hairloss-patient

Hair Loss Clinic

At Mass General Dermatology’s Hair Loss Clinic, our board-certified dermatologists are highly specialized in the diagnosis, management and treatment of hair loss that affects both adolescents and adults.

Call the hair loss clinic at 617-726-2914

Visit the H.A.I.R. Research Unit

H.A.I.R Clinical Trials

Overview

At Mass General Dermatology’s Hair Loss Clinic, our board-certified dermatologists are highly specialized in the diagnosis, management and treatment of hair loss that affects both adolescents and adults.   For most people, it is normal to shed 100-150 hairs a day; however, if you are noticing bald spots or excessive hair loss, it may be a sign of alopecia.

What is Alopecia?

 Alopecia is the medical term for hair loss. There are different types of hair loss including;

• patterned hair loss in men and women;
• situations that cause increased hair shedding;
• focal patches of hair loss due to immune conditions;
• and other conditions.

 Some types of hair loss are temporary and can regrow.  Other forms of hair loss are permanent and once the hair is gone, it cannot regrow.  Luckily, most causes of hair loss can be stopped (if diagnosed in time) or treated.

What Causes Hair Loss?

 There are many causes for hair loss, which is why it is important to work with a dermatologist skilled in diagnosing hair loss disorders to ensure you receive the correct advice and treatment.  More importantly, in some cases hair loss can be a sign of other internal health issues.  Below is a list of some possible causes:

 hairloss

•   Medical conditions like thyroid disease
•    Short or long term illness
•    Hereditary factors
•    Iron deficiency
•    Poor diet
•    Medications
•    Hormonal imbalance
•    Physical or emotional stress
•    Certain hairstyles/hair styling practices
•    Infections

Thousands of men, women, and children deal with hair loss.  Adult patients in particular often feel that they are being “too vain” in seeking the help of a dermatologist with a hair loss issue.  But hair is central to our identity, and hair loss is well known to cause negative effects on a person’s self-esteem and self-image.

Expert Care and Advanced Diagnostics

Depending on the type of hair loss a person has, here at Mass General, our alopecia specialists tailor the treatment plan to the individual.  We understand how devastating hair loss can be to a person, and it is our goal to provide patients with safe and effective hair loss treatments.

M.Senna Maryanne M. Senna, MD, co-director of the Hair Loss Clinic is a board-certified dermatologist who specializes in the diagnosis and treatment of hair loss. In addition to treating patients for hair loss: she is developing a specialized Alopecia Research Unit to identify new treatment methods.  Diagnosed herself with alopecia in the past, Dr. Senna has personal insight and empathy for her patients.                        


Mariko Yasuda

Mariko Yasuda, MD, co-director of the Hair Loss Clinic is a board certified dermatologist and dermatopathologist who specializes in the diagnosis and treatment of hair loss. In addition to her clinical skills, Dr. Yasuda has additional expertise in interpreting scalp biopsy specimens in patients who have alopecia.


We use advanced techniques for diagnosing hair loss from a scalp biopsy including using a specialized Headington technique (ie: transverse, horizontal sectioning of scalp biopsy specimens). Advanced diagnostics provide us with detailed information to help determine the best treatment for you. Additionally, we collaborate monthly with both dermatology clinical specialists and pathology specialists to review patient cases. These extra measures help ensure patients receive a complete evaluation; the best options for treatment; and the most successful outcomes.

Lynn A. Drake, MD  is a world-renown expert and lecturer on hair loss who provides additional consultation.

To Refer a Patient

For Mass General referring physicians, please refer through the EPIC system under Ambulatory Referral to MGH Dermatology --> Hair Loss Clinic.For referring physicians outside of Mass General, please call 617-726-2914 , Press 1 and ask for the Hair Loss Clinic coordinator.

