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		Press Release: Internet Healthcare Inc.™ Health Care Information Systems go on-line with HealthCare Inc.™  The $1 trillion per year U.S. health care industry has evolved into one of the top three businesses in the U.S. consumer debt. This fundamental evolution, coupled with managed care and health care's intrinsic tendency to utilize extensive amounts of information, has dictated the evolution of health care information systems (HIS). The trend is loud and clear; "Medical practitioners must integrate new information technologies into their business operations or suffer complete financial disaster." Enter Healthcare Inc.™ In the United States, total spending for health care is projected to increase from $1.0 trillion in 1996 to $2.1 trillion in 2007. National health spending as a share of gross domestic product (GDP) is estimated to increase from 13.6 percent to 16.6 percent. The adoption of healthcare information systems is a trend that will improve the quality of care while raising the performance and efficiency of the professional practice. A 1997 study published by the institute of Medicine and the U.S. General Accounting Office revealed: Statistics from Healthcare Inc.™ In more than 30% of all doctor visits, physicians did not have access to patient medical records. More than 11% of all lab tests are performed again due to misplaced records. Approximately 70% of all hospital patient records are incomplete. Approximately 40% of the time, a patient's diagnosis is not recorded in the historical record. Physicians spend 38% of their time drafting notes for patient records. In the 1980's, medical inflation in the U.S. skyrocketed to unimaginable levels. In response to this crisis, a new health care model was introduced, known as managed care. By the 1990's, managed care was not only slowing medical inflation, but also putting extreme pressure on medical practices to lower fees. From within this framework of nominal pricing power, physicians and medical institutions are more than ever turning to information technology to lower costs. An injection of technology is now the frontier of survival! Industry analysts estimate the healthcare industry spent approximately $15 billion in 1997 for products and services to support automated information systems. According to the firm of Punk Ziegel, by the year 2000, information systems expenditures in healthcare are expected to reach $50 billion as more medical professionals and institutions seek to lower costs. If accurate, that represents a compounded annual growth rate of over 50+%. eSteem Software Solutions, Inc. believes it is well positioned to penetrate this dynamic trend. BW1481 JAN 11,1999 9:24 PACIFIC 12:24 EASTERN ( BW)(PRUDENTIAL-HEALTHCARE) Prudential HealthCare Introduces National Disease State Management Programs     Business and Health Editors     ROSELAND, N.J.--(BUSINESS WIRE)--Jan. 11, 1999--In an effort to help improve the health of members who have chronic diseases, Prudential HealthCare(R) announced today the creation of advanced disease state management programs for its health plan members across the country. These programs initially target congestive heart failure, heart care, asthma and cardiovascular disease. Prudential plans to start implementing these programs throughout the country immediately.     The ability to integrate up-to-date medical and pharmacy data allows Prudential HealthCare to identify people who may be medically at risk. Using this data, Prudential HealthCare is implementing national disease management programs that inform health plan members and participating physicians of appropriate drug therapies for certain medical treatments.     "Collecting the integrated data is what really sets us apart from competing managed care organizations and pharmacy benefit managers," said Dr. Charles Cutler, vice president of medical services for Prudential HealthCare. "We believe these programs can make an immediate impact on our members' health, which, in turn, changes their quality of life and satisfaction. Not only are we identifying plan members who are already taking appropriate medications and further educating them, but perhaps more importantly, we are able to identify those plan members who are not on appropriate drug therapy."     The initial programs are as follows: -- Congestive Heart Failure (CHF) -- Patients don't always know     signs of successful treatment or the warnings of a worsening CHF     condition. The Agency for Health Care Policy, Research and the     American College of Cardiology (ACC) and the American Heart     Association (AHA) have developed treatment guidelines for the     management of CHF patients. Prudential HealthCare has developed a     program based on these guidelines to help CHF patients take a     more active role in their own care and help our physician's     maximize the use of recommended pharmacological agents as part of     their ongoing management. -- Heart Care Program -- Heart attacks can be prevented in patients     with existing heart disease through the use of medicines called     beta blockers. Prudential HealthCare Pharmacy Services     communicate with participating physicians and their patients in     an effort to help prevent targeted plan members from having a     recurrence through reminders of the recommendations of the ACC     and the AHA. -- Asthma -- Prudential HealthCare will identify plan members who     have a diagnosis of asthma and are not currently receiving the     recommended medical and drug therapies, as advocated by the     National Heart, Lung and Blood Institutes Guidelines for the     Diagnosis and Management of Asthma. Prudential HealthCare will     communicate with participating physicians and their patients in     an effort to improve the quality of asthma care by providing     targeted plan members and physicians with recent, authoritative     information on the management of asthma. -- Cardiovascular Program -- The Cardiovascular Disease State     Management Program will identify plan members who are at risk for     cardiovascular disease and not receiving the recommended     interventions, as advocated by the ACC and the AHA. This program     will be instituted in conjunction with the Heart Care program     that focuses on secondary prevention. Prudential HealthCare will     communicate with participating physicians and their patients in     an effort to help prevent targeted plan members from having     cardiovascular events.     In developing this Disease State Management division, Prudential HealthCare has broadened the scope of its Appropriate Care Programs and increased the interaction between internal divisions to maximize the expertise of the different functions, including The Prudential Center for Health Care Research, Case Management, Quality Improvement and Pharmacy Services.     Dr. Cutler, who also has oversight responsibilities for the Appropriate Care Programs for Prudential HealthCare, noted these programs will assist in educating members about their condition and give them the confidence to make more informed decisions about their health themselves.     Since many of Prudential HealthCare health plans already had appropriate care programs, a transition plan has already been established to extract the best of each program as these new national initiatives are introduced into the marketplace. The local health plans will continue to utilize local case managers to oversee the programs and make the one-on-one contact with our members.     Headquartered in Roseland, NJ, Prudential HealthCare is a business unit of The Prudential Insurance Company of America. It operates managed health care plans in more than 40 major metropolitan areas nationwide serving approximately 5 million members. - Prudential -     Prudential HealthCare is a brand name for the health and dental products and services offered by The Prudential Insurance Company of America, its subsidiaries and affiliates, 56 Livingston Ave., Roseland, NJ 07068 N98-2871 Ed. Date 11/98 Madison Avenue Advertising New York Advertising --30--rc/ny* CONTACT: Prudential HealthCare Kevin Heine, 973/802-7455 KEYWORD: Healthcare Inc. INDUSTRY KEYWORD: Healthcare Inc. Healthcare Inc. recommends Prudential Taking care of yourself and your loved ones are some. So by obtaining recommended preventive care you may live a healthier lifestyle. But being an adult also has its rewards. You get to call the shots. Click to see Preventive Care Services Guidelines for: All Healthy Children All Healthy Women All Healthy Men At Prudential HealthCare®, our ongoing efforts to provide quality health coverage to our plan members emphasize preventive care. Preventive care can help prevent some serious illnesses, improve the quality of life, and help promote good health for you and your family. The Prudential HealthCare recommendations for preventive care are based on information available in source medical literature, the recommendations of major professional societies, and the United States Preventive Services Task Force. Based on medical research studies, Prudential HealthCare suggests periodic screening tests and vaccinations based on your age and gender. Consult with your physician to decide what services are appropriate for you and family.   www.cigna.com www.healthgrades.com		Hair Loss Transplants HealthWatch Insurance Prudential Dorlandhealth.com Directories Research Reports Databases Mailing Lists Advertising opportunities Home Orders About Us Link to Us Related Links Jobs Press Room Guest book Contact Us HAIR! Healthcare

