Alopecia: For women and men experiencing hair loss, effective treatments are available


Sally Stevens was in her 20s when she began noticing the hair that came out in her brush each day, but she had such a thick head of hair that it wasn’t noticeable – at least not right away.

As the years went by and the hair continued to thin, Stevens became more unsettled about it.

“It started mostly on the top. I combed one strand at a time to try to cover my head. Then it started on the sides,” the Camp Hill resident said. “A bad hair day? You have no idea. That was me every day for so many years.”

By the time she was in her late 50s, she was nearly bald on top of her head and self-conscious. An attractive woman with a warm smile and beautiful eyes, Stevens could see only one thing in the mirror: Baldness. She turned away in tears many days.

“It made me look at everybody else’s head of hair and how beautiful it was,” she said.

Several causes for hair loss

Stevens, 77, suffers from alopecia – or hair loss.

“Any type of hair loss is a deeply personal experience. It’s an important part of someone’s self-image,” said Dr. Charlene Lam

“Alopecia is a general term for hair loss and, under this, there are several types of hair disorders,” said Dr. Charlene Lam, a dermatologist with Penn State Milton S. Hershey Medical Center.

First, it’s important to understand a little bit about hair growth cycles, she said.

“There are three phases that repeat. The growing phase is two to five years, followed by the transition phase, which lasts two to three weeks, when the hair roots shrinks and shortens,’’ Lam said. “The resting phase, which last about three months, is when you can lose hair. Everybody loses about 100 hairs a day.’’

Hair is in different stages of the cycle all the time, with only 10 percent of hair in the resting phase at any one time, so that the loss isn’t noticeable – unless something happens to disrupt the cycle.

For example, telogen effluvium is a type of alopecia that can occur several months after a stressful physical or psychological event, such as a high fever or a difficult childbirth, Lam said. It sends most of the hair into the resting phase all at once, causing hair loss. It usually resolves itself.

One of the most common types of alopecia is male- or female-pattern baldness, which is the cause of Stevens’ hair loss. Either type can affect either sex and is usually permanent.

Male-pattern baldness is characterized by a receding frontal hair line and thinning hair on the sides and crown of the head. Female-pattern baldness is marked by a diffuse hair loss over a broader area and thinning on the crown.

Alopecia areata is a condition where one’s immune system attacks the hair follicles, causing the hair to fall out, usually in patches. It often goes along with other autoimmune disorders such as vitiligo, pernicious anemia or diabetes, Lam said. The hair may or may not grow back.

The reasons for alopecia are varied and can be related to heredity, hormone levels, medications, autoimmune problems and just plain aging, she said.

Stevens assumes her hair loss is hereditary since both her mother and sister experienced it.

Treatments for alopecia include pharmacologic drugs such as minoxidil, known as Rogaine, which helps stabilize the hair cycle; steroid injections; surgical hair replacement; wigs or weaves; and cosmetic products such as temporary dyes to camouflage thinness.

Stevens said she had tried nearly everything, but nothing helped.

With several weeks to go before her marriage, Stevens’ daughter, Beth Giovanniello, was determined to help her mother feel better about her appearance.

“In the grand scheme of things, hair is so unimportant when you factor in your overall health in life, but still, it affects how you feel,” Giovanniello said. “For as long as I can remember, Mom would fuss with five little pieces of hair on the top of her head.”

Giovanniello heard about a promising remedy called a hair replacement system so she made her mom an appointment at Joseph Hair Loss Clinic in Harrisburg.

“At first, I refused to go. I had such a bad attitude,” recalled Stevens with a chuckle. She finally went, but she wasn’t expecting much.

“She was my worst customer! She sat in my chair and said, ‘I don’t know why I’m here; it’s not going to work; I’ve tried everything,’” said stylist Debbie Donahue. “When she got her system on, she took one look and said, ‘I love it!’”

Hair system blends hair piece into real hair

The difference between a wig and a hair system, according to Donahue, is in the custom-made process. Each person gets a mold made of their head, which is used to custom make their hair system to fit their head, down to the slightest indent or curve.

The hair system is feather weight and, once styled into a client’s existing hair, it can be impossible to tell it’s there. It can be held in place with clips and two-sided tape.

Hair replacements can cost anywhere from $200 for a piece to $2,000 for full coverage and need to be replaced every three years on average.

Hair systems can be made from synthetic, human or yak hair, or a combination of any of these, said Bob Powers, a consultant at Joseph’s Hair Loss Center for 35 years.

Powers, who speaks from personal experience with his own hair replacement system, typically meets with new clients for more than an hour to discuss their hair loss before designing a hair system for them – if they are ready.

Psychological effects of hair loss

“This is very psychological. You have to get to that point where you say, ‘It’s a trade-off. I want to look better so I am going to commit to the maintenance of doing a system.’ It’s like false teeth or eyeglasses; you have to gain the confidence to deal with it,” said Powers, who teaches people how to wash and style their hair replacements at home.

Lam agreed: “Any type of hair loss is a deeply personal experience. It’s an important part of someone’s self-image and it’s absolutely a reason to seek professional guidance to address it.”

Helping people overcome hair loss is very rewarding, the stylists say.

“It does something in here,” said Powers, touching his chest, “especially when you can help a child who has lost her hair or someone who has cancer.”

While many people are secretive about needing hair replacements, Stevens is vocal, hoping it will help others who think there’s no alternative to thinning hair but a badly fitting wig.

“I don’t care who knows I wear one. It just makes you feel so much better about yourself!” she said. “It’s worth every penny.”

By Carolyn Kimmel, PennLive on September 15, 2013