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How to Manage Hair Loss for Women

Writer Penny Musco is one of 30 million American women who suffer from thinning or lost locks. Here's what the infomercials don't tell you, and what doctors only reveal behind closed doors, about coming to terms with hair loss.
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Ann Cutting

Some women can restrain themselves from asking their husbands pointed questions they don't really want the answer to, like "Does this dress make me look fat?" or "Do you think our waitress is pretty?" I am not one of those women. Which is why as we stood in the bathroom brushing our teeth over the sink one night, I asked, "Do you think I'm losing more hair?"

"Yes," my husband replied without hesitation.

Stricken, I turned to him, his eyes growing wide with regret over his hasty answer, his fumbling apologies muffled by foaming toothpaste. But I couldn't blame him. He'd only spoken a truth I'd hoped he would deny. At 57 my hairline has receded, and no stylist's layered cut or deceptive part can hide that fact anymore. It's my private despair, what I call my "doll's hair," so sparse up front that I can make out individual follicles. The rest of my mane isn't anything you'd see swirling in a shampoo commercial either. And my eyebrows? Let's just say I'm singlehandedly keeping a certain cosmetic company's brow pencil line afloat.

I pulled myself together that night but my husband's words hit me harder the next day, when I crumpled into tears after another long, heartbreaking look in the bathroom mirror. Ironically, he's also losing his hair. But there's a devastating double standard in how men and women handle disappearing hair. Guys have sexy bald role models like Taye Diggs and Bruce Willis. Women have...a secret shame. A mere bad hair day is enough to undermine our self-confidence, so imagine dealing with my unnaturally high forehead and see-through locks every morning.

Then comes the blame. I trace the smooth, pale, slightly shiny band framing my face that used to be covered by hair and wonder: Is it my fault? Have years of coloring destroyed my follicles? Did the cornrows I got four years ago tug at my roots too tightly?

The first dermatologist I consult dismisses such thoughts -- and pretty much all my other concerns too. A blood test reveals acceptable hormone levels. She suggests Rogaine. It doesn't work. I try camouflage with a scalp-concealing powder. (You've probably seen the infomercials.) It looks ridiculous. I check out shampoos and volumizing conditioners with enticing promises. No success. I even move my part so much to one side that my fine strands come dangerously close to the dreaded comb-over.

We all expect some thinning as we get older, but not this. I'm shocked when I touch bare scalp as I run my fingers through my hair and see patches when I lift up my locks. Sometimes I imagine people looking at me with pity -- but then maybe I'm just projecting my feelings onto them.

No other women in my family have this problem, so hair becomes my solo obsession. When I surreptitiously check out women's heads at the gym and the supermarket, I become envious of their lush tresses. My husband and I visit a 92-year-old friend of his family whom we haven't seen in years. "Her hair looks better than mine!" I moan to him afterward.

My rising panic propels me to another dermatologist, who recommends a scalp biopsy. The devastating diagnosis: scarring alopecia, a usually permanent condition that occurs in 3% of hair loss sufferers as a result of inflammation due to anything from a chemical relaxer to hot-combing your hair to an autoimmune disease. (Non-scarring alopecia, which includes hereditary hair thinning, is more common and generally reversible). I'm referred to a rheumatologist, a specialist in joint, bone and muscle diseases, who conducts a slew of tests to see if the alopecia is a result of something like lupus. Thankfully, it's not. But I do have systemic inflammation. Why, no one can say. And I have no other symptoms except my dead follicles.

I seek out a dermatologist who specializes in hair, and she starts me on corticosteroid shots to the scalp to stop the loss. It's not fun. Even less enjoyable are the effects of a drug she prescribes to tackle the inflammation from the inside, which on top of heartburn can cause ulcers. After a month my stomach rebels so much that I ditch the pills.

Desperate to do something about what's left, I consult a plastic surgeon about a transplant. My intact lower posterior hairline is a good "donor site," I'm told, but even if the scalp inflammation is controlled, there's no guarantee it won't come back and attack the relocated hair. The $9,000 estimated bill to do the job is an awful lot to pay for a procedure that might not even work and won't be covered.

My hairdresser, who does her best for me, suggests a human hair weave. I meet with an "image consultant" at a nationally known company. The receptionist -- also a client -- lets me paw through her curls, like a mother chimp grooming her young, to see how the piece appears up close. Not bad. The cost is a few thousand. Maybe I could swing it -- except the hair has to be replaced annually. There's no way this middle-class middle-ager could ever justify dropping nearly four grand a year on hair for the rest of her life.

So after two years, five doctors, various remedies and a consultant who hounded me with follow-up calls for weeks, I'm done. Well, almost. I'll continue the injections until my dermatologist gives me the all clear. I'll keep investing in a good color, cut and styling. Someday I may even consider a wig. But for now, I've stopped trying to "fix" my hair. My husband (who has recovered from his momentary lapse in tact), family and friends love and accept me just the way I am, full head of hair or not. Now it's time for me to find it within myself to do the same.

Originally published in the March 2013 issue of Family Circle magazine.

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