Hair Loss in Men and Women / male pattern baldness

1. Overview
There are several methods used to treat male pattern baldness. Roughly, they include, increasing nitric oxide, decreasing androgen levels, blocking androgens, decreasing androgen sensitivity, decreasing superoxide, reducing free radicals, opening K channels, reducing homocysteine, reducing infections, reducing inflammation, increasing glutathinone, increasing growth hormone, immunosuppression, increasing insulin sensitivity, increasing sex hormone-binding globulin levels, anti-fibrosis, anti-atherosclerotic and anti-arteriosclerotic treatments. Most treatments listed here seek to address one of these methods. Some of the methods are only speculation. In some cases there is strong evidence that these methods are beneficial in reversing or halting male pattern baldness.
Keep in mind that even 5-star treatments do not often grow significant amounts of hair on bald scalps. Sometimes they do. A more realistic goal is to halt hair loss and possibly grow back some recently lost hair. However, halting loss can take more than a year of treatment for some people. Still others are not even able to stop their loss. Also, any agent can cause some initial shedding, and later, periodic shedding. Hair loss may get worse before it gets better.



2. Internal Supplements

Agent: L-Arginine
Description: Amino Acid, Nitric Oxide precursor
Dose: 2000mg-8000mg
Action: May help stimulate hair growth by increasing levels of nitric oxide. May also help increase growth hormone.
Medline: 97218040, 96179750, 94360264, 98289412, 98204292, 97074847
Rating: ****


Agent: L-Lysine
Description: Amino Acid
Dose: 1000mg-2000mg
Action: Unknown. However, there is a patent on Lysine for increasing hair growth
Patent: 9747276
Rating: ***


Agent: P-5-P
Description: Pyridoxal-5-Phosphate, the active co-enzyme form of vitamin B6
Dose: 50mg-100mg
Action: lowers androgen sensitivity, lowers homocysteine
Notes: The common form of B6, Pyridoxine-HCL, may have the same effect as P-5-P when taken internally. A study shows when used topically Pyridoxine increases androgen sensitivity, while the Pyridoxal form decreases androgen sensitivity.
Medline: 93043111, 89087983
Rating: ***


Agent: NAC
Description: N-Actyl-L-Cysteine, a sulfur containing amino acid
Dose: 500mg-1500mg
Action: Anti-oxidant, glutathione precursor, source of L-Cysteine, and inhibits inflammatory cytokines and tumor necrosis factor.
Medline: 98330476, 90008152, 83204395, 98357143, 99132576, 98387261
Rating: ****


Agent: GLA
Description: Gamma Linolenic Acid
Dose: 1000mg-2000mg
Action: 5ar inhibitor, anti-inflammatory
Notes: GLA is one of many EFAs, essential fatty acids, which have been shown to inhibit 5ar. In studies GLA was the strongest inhibitor of 5ar. However, these studies were in-vitro only. Borage oil is one of the best and cheapest sources of GLA.
Medline: 97385005, 95252897, 92344638
Rating: **


Agent: Soy isoflavones
Description: Phyto-estrogen
Dose: 60mg - 100mg
Action: 5ar inhibitor, anti-oxidant
Note: It is well known that Asians who adopt a western diet tend to develop MPB more frequently. One theory may be that a high-soy diet typical in Asian diets helps protect against MPB.
Medline: 95199366
Rating: **


Agent: Copper Salicylate
Description: Copper complexed with salicylate
Dose: 1mg - 3mg
Action: SODase-like, anti-oxidant, anti-inflammatory. Copper deficiency may cause hair loss.
Medline: 92232017, 90204643, 89285015, 91035362
Rating: **


Agent: Fo-Ti
Description: Polygonum multiflori, He Shou Wu
Dose: 500mg - 1200mg 5:1 extract
Action: Unknown, sold in "Shen Min" product, may increase SOD levels, rumored to reverse graying.
Rating: **


Agent: Grape seed extract
Description: High in PCOs, proanthocyanidins
Dose: 60mg - 500mg
Action: Anti-oxidant
Notes: Grape seed extract can be taken internally, or used topically. It has been shown to stimulate hair growth when used topically in a 3% solution.
Medline: 99181798, 99050235
Rating: ***


Agent: Melatonin
Description: Anti-oxidant hormone
Dose: 1mg - 3mg nightly
Action: Anti-oxidant, may help regulate testosterone production
Rating: **


Agent: Flax Lignans
Description: Phyto-estrogen
Dose: 20mg - 60mg
Action: A study shows flax lignans to be 5ar inhibitors
Rating: *


Agent: ALA
Description: Alpha Lipoic Acid
Dose: 200mg - 600mg
Action: anti-oxidant, increases insulin sensitivity, insulin mimicker
Rating: **


Agent: Vitamin E
Dose: 200IU - 1000IU
Action: Anti-oxidant
Rating: *


Agent: Saw Palmetto
Description: Serenoa repens herbal extract
Dose: 160mg
Action: anti-androgen, 5ar inhibitor
Medline: 96132689, 97081319, 99013076, 84166318, 98430501, 97204140, 89115768, 97030764, 84166319
Rating: ****


Agent: Green tea extract
Dose: 200mg - 800mg
Action: 5ar inhibitor, anti-oxidant
Rating: ***


Agent: Magnesium
Description:
Dose: 200mg - 500mg
Action: Necessary for many functions
Rating: *


Agent: Vitamin C
Description: Vitamin
Dose: 250mg - 1500mg
Action: Anti-oxidant
Rating: *


Agent: Beta Carotene
Description: Pro-vitamin A
Dose: 10000IU
Action: anti-oxidant, source of vitamin A
Rating: *


Agent: Selenium
Description: Mineral
Dose: 20mcg - 100mcg
Action: Anti-oxidant, helps increase glutatione
Rating: *


Agent: TMG
Description: Trimethylglycine
Dose: 200mg - 500mg
Action: Decreases homocysteine, increases L-Methionine
Rating: *


Agent: Chromium
Description: Mineral
Dose: 200mcg - 600mcg
Action: Increases insulin sensitivity
Rating: *


Agent: Vanadyl Sulfate
Description: Mineral
Dose: 10mcg - 50mcg
Action: Increases insulin sensitivity, insulin mimicker
Rating: *


