A 20-Something's Guide to Dealing with Thinning Hair

Yes, it happens more often than you'd think, and it's often a symptom of a serious illness.

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In my youth, stylists would always tell me, "Wow, you've got a lot of hair." So much so that I took my lush mane for granted—perming, straightening, and bleaching my way through my teens. But everything changed during my sophomore year of college, as I found myself pulling more and more tangles out of my brush and strands from the shower drain. The compliments stopped and the worry began. I jealously examined the girl next to me on the subway. Why couldn't I see through to the roots on her scalp, too?

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And once a lustrous dark curtain, my hair had taken on an alarming transparent quality. I spent hours staring at my scalp in the mirror, parting and re-parting my hair to see which side looked fuller. I drenched my head with volumizing sprays, detoxifying tonics, and shampoos for "weakened hair." Remedies were thick on the ground—but my hair kept getting thinner. I was molting. And I was scared.

Like a peacock's brilliant feathers, hair is a secondary sexual characteristic, explains London trichologist Dr. Philip Kingsley. "You don't need it to keep you either warm or cool, so its primary function is to increase attractiveness." We live in a culture of hair, coveting Victoria's Secret supermodels' voluptuous waves as much as their curves.

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So closely linked are sex appeal and self-esteem that a 2004 Rogaine survey of more than 500 women across the U.S. revealed that 24 percent equated losing their hair to losing a limb. Since 30 million women in America—roughly one in four—have thinning hair, there's a serious portion of the population at risk for an emotional crisis.

"I was molting. And I was scared."

When I eventually brought up my hair issue at an annual physical, my doctor tested me for lupus. But the tests came back negative. *Then* I was told that since I wasn't completely bald, I really didn't have a problem. So I began to wonder if it was all in my head. When my boyfriend ran his fingers through my hair, all I could think of was whether I was losing strands. Did this gross him out? Or more importantly, was a lot coming out?

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Needless to say, that relationship didn't last long, as I began to lose my sense of trust and self-confidence that he could find me attractive in this condition. I didn't dare ask my friends for a second opinion, because I didn't want them to scrutinize my scalp. After another frustrating physical (with no answers), I consulted my dermatologist. Instead of dismissing my concerns as mere vanity, he immediately wrote up requests for endocrine blood tests, which prompted my general practitioner to finally cave and grant me a specialist referral.

Here's what I gleaned from my blood tests and research into hair loss at-large. Many various symptoms can causes hair shedding—as any cursory WebMD search can tell you, from stress to chemotherapy–but 90 percent of hair loss is genetic and needs to be treated with medication. It can also be a sign of a thyroid disorder, says endocrinologist, Dr. Emilia Liao, who diagnosed me with mild hypothyroidism.

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"It's a good thing you came in when you did," she told me on my first visit. "It gets more complicated, and possibly dangerous, the older you get, especially if you want to have a baby." Apparently, hair loss during pregnancy is a big red flag. "One out of 50 women is diagnosed with hypothyroidism while pregnant. It's still the most common cause of mental retardation in children," says Liao. And the idea that thinning hair is simply a symptom of menopause is a myth: The average age for women dealing with thinning hair is 25 to 35.

"Unlike male-pattern baldness, female hair loss means a reduction in hair volume, making transplantation extremely difficult."

The blame can't be blamed solely on your hair care habits, either—if there's baldness anywhere in your family tree, you're at risk. Unlike male-pattern baldness, though, where patches of hair fall out over time, female hair loss means a reduction in hair volume, making transplantation extremely difficult. "The total number of hairs doesn't always decrease, but the diameter of each strand shrinks," says Kingsley. And too-thin hairs won't grow past a certain length—which explains the baby fuzz around my hairline.

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The Solution: Adding Volume and Growing Out Thin Hair

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If any of the above scares you because you recognize the symptoms, don't fret. The key to successful regrowth? First, admit you have a problem. Each day you dwell in denial, you're losing precious time. The more hair you've lost, the less likely it is to all grow back. Telltale signs, like a wider part or a smaller ponytail, don't show up until you've lost nearly half your hair! Seek out trichologists and dermatologists or endocrinologists who specialize in hair problems. (A good place to start is the American Hair Loss Association.)

Last summer, I started visiting the Philip Kingsley hair clinic in New York City every week to strengthen the fragile wisps that were sprouting up along my hairline as a result of my prescription treatments. There, I learned that physical as well as emotional stress can cause temporary thinning and make genetic hair loss worse. Consider it something like a domino effect. When 44-year-old fitness instructor Maria Santoro was hospitalized for a severe allergic reaction to her pneumonia medication, she lost 20 pounds in 10 days, and her chestnut waves started falling out in clumps. "People assumed I was anorexic," she says. "My body was in shock, and I felt really insecure because of my weight loss and thin hair. It was devastating."

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Design by Monica Park

1. Nick Chavez Plump 'N Thick Leave-In Thick Creme Conditioner, $7

BUY IT: dermstore.com.

2. Phillip Kingsley Scalp Toner, $34

BUY IT: philipkingsley.com.

3. Rogaine Women's Hair Thinning and Loss Treatment Foam, $40

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BUY IT: target.com.

Hair loss has a direct impact on psyche and morale, says Kingsley, who coined the phrase "bad hair day" 40 years ago. 34-year-old breast-cancer survivor Courtney Hagen found this out the hard way. She revealed to me that when she heard her diagnosis, her first fears were for her golden locks: "I had a double mastectomy, but I was more traumatized about losing my hair."

As for me, thanks to two years of regular treatment, I've finally reached the phase where regrowth is thicker every day. But the process has been arduous and pricey: Rogaine requires diligent use and $30 a month for the rest of my life. And some of my hormone-regulating prescriptions that I credit most for my good results—like Avodart, that cost upwards of $200 a month—are not covered because if you take them while pregnant, they can harm the fetus's development. But I continue with my regimen because, for me, the risk is worth the remedy—I'm not planning on pregnancy for a long, long time anyway. I also figure it'll be a lot easier to find a potential father with a full head of hair.

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