SPEAKER_00: 0:01

Welcome to the Healthy Matters Podcast with Dr. David Hilden, primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health, health care, and what matters to you. And now here's our host, Dr. David Hilden.

SPEAKER_03: 0:18

Hey everybody, and welcome to episode four of the Healthy Matters Podcast. I'm your host, David Hilden. Today we're going to be talking about hair loss. Have you ever noticed that your shower drain is starting to look like it needs its own hairbrush? If so, you are not alone. Hair loss happens to millions of people, men and women, and it's one of the most common reasons people see a dermatologist. Today, we're getting to the root, and that pun was fully intended, of why hair loss happens, what's normal, what's not, and what you can actually do about it. So joining me today is Dr. Audrey Jacobson. She is the chair of dermatology here at Heneman Healthcare in Minneapolis, and she is someone who helps patients understand, prevent, and treat hair loss all the time. Audrey, thanks for being here and welcome to the show.

SPEAKER_01: 1:02

Thank you for having me. I'm excited to talk about hair loss.

SPEAKER_03: 1:04

Okay, start with the basics then about hair loss. We all know what it is, your hair falls out, but what is it from a medical perspective? What is actually happening?

SPEAKER_01: 1:12

Yeah, so really what's happening is that your hair is coming out from the root, right? And there's different causes for that. So it's really important to know, you know, what is really, like you said, the root cause of your hair loss. So either there's some damage going on underneath the scalp, or your hair is just transitioning to a phase where it naturally wants to fall out.

SPEAKER_03: 1:32

So let's talk about that second half first. So some people lose a ton of hair and some people don't lose much at all. Is that just in the normal population that you lose your hair? Is that supposed to happen?

SPEAKER_01: 1:45

Yeah. So I mean, I think that that actually gets to the two most common causes of hair loss that I see in clinical practice. So that's gonna be your hormone or age-related hair loss. Sometimes that's called male or female pattern baldness. I don't like to call it baldness because you you might not go bald from that, and that tends to scare patients.

SPEAKER_03: 2:02

Right, right. But people know what you're talking about. They do. The receding hairline and all that.

SPEAKER_01: 2:07

Exactly. And then there's that other type of hair loss, which is that sudden shedding of hair loss that people say have after like a very stressful event, and that's called telogen effluvium. Those are the two most common types of hair loss that I see.

SPEAKER_03: 2:19

So let's do the male or female pattern hair loss, because that's what I think a lot of people think of. There's a lot of, there's probably a lot of men out there that says, yeah, my hair started leak leaving when I was 30, and others are 85 years old and they're still got a full head of hair. But it's both men and women, right? Correct. Why does it happen?

SPEAKER_01: 2:36

So that is all related to, I would say, genetics and hormones, right? So I see men and women with this. Men, it's more common. You've got that classic receding hairline around the temples, and then that top of the scalp there. Women also get it too, but it happens to tend to be more in that top of the scalp, that crown. But what people don't understand is that it's really genetics, right? So when I see patients with this, I go, tell me about your family members. Did anyone else in your family have thinning hair or any males in your family kind of go bald at an early age? That's really important. And when we also talk about hormones related with this, I encourage patients, I say, it's not that your hormones are out of whack. There's nothing wrong with them. It's just that those hair follicles are more sensitive to the normal hormones in your body, and that is related to genetics. And that's why you might have that early hair thinning.

SPEAKER_03: 3:24

What's a hair follicle?

SPEAKER_01: 3:26

So, hair follicle is like the little tube that your hair grows out of from the scalp. And that hair follicle is really important for the health of that hair.

SPEAKER_03: 3:34

So, in this hormonal type of hair loss, is that follicle okay? It's just that the hairs are, I don't even know, they're leaving the follicle in their entirety.

SPEAKER_01: 3:43

This might get a little too nitty-gritty there. No, but I'm curious. We actually talk about miniaturization of hairs in androgenetic alopecia. Androgenetic is that genetic related and hormonal.

SPEAKER_03: 3:56

Miniaturization of hairs? Okay, you've got to tell me what that is.