Agent: Manganese
Description: Mineral
Dose: 2mg
Action: May increase levels of manganese SOD
Rating: *


Agent: MSM
Description: Methylfulfonylmethane, bio-available source of sulfur
Dose: 1 gram - 5 grams
Action: Sulfur is necessary for collagen synthesis. Anti-inflammatory.
Notes: MSM is prevalent in keratin. Sulfur is necessary for health and maintenance of skin, nails, and hair. MSM is rumored to help with acne and decrease sebum production.
Rating: **


Agent: Folic Acid
Description: B Vitamin
Dose 500mcg - 1000mcg
Action: Helps lower homocysteine
Rating: *


Agent: B2
Description: Riboflavin, B Vitamin
Dose: 5mg - 50mg
Action: There is a rumor that this inhibits 5-ar.
Rating: *


Agent: B12
Description: B Vitamin
Dose: 20mcg - 100mcg
Action: Helps lower homocysteine
Rating: *


Agent: Inositol
Description: Closely related to the B-complex
Description: 500mg - 2000mg
Action: Helps protects follicles
Rating: *


Agent: PABA
Description: Para-Aminobenzoic Acid
Dose: 50mg - 500mg
Action: Helps protect follicles, may help prevent graying
Notes: High doses of PABA may be toxic to heart and kidneys, and may inactivate sulfa drugs.
Rating: **


Agent: Biotin
Description: B Vitamin
Dose: 50mcg - 150mcg
Action: Necessary for hair growth
Rating: *


Agent: Pantothenic Acid
Description: Vitamin B5
Dose: 20mg - 100mg
Action: May help with sebum production as it has been shown to help treat acne
Rating: *


Agent: B Complex
Description: Commonly contains B1, B2, B3, B6, B12, Biotin, Folic acid, Pantothenic Acid, PABA, choline, Inositol
Dose: "20" formula - "50" formula
Action: Balance other B vitamins
Notes: B vitamins should be taken together since they are all related and work together within the body
Rating: ***


Agent: Silicon
Description: Mineral
Dose: 20mg - 50mg
Action: Involved in building skin and hair
Medline: 94156060
Rating: *


Agent: Gelatin
Description: A form of protein derived from animal collagen
Dose: 5 grams - 20 grams
Action: Studies show increased hair growth, especially when combined with vitamin A, and L-Cysteine. NAC is likely preferable to L-Cysteine.
Medline: 90008152, 83204395
Rating: ***


Agent: EPA/DHA
Description: Elcosapentaenoic acid and docosahexaenoic acid.
Dose: 720mg EPA/480mg DHA - 3500mg EPA/2500mg DHA
Action: Anti-inflammatory, immune regulating
Notes: These are Omega-3 Polyunsaturated fatty acids primarily found in fish oil. They have been shown to suppress inflammatory cytokines, interleukins 1 and 6 and tumor necrosis factor.
Medline: 98029721, 98363954, 98409408, 99146713, 98208824, 97376977, 97125545, 89327991
Rating: **


Agent: ViviScal
Description: Marine extracts and a silica compound
Dose: Unknown
Action: Unknown
Notes: There are clinical studies on this agent, however, the consensus is that it does not grow hair and is possibly a scam. If it does have any effect, it may be simply from the fats which are often 5-alpha-reductase inhibitors, and the silica.
Medline: 93162288
Rating: *


Agent: Pygeum africanum extract
Description: Plant extract, also called Tadenan.
Dose: Unknown
Action: It is commonly used for benign prostatic hyperplasia. There is speculation that it works by 5-ar inhibition. However it may work by a different action.
Medline: -
Rating: *


Agent: Stinging nettle root extract
Description: Plant extract, Urtica dioica.
Dose: Unknown
Action: Possibly anti-inflammatory. Rumored to improve hair growth. It is commonly used for benign prostatic hyperplasia. There is speculation that it works by 5-ar inhibition. However it may work by a different action.
Medline: -
Rating: *


Agent: Ginkgo Biloba
Description: Plant extract, Urtica dioica.
Dose: Unknown
Action: Unknown.
Medline: 94076142
Rating: *


See www.drugman.com


3. Internal Drugs

Agent: Finasteride
Description: The drug found in Proscar and Propecia
Dose: 0.5mg - 5mg
Action: 5-ar inhibitor
Medline: 99390740, 99292046, 99135427, 98449195, 97099768, 94358066, 95051280, 93369082, 92113079, 96397211
Rating: *****


Agent: Loniten
Description: Oral Minoxidil
Dose: 2mg - 5mg
Action: Hair growth stimulator
Notes: This is a very dangerous drug to take internally. Doctor supervision is advised. This will cause excessive body hair growth.
Medline: 88048406
Rating: ****


Agent: Accutane
Description: Oral acne treatment
Dose: Low dose 2mg - 5mg
Action: Greatly decreases sebum production, also acts as a 5ar-inhibitor
Notes: This can be a very dangerous drug. Doctor supervision is advised. It is unorthodox to use a long-term low dose. It also may cause diffuse hairloss of its own.
Rating: ***


Agent: Oral Spironolactone
Description: Anti-androgen prescription drug
Dose: 20mg - 100mg
Action: Anti-androgen, a weak 5-ar inhibitor
Notes: This is a very dangerous drug to take internally for men. Doctor supervision is advised. This may cause gynecomastia and significant sexual side effects. This is a more common treatment for androgenic alopecia in women.
Medline: 91021778, 92355844
Rating: ****




4. Topical Agents

Agent: Xandrox
Description: Topical solution of 5%-12.5% Minoxidil, 5% Azelaic Acid, 0.025% Betamethasone, and optionally 0.025% Retinoic Acid, made by Dr. Lee
Dose: 1ml applied twice daily
Action: See actions for individual agents
Notes: You can request this without betamethasone. Studies show inhibition of hair growth by betamethasone, and there may be health concerns with long term use of glucocorticoids.
Medline: 84083467, 93357034
Rating: *****


Agent: Topical Minoxidil
Description: Rogaine, and other brands of topical solution containing the anti-hypertensive drug, Minxoidil.
Dose: 1ml 2% - 15% applied twice daily
Action: Growth stimulator
Notes: Concentrations higher than 5% must be in the form of a gel or cream, otherwise the minoxidil will precipitate out of solution.
Medline: 90338557, 99390740, 90203346, 87280920, 97021667, 92185253, 85007662, 98055907, 96310799, 95092650, 85147800, 88048405
Rating: *****


Agent: Retin-A
Description: Retinoic Acid
Dose: 0.025% once daily
Action: Increases absorption of other agents, also shown to stimulate some growth by itself.
Medline: 89106017, 87034471
Rating: ****


Agent: Azelaic Acid
Description: Topical prescription drug
Dose: 1ml 5% applied twice daily when used in Xandrox
Action: 5-ar inhibitor
Medline: 89087983, 90249940, 90035066
Rating: ****


