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HOUSE CALL WITH DR. SANJAY GUPTA

A Battle 80 Million are Fighting, Hair Loss

Aired August 21, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONENT: Good morning, welcome to HOUSE CALL. We're talking about hair loss today. While not life-threatening, this condition can certainly be life altering. More than 80 million are fighting hair loss. And while many think of this as a man's problem, one in four women are affected as well.
Christy Feig takes a look at what you can do about it.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Patrick Marcune was about 35 when he began losing his hair.

PATRICK MARCUNE, HAIR TRANSPLANT PATIENT: I started seeing a few hairs in the sink and maybe, like 10, 12. But you know, I thought that was a natural thing, until I looked at pictures. And then I realized I'm losing my hair.

FEIG: For Marcune, an aspiring actor who has been in several movies, losing his hair hit his self-confidence hard.

MARCUNE: I see myself as getting like old prematurely and I was panicked.

FEIG: Most people will normally lose about 100 hairs a day. But healthy hair is growing in at the same time.

(on camera): Some experts say 20 percent of women will have excessive thinning of their hair. Fifty percent of men will have significant loss by the time they're 50. And they say genetics is the most common cause.

DR. GARY HITZIG, AUTHOR, "HELP & HOPE FOR HAIR LOSS": If they start getting thinning at 18, 19, 20 years of age, those are the ones that are going to have a progression or more rapid hair loss in general.

FEIG: Dr. Gary Hitzig often prescribes chemical treatments like Rogaine.

HITZIG: It will take hairs that are dying or thinning, and it will slow down their death.

FEIG: And Propecia, which is more effective for men. But eventually most move on to hair transplants, now the leading cosmetic surgery among men. Hair is taken from the back and sides of the head and transplanted to the top, in a way that's meant to look natural. Marcune spent about $7,000 on two transplant procedures and calls it a small price to pay to restore his confidence.

Christy Feig, CNN, Washington.

(END VIDEOTAPE)

GUPTA: And as Christy pointed out, heredity is the most common reason for hair loss. But there are other reasons as well, such as: poor nutrition; or some medications you might be taking; also, medical treatment such as chemotherapy and diseases including diabetes and lupus. Now, if you get a very high fever or if you have surgery, you may also notice hair loss, as well as after giving birth. And lastly, some hair treatments, even some hairstyles may damage your hair. And that may cause hair loss.

This has been one of our most popular topics. We got hundreds of e-mails on this topic. And here to answer as many as we can is Dr. Sylvia Wright. She's a dermatologist who specializes in hair loss. First of all, good morning.

DR. SYLVIA WRIGHT, DERMATOLOGIST: Good morning.

GUPTA: Thanks so much for joining us.

WRIGHT: Well, thank you.

GUPTA: You get these questions all the time. We've got lots of e-mails on one of our most popular topics. Let's try and get to some of them right away.

Starting with Gail in New Jersey, who asks, "Is hair loss hereditary? Does it come from your father or mother? And does DHT play a role in hair loss?

First the hereditary question. Fathers -- father, mother, mother's father, who are you looking at?

WRIGHT: Hair loss is definitely hereditary. And there are many, many factors that affect it. And these genetic factors can come from either the mother or the father. So it is a myth that hair loss comes from the mother's side of the family. It is inherited from both sides.

GUPTA: Now, my mother's father was very thin. And my father's father was almost entirely bald. What does that say about my likelihood of balding?

WRIGHT: It means you could have some hereditary chance of balding.

(LAUGHTER)

GUPTA: That's not what I wanted to hear.

WRIGHT: Of course, it's not what I want to of course it's not. The good news is there are some treatments, if started early that can slow the process, but not reverse the process.

GUPTA: And we're going to certainly talk about that. But the second part of that question, DHT. First of all, what is that? And what kind of role does that play?