SPEAKER_01: 4:00

So when I do a hair exam, I am looking at someone's scalp like with a microscope, right? I am like all up in their scalp, and I see hairs with a normal diameter, and then I also see hairs that look really skinny. And when I see a lot of hairs that look really skinny, I say, hey, there must be some hormone-related changes going on to these hair follicles that is resulting in these like thinner hairs, and that can also lead hair to look thinner.

SPEAKER_03: 4:23

Wow. I never even thought of that. And I did actually graduate from med school, Audrey. So I do have to say, I do have to say, when you decided what you want, what you wanted as specialty, here's what I want to do. I want to be a dermatologist so I can get all up in people's scalps. Is that what you were thinking?

SPEAKER_01: 4:39

I don't, I don't actually know if I knew that that was involved at the time, but here I am.

SPEAKER_03: 4:44

Yeah, I don't think a lot of people know that. Your specialist for hair loss, folks, is your dermatologist. I can do a few things as your primary care doctor, but I digress. Okay, so the hairs fall out in uh both men and women. How common is this?

SPEAKER_01: 4:59

It's really common. I I I don't have an exact percentage for you, but I sometimes quote like 50% for women, and maybe even more common for men. It's super common. It may be just your hair is slightly thinner, but you're not gonna go bald, right? Or it's it's to the point where men will go bald at an early age. It just really depends. There's a huge variety.

SPEAKER_03: 5:19

And there's a variety of when it starts too.

SPEAKER_01: 5:22

Exactly, yeah. So especially for men, they may start noticing it in their 20s, even you know, when they're a teenager, if they have a really strong family history of it. But for others, it might not be till their 30s, 40s, 50s, even.

SPEAKER_03: 5:33

Is it all genetic, or are there things we do in our lives that might make your hair loss worse?

SPEAKER_01: 5:39

I think for that androgenetic or that male pattern or female pattern, that is typically just genetics, kind of luck of the draw. That being said, I see mixed hair loss too, right? Where you might just have yeah, living a really stressful life, have a stressful event, surgery, COVID. That leads to some like sudden hair shedding, and then it might unmask this hormone-related hair loss that you might not have known you had. So there's definitely a mixed component, and we always want to treat both if we can.

SPEAKER_03: 6:07

That's super interesting. So you mentioned earlier a big word teluvium, something or other. That was that what you said can be more sudden. Could you say more about first of all, what was the word you used?

SPEAKER_01: 6:17

Telogen effluvium. Telogen effluvium.

SPEAKER_03: 6:19

Okay, listeners, get that into a cocktail party sentence. I dare you. Telogen effluvium. What is that?

SPEAKER_01: 6:25

So I'll break down that crazy Latin term for you, right? So telogen is that phase of hair that is gonna shed, right? A lot of your hair is already in that phase. Like you're gonna shed hair. Normal shedding is 50 to 100 hairs a day, right? So I see it's kind of like a lot, right?

SPEAKER_03: 6:42

It does seem kind of like a lot.

SPEAKER_01: 6:43

Yeah. Effluvium is kind of the sudden shedding, right? The most common classic example I give that is you had a baby, four months later, you're like, why is my hair falling out? Right? Or you had a surgery or you had COVID, a few months later, your hair just sheds. It will come back though. It just takes a long time.

SPEAKER_03: 7:01

So stressful things in your life can lead to an acceleration of hair loss.

SPEAKER_01: 7:05

Totally. Finals. I see it in college kids uh coming in, they're really stressed out. They just had finals, and then they're like, my hair shedding, right? So it can be an emotional stressor, a physical stressor, really anything.

SPEAKER_03: 7:16

So let's go to the other causes that might be under your scalp that are causing hair loss. What are they?

SPEAKER_01: 7:22

So that I think is a more niche area of hair loss, and one that you definitely want to be seeing a board-certified dermatologist for. So those are gonna be your autoimmune or inflammatory type of hair loss. And that's where that hair follicle we talked about, that little kind of uh cylinder or sheath that the hair grows out of in the scalp is somehow being damaged or attacked by your own body. I think alopecia areata is the best example of that.

SPEAKER_03: 7:50

Many people I think have heard of alopecia areata. And alopecia simply means hair loss, right? True.