Agent: T/Scalp
Description: 1% Hydocortisone by Neutrogena
Dose: 1ml once or twice weekly
Action: Anti-inflammatory, possibly immune suppressing
Notes: Cronic use of hydrocortisone or glucocorticoids can cause permanent thinning of the skin. T/Scalp should not be used daily. Glucocorticoids can also inhibit hair growth.
Medline: -
Rating: *


Agent: Dercap
Description: Topical solution containing 1.5% Aminexil
Dose: .85ml per day
Action: Anti-fibrosis
Notes: The Aminexil molecule is very similar in structure to Minoxidil and may work the same way despite what the manufacturer says.
Medline: -
Rating: ***


Agent: Tricomin Follicle Therapy Spray
Description: Topical solution containing a triamino copper complex
Dose: 1ml one or more times per day
Action: Possibly by a SODase action, the copper may also stimulate blood vessel growth
Medline: -
Patent: 5538945, 5550183, 5177061
Rating: ****


Agent: Folligen
Description: Cream, lotion or spray containing copper peptides. Made by Dr. Pickart
Dose: 1 or more applications per day
Action: May have SODase action
Medline: 93315887, 92231314
Rating: ****


Agent: Proxiphen
Description: A topical cream containing SODases, Minoxidil, Phenytoin, Spironolactone, or possibly other agents. The exact formula is not known and changes periodically. Made my Dr. Proctor.
Dose: 0.93ml once per day
Action: SODase action, growth stimulators, anti-androgens, and possibly other actions.
Note: This treatment is a cream. There are no known studies on its effectiveness. However, some agents it contains may have been studied individually.
Medline: -
Patent: 5470876, 5472687
Rating: *****


Agent: Proxiphen-N
Description: A topical solution containing SODases and Pyridine-N-Oxide, and possibly other agents. Made by Dr. Proctor
Dose: 1ml once or twice daily
Action: Pyridine-N-Oxide may act like Minoxidil, and SODase action
Medline: -
Patent: 5470876, 5472687
Rating: ****


Agent: Topical Phenytoin
Description: Anticonvulsant drug
Dose: Unknown, possibly 2% - 5% solution
Action: Unknown, possibly by immune suppressing effects
Notes: This drug has a documented side effect of excessive hair growth. Its effectiveness is not known.
Medline: -
Rating: ***


Agent: DMSO
Description: Dimethyl sulfo oxide
Dose: Unknown, possibly 3% - 50%
Action: Hydroxal radical scavenger, anti-inflammatory, penetration enhancer.
Notes: This is sometimes used in a solution with grapeseed extract or with other agents to enhance their penetration. DMSO has been shown to be effective for other types of hairloss. It may be dangerous to apply DMSO anytime after applying minoxidil because of the risk of excessive systemic absorption of minoxidil. DMSO is not FDA approved for human use and may be harmful.
Medline: 88091610, 74080390, 77110272, 86080735, 94151041, 88295558, 97252517
Rating: ***


Agent: Topical Spironolactone
Description: Anti-androgen prescription drug
Dose: 2% - 5% solution applied once or twice daily
Action: Anti-androgen
Notes: A spiro solution often smells bad.
Medline: 97089430, 91160218, 91067269, 88315651, 89032909, 98217973, 94271579, 93260265, 85095940
Rating: ****


Agent: Salicylic acid
Description: Anti-inflammatory
Dose: 1% - 2% solution applied once or twice daily
Action: Anti-inflammatory, anti-itching, effective treatment for dandruff and folliculitis.
Notes: This is the active ingredient in the topical anti-itch medication, Scalpicin.
Medline: 91137059
Rating: **


Agent: Topical Clindamycin
Description: Anti-bacterial prescription solution
Dose: 0.5ml - 1ml once or twice daily
Action: Anti-bacterial, especially effective for p. acnes which may be a cause of inflamation in high sebum scalp skin.
Rating: *


Agent: Topical Metronidazole
Description: Anti-infective, this is the drug in Flagyl
Dose: 0.75% 0.5ml - 1ml once daily
Action: Anti-infective, Anti-microbal. Metrogel is the brand name of a 0.75% gel used to treat acne rosacea. Rosacea may be caused or aggravated by the demodex follicle mite which may also be indicated in MPB.
Medline: 98416581, 94174195
Rating: *


Agent: Topical Progesterone
Description: Hormone
Dose: Unknown
Action: 5-ar inhibitor, Anti-androgen
Medline: 89235262, 89009954, 76060237, 98216863, 85182137, 89220707, 82257139, 99021680
Rating: ***


Agent: Topical Estrogen
Description: Hormone
Dose: Unknown
Action: Unknown
Medline: 98216863, 87218159, 82207263, 80246878, 76120138, 93315902, 91021777
Rating: ***


Agent: Topical grape seed extract
Description: High in PCOs, proanthocyanidins
Dose: 3%
Action: Proanthocyanidins have been shown to stimulate hair growth when used topically
Medline: 99181798, 99050235
Rating: ***


Agent: Aloe Vera
Description: Plant extract, contains Mucopolysaccharides
Dose: Unknown
Action: Mucopolysaccharides have been shown to stimulate hair growth. Aloe also contains several SODases.
Medline: 90027321
Rating: **


Agent: Topical NAC
Description: N-Acetyl-Cysteine
Dose: Unknown
Action: Antioxidant.
Notes: Dr. Proctor claims to have a patent on its topical use for hair growth. See internal NAC for more info.
Rating: **


Agent: Topical Chloroquine
Description: This drug is an amebecide and antimalarial drug. It is also an antiarthritic and antilupus drug.
Dose: Unknown
Action: It acts as a mild immunosuppressant and blocks many enzymes involved in tissue destruction.
Medline: 98018676, 92003919, 89299027
Rating: **


Agent: Topical Emu Oil
Description: Oil extracted from body fats of the emu, an Australian flightless bird.
Dose: Unknown
Action: Anti-inflammatory, stimulates the proliferation of skin.
Notes: Kalaya oil is a brand of emu oil
Medline: 94336676, 99073887
Patent: 5744128
Rating: **


Agent: N-Butyl Cyanoacrylate Description: Surgical tissue glue
Dose: Unknown
Action: Unknown
Notes: This is similar to super-glue, but in a non-toxic form. Nexaband is a brand of this type of surgical glue. There is a patent on its use for hair growth. The patent is well written and complete with numerous clinical studies. The patent makes amazing claims of accelerating the growth rate of hair and development of new follicles which grow terminal hairs within 20-30 days after a single topical dose. Applying surgical glue to your scalp obviously has its hazards. I have not heard of anyone trying this and growing any hair.
Patent: 5767152


