In episode 104 Dr. Jill talks with stylist Gwen of Envogue Salon on Common Causes and Solutions to Hair Loss in women.
- Stress, infection and fever (post-COVID) are common causes of Telogen effluvium
- Key nutrients for preventing hair loss are zinc, selenium, biotin, choline, vitamin A, D and E
- Hair growth serums can restore loss of hair on scalp.
Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs.
Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names.
A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.
Dr. Jill 0:13
Good morning, everyone! I'm often not here on Facebook Live, but I'm so excited to meet you here today and talk about something that not only is super relevant—I had planned this talk before the relevancy [of it] in the news lately of alopecia and hair loss, [which] has become such a topic of conversation—but I know many of you listening out there have either experienced this or someone you care about has experienced this. I feel like many, many more of my patients are seeing issues with hair loss, so I wanted to talk about that subject today. And I couldn't think of a better person to bring in than my amazing stylist, Gwen, who's at Envogue Salon. She's live on-site today with lots of great solutions. I'm super excited to introduce her in just a minute to talk about some of those solutions.
Dr. Jill 0:58
But first, just a little background. You can hear me here on Youtube. You can also catch this podcast anywhere you listen to podcasts, [like] Stitcher, iTunes, etc. Of course, right now we're live on Facebook. This is Dr. Jill live. You can find all of my blogs, articles, and about 10 years of information on my website at jillcarnahan.com. All kinds of free resources [are] there. I actually, just a few months ago, wrote an article about the causes of hair loss. So if you want more information or want to read in-depth, you can find that on my blog at jillcarnahan.com.
Dr. Jill 1:31
Today we're going to talk about some amazing salon products and solutions that Gwen has and takes care of her clients with. But you can also find products and solutions on drjillhealth.com. There's one particular product we actually use for hair loss, and we'll talk a little bit about that later. I'm so excited, Gwen, to have you here today. We met a couple of years ago, right in the midst of the pandemic. You have been amazing in my life because I feel like you've taken the quality of my hair, my thickness, and the health of my hair to a new level. It's been so [much] fun to work with you and to try new things and learn new things. I just consider you an expert in the field, and obviously, you're an advanced stylist. You have a long client list. I just feel lucky and blessed to have you in my life in that way. So welcome.
Thank you so much. I'm looking forward to having this conversation with you and gathering client needs and solutions for our clients to have thicker, fuller, more beautiful hair.
Dr. Jill 02:30
Yes. Again, it's so exciting. I wanted to just share today on all levels. First of all, I might just share just a little bit about the causes of hair loss because I believe that lots and lots of people are experiencing problems with thinning hair, hair loss, and even complete alopecia, which is [alopecia] totalis, where you lose everything on your scalp. I also just want to share briefly [that] I have been there. You may think right now, I have this lovely hair that's all growing out. But I wanted to share—Gwen, I don't know if I've even shared this picture with you, just really quick—and tell my story.
Dr. Jill 03:02
Twenty years ago, I think many of you know, I had cancer. But this was me right after chemo. I don't know if you all can see that picture—totally bald. That's one of these types of hair loss called alopecia—I'm sorry—it's the alopecia that happens after chemo. So the chemo causes the hair follicles to fall out and you lose all your hair. All this to say, I actually have been completely bald before, in my 20s when I had cancer and chemotherapy. I know what it's like.
Dr. Jill 03:35
I told Gwen the other day, as we were talking when I was in her chair getting styled: “I had breast cancer. I had scars and surgeries on my breasts, which as a woman is a very personal part of my image and how I feel about myself. But the hardest thing about that cancer was not the surgeries, not the impact of scars on my breast, it was having no hair.” I know maybe some of you have dealt with that and dealt with it better than I did, but it was really hard to go out bald. Obviously, at the time, I had wigs. I had all kinds of things I could do.
Dr. Jill 04:05
I remember one particular incident when I was going through airport security and they were like, “Ma'am, take off your hat.” I had a hat that had beautiful hair. So I looked really normal. I was like, ‘Okay.' I take off my hat and I'm completely bald and there's a lot of shame and embarrassment in that situation walking through. Obviously, they didn't know that; they weren't trying to single me out. But it was one of those things that stick in my mind because there's something about our hair that makes us feel human and beautiful and connected.
