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Hair Loss in Women

November 17th, 2016

Dr. Michael Wolfeld was featured on the Dr. Oz Show where he was interviewed by Dr. Mehmet Oz about misconceptions on women’s hair loss, promising reports of JAK inhibitors in treating alopecia areata, and using men’s 5% minoxidil solution in female hair loss patients.

Below is a partial transcript:

Dr. Oz: We are back with our hair investigation and now what you really want to know about how to make it thicker, fuller, shinier, and last longer. We’re starting with the thicker and fuller part. Dr. Michael Wolfeld is a plastic surgeon who specializes in hair loss and thinning hair in women. So what’s the biggest misconception people have about their hair?

Dr. Wolfeld: Many women don’t realize that something can be actually done to treat their thinning hair. They’ve tried minoxidil, they’ve tried other over the counter medications, and they haven’t seen much response from that. The best thing to do is to come in and have your scalp examined. There are a lot of different types of hair loss, there is hereditary, autoimmune, inflammatory. Many women may need to have their scalp examined, and they may need a small biopsy, which is just taking a little piece of skin, maybe putting one stitch. That gives us a lot of information in order to treat the patient.

Dr. Oz: There was a headline recently about a cancer drug that had a side-effect of getting people to grow more hair. What’s the story there?

Dr. Wolfeld: There is a medication that is out there, it is called ruxolitinib. It’s in the class of medications which is an enzyme inhibitor. They’ve found that that medication can be used to treat certain bone marrow malignancies and other inflammatory conditions. They’ve also found in the lab that it is able to treat hair loss, specifically alopecia areata, which is an autoimmune type of hair loss that effects up to 2% of patients.

Dr. Oz: For folks watching right now, if someone came to your office, if I came to your office, and I had this problem, what would you give to me, the most common? What might work for the average viewer right now.

Dr. Wolfeld: Most common, I would use minoxidil, which is an over-the-counter solution. For women, the percentage is 2%, however we have found that a 5% solution, which is generally for men, has been more effective in regrowing hair, thickening hair, and allowing hair to grow longer.

Dr. Oz: So, treat yourselves like a man would. Take the ‘big boy’ minoxidil. Why don’t we normally recommend women take that dose?

Dr. Wolfeld: The 5% solution [containing propylene glycol] may irritate the scalp a little more, it may cause a little more inflammation by using the higher percentage, but women willing to try the 5% men’s solution have seen positive results.

Dr. Oz: So there are women all over the country right now who could take the man’s version of minoxidil, a little topical steroid if they need it, which is over the counter as well, and get results.

Dr. Wolfeld: They definitely can.

Dr. Oz: Let me explain this to you. This is such important news for a lot of folks. Let me show why this is so exciting to me. A lot of women get what is called female pattern balding, where you start to get a thinning of the hairline, in the part especially. What’s going on in there? You have the same number of hairs, but the actual hairs are getting thinner, and that’s the problem. You get inflammation. Now how do you deal with that? You drop two solutions. You put a little steroid on top to deal with the inflammation, the irritation of the hair. Then you drop another compound, like the minoxidil, with the “male” dose of it, and that sinks into the follicles and makes the hairs get big and thick like they used to be. Those new strands that come out, they’re happy, they last longer. And without that big part visible, look how happy she is. You want to look like her, not how we started.

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