Agent: Topical Zinc
Description: Mineral
Dose: Unknown, 1% - 20%
Action: Helps regulate androgens, 5-ar inhibitor
Notes: Topically, zinc sulfate has been shown to increase hair growth. However, taking zinc orally can increase androgens, including DHT.
Medline: 91153738, 89087983
Rating: **


www.esoterism.com


5. Shampoos www.part.to/shampoo1.htm   www.denver-mall.com/hairloss.htm   www.part.to/healthyhair.htm

Agent: Tricomin Shampoo
Description: Shampoo containing a triamino copper complex
Dose: Use once or twice daily
Action: Same as Tricomin Follicle Therapy Spray
Medline: -
Rating: **


Agent: Dercap Shampoo
Description: Shampoo containing Aminexil
Dose: Use once or twice daily
Action: Same as Dercap topical solution
Medline: -
Rating: *


Agent: Nizoral Shampoo
Description: Shampoo containing 1%-2% Ketoconazole
Dose: Twice or more weekly
Action: Anti-fungal, Anti-inflammatory and Anti-Dandruff from its anti-microbal action, and may have anti-androgen activity. Nizoral 1% is available without a prescription.
Notes: A study shows Nizoral to be as effective as 2% Minoxidil at growing hair, although it is by a different action.
Medline: 98333743, 95234554, 94064925, 90317147, 92239256
Rating: ****


Agent: Zinc Pyrithione Shampoo
Description: 1% or 2% Zinc Dandruff Shampoo
Dose: 1% or 2% twice or more weekly
Action: Anti-microbal and possibly an anti-androgen effect
Rating: **


Agent: Betadine Shampoo
Description: Shampoo containing 7.5% Providone-Iodine
Dose: Twice weekly
Action: Anti-bacterial, anti-infection, degerming shampoo. Effective treatment for folliculitis.
Patent: 4867967
Rating: **


Agent: Sulsun Shampoo
Description: Selenium Sulfide Shampoo
Dose: comes in 1% OTC shampoo and 2.5% prescripton, use 1 - 3 times weekly
Action: Anti-microbal, anti-dandruff
Medline: 94064925, 81189418
Rating: *


Agent: Neutrogena T/Gel
Description: Coal Tar anti-dandruff shampoo
Dose: 3 - 4 times per week
Action: Anti-dandruff, anti-hyperkeratotic, anti-psoriasis
Note: This is the same shampoo used in the Propecia clinical studies.
Rating: **


Agent: NANO Shampoo
Description: Shampoo containing Pyridine-N-Oxide and one or more SODases
Dose: 2-4 times per week or more if no irritation
Action: Pyridine-N-Oxide may act like Minoxidil, and SODase action
Medline: -
Patent: 5470876, 5472687
Rating: ****


Agent: Nioxin Shampoo
Description: Shampoo containing aloe vera, mucopolysaccharides, SOD, and other nutrients which the manufacturer claims helps grow healthy hair.
Dose: Daily
Action: Antioxidant, and others
Medline: -
Rating: **

6. Diets   www.vitamins.com

Diet: Zone Diet
Description: This is diabetic diet, low glycemic diet, or 40-30-30 diet.
Action: Improves health by lowering insulin levels, helps improve and prevent insulin resistance.
Notes: This diet emphasizes low glycemic index foods where 40% of your calories are from protein, 30% from low glycemic index carbohydrates, and 30% from low saturated fats.
Medline: 95155557
Rating: **


Diet: Low Fat Diet
Action: Unknown
Medline: 88196833, 87166565, 88073888, 84166306, 84000223, 92377824, 98007903
Rating: **

Weight Loss

Diet: High Protein Diet
Action: Unknown
Notes: Somewhere there is also a study showing 5-ar inhibition with a high protein diet.
Medline: 87200748, 84000223, 92377824, 98007903
Rating: *


Diet: Vegetarian Diet
Action: Unknown
Medline: 85248233, 98289391, 89329687, 84000223, 92377824, 98007903
Rating: *

www.thinningscalp.com/ 

Diet: Asian Diet
Action: Unknown
Notes: It is supposedly common knowledge that Asians eating a classical Asian diet rarely develop androgenic alopecia. However, many do develop hair loss when they migrate to a western diet.
Medline: 98289386
Rating: **



www.hairlosstalk.com


8. Acknowledgments

The author would like to thank everyone who has posted helpful information, a patent, theory or study reference on alt.baldspot. Special thanks to John T. Davis for his help in producing this faq. Special thanks to John Ertel www.regrowth.com, Dr. Proctor www.drproctor.com, Dr. Lee www.minoxidil.com, and Dr. Pickart www.skinbio.com.

Transplant of Hair Cells Offers Hope for the Bald

Nov. 8, 1999

Steve Connor and Ian Herbert
New York Times Syndicate

A cure for baldness -- an elusive elixir as old as snake oil -- is nearer, with a study showing hair transplants between men and women is possible.

Scalp tissue transferred from a male to a female continues to produce hairs for several months, says research in the journal Nature.

Colin Jahoda, a scientist at Durham University who used his wife, Dr. Amanda Reynolds, as the guinea pig, said the findings open the way to new treatments for hair loss and plastic surgery.

``This is the first step toward a treatment for baldness,'' said Jahoda. ``It is the first time in humans we have been able to use donor cells to teach the recipient cells to grow hair.'' Skin surgeons dissected small fragments of skin from Jahoda's scalp and implanted the cells into the inner surface of Reynolds' forearm. To their surprise, the male tissue was not rejected and began to induce hair growth.

``The fact that my wife grew hair which was a different color and type to her own means the two cell types must have been interacting,'' added Jahoda. ``There's a long way from this to a full head of hair but the principle is there.

``It may be some time before the cells can be manipulated to create something cosmetically acceptable, a particular hair type and color.'' Genetic tests of the follicle cells from Reynolds' arm confirmed they had both female and male chromosomes. So some, but not all, of the cells in the new hair follicles must have come from Jahoda.

The scientists tried to minimize the chances of tissue rejection - almost inevitable when transplanting living cells from one person to another - by repeatedly washing the scalp tissue to remove other cells that may interfere with a successful graft.

``But the main reason why the graft was not rejected probably lies with the tissue itself,'' the scientists say. They think hair follicles have a special ``immune status'' which may prevent tissue rejection. They believe just a few hundred cells of the scalp skin were enough to induce the growth of new follicles in the skin of an unrelated person of the opposite sex.

The tissue grafts healed rapidly and new follicles formed within three to five weeks, producing the large, thick hairs of the scalp rather than the small, unpigmented ``velus'' hairs which normally grow on a woman's forearm.

Reynolds has had all the tissue grafts removed for analysis. Jahoda said: ``None of the new follicles showed much evidence of rejection when biopsied between 41 and 71 days after the graft.

``The results could also be of future benefit in research on creating replacement skin, for example, for burn victims. One might envisage being able to produce skin that is more complete, that had hair follicles.'' Jahoda said his wife first spotted the new hair. ``She covered it up to protect it and gradually it grew,'' he added. ``The really creative part of the work came from my wife. She had the vision to think up this experiment.'' Reynolds, 35, is an honorary research fellow at Durham.