SPEAKER_01: 7:55

Yes, alopecia just means hair loss.

SPEAKER_03: 7:57

So it's something being destroying your hair follicles. Do they come back?

SPEAKER_01: 8:00

Yeah, so alopecia areata is a really interesting one in that your hair can come back. So it's that hair follicle is kind of temporarily being attacked by your own body. And then if we treat it with the right medications to kind of calm down your immune system, say, hey, don't attack to your own hair. You don't need to attack your own hair, it's yours, right? Um, we can get that hair to grow back.

SPEAKER_03: 8:21

What other kinds are there?

SPEAKER_01: 8:22

Yeah, so there's these inflammatory types of hair loss, and those are actually, I would say, more serious medical conditions where there's actual damage happening to the hair follicle. And that can actually lead in what we call scarring alopecia or scarring hair loss, where the hair follicle gets so damaged that it gets scarred and you cannot grow hair out of that hair follicle again. So it can lead to more permanent hair loss or hair thinning. Those are the ones that we need to catch as early as possible.

SPEAKER_03: 8:49

So, on any of these, how does your daily stress or your nutrition or your other medical conditions affect hair loss?

SPEAKER_01: 8:57

So I think when I talk to patients about hair loss, I like to take a whole body approach, right? I might ask about mental health, depression, anxiety, other things that might be exacerbating their hair loss. We know that skin health, hair health is all linked, and I am a huge proponent of getting patients mental health care if they need. So we'll address that if we need to. You did talk about nutrition. There are a few labs that I might check on a patient if I'm worried about any type of hair loss because I just want to promote a healthy environment for hair growth. It may not be the main cause of their hair loss, but we might check things like iron, your thyroid, maybe your zinc, maybe your vitamin D, just to make sure we've really optimized a good environment for hair growth.

SPEAKER_03: 9:41

What about medications people take or supplements or chemotherapy? Oh, I suppose chemotherapy causes hair loss. Let's put that aside for a second. What about other medications? Do you see much effect on the normal, usual stuff people are taking?

SPEAKER_01: 9:54

Not the normal, usual stuff, I would say. Um, I will say I have a lot of patients come in with biotin. They're taking biotin. It's, you know, supposedly magic for, you know, hair, skin, and nails, right? That's not actually the case. We don't actually think biotin works that well, and it can actually mess up some lab values. So say a patient's on biotin, they come to see you to get their thyroid checked. It can actually mess up those thyroid values, or they might go to the emergency room for some chest pain. It can actually mess up those values we might check in the emergency department, like your troponin for heart health. So we actually encourage patients not to take biotin.

SPEAKER_03: 10:29

Oh, that's a good tip. So there's probably nothing you need to be doing other than getting a good diet, a balanced diet. I'm gonna say don't smoke because you're never supposed to smoke, folks, if you haven't figured that one out yet. Um, uh, you don't need to take extra supplements, things like that. And if you are experiencing some hair loss, you know, go see a specialist. Which brings me to this question: what patterns might people notice in their own head that would cause them to come see you?

SPEAKER_01: 10:55

I mean, I definitely want to see a patient if they're experiencing a sudden loss of hair, sudden bald spots on their hair, or if they're experiencing any scalp pain, burning, itching, those are signs that, you know, I want to see you as soon as possible. Um, if you've noticed that gradual hair thinning over time, oh, for sure I still want to see you, but it may not be as urgent as some of these other types of hair loss where we're gonna need to start some pretty intense treatments right away to prevent more loss.

SPEAKER_03: 11:23

So before you go see your dermatologist and that more gradual stuff, go buy a lint trap for your shower.

SPEAKER_00: 11:27

Maybe that's what you need to do.

SPEAKER_03: 11:30

I'm gonna go back to chemotherapy. Just um this, we're not gonna get in a lot of detail about cancer treatments in chemotherapy, but why does it cause hair loss? Or some of the chemotherapies cause such substantial hair loss.

