A few of us are lucky in hair but for so many of us, losing our hair or merely the thought of it is making us crazy. Are you in that subset of the “follicly challenged?” What constitutes official hair loss and what can be done about it? We asked the OG of all things skin and scalp care, Dr. Ellen Gendler, and this is what she had to say. As is her custom, she lays it out straight.
1) How do we differentiate between “normal” and “go see a doctor?”
It’s normal to lose between 75 and 100 hairs a day. Obviously, if we never lost hair, we would all be like furry monkeys! However, as we age, the ability to regrow hair diminishes (as does the ability to do just about anything!), and much of this is based on our heredity. There are medical conditions that can lead to hair loss, such as anemia, chronic infections, chronic disease, and even medications. It’s rare to find anyone who thinks his or her hair is as thick and luxurious when they turn 50 as when they were 20!
If you notice that you’re shedding way more than usual, if you notice that your hairline has receded significantly, if your hair seems much thinner than before—i.e., if your usual ponytail holder falls out… and then of course, if your hair literally is falling out in clumps, or shedding all over your clothes and furniture, or if you find discrete bald spots on your scalp. These things can be signs of something else going on besides normal hair loss.
2) Are 100 strokes a day still considered a good thing? What kind of brushes are the least damaging?
I can’t say that 100 strokes a day were EVER a good thing! There is no rationale for it. Once the tangles are out and the hairstyle is set, why continue to brush? The best brush when hair is wet is a synthetic, soft rubber-bristle brush with adequate space between bristles. And when dry, I generally recommend the same type of brush or a natural boar bristle brush that does not have jagged points on the ends. When hair’s been over processed (bleached, straightened, frequently styled with a curling iron), it’s best to avoid brushing too much as the hair strands are more fragile and therefore more breakage will occur from over-manipulation.
3) Fact or fiction: is washing your hair encouraging hair loss?
Total fiction. When people think they are doing themselves a favor by not washing their hair frequently, they will notice that it seems that they are losing large numbers of hairs each time they do wash. If they washed it daily, it would leave fewer hairs in the drain each day!
4) Do hot dryers contribute to loss?
No, but they can contribute to breakage if they constantly damage the hair.
5) Do hair vitamins work? Which ones do you like?
I assume you mean things like Viviscal and Nutrafol. The evidence that either of these products works is pretty much anecdotal. People weigh in on whether they think they have regrown or kept hair after using either of these products. The ingredient in Nutrafol which has a little scientific heft is saw palmetto extract, which has been used by men to retain hair (it mimics the effect of finasteride). But Viviscal and Viviscal Pro don’t contain saw palmetto, they contain a proprietary marine extract so obviously there is not a real scientific basis for its efficacy. While Biotin has been touted for 50 years as helping hair and nails, I have never seen it do anything in anyone.
6) Are there any topicals besides Rogaine that work? How long does it take to see results?
Not really. There are all sorts of products that claim to help, such as the solution made by Isdin called Lambdapil, which also has a proprietary ingredient, but in my mind, there is nothing that actually works.
7) Is Rogaine for Men any different than Rogaine for women?
In the past, there was no 5% available for women, but now there is.
8)Is it possible to get a stronger concentration of minoxidil with a doctor’s prescription?
Yes, it can be compounded by a good pharmacy in higher concentrations.