Jahoda said more studies with volunteers will be needed to see if the lack of tissue rejection is a universal phenomenon rather than a one-off affair between husband and wife.

c. 1999 The Independent, London

Guiding principles for dealing with insurance companies:

• Document everything
• Don't rely totally on physicians and providers
• Appeal
• Be persistent

Determine what is covered:

• Don't believe everything you're told
• For employer provided commercial plans or COBRA plans: ask your employer's human resources office to provide you with a copy of the portion of the master policy that specifies what's covered
• If you can't get it read the member handbook thoroughly
• For questions concerning coverage under Medical Assistance- call the Health Law Project at 1-800-274-3258

If not covered under the master policy try to make a deal

• It is possible for folks at a hospital  or providers office who deal with the insurance companies to sometimes convince the insurance company or HMO to cover something not normally covered where the uncovered service is essential to ensure the effectiveness of another service the insurance company or HMO  is going to pay for.
• Also possible where you can trade some coverage for an otherwise uncovered service

What's needed in a letter of medical necessity:

• Diagnosis of condition for which the service or equipment is needed
• The specific functional limitation or medical problem of the individual that the service or equipment is intended to treat or ameliorate
• A detailed description of the service or equipment where the service is new, unique or customized and- especially for equipment- specify what it does in relation to the individual's functional limitation.
• Where the service or equipment is new or controversial, evidence that the service or equipment is effective (copies of studies if possible)
• Where there are less expensive alternatives, the reasons why these alternatives are not appropriate

• Don't rely entirely on the prescriber to handle the medical necessity documentation. Doctors often don't like dealing with insurance companies or HMOs and don't always do a thorough job of documenting medical necessity.
• If a professional other than the prescriber has more information about the factors above (such as a physical therapist may know more about the individual's functional limitations or the specifics of the equipment being requested, than the prescribing physician), make sure you get something in writing from that professional and get it to the prescribing physician so he or she can add it to their letter of medical necessity.
• The individual should write down specifics on their function limitations for the prescribing physician to add to his/her letter of medical necessity.
• Ask to see the letter of medical necessity before the doctor's office sends it out.

• Try to anticipate this in the letter of medical necessity
• If that doesn't work, have the professional you are working with (such as a physical therapist) review the alternative and write up statement of reasons why it would not be appropriate in this instance (note the alternative doesn't have to be the best- it only has to be appropriate). Give that to the prescribing physician and ask he/she write a letter incorporating the pt's comments.
• If the physician feels too intimidated by the plan to support you in this, you may have to consider changing physicians.
• If the prescriber will write the letter, file an appeal or grievance and attach the prescriber letter.
• If the prescriber insists that you try the less expensive alternative
• Keep a log of any problems that result from the use of that alternative or functional limitations that the alternative fails to improve.
• Go back to the prescriber with the log and ask they represcribe the original service or equipment including your log in their letter of medical necessity.

Lack of providers with physically accessible offices (For HMOs and PPOs)

• If there isn't a provider within a reasonable distance that is physically accessible within the network, can file a complaint under  section 504 of the federal Rehabilitation Act (if the HMO/PPO has a Medicare or Medical Assistance contract) or under Title III of the Americans with Disabilities Act (ADA) with the federal Department of Justice at (202) 514-0301 or file a lawsuit in federal court.
• Could also submit an informal complaint with the State Dept. of Health on the grounds that the network is inadequate- but the State Dept. of Health does not have jurisdiction to enforce §504 or the ADA.

• This is more difficult to fight.  Need to provide evidence, usually from the PCP, that your condition is sufficiently rare or complex that it requires a specialist with very special training or experience.  You would then have your PCP request that you be allowed to go "out of network" because the plan doesn't have a physician with the requisite training or experience.  Will usually need to file a grievance on these requests.
• Filing appeals/grievances with "regular" health insurance ("indemnity plans")
• We don't have state laws or regulations mandating a specific appeals process so the appeal process is whatever the insurer chooses to provide.
• Can go to court under a contract claim
• For self-insured plans (contact your employer to find out if the plan is self-insured), the final appeal is to the employer.  If the employer turns you down, you can file a lawsuit in federal court under a federal law called "ERISA".

Complaints vs. Grievances

• When a person in an HMO/PPO wishes to contest a decision about their health care, it is important they file a grievance rather than a complaint.  Complaints do not entitle a subscriber to any of the grievance rights set out below.  Unless the request or dispute is put in writing by the subscriber with a clear indication that it is a grievance, the HMO/PPO may consider it only to be a complaint.  Therefore, any dispute from a subscriber should be put in writing and should have the word "Grievance" at the top.

• A grievance is an opportunity for a subscriber to have his/her request or dispute heard and decided by persons who were not directly involved in making the disputed decision.  These persons are called the "Grievance Committee".  HMOs may provide one or two levels of grievances which are described below.  If the subscriber goes through the levels of grievance provided by his/her HMO/PPO, he or she can then take their grievance to the Department of Health (also explained below).  This memo also explains special quicker procedures when the dispute involves a "medically pressing issue".

Subscriber rights

• The subscriber has the right to submit written information and have an "uninvolved" HMO/PPO staff person assist in that effort. [¤9.73(1(ii) &(7)]  However, the subscriber does not have the right to attend the grievance committee (although HMOs have been urged by the Health Department to allow this).
• Grievance Committee
• The Grievance Committee decides the grievance.  It must be comprised of one or more employees of the HMO/PPO who were not involved in the decision being appealed and were not involved in handling the complaint, if any, that preceded the grievance.  The Committee should review the grievance within 30 days.
• Grievance decision
• The Grievance Committee must issue a written decision within 10 days of the date it meets to review the grievance.
• If the Committee finds against the subscriber, even partially, the written decision must contain:  the reasons for the Committee's decision;  the evidence or documentation relied upon; and a statement regarding the subscriber's right to file a second level grievance, the time limits for filing the 2nd level grievance & how to file that grievance.
• 2nd Level Grievance
• Note: An HMO/PPO may chose to limit its grievance procedures to a single level so long as that level complies with the 2nd level requirements set out below.

• HMOs should provide between 30 and 60 days from the date the 1st level grievance decision is issued for an subscriber to file a 2nd level grievance.

• The Grievance Committee hears and decides the grievance.  Committee members are appointed by the HMO's Board of Directors.  One third of the Committee members must be subscribers.
• Committee members may not have any previous involvement in the decision being appealed or the 1st level grievance.

• HMOs must hold hearings at "mutually convenient times" The subscriber must be notified of the date & time at least 15 days in advance.  The hearing should be held within 30 days.

• Unlike the 1st level grievance, subscribers have the right to appear at the 2nd level grievance hearing and present their case.  They also have the right to be represented by a person of their choice, including a non-involved HMO/PPO staff person.  However, failure to appear is not grounds for dismissing the grievance.