WRIGHT: DHT is dihydroxytestosterone, which is a breakdown product of testosterone. And it is critical in hair loss. It starts to create a shorter growth phase of the hair, and it starts to create finer hairs. And over time, that results in thinning hair and eventual balding.

GUPTA: The more testosterone you have, the more likely you are to lose your hair?

WRIGHT: No. It's not directly related to testosterone levels. The DHT is actually found in the hair follicles. And that's where the effect is exerted. Sometimes in women, if testosterone levels are very high or abnormal for a woman's level, it can create hair loss. But in most men, normal testosterone levels are not going to create any variation of hair loss.

GUPTA: OK. Let's keep on the subject here. If you think you're the next one in your family to start loosing hair, is there anything you can do to stop it? That's what David from Massachusetts wants to know? He asks, "Are there certain foods or vitamins I can eat that can encourage hair growth on my scalp."

What about that?

WRIGHT: There are no vitamins that have been scientifically proven to encourage hair loss -- hair growth.

GUPTA: Right.

WRIGHT: Biotin, which is found in green, leafy vegetables and can also be taken as a supplement, does help us to growth healthier hair and nails. But it does not truly stimulate hair growth.

GUPTA: So save your money, basically on those?

WRIGHT: Yes. Save your money. Eat a well-balanced, healthy diet. And save your money on the supplements.

GUPTA: OK. We're going to talk about the treatments as well, a little bit later on. But first, we get questions from all over the world on this topic. I guess it's a worldly concern.

Hari in Singapore asks, "What kind of shampoo is best for hair loss and should shampoo be used daily?"

GUPTA: Shampoos, products like that? WRIGHT: I don't find that shampoos do a tremendous amount in affecting hair loss in most circumstances. In patients that do have inflammatory causes of hair loss, they sometimes can be helpful. But those are typically prescription shampoos. Shampooing every day is fine for some hair types, but for drier hair types it can sometimes be too abrasive, and can cause more breakage and hair thinning.

GUPTA: Are there certain kinds of shampoos, certain thing you should look for though, in a shampoo, just for maintenance?

WRIGHT: For most people you want to look for a shampoo that is going to be moisturizing and that is also going to be easy to tolerate on a daily basis. Also using a condition after shampoo or a conditioning shampoo is helpful in minimizing breakage.

GUPTA: OK. Good advice.

Let's get to another e-mail from Mike in New York, who wants to know, "Is there any hope for those who are afflicted with a condition known as alopecia areata?"

And for those of you that are not familiar, alopecia areata is an autoimmune skin disease that results in the loss of hair on the scalp and other places on the body, and is usually not permanent. Now, it looks different than the hereditary loss of hair, as you can see in this photo. You have a complete loss of hair. We're not just talking about a thinning hair.

So doctor, you see the pictures there. And this is a condition you've probably treated. What kind of treatments do you use in this -- for this?

WRIGHT: Most patients with alopecia areata will respond to a number of treatments. Most of them are anti-inflammatory treatments, like cortisones or other anti-inflammatory medications. In some cases, alopecia areata will resolve without any treatment at all.

The vast majority of patients that have alopecia areata will have complete resolution of the disease and the hair will re-grow. However, it can come back at different times throughout the lifetime. Patients that have more severe alopecia areata are often more difficult to treat.

GUPTA: Right.

WRIGHT: And the hair does not always re-grow.

GUPTA: OK. All right. So for a lot of times, though, it's going to resolve on its own. Really good information.

When HOUSE CALL continues, solving the problem of hair loss. Stay where you are.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): From drugs to surgery, what's the best option for you? Our expert answers your questions about the safety and success of popular hair loss treatments.

Plus, what options do women have for thinning hair? We'll show you later on HOUSE CALL.

First, take today's "Daily Dose"quiz. Who typically has more hair: blondes, brunettes or redheads? The answer when we come back.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Checking the "Daily Dose" quiz. We asked, who typically has more hair: blondes, brunettes or redheads? The answer, natural blondes. They have 30,000 more hairs on their heads than brunettes and redheads have the fewest.

