I never took great care of my hair—but I was always good at faking it. As beauty editor at Condé Nast in my twenties, my fine waves were always blown out to perfection. I even modeled hair extensions for Mademoiselle. As you can imagine, years of abuse from styling tools, bleach, and hair bonds left my hair pretty ravaged. Then, I began to experience hair loss at 40. Naturally, regardless of cause, losing your hair can be really distressing. Over my yearlong journey, I learned there is typically a hidden culprit behind this issue, and feeling healthy and strong allowed me to keep perspective. I urge anyone who stresses over more-strands-than-usual in the shower to take a deep breath and do a little digging.
I called Shab Reslan—a NYC-based hair expert and founder of Leona.co, a soon-to-launch hair health service that matches people with compatible products—about the possible reasons behind sudden hair loss (not to be confused with chronic hair loss or hereditary baldness). "I usually start by asking if something traumatic happened around three months prior," she tells me. “Because usually, there’s something.” Telogen effluvium, the technical name for stress-related hair loss, is caused by a shock to the body that pushes a higher percentage of hairs into the telogen (or resting) phase, causing more than the average amount of 100 strands to fall per day. Losing a job, having surgery, and divorce are typical triggers.
"When stressed, your body recognizes hair isn’t required for survival, making it one of the first systems to shut down,” explains Reslan. She also cites good ol’ common, daily stress as a potential factor, as it can cause inflammation and cortisol spikes—two enemies of hair growth. She encourages anyone with brittle or allover thinning hair to get their thyroid checked. Medications like birth control and anti-depressants are also two commonly overlooked causes, along with an unbalanced diet. “Vegans often lack important proteins and amino acids necessary for strong hair,” she tells me. One culprit that’s easy to squash? “Repeated pulling—or traction alopecia—that’s caused by facelift ponies and hair extension use and abuse.”
The Treatment Options
Had I met Reslan sooner, I probably wouldn’t have been so lost. But even this beauty writer felt unsure where to start. My friend Leanne Citrone, the owner of Andy LaCompte Salon, is always a wealth of information. She suggested Harklinniken, a Denmark-born company that “turned cotton hair into silk” using only topicals. She had me at “Denmark,” so I made a beeline to meet with Gregg Rosenblum, the clinic director in Beverly Hills, who used a digital microscope to look at my scalp condition (not so great) and miniaturization of the hair strands (oddly okay) to determine if the cause of hair loss was female pattern baldness (nope). I begged him to let me just try the products but he denied me; I simply wasn’t a candidate. But even though I was iced out of the treatment, those with genetic issues have heralded the results (just google the Ricki Lake video!).
I knew about Blow Me Away because I used to go there for quickie blowouts. Over time it changed hands to Keiko Uehara, who flipped it into a full-fledged salon and organic Japanese head spa. When I used to get my hair waved, what I really wanted to be getting was an hourlong scalp massage with products from an Italian biodynamic farm, and now I had an excuse! Their Hair Growth Program addresses thinning hair through micro-misting, deep scalp cleaning, and a pressure point massage that increases blood flow and sends nutrients to the hair follicle. Think back to your dreamiest hair washing experience at a salon. Now multiply that feeling by one million and increase the length of time by about 60. In the end it didn’t help me, but let me tell you that I dream about going back Every. Single. Day.
My friend Erika, who had a bout of stress-induced hair fall in college, directed me to Philip Kingsley Trichological Center in NYC. As “hair doctors,” they address everything from postpartum hair loss to trichotillomania (a hair-pulling disorder) before providing a bespoke mask and infrared treatment that can help stimulate growth. I came back to Los Angeles with products tailored to my story that included a volume-boosting shampoo, conditioner, a weekly deep-conditioning treatment, and mask. Wondering if other products could help, I layered on the IG famous Vegamour scalp serum and breakage-reducing, quick-drying Aquis towel. I also dug out my silk Slip pillowcase, as cotton absorbs oils that can cause breakage, aka shedding’s not-so-pretty cousin.
