Leaving your locks on clothing, pillows and
others' shoulders? Nurse lets her hair down on hair loss.
Be Nice, Nursie,
I've enjoyed all your past tongue-lashings,
but fear it's my turn now. Lately, I've noticed more hair in my shower
drain and less on my head. Is this the beginning of the end . . .
balding? The last thing a "mature" HIVer like me wants to do is blind
the boys on a sunny day with the glare off my head. Anything to encourage
-- Wigging Out in Wisconsin
Well Said, Wiggy!
While Nurse may have occasionally employed a
tone a smidge too disciplinary, believe me, dear: It's always administered
with the greatest affection for her virally challenged brothers and
sisters. Lord knows you have enough to handle without having an old
nag like me adding to your -- pardon the expression -- headaches! Losing
one's hair is an irksome, and sometimes incurable, development. Besides
the inexorable advance of the years, balding results from genetics,
skin conditions, sudden weight gain or loss, fevers, certain diseases
(including anemia and an overachieving thyroid gland) and meds, some
of which the AIDSy take.
While balding is an equal-opportunity offender,
men tend to molt more. One in four American men starts to lose hair
by age 30; by 60, two out of three reach for a rug. If a teenager counts
hair loss among the troubles of his turbulent years, chances are he's
working his way toward a weave in the not-too-distant future. Male pattern
baldness usually starts at the temples and causes the progressive recession,
thinning and decamping of the hair -- leaving victims with an unflattering
horseshoe-shaped band on top. Also splendidly styled androgenic alopecia,
this maddening malady is associated with high levels of testosterone.
And hello, ladies: Female pattern baldness, which also begins around
age 30 and worsens after meno-pause, causes the scalps of the second
sex to thin evenly; only rarely do the gals lose it all. This kind of
baldness, for him and her, is permanent, so here's my severely
starched shoulder to cry on before you read on.
In contrast, patchy hair loss resulting from
conditions such as head fungus, skin and autoimmune disorders and stress-forced
fallout is usually temporary. So is toxic baldness, which may resolve
in months; it's caused by a number of drugs, including cancer chemotherapy
agents, cholesterol-fighters, anti-depressants and beta blockers. And
HIVers anecdotally point to these meds as causes of lost locks: anabolic
(muscle-building) steroids (such as testosterone), Megace, 3TC, hydroxyurea,
alpha interferon, famciclovir and fluconazole.
Here, then, are Nursie's hair-raising hints.
Two drugs for male pattern baldness have hit the market: the over-the-counter
(and good for the gals) topical minoxidil (Rogaine); and the prescription
(guys-only) oral finasteride (Propecia). Both drugs are somewhat effective
in maintaining -- and occasionally regrowing -- locks beaten by alopecia,
especially at the scalp's crown. (But don't expect miracle growth at
the front of that ebbing hairline.) These drugs tend to work best for
men in their 20s and 30s balding for less than five years; they take
up to a year to kick in -- and hair loss resumes when the meds are stopped.
Side effects? For Rogaine, they include scalp irritation and itching;
for Propecia, rash, itching, hives and swelling of the lips and face,
breast tenderness and enlargement, and -- sorry, stud -- ejaculation
difficulties, erectile dysfunction, testicular pain.
Hanging onto a head -- or mere wisps -- of hair
means making nice to your scalp. Excessive oil clogs pores and causes
hair-root malnutrition, triggering more shedding, so frequent shampooing
can help. Some HIVers swear by Revitalize, an herb-and-nutrient-packed
formula. The vitamin biotin can treat your tresses well, as do ginger
(powdered or tea), fish or flaxseed oil and bioflavonoids (quercetin
When the hairline starts closing in on the nape
of the neck, it might be time to consider gluing on a hairpiece. Available
in synthetic and natural hair, they cost $500 to $3,500. A more drastic
step is a surgical transplant. Besides the discomfort and humiliation
of sporting a plug, transplants are pricey ($1,500 to $10,000) and balding
may progress in untreated areas. In the end, a few minutes in the shower
with a disposable Bic razor and a dab of shaving cream may be the treatment
-- glare or no -- to get you the kind of attention a wig won't.