SPEAKER_01: 11:40

Yeah. So remember how we talked about that hair follicle. So that's kind of that cylinder, that sheath that the hair grows out of. Chemotherapy targets that hair follicle because it has really rapidly dividing cells. If you think about cancer, cancer cells are rapidly dividing, they're growing. Hair follicles do the same thing. So chemotherapy doesn't know, right? And so it just attacks those hair follicles as well. And that can cause that hair to fall out because it's no longer in that nice healthy environment for growth.

SPEAKER_03: 12:07

When it does come back, does it come back just like your previous hair? Because I've heard some people say it came back curlier or fuzzy or something.

SPEAKER_01: 12:14

So the hair follicle shape and orientation affects how your hair grows. So if that's been damaged by chemotherapy, your hair might grow back a little bit different when it comes back.

SPEAKER_03: 12:23

So we are talking about hair loss with dermatologist Dr. Audrey Jacobson. She is the chair of dermatology at Hennepin Healthcare here in downtown Minneapolis. We're gonna take a short break, and when we come back, we're gonna discuss the diagnosis of hair loss, available treatment options, and we'll find out if there are ways to prevent or reverse it. So stick around, we'll be right back.

SPEAKER_02: 12:43

When Hennepin Healthcare says, we're here for life, they mean here for you, your life, and all that it brings. Hennepin Healthcare has a hospital, HCMC, a network of clinics in the metro area, and an integrative health clinic in downtown Minneapolis. They provide all of the primary and specialty care you'd expect to find, as well as services like acupuncture and chiropractic care. Learn more at hennepinhealthcare.org. Hennepin Healthcare is here for you and here for life.

SPEAKER_03: 13:21

And we're back talking about hair loss with Dr. Audrey Jacobson. So I see people all the time in primary care with hair loss, and I gotta be really honest with you. I know precious little about hair loss. I really do. I don't know very much about it. So, folks, you can call your primary care doctor, but this is a specialty thing. Um, you might have your first visit with your primary doctor. If you don't know who to call, go see them. They can look at it and see if it's anything to be worried about. Um, but they'll probably do this as well. Make sure you see a dermatologist who does this. So they come see you. They're in your clinic. What do you do? Do you do tests? Do you look at it real close? What do you do?

SPEAKER_01: 13:57

Yeah. So, first of all, I'm gonna talk to my patient, right? We're gonna ask a whole history. I know we talk to our patients in dermatology too. Um, we're gonna ask a lot of questions about their family history, their personal history, stressors in their life, other medical conditions. And then we're also gonna do a really good hair and scalp exam, right? So I'm gonna get at my dermatoscope. That's kind of like my microscope.

SPEAKER_03: 14:17

So I'm gonna be looking at the Sherlock Holmes spyglass kind of thing.

SPEAKER_01: 14:21

I totally feel like Sherlock Holmes every day in clinic. Except you call it a dermatoscope. It's a dermatoscope, yep. And then after I look at the scalp, at that point I'm gonna have a good idea of what type of hair loss is going on. I'll oftentimes get some blood work. We talked about some of those kind of vitamins and minerals we might get. Rarely I'll do a biopsy if I'm not really sure, or it's I'm like, is this a scarring type of hair loss, or is this just regular hormone genetic, you know, that androgenetic hair loss? We might do a biopsy. I don't do biopsies as much on the scalp, but it's definitely something we can do.

SPEAKER_03: 14:55

Can you usually just kind of tell the scalp looks okay, everything's looking okay down underneath your hair?

SPEAKER_01: 15:02

Yeah, so there's a lot of clues, especially if I'm using my fancy dermatoscope, that can tell me how are the hair follicles doing? Is there inflammation? Is there no inflammation? You know, do we need a biopsy or not?

SPEAKER_03: 15:14

Because just underneath the hair is on your scalp is skin. So you can kind of get down there and look at it.

SPEAKER_01: 15:19

Yeah, but if we do need to do a biopsy, it's about a five-minute in-office procedure that we can do that same day.

SPEAKER_03: 15:25

Oh, that's good to know. Yeah, so it's not some massive thing where you're going to an operating room or anything like that. Would you just take a little piece of the skin?

