Diagnosis

Before making a diagnosis, your doctor will likely give you a physical exam and ask about your diet, your hair care routine, and your medical and family history. You might also have tests, such as the following:

• Blood test. This might help uncover medical conditions that can cause hair loss.
• Pull test. Your doctor gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process.
• Scalp biopsy. Your doctor scrapes samples from the skin or from a few hairs plucked from the scalp to examine the hair roots under a microscope. This can help determine whether an infection is causing hair loss.
• Light microscopy. Your doctor uses a special instrument to examine hairs trimmed at their bases. Microscopy helps uncover possible disorders of the hair shaft.

Treatment

Effective treatments for some types of hair loss are available. You might be able to reverse hair loss, or at least slow it. With some conditions, such as patchy hair loss (alopecia areata), hair may regrow without treatment within a year. Treatments for hair loss include medications and surgery.

Medication

If your hair loss is caused by an underlying disease, treatment for that disease will be necessary. If a certain medication is causing the hair loss, your doctor may advise you to stop using it for a few months.

Medications are available to treat pattern (hereditary) baldness. The most common options include:

• Minoxidil (Rogaine). Over-the-counter (nonprescription) minoxidil comes in liquid, foam and shampoo forms. To be most effective, apply the product to the scalp skin once daily for women and twice daily for men. Many people prefer the foam applied when the hair is wet.
Products with minoxidil help many people regrow their hair or slow the rate of hair loss or both. It’ll take at least six months of treatment to prevent further hair loss and to start hair regrowth. It may take a few more months to tell whether the treatment is working for you. If it is helping, you’ll need to continue using the medicine indefinitely to retain the benefits.
Possible side effects include scalp irritation and unwanted hair growth on the adjacent skin of the face and hands.
• Finasteride (Propecia). This is a prescription drug for men. You take it daily as a pill. Many men taking finasteride experience a slowing of hair loss, and some may show new hair growth. It may take a few months to tell whether it’s working for you. You’ll need to keep taking it to retain any benefits. Finasteride may not work as well for men over 60.
Rare side effects of finasteride include diminished sex drive and sexual function and an increased risk of prostate cancer. Women who are or may be pregnant need to avoid touching crushed or broken tablets.
• Other medications. Other oral options include spironolactone (Carospir, Aldactone) and oral dutasteride (Avodart).
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And

Laser therapy

The Food and Drug Administration has approved a low-level laser device as a treatment for hereditary hair loss in men and women. A few small studies have shown that it improves hair density. More studies are needed to show long-term effects.