(END VIDEO CLIP)

GUPTA: I guess that's good news for all the blondes out there. (LAUGHTER)

GUPTA: Other good news for hair loss, recent advances and treatments. If losing your hair, you have got some options from drugs to operations such as: hair transplantation, scalp reduction and something called scalp flaps. Explaining all those treatment options, Dr. Sylvia Wright. She's a dermatologist who specializes in hair loss.

First of all, Doctor, is there anything that we should be looking for on the horizon? Something coming up to try and combat hair loss?

WRIGHT: For time, I think there will be new medications that help to combat hair loss as we learn more about all of these genetic factors and hormonal factors that play a role in the development of hair loss over time. Unfortunately, there's nothing that is right at the door that's waiting for us.

But there are good advantages that are occurring right now in surgical treatment. And you mentioned hair transplantation, scalp reduction and scalp flaps. And I think all of those surgeries offer wonderful, wonderful results for patients that are appropriate candidates.

GUPTA: You -- you're -- this is what you do. You see patients who are concerned about hair loss. How busy is your practice, just out of curiosity?

WRIGHT: It is quite busy. It certainly is not all hair loss, but it's a growing concern not just among men but among women.

GUPTA: Right.

WRIGHT: Because women suffer from hair loss with almost an equal incidence to men. WRIGHT: And we're going to talk about that a little bit as well. Very interesting.

Let's get to another e-mail question. Well, Rodney in Florida wants to know, "I'm 34 and have lost much of my hair on the top of my head. What is the best method to re-grow hair, other than expensive operations?"

You don't -- you don't send patients for an operation right away, obviously. What sort of options does he have short of that?

WRIGHT: Generally, we will start in patients that are younger with using treatments like Rogaine twice a day. And Propecia, which is an oral medicine that helps to inhibit DHT and help younger men to preserve their hair growth for a longer period of time. Manoxidil or Rogaine can also be used in women. However, Propecia cannot be used very effectively in women.

GUPTA: Do these medications prevent hair loss or do they stimulate hair growth?

WRIGHT: They tend to stimulate some hair growth by taking hairs from a resting phase into a more active growing phase. And they also help patients to maintain the hairs that they have. So it slows down the process of hair loss.

GUPTA: Is anybody too young to take these medications?

WRIGHT: Generally, not too young to take the medications. Some patients are too young for scalp surgery.

GUPTA: Right. OK.

Let's get to another e-mail now from Monte in Virginia. "I've been using Propecia to prevent hair loss for over a year now and have had good results, though it seems to be losing its effectiveness. Is long-term use of Propecia safe? Is there a better alternative?"

What do you say about that?

WRIGHT: Long-term use of Propecia has been thought to be safe for several years now. A form of Propecia has been on the market for over 12 years. However, there have been recent articles that have questioned whether, while Propecia has been shown to reduce the incidence of prostate cancer in men that take it long-term, whether those that get prostate cancer have more aggressive cancer?

GUPTA: Interesting.

WRIGHT: It is not clear at this point. We still consider it to be a very safe and effective treatment, and one of the few that we really have available.

GUPTA: If you started taking it in your 30s or 40s, for example, would you take it for the rest of your life?

WRIGHT: Typically, at least until the age 55 or 60. After the age of 60 in men you tend to see much less benefit from it.

GUPTA: OK. Let's get to another e-mail. Now, this one coming from Thurman in New York who writes, "I'm a 27-year-old black American beginning to witness the initial signs of hair loss. It seems as though all the hair loss or replacement ads seem to focus on Caucasian men. Is there a difference in the battle against hair loss?"

He's talking about different racial backgrounds.

WRIGHT: There really is not a difference in the pattern of hair loss or the treatments that are available for hair loss among ethnic groups.

GUPTA: No -- no difference in there?

WRIGHT: No difference.