Dr. Jill 04:33
I think, especially as women—for me—it's just lovely to have hair again. I also always joke because I found a word at that time. Bald is one thing; it's just kind of this four-letter word. But there's another word that means hairless, and it's called ‘glabrous.' I always use that word because I thought it was so much more fun to say. Well, I'm ‘glabrous' than bald. But like I said, this is close to my heart. Because I have been there and I have experienced that.
Dr. Jill 05:01
People can have all kinds of types of hair loss. I'll just share a couple of those because part of the issue with hair loss is figuring out what might be going on and what kinds of hair loss might be happening. Because if you can get to the root cause, then you can have a solution. One of the things that is happening a lot right now is telogen effluvium. Most of our hair, about 90%, is in this growing phase for anywhere from two to eight years. It's growing, doing its thing, and then when it gets to the end of its cycle, it goes into this telogen phase and it falls out.
Dr. Jill 05:35
Usually, only about 10% of our hair falls out at one time. We notice there are a few hairs in the shower or the sink, but it's not like we're getting handfuls. But Gwen, have you been hearing more and more clients with handfuls of hair or a lot more hair than usual falling out? I'd love to hear [what is being brought up about this] when you have clients in the chair. What kinds of things are you hearing there in the salon about hair loss and the experiences of your clients?
Absolutely. It's one of the main causes that motivated me to want to have a conversation and seek out your expertise in this field. After two decades in my industry, it's a huge concern and it's growing and growing even more. I hear women say things [such as] “it's not as full as it used to be,” or “it has really thinned out over time.” Sometimes there's scalp exposure. Sometimes it's just the overall condition, the luster, the density, the fullness, the body that seems to be changing over time, and there are various factors that they are looking to me for answers. That's why I look to you to help me help them with: Why is it happening? And also, what can we do about it to help everybody look and feel their best?
Dr. Jill 06:41
I love that. And I promise you, hang in [there] because we've got some amazing solutions from Gwen. She obviously has a hair model there with the wig, and we're going to talk in-depth about what you can do if you've had hair loss. Just briefly, if you're having telogen effluvium—if you've ever been pregnant and three or four months after, you lose a lot of hair, that's the same thing that happens with this. It can also happen after an intense fever or illness. I'm seeing a lot of people that got sick with COVID. Two or three months later, if you look back, [you may notice the link]. One of the first questions I ask my patients if they have a lot of hair loss is when did it start? They might say, “It started in January.” So I say: “Go back three months from when it started. Did something happen in your life [such as] the death of a loved one, a high fever, illness, or some other thing that happened?” Because often they can pinpoint it back to some event in their life like being ill and then they lost their hair.
Dr. Jill 07:30
What I can usually say in that case is if I look at their scalp and there are no big bald patches, which is a whole other topic, I can tell them, “Your hair's going to grow back.” So if you're listening now and that fits you, it will grow back. It's just that all of a sudden, things shifted from that 10% of hair loss all of a sudden to about 50%. So it feels like tons of hair is coming out. But all those hairs are just in that cycle of falling out instead of growth. They will come back, and it may take a little while for you to get that fullness back because all of a sudden 50% of your hair is just starting over. But the truth is that it will come back in the coming years.
Dr. Jill 08:16
Other things I see are nutrient deficiencies and things, whether you have inflammation or gut issues. We need zinc, selenium, vitamin A, vitamin D, biotin, and choline. I always make sure nutrient-wise the patients have the right nutrients because whether you have a gut disorder where you're having malabsorption or other things, you can have issues with nutrients if you don't have the basics in your diet. And too much is sometimes just as bad as too little. So if you have excess toxicity of copper, zinc, or selenium, that can go that way too.
Dr. Jill 08:36
A few of the other really common causes would be issues with hormones and the thyroid. And of course, if you haven't had your doctor check your thyroid hormones like TSH and free T4 and free T3, those are some of the really important things to check and make sure a lot of issues with low T4 will cause hair loss. But if you excessively get prescription medication for your thyroid and you [suffer with] hyperthyroid, that can also cause hair loss. So either end of the spectrum with the thyroid can cause issues.
Dr. Jill 09:03
And finally, as we age—I'm in my 40s—our hormones change. Especially for women, loss of estrogen or menopause can cause thinning of hair, lack of luster, and some of the things that you talked about, Gwen, that you hear. Then there's something else. We call it male pattern baldness, but women can have this too. [It occurs when] you start converting your testosterone into dihydrotestosterone, or DHT. This can cause hair loss that's on the sides and the scalp here, so it thins out and there's usually a little bit of a peak here. You can probably actually look at it, Gwen, and tell [when there's] male pattern baldness. Some women get this too.
