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    I am a perimenopausal woman and I have started noticing that my hair is thinning. What can I do to fix this?

    Answer by:
    Doris Day, MD

    New York University

    Thinning hair is a very common problem. It's as common in women as it is in men. But unfortunately for women, it's much harder to conceal. And women don't really have the option of going bald and being proud of it the way men do sometimes. So it is important to be able to disguise that.

    Let's start with the underlying causes. There are two types of hair loss that occur in women: scarring and non-scarring. The most common is non-scarring, and this tends to be genetic and familial. Even if no one in your family had hair loss, it can still happen to you and still be part of your genetic makeup.

    So once you have that issue, it's important to be evaluated by a dermatologist or internist or OB/GYN. There are a lot of doctors who can do the evaluations for you. Sometimes we check hormonal levels.

    Often, even if the hormone tests come back normal, there is still somewhat of an hormonal imbalance that may be occurring.

    People often think that thyroid changes can lead to hair loss, but it really doesn't. It may make your hair more dry and brittle, but doesn't typically make your hair fall out. But it's worth having your thyroid checked as well to make sure that everything is in order.

    Taking supplements does not really help hair growth. I have a lot of patients who take Biotin to help their hair grow. But it doesn't really help if you don't have a Biotin deficiency.

    Biotin will make your hair stronger potentially, again, only if you have a deficiency in that area.

    There are no other supplements that I know of that have been proven in the literature to help grow hair. However, having any nutritional imbalance may have an effect on your hair.

    Another cause of hair loss would be stress. Sometimes when you have a stress, you can see the hair loss starting about three months later. You have to think about what stress you might have had three to four months before, because that's about how long it takes to show.

    To conceal hair loss, you can try combing your hair different, changing your hair style, or coloring it a little closer to your own natural scalp or skin color. Use more neutral tones, as opposed to very dark or light tones. Also, there are powders that you can add to your hair that work as hair expanders to make your hair appear more full and thick.

    The one thing you don't want to do is to over tease or over process your hair, because then you are pulling it out and causing more damage.

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