ASK THE EXPERT

Hereditary hair loss (HHL) accounts for 95% of men’s and women’s hair loss.
ROGAINE^® is the only topical brand FDA-approved to regrow hair for HHL.
ROGAINE^® is not indicated for other causes of hair loss. Below are some questions on the causes on other types of hair loss and answers by expert Dr. Robert Leonard.

DR. ROBERT LEONARD, FAACS

Dr. Robert Leonard, Founder and Chief Surgeon of Leonard Hair Transplant Associates, has specialized in hair restoration surgery for more than 23 years. He is a past president and a member of the Board of Governors of the International Society of Hair Restoration Surgery, a Diplomate of the American Board of Hair Restoration Surgery, and a Fellow of the American Academy of Cosmetic Surgery. Dr. Leonard has treated men and women with hair loss with medical therapies including ROGAINE^®, Propecia, and low level laser light therapy with great success.

DR. LEONARD'S Q&A

Get an expert’s take on the causes of hair loss, and other ways to support hair health and growth in Dr. Leonard’s Q&A.

• What is considered normal hair loss?
• I am losing large clumps of hair every day. What can I do?
• Can poor diet cause hair loss?
• I noticed that my hair is thinning post-pregnancy.
• Can medications cause hair loss? If so, what kinds are associated with hair loss?
• Do thyroid conditions/hormonal imbalances cause hair loss?
• Is there a way to determine if I’m genetically predisposed to Hereditary Hair Loss?
• What role does aging play in the process of thinning hair?
• Can sun (UV) damage thin hair?
• Are hair vitamins effective?
• Are there foods I can eat to promote healthy hair?

Q: What is considered normal hair loss?
DR. LEONARD: Most people lose between 50–100 hairs a day, which is considered normal hair loss. This is replaced with new hair through the three stages of natural hair growth: anagen (growth phase), catagen (transitional phase) and telogen (resting phase).

A consistent loss of 150 hairs a day is considered significant hair loss. If you start to notice more hair than usual in your shower drain, on your pillow, or in your hairbrush, then you may be experiencing hair loss/thinning.

Q: I am losing large clumps of hair every day. What can I do?
DR. LEONARD: This hair loss may be due to an autoimmune condition called Alopecia Areata, in which you lose a great deal of hair in a short amount of time.

Alopecia Areata is distinct from Hereditary Hair Loss. This type of hair loss is so extreme, it is best to take proactive measures.

Q: Can poor diet cause hair loss?
DR. LEONARD: Crash dieting can, indeed, cause reactive hair loss.
This reactive hair loss (called Telogen Effluvium) is different from Hereditary Hair Loss, however. Hereditary Hair Loss is the most common form of hair loss, and accounts for 95% of all cases in both men and women.

Telogen Effluvium is limited and temporary hair loss that will grow back on its own. In all, it takes about three to four months for the hair to shed, and then an additional three to four months for the hair to regrow from Telogen Effluvium.

Other conditions that can cause Telogen Effluvium include: anemia, pregnancy, general anesthesia and trauma.

If you experience Telogen Effluvium, but also have Hereditary Hair Loss, your hair may not grow back as full as it was prior to the temporary loss.

Q: I noticed that my hair is thinning post-pregnancy.
DR. LEONARD: Like crash dieting, a common occurrence of post-pregnancy is hair loss (another form of Telogen Effluvium). Typically, hair will start shedding a few weeks after childbirth, and will then begin the regrowth cycle in three to four months. However, if you have hair loss after pregnancy AND have female pattern hair loss, your hair may not grow back as thick as it was before the temporary hair loss took place.

Q: Can medications cause hair loss? If so, what kinds are associated with hair loss?
DR. LEONARD: There are a number of medications that can cause hair loss. The most common are:

• Medication for blood thinners (e.g., Coumadin)
• Anti-anxiety medications (specifically SSRIs like Prozac, Lexipro, and Zoloft)
• Drugs that employ chemotherapy agents (e.g., Methotrexate and Tamoxifen)
• Long-term use of steroids

To determine if your hair loss is due to medication, you must consult your doctor. Your doctor can then decide if you can switch medications.

Q: Do thyroid conditions/hormonal imbalances cause hair loss?
DR. LEONARD: Hypo- and hyperthyroidism can both cause thinning hair. It’s important to work with your doctor to treat these hormonal imbalances in order to get thyroid levels back to normal. Once regulated, hair loss will generally subside

Q: Is there a way to determine if I’m genetically predisposed to Hereditary Hair Loss?
DR. LEONARD: If you have a family history of Hereditary Hair Loss, there is a test available that can assess the risk of pattern baldness before any hair is even lost. The test, called HairDX, is a good tool for young men and women who have a family history of hair loss and wish to be proactive.

If you find that you are genetically pre-disposed to hereditary hair loss. As the saying goes: the early bird catches the worm.

Q: What role does aging play in the process of thinning hair?
DR. LEONARD: Hair loss in men can start as early as the late teens—and nearly half of all men have male pattern hair loss. This percentage increases with every decade, as men get older.

For women, in particular, menopause means a decrease in estrogen production. This decrease in estrogen in turn causes the hair to become thinner.

Q: Can sun (UV) damage thin hair?
DR. LEONARD: No, the sun will not make hair thinning worse, but it is a good idea to protect your scalp from the sun with a hat or sunscreen.

Especially for those with thinning hair, protecting the hair you have becomes vitally important. Protect your hair and scalp from the sun, since exposure to UV makes hair more brittle. Look for UV protectant styling products and wear a hat when you are in the direct sun, which will protect your scalp from burning as well.

Q: Are hair vitamins effective?
DR. LEONARD: Vitamins are important for general health—and by extension, hair health. And while there are many hair vitamins on the market, a good multi-vitamin taken daily will go a long way toward stronger, healthy hair.

Biotin—a natural supplement—is often cited as a natural way to promote healthy hair growth. While Biotin can make hair fibers stronger, it cannot slow down hair loss, nor regrow hair. In fact, Biotin generally benefits nails more than hair.

Q: Are there foods I can eat to promote healthy hair?
DR. LEONARD: It’s always in your best interest to eat a balanced diet. Plus, hair is 95% protein, so a high protein diet can help promote healthy hair, especially if you have a protein deficiency. Look for foods such as fish, eggs, beans, and yogurt.