It's not too late to save thinning hair

Hair loss doesn't typically cause pain, but it can be emotionally distressing when you realize that your hair is thinning, especially if you can see your scalp peeking out in places. Fortunately, there are several ways to treat thinning hair and keep the problem from advancing.

Why is your hair thinning?

Two common conditions account for most age-related hair loss.

The most common is androgenetic alopecia, also called male- or female-pattern hair loss. Thinning hair is the first sign. The hair follicles become smaller, which makes the hair strands that grow from them finer. Some hair follicles stop producing hair altogether.

This type of hair loss can result from genetics or age-related hormone changes. It occurs gradually, in patterns specific to men and women. The typical pattern in men features the front hairline receding or thinning at the temples or the crown on top of the head. In women, it can be more widespread, involving most of the scalp, or affect only certain areas, such as the middle part, the temples, and the frontal scalp area.

Another common type of hair loss is called telogen effluvium. This is more widespread hair shedding that occurs suddenly. It often is a reaction to emotional or physical stress, such as a high fever, a urinary tract infection, childbirth, or surgery. Shedding can also occur as a reaction to an underlying medical condition or as a medication side effect.

Alopecia areata is a less common type of hair loss that affects about 2% of the population. It is an autoimmune condition in which the body attacks hair follicles. Hair on the scalp and face - including eyelashes - falls out in patches, leaving exposed round or oval areas of skin.

Protecting your hair

The type of treatment your doctor prescribes will depend on the cause of hair loss.

Telogen effluvium corrects on its own or once the underlying cause is treated or resolves, usually improving in three to six months.

Hair loss from alopecia areata may correct itself on its own, but it also can reoccur. Three immunotherapy drugs called JAK inhibitors are highly effective for severe cases of alopecia areata. They include baricitinib (Olumiant), ritlecitinib (Litfulo), and deuruxolitinib (Leqselvi). Alopecia areata also may be treated with steroid injections or other medications.

For people with androgenetic alopecia, treatment aims to enlarge the hair follicles, so the hair strands become thicker and your hair appears to be denser overall. The following treatments may help.

Topical drugs. The FDA has approved minoxidil (Rogaine), available over the counter, as a treatment for both men and women. It increases blood flow to the hair follicles, helping to promote hair growth. Minoxidil comes in a liquid or foam that's applied directly to the scalp. The liquid form may be easier to apply if you have a lot of hair; you have to use it daily for at least six to nine months to see improvement.

Oral medications. Recent studies suggest that taking minoxidil as a pill, which has been used for decades to treat high blood pressure, is safe and effective for treating hair loss. Experts say it can be helpful for people who aren't getting enough benefit from topical minoxidil, or those who have scalp irritation from the topical form.

Other oral medications to treat hair loss include finasteride (Propecia, Proscar) and spironolactone (Aldactone). Dutasteride (Avodart) is not approved in the United States to be used for hair loss but sometimes is prescribed to treat it.

Oral medications can have multiple side effects. For example, oral minoxidil can cause increased hair growth elsewhere on the body, as well as low blood pressure or heart palpitations. Your doctor will carefully tailor your treatment regimen and be alert to any problems.

Platelet-rich plasma injections. In this procedure, high concentrations of components of your own blood are injected into your scalp to stimulate hair growth. Each treatment can cost $500 to $1,500 or more. You typically repeat the process monthly, for three months, and require follow-up treatments every year. The effectiveness of platelet-rich plasma for hair regrowth is not yet proven.

Laser light treatments. Devices that emit low-level LED laser light might promote hair growth. They're available (without a prescription) in combs and helmets that you use regularly at home. Prices range from a few hundred to a few thousand dollars.

Supplements. Supplements can be expensive, and there isn't solid evidence that they make hair grow. Check with your primary care provider before starting any new supplements, especially if you are taking any medications.

For any of these treatments, the key is starting them as soon as you detect hair loss. Once hair follicles stop working, the only option is hair transplant surgery. This usually involves moving healthy follicles from another area of the scalp to a bald or thinning area. Surgical options can be expensive, and it may take more than a year to see full results.

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