• Mayo Clinic Q and A: Hair loss that happens slowly likely a result of heredity

DEAR MAYO CLINIC: What are the best ways to prevent hair loss or to regrow hair? I want to try the hair-growth shampoos, but have heard that you have to continue to use them for life or the hair will fall out at an even faster rate. Is this true? Are there better ways to regrow hair?medical illustration of woman with hair loss

ANSWER: Hair loss can happen for a number of reasons. Most often, it’s caused by a combination of heredity and aging. Treatments are available that may slow that type of hair loss and help regrow hair, including over-the-counter therapies like shampoos.

Most people lose about 50 to 100 hairs every day. This hair loss usually doesn’t cause noticeable thinning of scalp hair because new hair grows in at the same time. The cycle of hair growth, shedding and regrowth can be disrupted, however, due to several factors, such as family history, hormonal changes, medical conditions and medication. Physical and emotional stress may also lead to hair loss.

Family history typically has an impact on pattern balding. This kind of hair loss usually happens slowly and in predictable patterns — a receding hairline and bald spots in men and thinning hair along the crown of the scalp in women. If your hair loss follows these patterns, it’s likely a result of heredity. In that case, trying over-the-counter remedies is a reasonable first step.

The most common hair loss treatment you can buy without a prescription is a medication called minoxidil (brand name Rogaine). It comes in liquid, foam and shampoo forms. To be most effective, you need to apply this medication to your scalp twice a day. For many people, it maintains the hair they still have, and it can regrow up to about 10 percent of lost hair.

I usually recommend the extra-strength liquid form of this medication for my patients with pattern baldness. Although it’s typically marketed for men, both men and women can use it. The liquid is preferable because it’s easier to apply directly to the scalp than the foam, which often gets absorbed by the hair. The shampoo isn’t ideal because many people don’t have time to shampoo their hair twice a day, and the force of shampooing can stress the hair, causing additional hair loss.

You do need to keep using this medication to retain the benefits. If you stop using it, the hair you’ve regrown may fall out, and you’re likely to return to the rate at which you were losing hair before you began treatment.

Another way to help reduce hair loss is to be very gentle with your hair. Decrease shampooing to two or three times a week. Use a light touch when brushing and combing, especially when your hair is wet. A wide-toothed comb may help prevent pulling out hair. Avoid tight hairstyles, such as braids, buns or ponytails. Try not to twist, pull or rub your hair. Avoid harsh treatments such as curling irons, straightening irons, hot rollers and hot-oil treatments.

Prescription treatments also are available for pattern balding hair loss. The medication finasteride has been shown to be effective for hair loss and regrowth in men. For women, hormone therapies that help balance the levels of estrogen and testosterone can often help maintain hair and decrease loss.

If over-the-counter remedies and self-care steps aren’t enough to decrease your hair loss, or if you’re concerned that your hair loss may be the result of a different underlying problem, such as a medication you take, talk to your doctor or make an appointment to see a dermatologist. Dawn Davis, M.D., Dermatology, Mayo Clinic, Rochester, Minn.

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