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Women too often suffer in silence over hair loss -- Newsday.com newsday.com/services/newspaper/printedition/saturday/act2/ny-act2spd5612973mar15,0,439038.story Newsday.com
Women too often suffer in silence over hair loss
Carmen Armstrong's auburn hair was always very thick and shoulder length. But a few years ago, Armstrong, 60, of Freeport, noticed a change. Her hair started falling out. "My ponytail was half as thick. I was distraught, beyond rational," Armstrong said. "I had had a little piece of skin cancer taken off my cheek and that's serious, but hair loss . my reaction to the thought of having no hair was 10 times worse than having a piece of skin cancer. "I was close to hysterics," Armstrong continued. "If you're a man and you're bald, it's one thing. But, if you're a woman and you're bald, it's, 'Oh, my God.'" Today, after about six months of treatment with a dermatologist who specializes in female hair loss, Armstrong's hair has stopped falling out and her doctor sees signs of new growth. She says she had an infection that affected her hair follicles and may have been stress-related. Initially, almost everyone Armstrong consulted, including some physicians, thought her problem resulted from the hormonal imbalances of menopause. And, while that is often the reason behind female hair loss, it is hardly the sole reason, according to Armstrong's dermatologist, Dr. Ted Daly, director of Garden City Dermatology. According to the American Academy of Dermatology, hormonal changes at such times as menopause, perimenopause and childbirth can cause hair loss, but it can also be related to heredity, illness, infection, medications, chemotherapy, stress, nutritional deficiencies, tight braiding and the use of heavy hair extensions. Sometimes the cause is not fully understood. The loss may be temporary or permanent. That said, women who first notice hair loss at the time of menopause may be experiencing a drop off in the production of estrogen and a resultant buildup of a chemical called dihydrotestosterone, or DHT, around the hair follicle, according to the academy. The buildup of DHT causes a shorter hair-growth cycle and eventual hair loss of a type known as female pattern baldness (androgenic alopecia). It is characterized by a diffuse loss of hair with generalized thinning on the top and often a widening of the part on the crown of the head. According to dermatologist Dr. Jeffrey Ellis, who practices at Belaray Dermatology in Jericho and is http://www.newsday.com/services/newspaper/printedition/saturday/act2/ny-act2spd561297. 3/17/2008 Women too often suffer in silence over hair loss -- Newsday.com director of Dermatologic Surgery for the North Shore-Long Island Jewish Health System, hormone-related hair loss is the most common type of female hair loss. He said it's believed that about 30 million women of all ages in the United States suffer from some type of hair loss. As with men, the cases of hair loss for women mount with age. Daly has found, through studying research, that about 85 percent of cases of female hair loss are attributable to androgenic alopecia (which includes menopausal hormonal changes), and British researchers found that 38 percent of all women in a study had female pattern hair loss by the time they reached age 70. The number of women suffering hair loss is obscured by many suffering in silence, experts said. Alone with their Rogaine Often women "are very much in the closet," about their hair loss, said Kathy Sharkey, 59, of South Floral Park. Women, she said, "hide their Rogaine bottles." As a former support group leader for a local chapter of the National Alopecia Areata Foundation, Sharkey has helped many women deal with hair loss. She herself is totally bald as a result of an autoimmune condition. Whatever the cause, severe female hair loss can devastate its victims. "When I was a support group leader, women would call me in the middle of the night," said Sharkey. "It's very painful for them; some will even lose their husbands or significant others." "It's a big problem that's underappreciated by the public. Women who have it feel they are the only ones, which makes it particularly terrible," said Ellis. "Men don't cry in the office," added Daly. "Women cry and are at their wits' end. They see a beautiful girl swirling her hair on TV and they feel their own beauty has been impaired." Ellis said women who notice their hair is thinning should quickly seek a proper diagnosis from a dermatologist who specializes in female hair loss. This could rule out any systemic medical issues and allow treatment to start early enough to forestall further hair loss. While dermatologists and others say not all cases can be helped, there are several approaches used. Aside from medications such as Rogaine, there are hair transplants and laser treatments, which, according to experts, may or may not stimulate hair follicle growth. For the future, there is ongoing stem cell research aimed at cloning cells capable of growing active hair follicles. Physicians who specialize in hair loss take a background history to determine how long the loss has been occurring, whether there has been recent stress, whether the woman is taking medications that could contribute to her problem and if she may have inherited a tendency to baldness. There can be a review of physical systems, blood tests and specialized tests such as thyroid or hormone. The doctor will examine the hair shafts under a microscope, check the scalp for scarring and possibly perform a small biopsy of the scalp for further evaluation. Tamara Erbach, 41, of Teaneck, N.J., travels to Daly's office in Garden City because she found visits to physicians who do not specialize in female hair loss were pointless.