GUPTA: And again, you would start medications before you'd obviously recommend any kind of operation?

WRIGHT: Oh, absolutely. Absolutely. I think that is the simplest intervention and it allow us to really control the hair loss for the longest period of time possible.

GUPTA: If you are choosing surgery for treating hair loss, here are your options. Scalp reduction, where the hairless part of your scalp is removed and the space is closed with hair-covered scalp. Doctors can also create something called a scalp flap. That's where hair-bearing skin is folded over an area of bald skin. This is especially good for those with extensive balding.

The other more common surgical option is something known as hair transplants. Donor hair is taken from other parts of the body, such as the neck or the back, and is transplanted into the scalp in small hair grafts. This requires going through several sessions over several months.

We've got a question on this procedure coming from Aviano, Italy. "Do I have to wait until a certain age or a certain stage in my hair loss to have a hair transplant? Will it really grow back? And can I lose it again?"

Who's a good candidate for this sort of thing?

WRIGHT: The best candidate for a hair transplant is someone who has stabilized their hair loss. So you don't want a transplant patient that are in an active phase of hair loss. But at some point with male pattern and female pattern hair loss, the loss will slow down. And that's the time when you want to start the transplantation. Otherwise, you transplant an area and then you get a rim of hair loss around it, and you're always chasing the hair. So it's not a matter of age, but a matter of stabilization...

GUPTA: Stability of hair loss.

WRIGHT: ... of your hair loss. GUPTA: We are talking with Dr. Sylvia Wright. Lots of good information on hair loss. We haven't forgotten about all the women out there. Answers to your hair loss questions are coming up next.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Is your shampoo causing it? What about your birth control pills? We'll get to the bottom of female hair loss after the break.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

We've been talking mainly about men's hair loss. But one in four women are also affected. The female pattern is different than men's though. Women's symptoms start later, between the ages of 25 and 45. Also, instead of balding, women tend to experience thinning of the crown of their head, around the center of their scalp, creating a see- through look. Like the one you see right here.

We're talking to Dr. Sylvia Wright, a dermatologist who specializes in hair loss.

Doctor, so many people think of hair loss as a man's problem. What percentage of your practice is women's?

WRIGHT: Interestingly, I have more women that come to the office about hair loss than men. Women are much more focused on the problem. And they come at a much earlier stage, which helps us to offer more viable treatment options earlier on.

GUPTA: What age are they typically when they come see you?

WRIGHT: Most are in their 30s.

GUPTA: OK. Again, it's that thinning on the top of the hair?

WRIGHT: It's that thinning on the top. And the men that come in about hair loss tend to be younger. Younger men are more bothered by it than the older men. The older men often accept it and don't want any treatment at all.

GUPTA: That's kind of a social statement there almost, isn't it?

WRIGHT: It is.

GUPTA: More concerned about the...

WRIGHT: It is.

GUPTA: Lots of e-mail questions coming in. Let's get to another one now. Margie from Michigan writes, "I'm a 43-year-old woman, who was born with very fine, thin hair. And I'm losing it steadily. Is it OK to shampoo and blow-dry daily using gel, mousse and sprays? What about highlights and dyes? This all adds body and improves the appearance of my hair, but I'm afraid it might accelerate my the hair loss?"

What about all these products? She's trying to -- it's -- is she working against herself by using these products to sort of poof up her hair?

WRIGHT: Well, external products are not going to change genetics. However, if you over shampoo, over blow-dry, over process the hair with chemicals, you can create breakage and further thinning. As long as these procedures are done properly. No more than one chemical treatment at a time, and assuring that the hair is not over processed; it's fine to do them to enhance the appearance.

GUPTA: We talked about men in preventing hair loss. Is there anything women can do to try and prevent the process in the first place?

WRIGHT: I think the main thing to do is to focus on good hair care. Good diet. And certainly if you have a hereditary type of hair loss, starting on Rogaine or Manoxidil very early on. Because these products have been shown to help women very, very well.

