Zoomerist Thin Hair

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How Do You Get More Hair?

Last week, we dealt with the hair you don’t want, on your chin. This week, we are looking into how to get more hair where you do want it, on your head. As a longtime magazine writer and editor working in the style zone, I know from speaking to readers and focus groups that hair is the big hot-button issue for everyone: how our hair looks makes or breaks our confidence every time we step out into the world. Hair is the frame for our face, often the first thing others clock about us, and there are a lot of preconceived notions floating around about what our hairstyle choices and attention to hair grooming say about us.

Even still, I was surprised at the number of hair thinning questions we received as soon as we put out the call for queries on Zoomerist. Right off the bat, a reader named Marilyn wrote in: “How do I get more hair? Mine has thinned out especially on top.” Good question, Marilyn, with your succinct wording. Then, three more hair thinning questions followed within the next week! You can see the emotion bound up in hair clearly in these letters. Enquiring minds want to know, and this is clearly a broad concern for the 45-plus demographic, so let’s go straight into the thick of it.

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The Zoomerist

The best expert I’ve ever interviewed on this subject is dermatologist Dr. Julia Carroll, the head of Compass Dermatology in Toronto. You can read the full interview here, but I’ve pulled some relevant info and Dr. Carroll has reviewed and updated her comments. First of all, she points out that there are many different causes of hair loss and thinning, and that it is always important to consult your doctor to determine the cause and also treat any underlying issues. 

But mostly, Marilyn, you should know you are not alone. Hair thinning is a traumatic issue for both men and women. It is also a natural part of the aging process, as the skin loses laxity. Hormones level changes tied to ageing play a large part, as does genetics, as we will learn. Hair loss is an equal opportunity issue: even Princes William and Harry have not been spared from thinning out up top. And women can suffer from hair thinning due to hormonal changes as well. Let’s let the doctor break this down. 

Hair thinning and loss is a huge subspecialty in the dermatology cannon. To cover off the possible medical causes, here is Dr. Carroll’s catalogue of the major causes of baldness and thinning: Androgenic alopecia is pattern baldness, an inherited sensitivity to DHT, a byproduct of testosterone, and it can affect women as well as men. Alopecia areata is “an autoimmune disorder that causes hair to come out in clumps the size of a quarter and sometimes larger,” Carroll says. 

Telogen effluvium is a condition where hair falls out easily. It has a large number of possible causes, including nutrition issues and extreme diets to mental or physical stress. Traction alopecia, she says, “is caused by prolonged or repeated tension on the scalp hair, which could be caused by tight ponytails, weaves, extensions or braids.” 

Alopecia is either non-scarring (treatable) or scarring (which means the hair loss can be permanent). And non-scarring alopecia can itself progress to a permanent issue. Lichen planopilaris is a rare progressive condition that also causes hair loss.

Information is power, people! Now, for the hopeful part, the solutions. Carroll recommends Viviscal, a hair growth supplement that has been around for 30-plus years, “a marine-based supplement with really good data.” Both Jennifer Aniston and Reese Witherspoon have raved about the product, though neither is an official endorser of it. Hollywood is tough on hair, after all that styling and dyeing for actor’s roles. Carroll cautions that this is “for people with good hair who want to make their hair better,” she says, meaning it can help with hair thinning or shedding, but won’t regrow lost hair. There are formulations for both men and women; the women’s version includes an iron supplement. Be patient with this approach, as Carroll adds that it takes about six months to start seeing results, expressed as thicker hair with less shedding.

Dr. Carroll says the topical treatment minoxidil, also known as Rogaine, is a good first-line defense; there are also separate formulations of this product for both men and women. It is available over the counter, as in without a prescription, but it really is always best to check with your doctor. It was discovered in trials for a blood pressure medication, when it was found to promote hair growth. It increases blood flow to the hair follicles, stimulating regrowth and some new growth, as well as shortening the dormant phase of hair growth. 

For the bigger guns, there are prescription options. Propecia is the pattern baldness pill, says Carroll, who adds that there is good scientific evidence it works. Long-term studies have shown that eight out of 10 men stop losing their hair, with some two-thirds of study patients seeing some regrowth. It basically halts the conversion of testosterone to DHT, so it stops working when you stop taking it. There are notable, if rare, side-effects, including erectile dysfunction, decreased libido and male breast swelling.

And the big ticket (as in price tag) option is PRP. Short for plasma-rich platelets, a doctor or medspa clinic takes your blood and spins it in a centrifuge until stripped down until collagen-boosting platelets are refined, then injected into the scalp to stimulate the skin. This is usually done over multiple sessions with down time in between, and it is effective though it also takes time for results to show, says Carroll. 

Treatments start at $600 per session, she says. “We recommend starting with five sessions, six to eight weeks apart, followed by maintenance every four to six months.”

On the purely cosmetic front, you could try Toppik, which is widely available online. Now, this isn’t the old-fashioned hairspray bald men used to use in the ’70s to paint over bald spots. This is meant for both men and women and it uses coloured hair-building fibres to give a thicker hair appearance. You don’t have to fear a Giuliani moment: it doesn’t streak or run or collapse in rain or wind, and comes in nine shades, including the rarely offered white and grey tones.

Semi-permanent options for men and women come in the form of hair systems. LordHair.com is the site to check out for these high-tech toupées, with very thin, flesh-coloured scalp hair pieces that seamlessly blend into your own hair. They cost anywhere from $200 and last four to six months, you can swim and wash your hair. They do need to be applied professionally at first, but you can learn to do it yourself to save the $150-plus installation fee.

The last (and free) thing to consider is common sense: treat your hair more gingerly with brushing, styling, heat and dye processes. Your hairstylist can also help minimize the visual effects of thinning and balding, for men in particular. Tony Masciangelo, co-owner of Alcorn Hair in Toronto, says he uses edging to fade the hairline and around the crown for male clients with male pattern balding, a technique adapted from Black culture that employs an electric razor to cut into the edges of the hairline. “Let’s say you have your receding points, where it’s a little thinner: You take the middle part back a bit, creating a stronger, pronounced hairline. Then you ‘edge’ the hairline, going over it with a razor so it looks very smooth.” 

As for the crown, “Here, you want to avoid the ‘bump’” he says, the hair that can puff out around that bald spot. “You need to work with the overall shape of a man’s head,” he says, “to integrate the line. It’s about the whole look, not just about the balding parts.” Overall, says Masciangelo, shorter for men is better when the hair starts to thin. If you let it get too long, you risk going into comb-over territory, somewhere you really never want to go. “Everyone can tell,” he says. “You aren’t fooling anyone.” 

For women with longer hair, you could consider extensions to thicken things up, but be aware that, as Carroll discusses above, these can cause more hair loss from the stress and pulling on existing hair. Temporary clip extensions, not sewn into the hairline, can be a better option.

That is a lot of options, Marilyn and the other readers who wrote to us about this issue, at a lot of price points. The main thing is, you don’t have to suffer. Talk to your doctor, talk to your hairdresser, and they will work with you on solutions and strategies so you are not alone in the battle against thinning hair. 

Always asking questions.

—Leanne Delap