Cortisone

Love is in the hair!

Hold on and don't freak. We've got the 411 on hair loss that will put you on track to recovering and maintaining a glorious mane

Hair loss among Black women has reached near epidemic proportions. "I see at least five women every day with this concern," says dermatologist Susan Taylor, director of Society Hill Dermatology in Philadelphia. Different from hair breakage, in which the hair snaps off, loss occurs when "the hair comes out from the root, leaving patches with no hair, or alternatively, if there is still hair, the density is markedly less, and you can see the scalp through the hair," explains Taylor. Many Black women suffer from what doctors call traction alopecia. Tight hairstyles--braids, weaves, ponytails and cornrows--worn over long periods of time pull on the hair, causing the natural hairline to recede.

Central centrifugal cicatricial alopecia, another condition common among Black women, is characterized by circle-shaped balding at the crown toward the front of the head. Many dermatologists blame this condition on the sometimes outrageous things we do to our hair with tension, heat and chemicals. Other forms of hair loss include female pattern baldness, a hereditary condition, and alopecia areata, random quarter-size bald patches throughout the scalp, which can be caused by stress. In addition, pregnancy, certain medications, hormonal imbalances and thyroid malfunction can cause hair to fall out. The good news: Taking a proactive approach can improve your situation, and there are scientific options that can make a difference.

What to do now: five tips to give your hair a fighting chance in the battle against hair loss

1. Don't wait. Unlike a fine wine, hair loss won't get better with time. Taking action at the first signs of thinning may increase your chances of regenerating growth. "After the roots are destroyed, there is nothing that can be done to bring the destroyed follicles back," says Taylor.

2. Leave it to the experts. "Black hair is more delicate than people realize," says Barry L. Fletcher, stylist, trichologist and author of Why Are Black Women Losing Their Hair? (Unity Publishers). Often the best way to nourish hair is to enlist the help of a qualified professional. At the first sign of thinning, visit your dermatologist to diagnose the problem. Also consider a trichologist (hair and scalp expert). Misuse of chemicals, relaxers and color can cause hair loss, so ditch the do-it-yourself mentality and go to a stylist who's well versed in hair and scalp care.

3. Style wisely. Taut hairstyles like braids, weaves, extensions, cornrows and even rollers can pull on the hairline and cause the hair to fall out. "The less you do in general, the better your hair is going to be," contends dermatologist Rosemarie Ingleton of New York City. Also avoid applying direct heat to hair. Air-dry, wrap or roller-set hair as much as possible.

4. Develop a home-care regimen. You are born with all the hair follicles you will ever have. "So take time to nurture your hair, says New York City hair guru Sabina Francis, who treats hair-loss clients using an all-natural preparation, direct from her St. Lucian grandmother, with ingredients that include nettle, sage and castor oil. As far as shampooing goes, you may need to cleanse your hair more than once a week if you're physically active or perspire heavily, says George Buckner of New York City's Hair Fashions East, who prescribes a personalized hair-loss regime after scrutinizing the client's scalp under a microscope. After shampooing, condition hair with an ultrahydrating formula (try Nioxin Intensive Therapy Hydrating Hair Masque) and strengthen hair with a protein conditioner monthly (try Warren Tricomi PureStrength Strengthener for All Hair Types).

5. Live well. Taking care of your body is the first step in taking care of your hair. "Enhancing a healthy diet may be the newest approach to treating hair loss," says Ingleton. Try supplementing with B vitamins, including biotin, and ask your doctor about your correct daily dosage. "We need both biotin and protein because they are part of the natural manufacturing process of hair and nails," says Ingleton. "Eat wholesome carbohydrates like whole grains, fresh fruits and vegetables," says Baltimore trichologist Angela Jones. "For people who are prone to alopecia areata, decreasing stress is one way to keep it from getting worse," says Victoria-Holloway, M.D. director of the L'Oreal Institute for Ethnic Hair and Skin Research in Chicago.

Your Hair-Loss Resource Guide

INFORMATIONAL WEB SITES

* Aad.org (American Academy of Dermatology): Access general information about hair loss.

* Ahlc.org (American Hair Loss Council): The not-for-profit agency's site gives impartial information on treatments and helps browsers find a local expert.

* Brownskin.net: Dermatologist Susan Taylor's educational site for women of color has information on keeping hair, skin and nails in optimal condition.

* Hairlosstalk.com: Learn about the latest in research and treatments, search product reviews, or join an online discussion.

* Womenscenterforhairloss.com: The organization's site provides the latest information as well as restoration options.