Dr. Jill 09:38
A lot of women now supplement with hormone replacement therapy, and you get testosterone and your body converts it to DHT, or dihydro[testosterone]. These are measurable in the blood, so there are other tests that you can ask your doctor for. You can check all the vitamins I mentioned in the blood. You can check the testosterone, estrogen, DHEA, cortisol, and DHT—the dihydrotestosterone—and then, like I mentioned, the thyroid. Those are some critical things you can do.
Dr. Jill 10:04
So basically, we have this falling out from illness, the telogen effluvium. We have hormone-related thyroid adrenal end female and male hormones. And this other spectrum—this is probably the most difficult one [which] I'll briefly mention and then we'll go to solutions—is the autoimmune or the scarring alopecia. Sometimes people can get diseases like lupus or fungal infections, and these can cause scarring of the hair follicles and hair loss. Usually, this is patchy, and there are big bald spots, and they're kind of shiny. You don't see any of the follicles there anymore. This can be permanent, and this is much scarier because you're getting these big patches and you don't see any new hair growth. Even with that, there's a lot you can do with steroids to calm inflammation, or with functional medicine to look at the root cause and reverse inflammation.
Dr. Jill 10:50
I have a 14-year-old patient who lost all of her hair after mold exposure. That can be related to high histamines and issues with mold. I remember, after I had mold, I lost about an inch or half an inch of my scalp hair because it kind of pulled back and fell out. It all came back afterward. But histamine, which is part of mast cell activation, can also cause hair loss. So that's a very brief but very broad overview of a lot of the things that we're seeing. Gwen, would you say in the last two years, with a pandemic and more and more people experiencing COVID, that one of the things you're seeing is hair loss in the last two years?
I think it's increasing. Stress levels are up. People have gone through a lot in the last couple of years, and it's showing in their hair.
Dr. Jill 11:34
Yes. So let's talk about solutions. I want to dive into some things. Say someone comes in [with] post-chemo thinning and maybe we [can] talk about someone who really has the scarring, the glabrousness where they [are having] massive hair loss and their hair is so thin. They need a real solution for that. Then we can talk about products and options if they're just thinning or lacking luster.
Absolutely. One of the things I wanted to start out with was a couple of images of clients that are before and after, just so someone could imagine: What could that look like for me? And what's out there that could be a solution to get more information to our clients? I wanted to show this picture here. This is a before and after. You can see.
Dr. Jill 12:21
This was brought by an educator from hairtalk, and it features a product called hairwear. So it's a semi-permanent piece that is applied to the top to involve more density and more volume on the top of the head. So I'll show you what this piece looks like. Essentially, this can be worn semi-permanently or daily to take on and off for temporary wear or for monthly maintenance. It can be applied in various different ways, and it comes in various different sizes. It's able to instantly change the way that your hair looks and likely how you feel. It's going to be applied over the top, and a stylist that is trained in this method is going to apply it. They're going to custom order the color, cut it and blend it, so you're going to look very natural.
Dr. Jill 13:12
Wow. I love that. Do you see a lot more in this scalp area where it's thinning up top? Is that where the—
There are multiple places where people can be lacking density. It can be on the top, it can be on the sides, or on the bottom. Sometimes it's very obvious in one specific spot, which is where the topper would be a great option just to get awareness out and know that that's an option for people. I'll go ahead and show [you] this second image to give you another client that this would be an example for. So you can see with her hair, she is really starting to get separation on her part line. There's more scalp exposure and thinness in general to the point where it's almost getting to a balding situation. So again, a topper is applied and instantly changes the way that the hair looks.
Dr. Jill 14:00
That's amazing and it looks so natural—even the color there, the ombré kind of blending. Obviously, you guys are pros at that, but that looks amazing.
I think that the client definitely wants to feel secure that no one's going to notice—it's going to be very discreet and very natural looking—and that they don't have to share unless they choose to.
Dr. Jill 14:21
Yes, oh that's amazing. I love that. For me, it's interesting because even this last year you and I talked [about this]. I think it was around September-October. I started having a lot of hair falling out of the top. I started using several different products and things. I think in that case it might have been a little conversion to DHT, stress, post-COVID—a bunch of different things are playing into that. And now it feels like it's starting to come back to normal. What kind of products or recommendations would you have there?