http://www.newsday.com/services/newspaper/printedition/saturday/act2/ny-act2spd561297. 3/17/2008 Women too often suffer in silence over hair loss -- Newsday.com Insurance can be an issue According to Ellis, insurance will cover the costs of office visits for initial diagnosis and for treatment of some medical issues related to hair loss. But treatments such as Rogaine or transplants and wigs are considered cosmetic and are not covered by insurance. Erbach said, "There's a lot of quackery out there" when it comes to treating hair loss. "The first guy said, 'It's not so bad.' The doctors I went to didn't seem to have a clue. One had me counting hairs to see if it was really happening. They would put me on something and say, 'We'll give this a shot.'" Erbach's hair had been full, curly and below shoulder length. "I had hair," she emphasized. Doctors suggested her hair loss may be hormonal, because it followed the birth of her child. Several women interviewed said commercials for luxurious hair drive them "crazy" and give them "hair envy." Susan, 61, who didn't want her last name used, first noticed her short brunette hairs turning up on her clothes and pillow concurrent with menopause. For the past 2 1/2 years, she has been taking a vitamin and medication combination prescribed by Daly and she said her hair "has never looked better." The only hair restorative product approved by the Food and Drug Administration for women is topical minoxidil, commonly sold as Rogaine, which the FDA approves at 2 percent strength for females and 5 percent for males. The benefits of new hair growth only continue for as long as the person uses the drug. Even so, most specialists, according to Ellis, recommend women use the over-the-counter 5 percent version of minoxidil, since, he said, it is "more effective, easy to use, inexpensive, and has no side effects." Diane, 63, who also didn't want her last name disclosed, was diagnosed with ovarian cancer and underwent chemotherapy in 2005. Following her treatments, her hair came back thinner than it had been. "I have hair, but you can see on the top and at the front that it's very thin," said Diane. Her hair stylist used "a kind of powder" to camouflage the sparse hairs. No one, however, has suggested she see a medical hair specialist. "I just assumed they couldn't do anything about it," she said. After learning there may be something that can stimulate new hair growth, Diane thinks it's worth a try. "People do judge you by your hair," she said. Hair transplants are gaining popularity for women. Dr. Neil Sadick, a dermatologist who practices in Great Neck and Manhattan, said new techniques make female hair transplants more successful. http://www.newsday.com/services/newspaper/printedition/saturday/act2/ny-act2spd561297. 3/17/2008 Women too often suffer in silence over hair loss -- Newsday.com "Sometimes there are problems getting enough donor hair from the back of a woman's head. But, now we take strips out and actually dissect those strips in single and double units of hair follicles, making it possible to use less dense donor areas," Sadick said. Transplants are pricy But transplants can cost between $6,000 and $10,000, which is not covered by medical insurance. Carol, 58, who didn't want her full named used, underwent a transplant at Sadick's office. "They anesthetized my head, there was no pain." Carol stayed home for a day and noticed regrowth in about four to six months. "Today my hair is great. I have hair as thick as when I was a child, and nobody knows," she said. Vincent Bruce, owner of Vincent Bruce Salon in Dix Hills, sees much female hair loss and is diplomatic about it. "It's taboo to say they are losing their hair. We say, 'fine hair.'" It's important, he said, to cut fine hair with "sharp lines that make the hair appear fuller . not actually short, but above the shoulders. You want the hair to move, it looks thicker and you need a wave, particularly at the top. . You want the roots to look more swollen. Coloring the hair lighter than the skin tone is helpful. You have to create illusions," Bruce said. Tip to wig buyers: Get two For women experiencing hair loss, wigs often are part of the solution. Vincent Bruce, owner of Vincent Bruce Salon in Dix Hills, advises purchasing two wigs so one can be worn while the other is being cleaned or styled. Wigs can be of synthetic or human hair. Synthetics can be permanently set and tossed into a suitcase for travel. Human hair wigs have to be reset and carry "all the responsibilities of human hair," said Bruce. Synthetics usually cost between $150 and $350, while human hair wigs start at twice as much and go up. Full wigs usually are secured to the head with an adjustable band or netting beneath the cap. The more expensive the wig, the better the air flow in the netting, which makes it more comfortable. Wigs need not be a perfect color match for a woman's own hair. They can be a shade up or down and still look natural. Many wigs come in multicolored shades for a more natural look. Kathy Sharkey, who is bald herself and has helped women going through hair loss, advises women go to a wig store and "try on a whole bunch of wigs and not be upset about it. " Wigs also can be bought online. Sharkey said of wearing wigs: "You get used to them." - Ellen Mitchell http://www.newsday.com/services/newspaper/printedition/saturday/act2/ny-act2spd561297. 3/17/2008 Women too often suffer in silence over hair loss -- Newsday.com http://www.newsday.com/services/newspaper/printedition/saturday/act2/ny-act2spd561297. 3/17/2008

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