BOOKS

* The Black Woman's Guide to Beautiful Healthier Hair in 6 Weeks! (Life Changing Publications, LLC) by Carolyn Gray

* Brown Skin: Dr. Susan Taylor's Prescription for Flawless Skin, Hair and Nails (Amistad) by Susan C. Taylor

* The Hair Bible: A Complete Guide to Health and Care (Aurum Press) by Philip Kingsley

* Why Are Black Women Losing Their Hair? The First Complete Guide to Healthy Hair (Unity Publishers) by Barry L. Fletcher

* Healthy Black Hair: Step-by-Step Instructions for Growing Longer, Stronger Hair (Panacea Pub) by Nicole Elizabeth Smith

* Ultra Black Hair Growth II 2000 Edition (UBH Pubns) by Cathy Howse

SCALP SPECIALISTS

* Angela Jones, Vidae International Health and Wellness Center, Baltimore, (410) 602-6242

* June Armstead, Body, Soul and Spirit Salon--A Trichology Clinic, San Francisco, (415) 333-7261

* Philip Kingsley, Philip Kingsley Trichological Centre, New York City, (212) 753-9600; London, 0207 629 4004

* Rodney Barnett, Dallas, (214) 904-0330, rodneybarnett.com

* Sabina Anibas, Aurbeautica Hair Salon, New York City, (917) 837-5379

* Tariq Madyun, International Institute of Trichology, Madison, Alabama, (256) 461-4264

Tress Savers

The products, expert advice and procedures to save our strands

Rogaine

Looking for an over-the-counter remedy? Try Women's Rogaine. This solution, which stimulates hair growth, contains minoxidil--the only FDA-approved ingredient to treat female pattern baldness. To see the best results within four months, apply twice a day. The cost? About $25 for a month's supply.

THE CONS Although it's FDA-approved, Rogaine doesn't work for everyone. The amount of hair regrowth varies for each person. "Rarely there are allergic reactions with Rogaine---redness and itching of the scalp," says dermatologist Susan Taylor. "And remember, Rogaine's a lifelong commitment. If you stop using Rogaine, the hair you've brought back may fall out."

Trichology

"A trichologist deals with the science of hair growth and all the modalities related to it--nutrition, lifestyle, hair treatments, product knowledge and overall wellness of the body," explains Angela D. Jones, a Baltimore trichologist. What to expect? A typical visit includes a general health assessment and a 60-to-90-minute scalp treatment (for example, exfoliation, steam and scalp massage). Scalp-treatment gurus attest that creating a healthy scalp through regular treatments may give new hairs a fighting chance for a lengthier life span and keep existing hairs rooted longer. See our listing of trichologists on previous page.

THE CONS If you're cash-strapped, consider the cost--$50 to $150 per visit. And to really reap the full benefits of a trichologist, you may need up to ten sessions a month. Trichologists aren't doctors, so most health plans will not cover treatment.

Cortisone Injections

Ask your dermatologist about these injections, a procedure that reduces inflammation around the hair follicles to treat certain forms of hair loss such as alopecia. "When you remove inflammation, often the hair will start growing on its own," says Taylor. Three to five monthly injections are typically required and are covered by most insurance plans.

THE CONS In some cases the injections may cause thinning of the skin as well as create temporary discoloration.

Hair Transplants

You may consider hair transplants. During this surgical procedure, healthy follicles are transferred from less noticeable areas and grafted into the trouble spot. "After medical treatment has failed or stabilized, the only way to get thickness or increased density is to transplant hairs in that location," says Valerie Callender, M.D., of Mitchellville, Maryland, who specializes in hair transplants for us.

THE CONS It takes about three months for hair in the transplanted area to grow. And it's expensive, with costs up to $20,000. Possible side effects include keloids and scarring. Furthermore, if your follicles are damaged during the procedure, your hair will not grow.

Looking Ahead

There's new hope for hair loss, thanks to a fresh crop of innovative therapies

Cosmetic Trichogenesis

This technology, which uses microelectric currents, has just recently been introduced in the United States. During these weekly 12-minute sessions, a specialist applies the currents to the affected area. "There is no pain, it's safe, and it often works on people who have failed with other procedures," says New York dermatologist Morris Westfried. "This unique treatment has also been shown to work on hair loss resulting from chemotherapy, allergic reactions (alopecia areata) or genetics." This treatment takes at least three months to see results. Westfried charges $100 a month for weekly treatments and recommends ongoing treatments for genetic hair-loss cases. Visit current-technology.com.

HairMax Laser Comb

Lasers have changed the face of skin care. Now the HairMax Laser Comb brings this technology to hair, using miniaturized, low-level cold lasers that deliver energy to the hair. You run the $645 comb through your hair for 15 minutes two or three times a week. The makers claim it will make hair thicker; you should see optimal results after three months. Visit HairMax.com for more info.

Fetal Stem-Cell Research

Can you imagine that a technique based on this controversial scientific issue may prevent hair loss? "Stem-cell research may correct hair loss from the get-go," says Jeannette Graf, M.D., of Great Neck, New York. Insufficient data and ongoing moral and political debates suggest that this medical revolution may be a long way off, but experts still agree that those who suffer from hair loss will eventually benefit from this science.

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