AYESHA RASCOE, HOST:
For women with hair loss, there are more treatment options than ever before, and more ways to access them, as anyone scrolling social media is likely to find out. But all those choices can be confusing. NPR pharmaceuticals correspondent Sydney Lupkin reports on how best to navigate the world of hair-loss remedies.
SYDNEY LUPKIN, BYLINE: When Allison Richards (ph) was little, she had long, straight blond hair, and a lot of it.
ALLISON RICHARDS: That was the beauty feature that people commented on. They're like, oh, your hair is so pretty. It's so long.
LUPKIN: It started thinning in her 20s and then got really bad during the pandemic.
RICHARDS: There was one day, in the shower, where just I had hundreds of strands of hair. Like, fistfuls of hair coming out. It was a very scary experience.
LUPKIN: To understand hair loss, it's important to understand hair growth, says Dr. Carolyn Goh, a clinical professor of dermatology at UCLA Health. Each hair on your head goes through cycles of growth, transition and rest. The rest phase is called telogen.
CAROLYN GOH: So it's at the end of that telogen phase is when your hair actually sheds. And when the hair's shedding, it's actually because there's a new hair growing and pushing it out.
LUPKIN: And each strand of hair does this at different times. Sometimes, however, stress, like having a baby or even COVID, can cause the hair cycles to sync up, causing a bigger shed. But it's temporary.
GOH: Mostly it's time will tell, and that's really difficult to deal with. You know, you see all this hair coming out. It is this huge change, and it seems like the world is ending. But in fact, most of the time is fine.
LUPKIN: She says about half of all women will experience hair loss in their lifetime, and sometimes it doesn't resolve on its own. Goh says patients have come to her with all kinds of solutions they've seen on social media, from onion juice to rosemary oil. Goh says there is one randomized controlled study of a hundred people showing rosemary oil could work, but there's also a lot of misinformation.
GOH: I think somebody asked me about cucumber today, and I said, you know, I think if that worked, cucumbers would probably be $50 a pop for hair loss, you know? Someone would've figured, you know, a way to monetize it.
LUPKIN: When it comes to prescription drugs, it's important to get a formal diagnosis because different kinds of hair loss respond to different treatments. But some people say their doctors can be dismissive or it can be hard to get an appointment. So telehealth companies are stepping in. Dr. Jessica Shepherd, chief medical officer of Hers, says the company takes women's hair loss seriously.
JESSICA SHEPHERD: We are going to be there when you're scrolling your phone, on commercials. That's really how we are exposed or how we introduce ourselves to our community.
LUPKIN: But Thea Chassin, the founder and CEO of the nonprofit Bald Girls Do Lunch, says telehealth isn't always the answer. She has alopecia areata - an autoimmune kind of hair loss - and says a telehealth visit alone wouldn't have gotten her diagnosis right.
THEA CHASSIN: They don't know because even with alopecia areata, there are look-alike conditions that are completely different. For example, you could have a fungal condition, and that's treatable, but you don't want to wait.
LUPKIN: New drugs to treat alopecia areata were approved in just the last few years. They're called JAK inhibitors. As for Allison Richards, who first noticed hair loss in the shower, she considers herself lucky. She was able to get to a dermatologist in person, who took her seriously. Now she takes oral minoxidil - the same compound in Rogaine but in a pill - and spironolactone. Both are being prescribed off-label, meaning they weren't approved by the Food and Drug Administration to treat hair loss. But they're working for her, and her doctor monitors her for side effects. Richards mostly wants other women like her to know they're not alone.
RICHARDS: There's always going to be somebody to hold your hand, cheer you on. And if you ever feel like your beauty is compromised, beauty gets redefined.
LUPKIN: Sydney Lupkin, NPR News.
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