A veteran magazine beauty editor/writer (and a member of the 40+ club), Genevieve Monsma created MediumBlonde to help Gen Xers and Baby Boomers age the way they want.


Growing Pains: How I Overcame Hair Loss

Growing Pains: How I Overcame Hair Loss

One in four women in the U.S. (or one in two women, if you’re over 40) suffer from thinning hair. I’m one of them. I’ve written in earlier posts here and here about my struggles with shedding, but because August is National Hair Loss Month (who knew?), and a number of you have asked…I’ve consolidated the details of my routine (the what and the why) in this post.

Before I begin though, I should note that my hair loss has been relatively minor. I took action at the very first signs of sparse spots and managed to temper the fallout. If your thinning has progressed to what you'd call moderate or extreme, I’d recommend enlisting the help of a dermatologist. You may have an underlying health condition (e.g. thyroid problems, anemia) driving your issue—and only an M.D. (and an Rx) will help.

If, however, like me, you're in the fairly-minor-thinning camp, the good news is there are a number of effective treatments. The not-so-great news is the reason there are a variety of treatments is that there's typically more than one culprit for the fallout.

I recently listened in on a hair loss webinar hosted by Joshua Zeichner, M.D., the director of clinical and cosmetic dermatology at Mount Sinai Hospital in Manhattan, during which he outlined those common causes:

AGING After the age of 40, the diameter of individual strands of hair starts to shrink. (The official name for this is miniaturization.) The result? Your hair appears thinner, even if you still technically have the same number of hairs on your head.

HORMONES Perimenopause (or full-blown menopause) can wreak havoc on hair, causing hormonal fluctuations that result in thinning or fallout. In particular, higher-than-normal levels of DHT (a.k.a. Dihydrotestosterone), a male hormone, has been shown to shrink hair follicles, making it harder for them to produce healthy hair.

STRESS It’s believed that high stress levels (and the subsequent spike in cortisol) can impact hair growth by pushing follicles into a temporary “resting phase,” which limits the number of strands they sprout. In the case of severe stress, the immune system can go so far as to attack hair follicles and halt hair growth altogether.

NUTRITIONAL DEFICIENCIES Hair is one of the last areas of the body to receive nourishment. First on the list? Vital organs that keep you alive. Thus, if your diet is spotty, your heart and liver will get first dibs on nutrients, and your hair will get short shrift.

THE SUN UV rays are not just dangerous for exposed skin. They can cause free radical damage on the scalp too, impeding future hair growth.

AGGRESSIVE STYLING Wearing tight braids, ponytails or hair extensions—or relaxing treatments that burn the scalp—can all traumatize hair follicles and inhibit their ability to produce.

INFLAMMATION Chronic, low-grade inflammation in the body (from diet, from stress, from illness, etc.) can interfere with your cells' ability to signal to one another—and ultimately, for hair follicles to function efficiently.

So, given these myriad causes, I've elected to make my anti-hair-loss strategy multi-faceted. In addition to obvious (and easy) behavioral tweaks, like not pulling my ponytail too tight; wearing a hat when I’m in the sun for the day; and trying to temper stress with yoga, sleep, and the occasional glass of wine, I rely on these treatments:

Nutrafol I’ve been taking this supplement every morning with my coffee for almost a year. I’ve tried a number of other “hair vitamins” over the years, and, while I do believe some have been helpful (notably, Viviscal and Philip Kingsley’s PK 4 supplements), I’ve personally seen the most improvement in density (and speed of growth) with this one. The science behind it also makes sense to me: Rather than just loading up on biotin or keratin (a B vitamin and a protein, respectively, believed to help strengthen hair), Nutrafol boasts ingredients that combat and counteract the aforementioned hormone fluctuations, cortisol spikes, inflammation, and diet deficiencies.

Minoxidil I wrote extensively about the benefits of this scalp serum here, and I apply it once a day either after I shower in the morning—or before bed. I don’t use it all over, just in spots that tend to be sparse, like near my temples and across my forehead/hairline border. This treatment is believed to work by widening the follicle to enable it to grow fatter strands, mitigating the effects of the age-related miniaturization, mentioned above. I’m currently using Nioxin’s Minoxidil Topical Solution USP 2% for Women.

Evolis Reverse Activator I apply a dropper of this treatment daily, in conjunction with my minoxidil. It inhibits a protein called FGF5, which, when overproduced, has been shown to shorten the hair’s growth cycle and cause premature fallout. Overproduction is believed to be tied to a spike in testosterone (which converts to the aforementioned DHT).  Again, as with minoxidil, I apply this only to spots with a propensity to become sparse.

Aveda Pramasana Scalp Cleanser All the minoxidil and Evolis Activator in the world would be applied in vain if I had a buildup of dead skin cells and styling products on my scalp—and no clear path to my hair follicles. Therefore, I use this gentle exfoliating product two to three times a month to improve absorption. I outlined my initial encounter with it here.

Results after four months of taking Nutrafol PLUS four PRP treatments. Photo is courtesy of  Julia Russak, M.D . a dermatologist in NYC.

Results after four months of taking Nutrafol PLUS four PRP treatments. Photo is courtesy of Julia Russak, M.D. a dermatologist in NYC.

One final note: I’ve seen some fairly convincing evidence that PRP (Platelet-Rich Plasma therapy) is also an effective (albeit pricey) growth-stimulating option for more significant hair loss. I’ve not personally tried it (and I’ve seen significant enough with my current regimen that I feel no compulsion to do so soon), but I think it’s worth investigating for those of you who are not getting enough improvement from the aforementioned treatments. This before/after (at right) shows the improvement one women got after combining PRP with Nutrafol supplements..

Have an antidote to thinning hair you'd like to share? Email me at or tell us all in the Comments, below.







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