It started slowly. Karen Meyer's already thin hair seemed to be getting more and more sparse each year. By the time she graduated high school in 1966, she knew what was happening. She was barely 18 years old, and she was going bald.
"I alternated between a hairpiece and a wig," said Meyer, 63, of North Cumming. "Back then, it was more of a fashion trend, but I was one of the few who actually needed to wear hair."
Women make up about 40 percent of Americans experiencing hair loss, according to data from the American Hair Loss Association, a California-based organization dedicated to educating and improving the lives of those affected by hair loss. Despite growing concern among women, hair loss is still often considered a male issue, but there are signs that women are no longer willing to suffer in silence.
Many women have taken to cyberspace, creating online communities to share their hair loss stories, treatments and other information. As a testament to the marketing potential of women with hair loss, Aveda recently introduced Invati, a line of hair care products designed to boost thinning strands.
As an adult, Meyer was diagnosed with androgenetic alopecia, also known as male or female pattern baldness. Meyer's mother had lost all of her hair, and her brother was bald by age 21. Doctors confirm that female pattern baldness has a genetic link, but there are many other reasons that women lose their hair and many are losing it at increasingly younger ages.
"About 50 percent or more of women have some shedding by age 50," said Dr. Ashley Curtis of Dermatology Associates of Atlanta. Medications, autoimmune disorders, pregnancy, birth control pills, menopause and stressful hair styling are just some factors that can cause hair loss in women of various ages, with the effects ranging from temporary, isolated patches of hair loss to widespread permanent balding.
In female pattern balding, dihydrotestosterone (DHT), a derivative of the male hormone testosterone, binds to receptors, causing negative effects on the hair follicle that lead to thinning. The only Food and Drug Administration-approved hair loss treatment for women is a 2 percent concentration of minoxidil topically applied to the scalp.
With few treatments being tested on women, particularly women of childbearing age, it is often left to dermatologists to find the right combination of medications, some of which are prescribed off-label, to assist in managing the condition.
Dr. Melissa Babcock of Babcock Dermatology in Sandy Springs has prescribed spironolactone, a medication used to reduce blood pressure, which also slows the production of male hormones and blocks DHT from binding to receptors. Estrogen, oral contraceptives and the drug finasteride (more widely known as Propecia or Proscar) -- an FDA-approved pill for male pattern baldness -- also have been used to combat hair loss in women.
Other solutions include hair transplants in which a strip of hair with active follicles or individual follicles are taken from the one part of the head and transplanted to the bald areas. Natural follicle simulation is a method of tattooing the scalp to camouflage patchy hair loss. But because female pattern baldness differs from male pattern baldness in that the hair loss is diffuse, women may or may not be candidates for these treatments.
Meyer, who was not a good candidate for a hair transplant, knew given her family history there was little she could do to stop the process of losing her hair. When the former hairstylist moved to Atlanta in 1992, she decided to work in hair replacement full time. She knew how devastated a woman could feel when she was losing her hair.
"I wear my hair from the time I get up in the morning to the time I go to bed at night," said Meyer, who has about 30 percent of her hair and wears a three-quarter prosthesis. "Even after 44 years of marriage, I don't feel comfortable being around [my husband] without my hair."
At New Horizons, an Alpharetta-based company that offers custom hair restoration solutions, Meyer's youngest client is 7, and her oldest client was 93. Company owner Sharon Mason said women are more aware now than in the past that they do have options to address hair loss.
"Before, they were like, this is too silly to go to the doctor," said Mason, who has been in the hair replacement business since 1976. "Now they go online, they see symptoms and they go to the doctor."
When clients come to Meyer, she helps them find solutions to suit their condition and lifestyle. But fitting them for a "cranial prosthesis," as the hair systems are called, is just part of the job, Meyer said. She also shares her story with clients in the hopes that they will be encouraged.
"We have a lot of crying and a lot of support," she said. "I always said ... I was going to do something important. That is exactly what this has been."
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