So I'd like to showcase just a couple of products for us because the needs are so diverse and different things that people go through, anywhere from overall thinning to wanting more volume, dealing with breakage, dealing with the loss of density, loss of fullness. Kérastase came out with a product called Densifique. So, if you're looking for thicker, fuller hair… I'll go ahead and just give you an image of this product. This is for clients who are thinning and just would like to have more fullness and more body over time. This is a shampoo. There's a full line of products that they can use. This is just one example that can really help increase hair growth for clients.
Secondly, some people deal with hair falling out. They might have a lot of hair on their brush, possibly in the shower. Sometimes it's even on their clothing items. Genesis is another product that Kérastase makes. This one is going to really, really help reduce the breakage in your hair and the hair fall. That's been very, very common in clients, I've noticed. Initialiste is a super hair serum. This is something that I think would be a go-to for anybody just looking to have more hair, healthier hair, and fuller hair. This is going to be applied weekly and, over about a two-month period of time, will make your hair feel thicker and fuller. Now, if you're wanting to take the next step and just maximize everything that's out there and available, Kérastase makes a product called Specifique.
So, these are going to be [for] scalp treatments that are applied to your hair weekly. They're kind of like a super serum so that you can grow as much hair as possible. These are suitable for women. They're suitable for men. It's really going to [show] when you're dealing with something along these lines, where the hair is spreading apart, [there's] more scalp exposure, and they'd just like to see even small hair start to cover and give more density, more fullness. These treatments are applied to the scalp and can really help with that.
Dr. Jill 16:55
Wow, I love it. I've used some of those. I love the pink one.
Yes, absolutely. The best thing is that there's such a variety of products that can be customized and used for people. It's not something that you have to suffer with; there are solutions.
Dr. Jill 17:12
Yes. There's a solution. Let's see, Kérastase has that blue one. Do you remember? I love that one too. I've been using that. I'll share another screenshot because those are [from] Kérastase. I literally have those in my shower. I love them. [As] I mentioned earlier, I have a product of my own that I've found really helpful. You guys can see that rapid regrowth serum down here at the bottom. I'll try to [zoom in]. For DHT, dihydrotestosterone, if you're having the male pattern stuff, that can be really helpful at blocking the DHT. In the beginning, when I was having that thinning, I used that serum. Now I'm using the Kérastase serum, and it's just great for maintenance. I feel like I have my hair back. It's like 80% back to where it was. So it's super, super important. And these serums, I brought [them] to show [you]. These are actually in real time. These are prescription peptides that also work at the scalp level.
Dr. Jill 18:09
So we have all these things and I literally combine them with patients. You can use a great line like Kérastase, you can use some of the growth serums like the Dr. Jill line, and then these peptides are super powerful. They're by prescription only. One of them particularly is for if you really have lost your hair, it'll help the regrowth of the hair at that follicular level. And the other ones are those dihydrotestosterone blockers.
Dr. Jill 18:33
I think that even a lot of the over-the-counter products have those DHT blockers in them because it's such a common thing. When we as women get into menopause, what happens is our estrogen usually drops. That can cause thinning and a lack of luster in the hair. So one of the things you can do with your doctor is talk about hormone replacement therapy. If you check and your levels are really low—like we said, low estrogen—you might want to replace that because that's going to be something that really helps your skin and hair.
Dr. Jill 18:57
A lot of the elasticity of our skin and the strength of our hair are related to hormones. So, as we go through menopause and those drop, you can replace those at the physical level. And then, like we said, the thyroid is a key. Some of the ingredients that make thyroid hormones are zinc and selenium. Those are absolutely key. So if you don't even know where to start with nutrients at the very basis, I would say usually zinc is appropriate—vitamin D and vitamin A can be appropriate.
Dr. Jill 19:24
Interestingly too, some of the fat-soluble vitamins which are A, D, K, and E, all of those are important for hair growth. If you have an issue with your gut where you're not absorbing things, or you've had Crohn's or colitis, or you've had gut inflammation, sometimes over time just the lack of nutrients—because you're not absorbing them—will lead to hair thinning and loss.
Dr. Jill 19:46
This is one that's really common and I've had this off and on where I just feel like, “Oh, it's kind of dry and brittle and lacking luster.” What would you recommend or what would you do with someone who has dry, brittle [hair], or a lack of shine? Anything in particular there that you would recommend?
Yes, dryness is very common in our climate, and I'm noticing it in almost every client that I have in the salon. So I would say a deep conditioning mask would be a great place to start. [It's] something that you can do weekly and just apply to your ends. Leave it on for about 15 minutes. Kérastase has 10 different ones to choose from and they really get your hair looking [great with] lots of shine and in beautiful condition.