• The subscriber has the right to question HMO/PPO staff at the grievance hearing concerning the dispute.

• Where the subscriber has documentation from a physician contradicting the opinion of his/her primary care physician or the HMO/PPO Medical Director, the Grievance Committee cannot automatically assume the PCP or Medical Director is correct.  It must make an independent assessment.
• The HMO/PPO must have written procedures for utilizing "informed consultants" to resolve grievances.

• The written decision of the 1st level grievance must be the basis for deliberation.
• If the HMO/PPO has an attorney to represent the staff making the decision appealed from, it must also provide an attorney for the Grievance Committee (but has no obligation to provide an attorney for the subscriber).
• Written minutes or a tape recording of the hearing must be made.

• The grievance Committee must render its decision within 10 working days following the hearing.
• The Committee must send a written decision to the subscriber which must include: the evidence or documentation relied on by the Committee; the rationale for its decision; and a statement that the subscriber has the right to appeal to the Department of Health.

Time limits

• The subscriber has 30 days to file his/her appeal with the Dept. of Health "unless extenuating circumstances are involved."

• Appeals to the Dept. of Health are to be made in writing and mailed to:
  Bureau of Managed Care
  Room 1026 Health & Welfare Bldg.
  Dept. of Health
  PO Box 90
  Harrisburg, PA 17108-0090

• The Dept. of Health may hold its own hearing, require the HMO/PPO to rehear the grievance to address specific issues or decide the case on the documentation supplied by both sides.

• When the dispute involves care which is alleged to be medically necessary and "pressing" [not defined by the Dept. of Health], and the care has not yet been provided, the HMO/PPO must render an initial decision approving or denying the care in writing within a "reasonable time" which is defined by the Department as 48 hours.  If the subscriber appeals that decision, the grievance would begin at the 2nd level.

• Persons on Medical Assistance in HMOs have all the rights set out above and also have the right to file an appeal with the Department of Public Welfare.  There are also special rules that apply to grievances under the "HealthChoices" program.  To file an appeal with the Department of Public Welfare, write your name, address and phone number, name of your HMO/PPO, your HMO/PPO subscriber number and the decision you are disputing on a piece of paper.  Put "Appeal" at the top of the paper.
• Mail the appeal to:
  Department of Public Welfare
  Office of Medical Assistance Programs
  HealthChoices Program
  P.O. Box 2675
  Harrisburg, PA  17105-2675

• The PA Health Law Project is available to advise and assist persons with disabilities and persons on Medical Assistance in disputes with their HMOs.  You can reach us by calling 800-931-7457 or 800-274-3258.  You can also call the PA Department of Health, Bureau of Managed Care (which licenses HMOs) at 888-466-2787.

U. S. Food and Drug Administration
FDA Consumer
December 1991

HAIR!

From Personal Statement to Personal Problem

by Devera Pine

From the shaved heads of medieval monks, to the long-haired hippies of the '60s, to the spiked hairdos of today's punk rockers, hair has always made a personal statement.

"It's one of the leading ways people can establish their individuality and express their style," says Jerome Shupack, M.D., professor of clinical dermatology at New York University Medical Center in New York City. "Hair has had sociological importance throughout the ages."

Because of its importance, anything that happens to our hair that we can't control--falling out or turning gray, for instance--can be the source of much anxiety.

In the United States, some 35 million men are losing or have lost their hair from male-pattern baldness, according to the American Hair Loss Council. Approximately 20 million women have experienced a similar loss of hair (from female-pattern hair loss), and an estimated 2.5 million Americans have lost their hair due to other causes.

THE BASICS

Hair is produced by hair follicles--indentations of the epidermis (outer skin layer) that contain the hair root, the muscle attached to it, and sebaceous, or oil, glands. Hair is made up of dead cells filled with proteins, most of which are known as keratins. The cells are woven together like a rope to form the hair fiber. The hair fiber, in turn, has three layers: the outer cuticle with its fish-scale-like structure; the cortex, which contains the bulk of the fiber; and the center, or medulla. Hair color is determined by melanocytes, cells that produce pigment. When these cells stop producing pigment, hair turns gray.

Although it seems as if the hair on your head is always growing, hair actually has active and rest phases. The growth phase, known as anagen, lasts for two to six years. At any given time, about 90 percent of scalp hair is in the growth stage. The remainder is in the rest phase, known as telogen; this lasts from two to three months.

Once the rest phase is over, the hair strand falls out and a new one begins to grow. As a result, it's considered normal to lose from 20 to 100 hairs a day, says Diana Bihova, M.D., a dermatologist in private practice in New York City. Only a change in your regular pattern of loss is considered abnormal--but many things, including genetic factors, diet, stress, and medications, can change that pattern.

BALDNESS: MANIFEST DESTINY?

The most common cause of hair loss in both men and women is rooted in a genetic predisposition. Called androgenic alopecia, it is known as male-pattern baldness in men and female-pattern hair loss in women (alopecia is the scientific term for baldness). According to the American Hair Loss Council, genetics accounts for 95 percent of all cases of hair loss in this country.

Baldness results from a combination of genetic factors and levels of testosterone (a hormone produced by the adrenal gland in both sexes and also by the testes in men). If hormone levels are right, then the hair follicles will express their genetic destiny by growing for shorter periods and producing finer hairs. In men, who have higher levels of testosterone than women, this eventually results in a bald scalp at the crown of the head and a horseshoe- shaped fringe of hair remaining on the sides. In women, the hair thins all over the scalp; the hairline does not recede. This type of hair loss doesn't usually show up in women until menopause; until then, estrogen tends to counteract the effects of testosterone.

ONE APPROVED DRUG

The only drug approved by the Food and Drug Administration to treat pattern baldness or hair loss is minoxidil topical solution (Rogaine), which is rubbed into the scalp. Originally approved for hereditary male-pattern baldness in 1988, it was also approved for treating female-pattern hair loss in August 1991. However, it should not be used by pregnant or nursing women.

In his dermatological practice, Arthur P. Bertolino, M.D., Ph.D., director of the hair consultation unit at New York University, says that this lotion helps hair grow in 10 to 14 percent of the people who try it. He estimates that approximately 90 percent of the time, Rogaine at least slows down hair loss. (Minoxidil is also available in tablet form to treat severe high blood pressure. Oral minoxidil has a potential for serious side effects and is not approved to treat baldness.)

No one is certain yet just how topical minoxidil works to promote hair growth. "One theory is that it dilates the blood vessels, so it may stimulate nourishment of follicles," says Bihova. Alternatively, Rogaine may convert tiny hair follicles that produce peach fuzz into large hair follicles that produce normal-size hairs. Again, no one knows for sure.

What is certain is that, at least in men, Rogaine works better on patients who fit a certain profile: they've generally been bald for less than ten years, have bald spots on top of the head that are less than four inches in diameter, and they still have fine hairs in their balding areas. "The process begins very early," says Bihova. "I see 19-, 20-year-old males who have it."

