FASHION : Saving Your Crowning Glory : Minoxidil Is Latest Option for Women Who Are Losing Their Hair
For two years, California businesswoman Rita Lazar panicked every time she looked at her hair. It was thinning and she couldn’t stop the process.
But Lazar is lucky. Diagnosed with androgenetic alopecia, or genetic hair loss, she was able to stop the fallout and regrow hair with minoxidil, the only FDA-approved treatment for her condition.
Patented by Upjohn and marketed as Rogaine, the topical preparation was introduced for men only in 1988. Three months ago, following clinical trials for women, the FDA officially admitted females into the club.
An estimated 20 million women exhibit some hereditary hair loss, and a recent study shows the problem is much more traumatic for them than for men. But for a long time, no one seemed to care.
Typically, women lose hair in a diffuse pattern rather than turning blatantly bald, which makes the condition easier to conceal. That, in turn, fuels a conspiracy of silence and leads to frustrating consequences.
Lazar, for example, engaged in a demoralizing search that led from doctor to doctor until she found a dermatologist who specialized in hair loss.
Along the way she says she was given useless medications, such as topical cortisone, and useless advice that ranged from washing her hair only once a week to dealing with her stress. “I’ve had stress all my life,” she says.
By the time she reached Dr. Michael Freed, a Los Angeles dermatologist with a keen interest in hair loss, Lazar calculates her crowning glory was 50% depleted.
After a barrage of questions and a battery of blood tests, she was prescribed twice-daily topical applications of the female hormone progesterone, followed by minoxidil combined with Retin-A (for better absorption) and monthly scalp injections of progesterone.
The regime isn’t painful. But it is time-consuming, costly (about $145 a month) and until something better comes along, it is for life. Lazar says that’s fine with her: “I would do whatever it takes. I would borrow money if I had to. My hair is one of my nicest features.”
Her reaction isn’t unusual. A study by Thomas Cash, professor of psychology at Old Dominion University in Virginia, indicates that women are more devastated by hair loss than men. But because they shed less and can camouflage it better, the problem becomes “their private agony,” Cash says.
“It’s part of this well-kept secret. Most women don’t even know it exists. They think of hair loss as something that happens to men or when you get real old. So just the uncertainty of what’s going on is frightening.”
In light of his research, Cash says, “I think women need information. There are alternatives, (from) surgery to wigs to Rogaine to doing absolutely nothing. But what I find most important is that women get with a dermatologist who understands the condition and won’t look at them as if they’re crazy, or say: ‘Everyone’s hair thins, so get off this vanity kick.’ ”
But even understanding specialists confess to limited options. Dr. David Orentreich--a New York City dermatologist in practice with his father, Norman, a hair-transplant pioneer--estimates that “half our patients are women for hair loss.”
Although the team has developed its own topical treatments, which contain minoxidil plus as many as seven other ingredients, David Orentreich isn’t thrilled with the arsenal. “Today, we have only fairly effective, so-so medications,” he says.
And to be a successful transplant candidate, he notes: “The back and sides would have to be very good quality hair. For someone who is thin all over, there is not much advantage.”
But for Julia, a 27-year-old California real estate broker who asked that her real name not be used, hair transplants became her last hope. When she noticed thinning, “about five years ago,” she opted for hair extensions, which were woven into her own hair.
As hair grows, the extensions have to be tightened and eventually replaced. The process “is hard to keep up and very expensive,” Julia says. More important, she is convinced “it makes the hair worse.”
Experts say extensions should be worn only two to three months, followed by a two-week rest period. But Julia wore hers nonstop for two years. The tension created traction alopecia, leaving tracks across her scalp where hair will never grow again. To correct the damage, she has had two transplant operations, at a cost of $13,000, and says she will probably need more.
Some savvy women have tattoo artists camouflage their scalps and hairlines. The practice is called “cosmetic dermagraphics” by Joe Kaplan, who owns Skin Designs in Mt. Vernon, N.Y., and “dermapigmentation” by Sheila May, who shares an office with ophthalmologist Richard Holmes in Pacific Palisades.