SPEAKER_01: 15:32

Yeah, we numb up the skin with an injection of anesthesia, then we take just, I call it a tiny cookie cutter kind of cylinder of the scalp, and then we put in one or two stitches, and then we're done.

SPEAKER_03: 15:41

Oh, okay. So that's not a very big deal if you do need that, folks. Okay, so let's say they have the androgenetic, the hormone-related, the genetic-related hair loss. What treatment options are available?

SPEAKER_01: 15:52

Really good question. So I like to break those treatment options into two categories. So I talk about hair growth. We want to help grow the hair. And then for some patients, we want to say, hey, we kind of want to block that hormone that's causing that hair loss in the first place. And there's different medications, topically or oral, that we can combine to kind of treat both of those areas. So promoting hair growth and then also blocking that male hormone that causes the hair loss.

SPEAKER_03: 16:17

So start with the topicals. Do they work?

SPEAKER_01: 16:19

They do. So that's gonna be your topical monoxidil. A lot of people know it as rogaine, but minoxidil is the generic version, and studies do show that it is effective when used regularly.

SPEAKER_03: 16:29

So the what people have told me, especially women, oh boy, I'm gonna get this thing that grows hair. Um, it's gonna, I'm gonna, I'm gonna look like a hairy gorilla, uh, you know, when it's all done. I take it it's not like that.

SPEAKER_01: 16:41

Definitely not the topical version of minoxidel, because that's just gonna treat locally wherever you put it. The oral version of monoxidil, right, which you may know is a blood pressure medication, we use in low doses for hair growth. One of the most common side effects is hair growth. And women that could wean some extra chin hairs that they might have to pluck.

SPEAKER_03: 17:01

Okay, so that is a thing when you because it doesn't really know which hair follicles to go after. And if you have a hair follicle on your face, even women, yep, exactly. You could have some hairs growing where you didn't really want them.

SPEAKER_01: 17:14

Exactly.

SPEAKER_03: 17:15

Do you use systemic or oral monoxidyl on women though?

SPEAKER_01: 17:19

I do. I use systemic monoxidal really, it's so common now, actually, it's getting extremely popular. And it's it's nice for people who don't want to have to put kind of a greasy or messy solution in their hair every single day who prefer a pill.

SPEAKER_03: 17:32

So you take this thing every day. Does it make the hairs you have grow better or does it grow new ones? What does it do?

SPEAKER_01: 17:39

Um so ideally, it would make the hairs you grow grow a little bit more effectively or thicker, right? And then that can lead to, you know, a thicker overall head of hair.

SPEAKER_03: 17:49

Okay. What other treatments? I take it, those are the ones to make your hair grow better.

SPEAKER_01: 17:52

Yes.

SPEAKER_03: 17:53

What are the ones to block the hormones? What do you do?

SPEAKER_01: 17:56

So you're gonna know a lot of these medications from internal medicine, right? So we can use sphenasteride.

SPEAKER_03: 18:01

Which I use for prostates.

SPEAKER_01: 18:03

Exactly. So phenasteride I can use for men or women actually to block that male hormone that causes that hormone-related hair loss. Um, and then for women, I can use another pill called spironolactone as well that also helps block that male hormone. But both of those do come with some potential side effects that is makes it important to see, you know, your dermatologist to talk about those before you start.

SPEAKER_03: 18:26

Right, because they are altering your hormones in your body. They're blocking androgens, they're anti-androgenergic. Oh, that's a that's a mouthful. We're recording this on the morning. Yes. Um, yeah, so they block like testosterone and hormones that tend to make you lose your hair.

SPEAKER_01: 18:44

Exactly.

SPEAKER_03: 18:44

Is it common to do just one of those, the the monoxidil, or is it common to do just the hormone blockers, or is it usually both? What do you do?

SPEAKER_01: 18:52

You know, I talk with my patients about what they want to do. If they're a little nervous about pills and side effects, we might say, hey, let's just start with some topical monoxidil and see how that goes. If they're coming in really motivated and they're okay with some of the potential side effects of some of the pills, they say I want it all, we'll definitely do combined treatment.

