Female Hair Loss

The Orentreich Medical Group has been treating hair loss of all types for over 60 years. We begin treatment with an in-depth consultation, including a physical examination of your hair loss and possible testing to determine an accurate diagnosis.

There are many underlying reasons for hair loss. We arrive at a diagnosis, by initially asking you questions. Please review the list of questions below; your answers will help us diagnose your condition.

QUESTIONS
1. When you report “hair loss”, do you mean that

a. you see more shed hair than usual when shampooing, on your clothing, and on your hair brush?
b. you see less hair on your head?
c. both

2. Does shed hair have a little bulb at one end or is it even on both ends?
3. How long ago did you first notice hair loss?
4. Has your hair loss been gradual or sudden?
5. Please list any new medications, vitamins, herbs or supplements that you have started or stopped during the last six months.
6. Have you been hospitalized, experienced trauma, been ill, or had any surgery within six months prior to the onset of hair loss?
7. Does anyone in your family have hair loss? Who (relationship to you)? What is the pattern of hair loss?
8. Do often do you color your hair?
9. How often do you chemically straighten your hair?
10. How do you style your hair? 
11. Does your scalp ever hurt or itch? 
12. Do you have hair loss in other areas of your body?  
13. Do you have unwanted or excess hair on your face or body? Where? How long? 
14. Are your menstrual cycles regular or irregular? 
15. Do you ever skip a period? 
16. Do you use birth control pills? What type? 
17. Do you break out with acne when you have your period? 
18. Are you pregnant?  
19. Have you given birth within the last six months?  
20. Are you nursing? 
21. How many pregnancies have you had? How many children do you have? 
22. Have you gone through menopause?  
23. Are you currently taking hormone replacement therapy? If so, what type?  
24. Have you ever been diagnosed with the any of the following: Polycystic ovary syndrome? Endometriosis?  
25. Have you had a hysterectomy (removal of uterus)? Oophorectomy (removal of ovaries)? If so, when?

EXAM
After the questions have been answered, we usually perform a targeted physical exam. We will thoroughly examine

Your scalp skin
The hair itself and note:
- pattern of hair loss
- texture of your hair
- your hair style
Body - looking for areas of hair loss or increased hair growth.
Fingers and nails - certain hair loss conditions are associated with change in the finger nails and fingerprints.
Your face - checking for acne and oiliness.

TESTS
If additional information is needed to arrive at a diagnosis, we might order some tests. In other cases, a diagnosis has already been made and treatment is guided by results of the blood tests. Possible tests include but are not limited to:

Blood tests
Routine blood tests
Hormone blood tests
- Thyroid
- Androgen
- Estrogen
- Prolactin
Scalp biopsy
Fungal or bacterial culture

DIAGNOSIS
It might take time to find the cause of your hair loss and there are many potential causes that can contribute to it, including:

  • Androgenic alopecia (link to male and female pattern hair loss)
  • Telogen effluvium
  • Alopecia areata
  • Medication side effects
  • Stress
  • Chemotherapy

TREATMENT
We offer a variety of treatments, including:

  • Topical preparations: We custom compound a variety of prescription formulas in the form of topically applied hair drops (tinctures) to treat most types of hair loss.
  • Oral medications: Anti-androgen medications, such as Finasteride, Dutasteride and Spironolactone are frequently used successfully to treat androgenetic hair loss.
  • Scalp injections: Medications are injected locally into the scalp to halt hair thinning and promote growth. Certain hair loss diseases may be treated with scalp injections of the appropriate medication.
  • Hair Transplant Surgery: A surgical procedure first performed by Dr. Norman Orentreich in 1952, during which hair follicles are taken from an unaffected area (the donor site) and re-planted in an area of thinning hair (the recipient site).  After surgery, the donor hairs grow as they would in their original site, resulting in the appearance of a fuller head of hair.

Click here to read more about our approach to treating female hair loss.