with all of these ingredients and is
consistently and for long enough, will always work better than
experimenting with treatment in a haphazard manner. A lot of women waste their time trying this single treatment then that one, before
And the future?
New medical treatments seem to be in limbo at
giving it all up as a waste of time. This is the number two mistake
present as drug companies come to terms with disappointing sales
made. Number one is waiting too long to start treatment.
of Propecia and Rogaine. Hopefully they will get back on track. Hair
Combination treatment is excellent at preserving hair and slow and
cloning is the next great hope but seems years away at present.
weak at regrowing it - so don’t leave it too long. Remember what
Small gains seem to be the rule for now. You can wait for better
Susan Devoy says about success. Success comes from working out
treatments if you like but you may have to wait 15 years.
what needs to be done to reach a goal and then doing that every day.
effects of minoxidil, 1% pyrithione zinc and a combination of both on hair density: a
13. KEEP A POSITIVE ATTITUDE
randomized controlled trial. Br J Dermatol. 2003 Aug;149(2):354-62.
2. Ilian Bandaranayake, BA, Paradi Mirmirani MD. Hair Loss Remedies—Separating Fact
It can seem hard to remain positive when life has dealt you the female
From Fiction. Cutis. 2004;73:107-114.
pattern baldness card, even more so now that you’ve been told that
3. ostaglandin analogs for hair growth: great
your hair loss could be a threat to your health. That you should is
expectations. Dermatol Online J. 2003 Aug;9(3):7.
4. . Approach to the adult female patient with diffuse nonscarring alopecia. J Am Acad Dermatol. 2002 Dec;47(6):809-18.
1. You’ve only got one life. Each day that you spend isolating yourself from life is a day you’ll never get back again.
2. You’ve already learned you have the genetics that make it all too easy for you to get fat and bald with consequences for your attractiveness and future health. You need to be motivated to eat, exercise and take your medication to prevent this.
The good news is that you can control your mood. The field of cognitive behavioural therapy has shown this. The easiest and best place to start is at www,HowToBeHappy.org. Go there and learn something.
14. BE SERIOUS
Saving your hair is not easy, it requires discipline and focus. Think about it like you think about weight control, hard work and discipline
CVS Caremark Drug List Changes – Removal from Formulary – Rationale Effective January 2014 Note: This document is specific to the removal of drugs from the standard formulary for January 2014. This document does not address other drug list changes that are focused on non-preferred/preferred status changes. Changes will be made to the CVS Caremark standard formulary eff
LABORATÓRIUMI ADATLAP (2013) VETLABOR ÁLLATORVOSI DAGANAT MARKER LABORATÓRIUM …… CEA [<5, 5-20, >20] (S) SZEROLÓGIA/VIROLÓGIA (S) TLI (EPI diag.)[8-35 ug/l] (LH) sPL (spec.panc.lipáz) Troponin I (<80) (LH) NT-proANP (<1350) (HP) Cystatin-C (<1 mg/l) (LH) B12-vitamin (250-900 ng/l)(LH) Fólsav (8-25 ug/l) (LH) Húgysav (L