Medical Edge Newspaper Column

Limited Options For Thinning Hair

Jan. 29, 2006
DEAR MAYO CLINIC:
Can thinning hair be controlled by either vitamins or a specific shampoo? -- Tucson, Ariz.

ANSWER:
Maybe and no, respectively.

A balanced diet is as important for healthy hair growth as it is for good health. Nutritional deficiencies brought on by, say, a crash weight-reduction program can cause temporary hair thinning for as long as the dietary shortfall lasts.

Because certain B vitamins and folic acid, for example, are needed for hair nourishment, some think that taking extra doses of these and other nutrients can stave off thinning hair. Such claims have not been verified by scientific studies. If nutritional deficiencies cause or exacerbate a patient's thinning-hair problem, a quality multivitamin preparation taken in recommended doses will usually suffice.

Some patients report that their hairdressers have given them a shampoo that seems to make a difference. But here, too, no scientific studies legitimize such claims. Because shampoos and other hair-care products deal with hair and literally do not get to the root of the problem -- goings-on at the follicles within the scalp, where hair growth begins or ends -- these products neither help nor hurt. Perms or darker colors can help by giving the illusion of thicker hair.

One possible hair-care-related source for temporary hair thinning is the mechanical trauma caused by styles such as pigtails and cornrows, or by hair rollers that pull too tightly.

While a relatively small number of thinning-hair cases may be traced to specific factors -- reaction to a drug, the aftermath of a serious bout of the flu, or some other bodily change (menopause, for example) -- some 95 percent of cases are caused by male or female pattern baldness which is often inherited. With this so-called "pattern hair loss," men develop a receding hairline and/or bald spot, and women show diminished hair density in the front and top of the scalp. If thinning hair and subsequent baldness run in the family, it may be your heritage, and medical science can do little. Before making that assumption, however, it is important to see a dermatologist so that potentially reversible or harmful causes may be excluded.

Two drugs exist that may help with thinning hair -- minoxidil and finasteride -- but the response depends on the cause of the hair loss, the extent of the loss and the individual. If these drugs work (either singly or in combination) for a patient, results will not be known for several months. Benefit can vary significantly among patients and often stops if the drug is discontinued. While the new hair growth can be thinner and shorter than previous hair, enough regrowth may allow some people to hide their bald spots and blend with existing hair.

Women need to know that finasteride is Food and Drug Administration (FDA)-approved only for use by men. It can pose significant danger to women of childbearing age. A pregnant woman should not handle crushed or broken finasteride tablets, as absorption of the drug may cause serious birth defects in male fetuses.

Surgical options are available if pattern hair loss is truly distressing. Hair transplantation involves taking tiny hair-bearing plugs of skin from the back or side of the scalp and implanting them into bald sections. Scalp-reduction surgery entails decreasing the area of bald skin on the head. Both options are time-consuming and expensive, can be painful, and may cause infection or scarring.

Another option includes hairpieces, extensions or braids. Those done professionally with human hair are virtually indistinguishable from the patient's own hair and can be very satisfying cosmetically.

-- K. Lyn Hamacher, M.D., Dermatology, Mayo Clinic, Rochester, Minn.