Kaplan charges from $100 “up to thousands” and claims good results with celebrities and others. May says she decides “on an individual basis” what to do and will consider helping women “only if the thinning has stabilized.”
For many women, someone else’s hair becomes the best solution. Roland Eggler, owner of Top Secret in Santa Monica, changes the look of movie stars with wigs, as he did for Kenneth Branagh and Emma Thompson in the flashback scenes of “Dead Again.” He uses the same skills in custom-made pieces to augment or conceal thin tresses.
The handmade units take three to four weeks to deliver and range in price from $1,000 for a small synthetic piece to $3,000 for a full wig of European human hair.
In every case, Eggler suggests less is better. “We don’t change the look of someone’s hair too much,” he explains. “You suddenly don’t want to give them a ton of hair on their head. If someone wants a lot of hair, I will recommend going in steps over a longer time period.”
If the jump into an expensive, custom-made wig is financially impossible, there are many ready-made ones on the market. At Wilshire Wigs in North Hollywood, the daily offering includes 800 models, priced from $30 to $200.
“We sell at wholesale. Consequently, we don’t give the red carpet treatment,” cautions owner Ralph Sampson. But the company does do custom work, ranging in price from $200 to $1,000, and Sampson suggests bringing along a visual aid: “Preferably a picture--maybe one that was taken two years ago when you had a hairstyle you liked.”
At Charle in San Rafael, owner Charle Dewitt specializes in Australian handmade, human-hair wigs. Prices start at $2,450, and there is a charge for styling. But for makeup artist Linda Rieschel, the purchased hair has been worth every penny.
She skis in it, swims in it and goes to restaurants--where she used to cringe--in it. Suffering from hair loss since age 17, Rieschel, now 43, says she thinks her meager strands “damaged my marriage for the first seven years. I was so self-conscious, I would hate to go to certain restaurants that had lights that would shine on my scalp. (My husband) got very tired of me saying:,’I won’t go to that restaurant. I don’t want to see those people.’ ”
Help also comes from the androgenetic alopecia support group, which Rieschel helped establish in San Francisco earlier this year. Another founding member, Tracy Pattin, calls the organization “the first support group in the country for women with this condition.”
Pattin, a 34-year-old actress, who is participating in Rogaine’s clinical trials, says her hair began to thin when she was 18. The loss was enough to cause “people to notice and comment on,” she recalls. “It kept me from realizing my dreams. It kept me defeated. Whether it’s minimal, moderate or significant, hair loss still affects us deeply, emotionally.”
By age 29, she says, “I was really ready to find out what was going on with my hair. I wanted to take control of my life.”
Sometimes taking control can be as basic as getting the existing hair to look healthier. At the Aida Thibiant salon in Beverly Hills, trichologist Michael Bernstein uses heat lamps, massage, specially formulated shampoos and conditioners. During the hour session, which costs $45, he also tries to calm fears about daily washing, perming and coloring.
Yet nothing Bernstein can do will regenerate hair. For that he refers clients to Drs. Peter Goldman and Michael Freed, who are in the same Los Angeles practice.
To find a reliable specialist, Freed says: “Check out their credentials. Ask if they have published anything on the subject. Find out if they are well-known in the community. Ask them directly and ask other doctors. Ask if you can speak to their patients and see examples of their work.”
According to Freed, women respond better to minoxidil than men, with the majority of his patients producing “cosmetically acceptable mature hair” rather than peach fuzz. Given the right conditions, he and Goldman perform transplants. And in the future, Freed believes research could bring major improvements, including a protein to turn off hair loss--or hair cloned in a laboratory.
But Dr. Vera Price, a noted San Francisco dermatologist, is looking for lesser miracles. For starters, she’ll take the abolition of the lay term female pattern baldness inaccurately coined from the male condition.
She uses the term hereditary thinning, explaining that in females the trait “is not as patterned. And women are truly upset when they hear the word bald . They see a bald scalp with a fringe of hair around it.”
In medical advances, she would be satisfied with “an improved higher dosage of minoxidil. As far as a totally different medication,” she observes, “there is nothing imminent around the corner. But there is a terrific amount of research, more than ever before.”