Dr. Jill 20:23
It does. It's amazing. When I come back from the salon, [I'm] like, “I don't know what you did, Gwen!”
In the salon, we carry the Fusio-Dose treatment. So if you're just looking to address a variety of concerns, we have products that are for thinning, for losing hair, [for those] wanting more body. We also have them for dryness, brittle ends, if your hair is splitting or breaking, or damage from chemicals.
We have a Fusio-Dose product that you can have applied in the salon, whether you're going to have your hair blown out or if you're going to have a color service done. It's going to really improve the condition of your hair instantly, and it lasts over a month.
Dr. Jill 20:59
Yes, that's the truth. Literally, I don't know what goes into that stuff. I was like, “Oh, what is this? This is amazing!”
Dr. Jill 21:04
Yes. You also gave me—I don't know if you remember, it was a Kérastase—the real shiny stuff. It's in a bigger bottle. What is that called? I love that I've been using that in my hair.
Fibre Architecte, a blue product. It's a dual-treatment serum. It's really going to address any damage from heat, if you're over-styling your hair, excessive brushing, or if you just have general hair that tends to split and break on the ends—some hair just naturally does that. So that's a really great solution. I love to apply it dry after your hair has been blown out or styled, and just absorb it into your hair. It also has heat protection up to 400 degrees.
Dr. Jill 21:41
Oh wow. That's amazing. In Colorado, you have an extra hard job, I think. Say I'm flying to speak in Orlando or somewhere where it's much moister, literally my skin and my hair [improve]. I'm like, “What happened?” It's like new because of [all] that moisture in the environment. We just happen to live in an incredibly dry climate. If you're not using a really good sunscreen—I mean, all of these things that we do and the moisture, it's such a big deal, especially in Colorado, where we live.
It’s common for people to have both issues at the same time. Sometimes, what's going on with the scalp can be completely different from what's going on at the ends. So they might be experiencing dry ends and also thinning at the same time. They might have oil through the top, which can clog the follicles and prevent hair from growing, and then also have dryness and breakage at the bottom.
Dr. Jill 22:30
Yes, and that's where those treatments can probably really work because you can treat the hair—
Yes, the Fusio-Dose is excellent. We have a variety of products. There are even specific shampoos that will help treat the condition of your scalp. We have scrubs. [We have] any sort of different things to address what might be happening at the root, in the midst, and on the ends.
Dr. Jill 22:49
Wow, this is amazing and I know [it will be] super helpful to people who are experiencing this. Like I said, the main thing that we want to do is bring hope and solutions. Wherever you're at on that spectrum of hair loss, like I said, I've been there too. I've been bald. So I know what it's like to not have hair at all. Any last words of wisdom, Gwen, or things that we didn't talk about that would be ideas or solutions for patients or clients in your case?
I would like to just encourage anybody listening, or even if it's a friend or family member, to not be shy about asking for the things that are concerning to you, whether it's booking a consultation with a stylist, or if you're already seeing someone regularly, bringing up the things that are bothering you, because likely they're bothering other people.
Specialists, like myself—I've been educated on multiple different hair extension methods, topper methods, products, and even sometimes just blow-dry tips and a Fusio-Dose. You never know what can make a difference. So I would suggest a complimentary consultation. I would do that. Absolutely. I'd love to meet anybody who's interested in that or just wants to talk about it because there are so many things out there that can really change how you look and feel about your hair.
Dr. Jill 23:56
Gwen, you're amazing. I know you've changed my life because when you feel your hair looks good and you feel good, it really makes a difference. As I've been doing live and talking and speaking, it's really one of those things that's in the background and it's something hard for people to talk about. But it really does matter and it makes a difference in your confidence and how you appear.
Dr. Jill 24:15
So, thank you, not only for what you do for all of your clients, but personally, I am so grateful to have you in my life and as an expert on my hair. You've even added pretty color. We've been experimenting with colors, and it's been so [much] fun. So thank you for taking the time this morning to share with us. Thank you for all your expertise. Gwen is at Envogue Salon in Denver, so if you're local, she is one of the best. Thank you so much for your time today!
Thank you so much!
* These statements have not been evaluated by the Food and Drug Administration. The product mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease. The information in this article is not intended to replace any recommendations or relationship with your physician. Please review references sited at end of article for scientific support of any claims made.