SPEAKER_03: 19:08

It sounds like there's some decent treatments out there if you're having this type of hair loss. That's my take home from that, is that some things can there's there's some relief for you for you out there, listeners. Okay, what about procedures or lasers or implants or transplants or I don't know, all the stuff you hear about.

SPEAKER_01: 19:24

There's a lot out there. Um, a lot of these other procedures are not covered by insurance, unfortunately. So they get to be quite pricey. I think we're starting to get more and more studies that show in certain populations they might be effective. So things like platelet-rich plasma injections, right? Oh, or microneedling. There's people who specialize in those procedures. I don't specialize in those procedures, um, but I can get you to the right person who does do them if you have the extra dollars in your bank account to afford it.

SPEAKER_03: 19:54

Okay. So and is that hair transplants too? I never, frankly, I never understood this. I've been practicing 25 years. I never quite got the hair transplant thing that well, you take a hair follicle from somewhere else, or what do you do?

SPEAKER_01: 20:06

So there's certain hair follicles on your head that are more sensitive to those hormones. So what you do in a hair transplant is you take hair follicles from areas that are not sensitive to the hormones, and then you put them in the areas where you're having hair loss.

SPEAKER_03: 20:20

Well, I know. That sounds like a not something I do. That sounds like quite the procedure.

unknown: 20:25

Okay.

SPEAKER_01: 20:26

I will say none of those procedures are magic, right? They're gonna be an add-on treatment to whatever medical therapy that you're on. So I don't want patients to think, wow, I can't afford this treatment. I'm so sad I can't get it. It would make my hair so much better. Like, no, they're really just an add-on to kind of our big hitters, which are gonna be the monoxidyl or the finasteride.

SPEAKER_03: 20:46

Okay, that's actually good to know. You don't you don't have to go first to those things. Exactly. Okay. What about over-the-counter stuff? People, I bet are just inundated with things that claim to help hair growth, shampoos or pills, or supplements. Is there anything to those?

SPEAKER_01: 21:02

There's so much out there. Um, there's maybe a couple of supplements that have some small amount of data that show that they're effective, but those studies are also sponsored by the manufacturer. So I'm always skeptical of that. I really think it comes down to seeing a dermatologist, getting those high-value labs checked, like we talked about, determining the cause of hair loss before wasting a bunch of money on these over-the-counters.

SPEAKER_03: 21:28

Yeah, one thing it will do is it will uh it'll cause your wallet to be thinner. I don't know if it'll cause your hair to be thicker, but it those things will cause your wallet to be thinner.

SPEAKER_01: 21:36

Very expensive. There's one that's over$80 a month, right? That's a lot of money for something that may or may not help.

SPEAKER_03: 21:42

Yeah, exactly. So when you do these treatments, um, what kind of uh time frame are people talking about? And next week, do you suddenly have a big head of hair? Is it something you notice a month later, a year later, and do you do it forever? How does it work?

SPEAKER_01: 21:56

So I tell patients that this is really slow and really frustrating. I do a six-month follow-up as the first follow-up for the first one. And that depends on the type of hair loss. Six months is general for that, you know, female or male pattern baldness that we've been talking about. If it's something like an inflammatory or alopecia areata, we're gonna do a much sooner follow-up. But for that most common type of hair loss, I do six months because that is how long it's really gonna take for me to see if these treatments are working. And one other thing I counsel about is that monoxidil, when you first start using it, it can cause some hair shedding. So patients often come back and they'll say, This made it worse. I stopped it after a month. And I'm like, oh no, like what it's doing is we're getting rid of the hairs that are gonna shed anyways. We're making room for those new hairs that are gonna grow. So it can be frustrating, especially at the start.

SPEAKER_03: 22:43

Patience in this one sounds like you really it is uh probably frustratingly long for people. Okay, before I let you go, Audrey, let's play a little game here on the last segment of the podcast. You up for it?

SPEAKER_02: 22:54

Mm-hmm.

SPEAKER_03: 22:55

Okay, we're gonna call it what's my hairline. I'm kidding, you I'm kidding you. It's simple. I'm gonna read you a few statements. You tell us if it's fact or fiction and maybe shed some light behind it. Sound good?

SPEAKER_01: 23:07

Sounds good.

