What’s really causing your hair loss? Dermatologist separates fact from fiction

MIAMI — Hair loss affects millions of Americans, but dermatologists say many people don’t know what’s causing it and may turn to social media for answers before seeing a doctor.

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Dr. Aaron Nussbaum, a dermatologist at Miami Hair Institute, said getting the right diagnosis early is critical because hair loss can have many different causes, including genetics, hormonal changes, stress, illness, medications and autoimmune disorders.

“The first thing always to do in hair loss is to make the correct diagnosis. Not all hair losses are created equal,” he said. “There’s many different types of hair loss disorders. It’s really important to seek out the opinion of an expert hair specialist or board-certified dermatologist.”

Nussbaum said people should seek medical advice as soon as they notice changes in their hair, including increased shedding or loss of volume.

“Like everything in medicine, the earlier you start the better. At the earliest stages of noticing something changing — your hair, your volume, your shedding — it’s better to come in first, detect it early and get you started.”

He also cautioned against relying on online sources or attempting to diagnose hair loss without seeing a physician.

“Nothing is going to be the same as actually seeing a physician in person who can examine you and put you on those treatments,” he said. “These medications can have side effects, so they should be prescribed by a doctor.”

Social media is also filled with claims about what causes hair loss. Nussbaum said common activities such as wearing hats or using hair gel do not cause hair loss.

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“Hats, hair gel, combing your hair — all that does not cause hair loss,” he said. “The problem in hair loss is underneath the scalp at the root of the follicle.”

Nussbaum also said there is no evidence that shampoos can prevent hair loss.

At Miami Hair Institute, doctors use scalp imaging and detailed evaluations to determine the cause of hair loss before recommending treatment.

Treatment depends on the diagnosis and can include topical or oral medications, injections and lifestyle changes. For some patients, hair restoration surgery is another option.

Carlos Pizarro, who underwent a hair transplant procedure, said he prefers a subtle result.

“It is very taboo to talk about, so you don’t know who to ask for advice,” he said. “If anyone asks me or see(s) my hair transplant, (they) don’t think I’ve done anything.”

Nussbaum said patients should also understand that many hair loss treatments require ongoing use.

“Hair loss treatments only work while you’re doing them,” he said. “This is not like an infection where we give you a short course of treatment. You have to continue doing these.”

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