The world of hair care and how to properly look after it can often be daunting and confusing. Today, dermatologist Angelo Landriscina, MD joins SELF to answer hair care questions and debunk some myths along the way.
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00:00I always say time is hair, so don't waste it.
00:07Hello, I'm Dr. Angelo Landrocena, and I'm a board-certified dermatologist.
00:13Looking for medical information online could be unreliable or anxiety-provoking,
00:19so today I'm going to be answering some of the questions that might be getting under your skin.
00:26Are there any products or treatments for thinning hair that are actually legitimate?
00:31Yes, absolutely. Hair loss is one of the most common conditions that I see as a dermatologist,
00:39and part of the reason for that is that everybody will experience it at some point
00:45if we're lucky enough to grow old enough. The primary condition in which we see hair thinning
00:51in most people is something called androgenic alopecia, and really it's more of a trait
00:58than it is a condition or a disease process. It is kind of complex because it does have to do with
01:05our genetics. However, the basis of it is that as we grow older, the actual hair shafts on our head
01:14become thinner and thinner and smaller and smaller and miniaturize until they become what we call
01:20vellus hair. That's like the peach fuzz that you might see on other parts of your body.
01:25Some of the products or treatments that may work for this kind of hair loss include minoxidil,
01:32which is available as an over-the-counter drug in the United States. It's also available as an
01:37oral drug by prescription, and part of the way that that works is by lengthening the growth phase
01:44of the hair, meaning that more of the hair on our head will be growing at any one time, and also it
01:51results in a thickening or a conservation of the diameter of the individual hair shaft. So
01:59essentially doing the opposite of what androgenic alopecia does. There are other procedures that
02:06could work, including something called platelet-rich plasma injection. That's when your
02:11provider draws some of your blood, extracts part of it that's rich in growth factors, and then
02:17injects it back into the scalp. However, what I would caution people about is automatically going
02:25for a treatment, a supplement, or an over-the-counter medication without knowing why their hair is
02:31thinning. There are some disease processes in which hair loss can be progressive or cause scarring,
02:39and once hair tracts are scarred over, there is no chance that hair will grow in that area
02:45again. There are also medical conditions like vitamin deficiencies or chronic inflammatory
02:51diseases that can cause hair loss. So what I always tell people is if you notice your hair
02:57thinning, definitely try to see a dermatologist if you can. Even discuss it with your primary
03:03care doctor because there may be some underlying medical condition that needs to be addressed.
03:09Also, time is of the essence. The earlier you get treated, the more likely you are to preserve your
03:14hair. I always say time is hair, so don't waste it. Stress-related hair loss, hair loss after
03:22giving birth, these are really common things that people do notice. This can quite often be due to
03:28a condition called telogen effluvium. I know that's kind of a mouthful, but essentially what
03:36it is is a mass shedding of the hair following a specific event. Now, it could be a stressor.
03:46This is something that we saw a lot during the pandemic because things like high fevers or
03:51severe illness could cause this, and usually what happens is after the stressor takes place,
03:57it takes a few months to notice the hair shedding. Other things that could cause it are obviously
04:02psychological stress, and the most common condition that we see it is in post-pregnancy. You know,
04:08that classic idea of having gorgeous hair during pregnancy, and part of the reason for that is that
04:14most of the hair stays in its growth cycle due to the hormones. So yes, during pregnancy, you may
04:20notice that your hair is thick and luscious, and then after you give birth, you may notice that
04:25your hair is starting to come out in clumps, and that is the hair cycle of the different hair shafts
04:31kind of normalizing. Are there treatments to help with this? Again, I don't want to sound like a
04:36broken record, but topical minoxidil is one of the great treatments that we have for this. I would say
04:43again, this is something to talk about with your specific doctor, and I always advocate that people
04:49talk to their doctor before starting any over-the-counter medications. If you're starting
04:54to see gray hair in your 30s, are you going to be completely gray by the time you're in your 40s?
05:01I wish I could tell you. Hair graying, just like a lot of other features of our skin, hair,
05:08and nails, is something that's partially genetically determined, and interestingly,
05:13as we're learning now, probably related to your environment too. For a long time, it's been
05:21suspected that stress could cause hair graying. There is new data, though it is kind of low-level
05:28data, showing that stress can be correlated with seeing gray hair. Decreasing your stress may
05:34reverse some hair graying, which is really interesting to me. I know that it's difficult
05:40to say, hey, decrease the stress in your life, but it may be a way to prevent more hair graying.
05:48I know a lot of people pluck their grays. However, if you over-pluck your hair, that hair may never
05:53grow back, and eventually when your entire head is gray, maybe you'll miss those hairs. Your hair
05:58will look a little bit thinner. Dyeing is definitely an option, but it does come with potential
06:05downsides, such as changes in your hair texture, damage to the hair, hair breakage. If you're not
06:11particularly sensitive to hair dyeing, it shouldn't be a problem. There are some new products on the
06:18market with peptides that have shown maybe a little bit of promise when it comes to turning
06:24back hair graying, but I'm not really convinced yet that that's an across-the-board solution
06:31for everybody. No wrong answers, except don't pluck them. How to work out regularly, keep your hair
06:41clean, not over-wash it. I wish there was one good answer I could give everybody, but there's not.
06:49It's going to be a little bit of a trial and error process. Depending on your hair type, washing your
06:55hair every day or after every workout may not be feasible. It could lead to dryness, breakage,
07:01and other issues with the hair. There are some tactics you can use to extend the life of your
07:08hair wash, even if you're working out regularly. The first is using something like a dry shampoo,
07:14which is going to absorb some of the oils on the scalp and help to keep the hair cleaner between
07:22true shampoos. Take a little bit of caution with that, just because overuse of dry shampoo
07:27can lead to some issues with hair dryness and breakage itself. Also keep in mind that you're
07:32supposed to be removing as much of that dry shampoo as possible. The way that you could do that
07:38is either brushing it out through the hair, or another way to do it that might be a little bit
07:43easier is using a blow dryer on the cool setting to just kind of blow it out of your roots. In
07:49addition to that, it is possible to actually just wash your scalp and not wash your hair.
07:55It is a little bit of a challenge, but if you're able to get in there with something like a
08:02tint bottle that's used for hair dyeing and just get some of that lather on the scalp,
08:08wash it out without really fully washing the lengths of your hair, that could be an option too.
08:14I hope this has been helpful. However, keep in mind everybody's different, so make sure to check
08:21with your own doctor, who knows you, before making any changes. You can find me on all
08:28social media at Dermangelo.