SPEAKER_03: 23:07

Okay, first one wearing hats causes hair loss. True or not?

SPEAKER_01: 23:12

I'm gonna go with not true.

SPEAKER_03: 23:13

Yeah, I you know, so a lot of people say this. I've never even really heard this myself, but I mean, baseball hats or your basic cowboy hat that I wear every day. Um, that doesn't do it.

SPEAKER_01: 23:23

I'm gonna say no.

SPEAKER_03: 23:25

All right, that's a myth. That's a myth. Okay, number two, frequent washing and brushing your hair makes it worse.

SPEAKER_01: 23:31

I'm gonna say also not true to that one. The hair that's gonna fall out is gonna fall out. So what you're seeing when you wash or brush your hair is not necessarily making it worse.

SPEAKER_03: 23:40

Okay, so you're just noticing it because it's in the shower drain, that kind of thing. Okay, number three, celebrities have some hair loss secrets that the rest of us don't know about.

SPEAKER_01: 23:49

I wish that was true. They're probably just doing all the same things we're doing, but not uh not talking about it.

SPEAKER_03: 23:55

Or maybe they have a really good wig and you just don't know it.

SPEAKER_01: 23:58

I think that they have some really good hairstylists.

SPEAKER_03: 24:00

Yeah, I think that's probably what they have. That's probably what they have. Okay, lastly, in case people missed this earlier, hair loss is only a men's issue.

SPEAKER_01: 24:07

Definitely false. Men and women both experience hair loss. I would actually say I see more women with hair loss in my clinic than men.

SPEAKER_03: 24:14

I wonder why that is. Is that just because men kind of expect it?

SPEAKER_01: 24:16

Probably. I think there's also a lot of social expectations around hair for women as well. And it's uh it's a huge part of identity for a lot of women.

SPEAKER_03: 24:24

Okay. All right. Well, thanks. I liked that little lightning round game. That was fun. Now let's get back to one or two more questions before I let you go. You know, so it can be, you just kind of touched on it, it can be emotionally draining for people. Maybe, maybe people identify as women more than men. Um, but for everybody about losing your hair, how can we help people cope with that confidence or that emotional side of hair loss?

SPEAKER_01: 24:46

Yeah, for sure. I mean, I think seeing your dermatologist so you can start treatments and have that support is really important. For different types of hair loss, there's even support groups out there. So there's a support group for patients with alopecia area. There's a support group for patients with scarring alopecia. So all those nationwide support groups are out there for patients. So we try to hook patients into those if we feel like it would be helpful.

SPEAKER_03: 25:08

That's really helpful. You are not alone. It is very common, is it not? It's really common. Yes. So, okay, Dr. Jacobson, before I let you go, is there anything you'd like to leave our audience about the subject of hair loss?

SPEAKER_01: 25:19

Gosh, I mean, I think you just said it in that you're not alone. There's treatments available, and there are dermatologists more than willing and excited to help you with your hair loss.

SPEAKER_03: 25:28

Yeah, really good tip. Um, listeners, if you are noticing changes in your hair, talk to your dermatologist, your board-certified dermatologist. They are your experts when it comes to your skin, hair, and nails. Thanks for being here, Dr. Jacobson.

SPEAKER_01: 25:40

Thank you so much for having me. This was a lot of fun.

SPEAKER_03: 25:42

It has been a lot of fun and informative. Listeners, I hope you agree with that. If you want to find more episodes of the Healthy Matters Podcast, go to healthymatters.org or wherever you get your podcast. Thank you for listening to this episode, and we will be back in two weeks' time with another episode. And in the meantime, be healthy and be well.

SPEAKER_00: 26:02

Thanks for listening to the Healthy Matters Podcast with Dr. David Hilden. To find out more about the Healthy Matters Podcast or browse the archive, visit healthymatters.org. Got a question or a comment for the show? Email us at healthymatters at hmed.org. Or call 612-873-TALK. There's also a link in the show notes. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota, and engineered and produced by John Lucas at Highball. Executive producers are Jonathan Comito and Christine Hill. Please remember we can only give general medical advice during this program. And every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.