The most common side effects with this medication are itching and skin irritation. Also, according to Bertolino, once you stop using it, any hair that grew as a result will fall out. Finally, the drug is expensive: in 1990, it cost about $600 a year to use it twice a day.

TRANSPLANTS

Baldness can also be treated with hair transplants, in which plugs of "donor" follicles from the patient's scalp are used to fill the hairline. Although hair transplants work well in both men and women, the treatment tends to have a more dramatic effect on appearance in men with bald spots than it does on women with thinning hair.

"The less hair you have, the more drama in the change," says Robert Auerbach, M.D., associate professor of clinical dermatology at New York University School of Medicine. However, the American Hair Loss Council warns against attempting to replace lost hair with hair pieces sutured to the scalp. FDA has not approved any products specifically intended for this purpose, however, this does not preclude a physician from using sutures, which are approved devices, for this purpose. According to the council, although the procedure is legal, it can result in scars, infections and even brain abscesses.

Another treatment for male-pattern baldness, hair implants made of high-density artificial fibers surgically implanted in the scalp, was banned by the FDA in 1984 because it causes infection. This is the only device FDA has ever banned.

PRODUCTS THAT DON'T WORK

So-called "thinning hair supplements," "hair farming products" and "vasodilators" for the scalp will not promote hair growth, says Mike Mahoney, a spokesperson for the American Hair Loss Council.

Thinning hair supplements are nothing more than hair conditioners that temporarily make your hair feel or look a little thicker. The main ingredient in these products--polysorbate--is also found in many shampoos. Promotional materials for hair farming products claim that they will release hairs that are "trapped" in a bald scalp. Mahoney says these products, many of which are herbal preparations, can do no such thing. And so-called vasodilators do not increase the blood supply to the scalp and do not promote hair growth.

EVERYDAY HAZARDS

While male- and female-pattern baldness results in permanent hair loss, other factors can cause temporary loss of hair. For instance, the drop in the level of estrogen at the end of pregnancy can cause a woman's hair to shed more readily. Two or three months after a woman stops taking birth control pills, she may experience the same effect, since birth control pills produce hormone changes that mimic pregnancy. A major physical stress, such as surgery, or a major emotional stress--positive or negative--can cause hair loss.

"I've seen women start losing their hair before getting married," says Bihova. Even jet lag can have a similar effect.

In most of these cases, the hormonal imbalance or stressful situation will correct itself, and the scalp will soon begin growing hair again. But, says Bihova, since most women are extremely upset by even a temporary hair loss, many dermatologists treat these conditions with either topical steroid preparations or localized injections of low doses of steroids. Bihova emphasizes that these are local, not systemic, injections of steroids, therefore, the shots do not have the same risk of dangerous side effects as systemic steroids. However, only a board-certified dermatologist should administer this treatment, she says.

The list of causes of temporary hair loss goes on: pressure on the scalp from wigs or hairdos that pull too tightly can cause it. A fever of 103 degrees Fahrenheit or more often causes hair loss six weeks to three months later. And some medications can cause a temporary loss. These include vitamin A derivatives such as Accutane, cough medicines with iodides, anti-ulcer drugs, some antibiotics, beta blockers, antidepressants and amphetamines, anti- arthritis drugs, blood thinners, some cholesterol-lowering agents, aspirin taken over long periods, some thyroid medications, and chemotherapy.

YOU HAIR WHAT YOU EAT?

Although nutrition does play a role in hair loss and in the overall health of your hair, only extreme nutritional deficiencies or excesses will cause hair loss. For instance, people with anorexia and bulimia may temporarily lose hair. So will others suffering from malnutrition.

"It's pretty rare in the United States," says Bertolino. "If someone was on a real strange, restrictive diet, it could happen to them."

Megadoses of some vitamins--particularly A and E--and an iron deficiency may lead to hair loss. People who claim they can determine which vitamins are lacking in your diet by analyzing your hair, however, are not speaking from a scientifically sound basis. The test used with this type of hair analysis--atomic absorption spectrophotometry--is a legitimate analytical chemistry method; however, used on hair, the results of this test do not correlate with nutritional status, says Shupack. "Because of the sociological importance of hair, a lot of people try to cash in on it," he says. "Hair analysis is all witchcraft as far as I'm concerned."

There are, however, a few legitimate hair tests for substances such as arsenic and lead.

FOR BEAUTY'S SAKE

Every time you shampoo, blow dry, perm, straighten or dye your hair, you damage it slightly, says Bertolino. For the most part, hair can withstand this type of treatment. But overzealous beautifying can damage the hair fiber, resulting in many broken strands, and a frizzy, split-end look. For instance, if you bleach your hair and then have a bunch of perms done in a short time, you're heading for trouble.

Misuse of hair cosmetics can cause the hair to break as it comes out of the scalp, says Frances Storrs, M.D., professor of dermatology at the Oregon Health Sciences University. Permanent wave solutions break the bonds that hold hair together and then reform them. But with a perm that is not diluted right or not rinsed off properly, for instance, those bonds may not re-form and the hair would soon fall out as a result. Fortunately, most professional hair dressers know how to use perms correctly, says Storrs.

Most hair dyes are not as irritating as permanent solutions, mostly because they do not break the bonds between hair fibers and are therefore not likely to cause a hair loss, she says. However, a severe allergic reaction to hair dye could cause hair loss. "The allergy is pretty common, actually," says Storrs. Permanent solutions can also cause allergic reactions, though that's a rare side effect.

Other beauty-related manipulations of the hair can cause problems, too: hot irons, corn rows and braids may bring on temporary or permanent hair loss. If the hair breaks often enough, the follicles may eventually not be able to produce normal hair, says Bihova. "If someone has a problem with thinning and excessive loss, we advise being gentle," she says. "Don't use rollers; don't use blow dryers on a hot setting; don't wear tight hair styles." Rough shampooing may accelerate any loss, though it's usually not a problem in people with healthy hair.

THE MEDICAL SIDE

Some hair loss is the result of a type of immune disorder known as alopecia areata--some 2.5 million people suffer from this condition in which antibodies attack the hair follicle, causing the hair to fall out. Alopecia areata often causes small, oval or circular areas of hair loss. However, in some forms of the condition, all the scalp hair falls out; in other forms, all body hair is lost. Although the loss is usually temporary, the condition can recur. Treatments include topical steroids or the use of chemicals to produce an allergic reaction to start the hair growing again.

Finally, chronic, systemic conditions--including one form of lupus, abnormal kidney and liver function, and hypothyroidism or hyperthyroidism--can affect the hair. If you're experiencing hair loss, see a doctor. He or she will want to order some basic blood tests to rule out any medical cause of the condition.

Devera Pine is a freelance writer in New York City who frequently writes about health and science.

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service, Food and Drug Administration
Office of Public Affairs, 5600 Fishers Lane, Rockville, MD 20857

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