Your Hair Is Changing. Let's Do Something About It.
Hair thinning is one of the most common concerns we hear from both men and women. Sometimes it develops gradually over many years. Other times it seems to happen almost overnight after a stressful event, illness, significant weight loss, menopause, or other hormonal changes.
At Encore Health, we focus on identifying the most likely factors contributing to your hair loss and determining whether medical therapies may help support healthier hair growth.
Hair grows in cycles, and many factors can interrupt that process.
Genetics
The most common cause is androgenetic alopecia, often called male or female pattern hair loss. In genetically susceptible individuals, hair follicles gradually become smaller over time, leading to thinner, shorter hairs.
Hormonal changes
Women often notice thinning during perimenopause or menopause, while some men may notice increased shedding related to their genetic sensitivity to DHT.
Stress, illness & rapid weight loss
Surgery, illness, emotional stress, rapid weight loss, or even GLP-1 therapy in some patients can temporarily shift more hairs into the shedding phase. This condition, known as telogen effluvium, is often temporary.
Nutritional factors
Healthy hair requires adequate protein, iron stores, and other nutrients. When appropriate, we may recommend laboratory testing to help identify contributing factors.
Testosterone itself doesn't necessarily cause hair loss.
However, in men or women who are genetically predisposed to hair shedding, some testosterone is converted into dihydrotestosterone (DHT). DHT can accelerate an existing tendency toward androgenetic alopecia by gradually shrinking susceptible hair follicles.
In other words, TRT doesn’t create the genetic tendency but it may make it become noticeable sooner in men who already have it. If hair changes become a concern during testosterone therapy, let us know. There are often treatment options that can help, and stopping TRT isn’t always the answer.
Hair restoration is rarely about a single medication.
Depending on your history, symptoms, and goals, treatment may include one or more of the following.
Topical minoxidil
Topical 5% minoxidil remains one of the most effective first-line treatments for both men and women. Increased shedding during the first 6 to 8 weeks is common and often represents older hairs making way for new growth.
Low-dose oral minoxidil
For carefully selected patients, low-dose oral minoxidil may be an option. Because it can affect blood pressure and fluid retention, it requires appropriate medical supervision.
Finasteride
An effective treatment for many men with androgenetic alopecia. It reduces the conversion of testosterone to DHT, helping slow follicle miniaturization. We discuss risks and benefits carefully with each patient.
Spironolactone
For many women, particularly postmenopausal women or those with androgen-related thinning, spironolactone may be an effective option. It reduces androgen activity at the hair follicle.
Ketoconazole shampoo
Ketoconazole 2% shampoo is often used as an adjunct to other treatments. It supports scalp health, may help reduce inflammation, and has mild anti-androgen properties.
Consistency is one of the biggest predictors of success.
6–8 wks
Initial shedding with minoxidil is common and usually temporary.
3–6 mo
Before most medical therapies show noticeable improvement.
12+ mo
Maximum benefit often takes a year or longer.
You may benefit from a discussion if you've noticed:
- Increased hair shedding
- Gradual thinning
- Hair changes after menopause
- Hair thinning while on testosterone therapy
- Hair loss following illness, stress, or significant weight loss
- A family history of hereditary hair loss
Not every patient needs treatment, and not every treatment is appropriate for every patient. We’ll help you understand the options that make sense for your particular situation.
Frequently asked questions
Does testosterone cause hair loss?
Not directly. Testosterone itself doesn’t usually cause hair loss. However, in genetically susceptible individuals, increased conversion to DHT may accelerate an existing tendency toward male pattern hair loss.
Is shedding normal when starting minoxidil?
Yes. Many patients notice increased shedding during the first six to eight weeks. While it can be concerning, this is often a normal part of the treatment process before new growth begins.
How long does it take to see results?
Hair restoration is gradual. Most patients begin noticing improvement after three to six months, with continued progress over the following year.
Can women use these treatments?
Yes. Treatment depends on the cause of the hair loss and the individual patient. Options differ between men and women, and your provider will discuss what may be appropriate for you.
Will my hair grow back completely?
Every case is different. Results depend on the underlying cause, how long the hair loss has been present, and how early treatment begins. The earlier treatment is started, the greater the opportunity to preserve existing hair.
Concerned about hair thinning?
Hair loss is common, and it’s not always caused by the same thing. If you’ve noticed increased shedding, gradual thinning, or hair changes after menopause, testosterone therapy, significant stress, or weight loss, let us know. We’ll help determine whether medical treatment may be appropriate.