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Should I see an endocrinologist for my hair loss?

Dr. Jack Merendino, MD
Endocrinology Diabetes & Metabolism
The commonest form of hair loss is termed "androgenetic alopecia," meaning hair loss that is the result of exposure to male hormones ("androgens", the most important of which for this form of hair loss is dihydrotestosterone or DHT) in a genetically susceptible person. Androgenetic alopecia is therefore a hormone "problem," though usually there is nothing abnormal about the hormone levels. Completely normal levels of testosterone or DHT usually give rise to the hair loss; it just depends on whether you are genetically programmed to lose hair as a result of the androgen action. Since this form of hair loss is driven in part by male hormones, it’s reasonable to see a hormone specialist -- an endocrinologist -- for treatment.

Most people don’t realize that androgenetic alopecia is equally common in men and women. Women start out with a larger number of hair follicles on the scalp than men, generally speaking, and they have lower testosterone levels, so it usually takes much longer for the hair loss to become apparent. But many women have significant thinning of their hair by the time they are in their 60s or older.

I see a lot of people for hair loss, especially women, but there's no reason that a man shouldn't see an endocrinologist as well. The approved treatments for men include topical minoxidil (brand name Rogaine) in both liquid and foam and the oral medication finasteride (brand name Propecia. Finasteride is also available as a higher dose medication for prostate enlargement as the brand-name medicine Proscar.) Unapproved medications, especially useful in women, include spironolactone, which blocks testosterone action. A good endocrinologist will also take a careful history and examine the scalp to be sure the hair loss is not a non-hormonal issue. He or she can then explain which combination of treatments is likely to be of value in an individual and can discuss possible side effects of treatment.

We’re expecting more and better options for treatment in the future. Lots of pharmaceutical companies are putting hefty research dollars into the treatment of hair loss since few things prompt people to part with their hard-earned cash faster than vanity. Not that I would ever be caught worrying about such things. Now, where did I put that Rogaine?

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.