GUPTA: Can you take if you're pregnant?

WRIGHT: I would not recommend taking it while pregnant.

GUPTA: OK. Another question coming in now from Ellen in Minnesota, who asks, "Is there anything that can slow hair loss after the age of 60? Rogaine states that between the ages of 25 and 45, most women can see results. What works for those of us who are getting older?"

WRIGHT: None of the treatments that we have work as well after 60 as they do before 60.

GUPTA: Why is that?

WRIGHT: However, I think there's a different mechanism in the hair loss, and the things that we are treating become less important factors at that point in life. I think that for people who are willing to use Rogaine, it certainly can help to maintain what you have, even beyond the age of 60. But you may not see as good of results at that age as can you at an earlier age. But I think the surgical options are excellent for healthy 60-year-olds.

GUPTA: OK. Because they want their hair, too, as it turns out.

WRIGHT: Absolutely. Absolutely.

GUPTA: I think we time for one more question before we move on. Melissa, from Florida writes, "I am 24 years old and noticed my hair thinning since October of 2003. Could my hair be thinning as a result of birth control pills?"

Is that possibility? WRIGHT: It is possible that it could be due to the birth control pills. Certain types of hormonal therapies are more likely to cause hair loss than others. There are certain birth control pills that tend to create less of a problem with hair, but we can't be certain. There are so many factors that can affect hair loss, from internal disease to external trauma, to infection and other inflammatory disease of the scalp. So the most important thing is to find out what the causes of the hair loss is. And if there's no other cause, then consider consulting a GYN and trying an alternative.

GUPTA: Possibly changing your birth control pill. Good advice, Dr. Sylvia

Wright.

We're coming up on HOUSE CALL, need to find a hair doctor? We're going to show you how, after the break.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Looking for more information about hair loss, grab a pen. We'll give you some helpful web sites.

Plus, cholesterol lowering statins in the fight against AIDS. We'll tell you how statins might have an impact. That's all coming up on HOUSE CALL.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

FEIG: The popular cholesterol lowering statin drugs may also help slow down the AIDS virus, according to a new Spanish study. Researchers found that the statin drugs appear to do this by limiting the virus' ability to spread, and by increasing the number of immune cells made to combat the virus.

And the governor of Illinois is introducing an online pharmacy so residents can buy their prescription drugs from Canada, Ireland and the United Kingdom. While the FDA opposes buying drugs from Canada because it has limited control over their quality, it has not stopped other states that have created similar web sites. Prescription drugs are often cheaper in Canada, because the government there has limits on what drug companies can charge.

Christy Feig, CNN.

(END VIDEO CLIP)

GUPTA: Thanks Christy.

If you're looking for a hair loss doctor, go to www.aad.org. That's the American Academy of Dermatology. Click on "Aging Skin," and you're going to find information on all forms of hair loss. While you're there you can search for doctors in your neighborhood on the dermatologist search page. Also, try calling them at 1-888-462-DERM. It's been a great show.

WRIGHT: Thank you.

GUPTA: A really interesting show. What is a final thought you'd like to leave with our viewers today?

WRIGHT: I think it's important for patients to get treatment for hair loss when they notice it. Because there are a lot of things we can do to try to slow it down, or stop it if treatment is gotten very early in the process.

GUPTA: Doctors available, treatments are available. I also want to keep in mind that you lose about 50 to 100 hairs a day; that's a good thing for me to remember when I'm brushing my hair and some hair comes out. It's not the end of the world.

Well, we're out of time this morning. Thank you Dr. Sylvia Wright, first of all, for all your time. Thank you as well at home for all of your questions. There were hundreds of e-mails this time.

Make sure to send us your questions for next week as well. We're going to be talking about heading back to school. After months of summer fun, we're going to give you tips on helping both you and your child make that transition a little bit easier.

Remember, this is the place to ask the experts your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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