It was time to get real. Dominique Fraden-Reade is a French functional medicine doctor I heard about through the editor grapevine, as she specializes in hormone-related problems (and lots of hair problems are hormone related). She introduced me to Nappage, a mesotherapy commonly used in Europe (said yes immediately). Micro quantities of peptides, vitamins, amino acids, and growth factors help revive follicles and assist in slowing down loss in 10-minute micro-needling sessions. I committed to six (not painful, somewhat affordable) treatments before admitting that they weren’t changing anything. In the final hour, Fraden-Reade offered me an OTC pill that all her clients requested from her trips to France. They’re hard to find, but the pill had something to do with regulating low levels of DHT, a derivative of testosterone that, under certain conditions, could kill hair follicles. Sadly it only caused me to skip periods, an alarming detail I somehow missed during our initial conversation. But I later learned that the common skin-clearing Rx spironolactone, slows down the production of androgens—or male sex hormones—which can help regrow hair and slow down loss. This is a good option if your blood panel reveals that you have high testosterone (mine didn’t).
While hormone readjustment isn’t a walk in the park, I was almost bummed to learn that this wasn’t the root of my problems, because if it were, Fraden-Reade would have been my answer.
My friend Ruth told me about Margaret Floyd Barry, a Portland-based functional medicine doctor who helped her get to the bottom of an undiagnosed health condition. I’d wanted to ditch my regular internist for a more holistic practitioner, so the switch felt like a worthwhile investment. And it was. We did extensive blood panels, hormone tests, gut checks—it was time to start regulating from the inside out (which in hindsight, should have been step one). I weaned myself off metformin, an elective medication beloved for its cancer-protective properties, which (unbeknownst to me) happens to deplete B12 stores, a crucial vitamin for hair growth. We layered in a mineral complex with zinc and selenium, along with an iron supplement, widely known to mess with hair if you don’t make enough. I added in the model-approved Viviscal to my existing Nutrifol regimen, along with an adaptogen cocktail of ginseng, rhodiola, and ashwaganda after hearing an expert on The Doctor’s Pharmacy podcast touting the mix for curbing anxiety-induced shedding. Surely something would regulate, but as Barry liked to repeat, “Going the natural route takes patience.” And I was running out.
My final stop was for platelet-rich plasma (PRP) hair treatments with Brian Dubow, a medical doctor whom people claim “can save hair.” But let me just say, PRP isn’t for everyone. It’s painfully expensive and also straight-up painful. And it takes forever. Results take at least three treatments, spaced apart over the course of months. A quick fix, this is not. But after hearing that it can make existing hair thicker and stronger, I decided to commit; at the very least, what I still had would look prettier.
The process goes something like this: If you have roll-y veins like I do, you get stabbed a few times for blood withdrawal. This gets spun into growth-factor-secreting platelets that assist in tissue regeneration, and is often referred to as “liquid gold” for its amber color and restorative ability (it also works wonders for your face). Then, more needles: Anesthesia is used to numb your scalp for the main event…which obviously includes more needles. Your own golden plasma is injected back into the scalp to stimulate a specialized group of cells that play a critical role in hair growth. And then you wait. After my third treatment, I called Dubow’s technician, Craig, discouraged that it wasn’t working its magic ,as there were still hair clumps in my brush and some pieces on my pillow. “Just remember that three strands of long hair like yours look way scarier than three strands of short hair like mine.” It was an obvious but poignant point. Then, about two weeks later, my hair chilled out. It just kind of went back.
The Bottom Line
Maybe all those products finally did what they promised to do. Perhaps I properly restored my B12, or it definitely could have been my magical golden plasma. When a few strands would pull out as I was making a ponytail, or I’d notice some trapped in the drain, Chris, who has the hair of a Disney princess, would remind me that it happens to hers too. And then one night, as I was loading the dishwasher, I couldn’t help but notice that my red string had fallen off my wrist.