Dr. Marc Glashofer, a board-certified dermatologist based in North Jersey, understands the often-excruciating stigma women when face when they lose their hair. “Most women don’t talk about hair loss,” he explains. “And most suffer silently – even though about 50% of women have some form of hair loss after the age of fifty.”

He should know. An expert in the field, he is a firsthand witness to the “psychosocial aspect” of hair loss, noting, “It’s very stress-inducing. It can affect your overall life and the quality of your life in a very negative way.” Compounding this stress, many women don’t understand both the root causes behind and viable treatments for hair loss, leaving them searching for solutions the vitamin aisle of CVS. (More on that, below.) To clear the air, we spoke to Dr. Glashofer about women’s hair loss — causes, treatment options, myths and facts. His insights are ahead.

HAIR LOSS CAN BE ATTRIBUTED TO MANY THINGS

Genetics, hormones, lifestyle, environment and even harsh and aggressive hair styling – all are contributing factors for various forms of hair loss. Dr. Glashofer notes that androgenic alopecia – also known as female pattern hair loss – is the most common diagnosis he doles out; it encompasses both hormones and genetics. The second most common – telogen effluvium – usually occurs after a physical or emotional trauma, such as pregnancy, rapid weight loss or even surgery.

With that noted, it’s not always easy to attribute hair loss to one sole factor. He explains, “There is sometimes overlap between these different forms of hair loss; it’s not always a clear-cut, single type of hair loss. I saw a women today who has a little bit of stress-related hair loss, plus she’s in the perimenopausal age, combined with an inflammatory angle.” In short: If you’re experiencing hair loss, be prepared to utilize a multi-pronged approach to address all possible root causes.

WITH HAIR LOSS, THE GOAL IS RETENTION, NOT REGROWTH

How do I regrow my hair? This is the first question Dr. Glashofer usually receives, and it is arguably a misguided one. He elaborates, “Most people don’t realize that [re-growing the hair] is a much harder goal to achieve than retaining the hair that you already have.” As a first step, Dr. Glashofer often resets expectations, advising his patients to focus more on slowing down hair loss, prioritizing therapies that help to retain as much hair as possible.

ROGRAINE IS A REAL THING…

While it may seem decidedly retro – I can’t help but flash to 90s commercials like this one – Rogaine is very much a staple in Dr. Glashofer’s treatment arsenal. He notes, “Rogaine minoxidil 5% is often the first line of defense with treating hair loss, specifically to help retain the hair you already have. It’s not really effective for regrowth, but it is good to get into the regimen to slow down the hair loss.” Another tried-and-true therapy? Propecia, a common medication prescribed in male pattern hair loss that is anecdotally effective when addressing women’s hair loss.

…BUT BIOTIN IS NOT

Biotin supplements like this one continue to be marketed as natural treatments to strengthen and regrow hair. Not so fast, says Dr. Glashofer. Although a lack of biotin can cause hair loss, our modern diet is rarely deficient. As such, supplementation isn’t necessary.

Dr. Glashofer puts it even more bluntly: “Here’s the truth: Studies have shown that biotin supplementation does nothing for hair growth.” As for other forms of supplementation? He concedes that if bloodwork reveals a patient is deficient in something – iron, for example – he will recommend supplementation, but doesn’t consider it a standalone treatment for hair loss.

NEW THERAPIES ARE CHANGING THE GAME

Although it’s a coveted result, stimulating regrowth isn’t the most realistic outcome when treating hair loss. In fact, several years ago, the only real option for attaining thick, restored locks were hair transplants – an expensive and invasive procedure.

But recently, a new treatment called platelet rich plasma (PRP) has transformed the ability to address hair loss. It begins with a simple blood draw; blood is next concentrated through a centrifuge and then re-injected directly into the scalp. “What PRP does is utilizes your body’s own regenerative abilities to stimulate hair growth,” Dr. Glashofer explains. “When you’re injured, either externally or internally, your platelets release their content, some of which has rejuvenating factors; these have been shown in both orthopedic and cosmetic literature to be helpful with stimulating both the regrowth and repair of systems.”

And the results are more than encouraging. “In my hands, about 50% of people will get increased hair growth, density and thickness – and the best part is that it’s all-natural.” A natural hair loss treatment that works? That’s something most women are definitely willing to talk about.