Medical Dermatology - Hair Disorders

Regardless of gender, it can be upsetting to unexpectedly start losing your hair. If you have hair loss or thinning hair, you may also have an itchy, painful or sensitive scalp. In the UC Davis Health Specialty Clinic for Hair Disorders, we offer effective, advanced treatments for all types of alopecia, or unexplained hair loss.

What is alopecia?

This skin disorder causes hair to fall out from the scalp, face or body. There are different types of alopecia, including:

• Alopecia areata causes isolated, circular bald patches on the scalp.
• Central centrifugal cicatricial alopecia (CCCA) causes hair to thin outward from the crown of the scalp.
• Lichen planopilaris causes thinning hair or bald patches along with itchy, scaly skin. It may lead to permanent hair loss.
• Androgenetic alopecia causes the hairline to cede as well as hair loss on the top and front of the head.
• Telogen effluvium causes temporary hair loss typically due to stress or a traumatic event.

What causes alopecia?

Alopecia affects people of all ages, genders, races and ethnicities. It can start in childhood. Several factors may contribute to hair loss, including:

• Autoimmune disease: For unknown reasons, the immune system mistakenly attacks healthy hair follicles, stopping hair growth.
• Genetics: Genes play a small role in alopecia. Most children with alopecia do not have a parent with the disorder. And most parents with alopecia do not pass on the disorder to their children. UC Davis Health counselors in genomic medicine can help you understand potential genetic links.
• Hair products: Women who use hot oils and chemical relaxers may be more prone to CCCA. These hair products can inflame the scalp and cause hair follicle scarring that stops hair growth.
• Hairstyles: Repeatedly pulling on hair to create certain hairstyles can damage hair follicles. This condition, called traction alopecia, is more common in Black women.
• Hormones: The androgen hormone regulates hair growth in both men and women. People with high androgen levels may experience rapid hair loss. Others have a faulty androgen receptor gene that causes androgenetic alopecia. Men with this faulty gene experience male-pattern baldness while women have thinning hair.
• Nutritional deficiencies: A diet lacking in certain vitamins and nutrients may affect hair growth.

Why choose UC Davis for alopecia and hair disorder care

Our Specialty Clinic for Hair Loss Disorders stands out in Sacramento for many reasons. We offer:

• Leading expertise: Our clinic director Oma Agbai, M.D., has completed the highest level of training in the treatment of hair loss and ethnic skin conditions. She uses her advanced education and experience to accurately assess your situation and identify a treatment that works. We are the only hair loss disorders clinic in Sacramento that has this level of expertise. Dr. Agbai also oversees the Multicultural Dermatology Clinic.
• Wide range of treatments: Once we know what is causing the hair loss, we customize your treatment plan for maximum effectiveness. Dr. Agbai is actively involved in dermatology research and clinical trials to find new ways to stop unwanted hair loss. You may be able to try new therapies still in development.
• Specialized team: Our team of board-certified dermatologists provides advanced care for all types of common and complex skin and hair problems. Learn more about our dermatology specialties.
• Advanced diagnostics: Pinpointing the underlying cause and type of alopecia is key to proper treatment. You undergo a thorough evaluation that includes:
  • Personal medical history
  • Dietary assessment
  • Blood tests
  • Tissue sample (biopsy) sent to our Dermatopathology Service for tests

Our hair loss treatments

Depending on the hair loss type and cause, treatments may help your hair grow back. When hair regrowth is not possible, we offer treatments to stop or slow hair loss. Your physician may recommend one or more of these treatments:

• Rogaine® (minoxidil)
• Topical corticosteroids
• Topical anthralin
• Topical immunotherapy
• Corticosteroid injections
• Propecia® (finasteride)
• Oral immunosuppressants

Rogaine® (minoxidil)

Twice-daily treatment with topical minoxidil (Rogaine) can slow hair loss and stimulate new hair growth. This prescription cream may be combined with a topical corticosteroid cream. Hair may gradually fall out when treatment stops. Minoxidil is not effective on people who have complete hair loss.

Topical corticosteroids

Topical (applied directly to skin) corticosteroid products decrease hair follicle inflammation, which promotes new hair growth. Your physician may combine this topical treatment with other therapies.

Topical anthralin

This anti-inflammatory product stimulates new hair growth. You apply the substance to bald patches daily and then wash it off within an hour.

Topical immunotherapy

Topical immunotherapy creams alter the immune system by causing an allergic rash (also known as allergic contact dermatitis). The rash looks like poison ivy and may be red and itchy. It lasts about 36 hours.

Approximately 40% of people with alopecia areata experience hair regrowth within six months, but you must continue treatment to maintain your results.

Corticosteroid injections

This treatment for alopecia areata stimulates hair follicles to grow new hair. New hair growth may be noticeable within two months.

Corticosteroid injections do not prevent hair loss. New hair growth may fall out when treatments end.

Your physician:

1. Injects a steroid solution into and around bald patches
2. Repeats the process every six to eight weeks

Propecia® (finasteride)

This prescription oral medication lowers the dihydrotestosterone (DHT) hormone in men that shrinks hair follicles. You take the medication daily to stop hair loss and stimulate hair regrowth. Results can take up to six months. Hair loss resumes when treatment stops.

Oral immunosuppressants

If an autoimmune disease is the cause of alopecia, immunosuppressants can lessen the abnormal immune response. The new hair growth may fall out when treatment stops.

Immunosuppressants, such as oral corticosteroids, can cause side effects. Your physician will closely monitor your health. Potential side effects include:

• Acne
• High blood pressure
• Vision problems
• Weight gain

Vitamins and supplements for hair loss

Certain nutritional deficiencies can affect hair growth. Your physician will review your nutrient intake and recommend supplements to support hair growth. These supplements may include:

• Iron
• Vitamin D
• Zinc

Contact us

To schedule an appointment, please call (800) 770-9282 or (916) 734-6111.