Conditions We Treat

  • Alopecia Areata
  • Cicatricial (scarring) Alopecia
  • Lichen planopilaris
    hairloss-baldness;
  • Frontal fibrosing alopecia
  • Central centrifugal cicatricial alopecia
  • Lupus
  • Folliculitis decalvans
  • Female Pattern Hair Thinning
  • Hirsutism
  • Androgenic alopecia (male pattern hair thinning)
  • Chemotherapy related hair loss
  • Telogen Effluvium
  • Traction Alopecia
  • Trichotillosis
  • Scalp ringworm (tinea capitis)
  • Folliculitis
  • Congenital hair loss disorders
  • Hair breakage
 

PRP-Platelet Rich Plasma

Platelet Rich Plasma Therapy (PRP) for Hair Thinning

Platelet Rich Plasma therapy (PRP) is a restorative treatment that uses plasma from your own blood to stimulate re-growth of your hair. PRP therapy stimulates the body’s inactive hair follicles to re-grow healthier, thicker hair and aids in the body’s natural healing process. Performed in our office, PRP is a simple, non-surgical treatment that takes less than hour per treatment.

Who is a good candidate for PRP?

PRP has proven effective for common non-scarring forms of hair loss, which are also known as:

    • Female pattern hair thinning
    • Male pattern hair thinning

Who is NOT a good candidate for PRP?

PRP is unlikely to be effective for the following hair loss conditions:

  • Alopecia Areata (autoimmune form of non-scarring hair loss)
  • Scarring Hair Loss (lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia)
  • Telogen Effluvium (temporary over shedding of hair caused by several factors including stress, medications, significant weight   loss, major surgery, childbirth, anemia, and thyroid dysfunction).
  • Patients with a medical condition affecting the platelets, including patients with a very low platelet count (thrombocytopenia).
  • Patients who have had a bacterial infection of the blood within the past year.
  • Patients who have a current infection of the scalp.
  • Patients who are pregnant or breast feeding.
  • Patients with a history of blood or bone marrow cancer.

Is PRP safe for hair loss?

PRP has been used for its wound healing properties in several medical specialties for more than 20 years, and has been used since 2004 for hair loss treatments. The procedure is well tolerated by patients and overall very safe. More recently, studies have shown proven positive results for PRP as an effective treatment for female and male pattern hair loss.

What to Expect

You may be required to have a hair loss consultation before your first treatment.  If  you are determined to be a good candidate for PRP treatments, you will be scheduled for your first visit.

How many PRP treatments should I expect?

You will be scheduled for 3 appointments, one month apart.

Before Your PRP Treatment

  • You should not take ibuprofen or aspirin (other than baby aspirin) within 48 hours prior to your PRP treatment.
  • You should not have had a steroid injection into the scalp within 1 month of your treatment, or used oral steroids (like prednisone) within 2 weeks prior to your PRP treatment.
  • You should not have had a recent significant illness or fever within one month of your PRP treatment.

The Day of Treatment

The day of your treatment, you will be asked medical questions by our nursing staff and we will make sure you are comfortable. One of our board-certified doctors will explain the procedure, benefits, and side effects. The doctor will ask you to sign a consent form.

Afterwards, a nursing staff member will draw blood from your arm and hand the tube to the doctor. The blood will be put into a machine, called a centrifuge that separates the platelet rich plasma. This plasma will have about 5 times more platelets than your normal circulating blood.

Once the PRP is separated, our board-certified doctor will inject the platelet rich plasma to the scalp where the hair loss has begun. By placing the platelet rich plasma directly into the affected areas, it amplifies the body’s natural ability to grow thicker, more dense hair.

Most patients experience minimal discomfort and are able to drive or travel home after the treatment.

When will I see results?

Generally, it takes 3-6 months to notice initial hair re-growth. Individual results vary. Within 6 to 12 months, most people notice remarkable improvement.

Is PRP covered by medical insurance?

No. PRP is not covered by medical insurance; you will be expected to pay 50% of the cost prior to your first treatment.

What is the cost of PRP?

The cost of the procedure is $2,700 total for three monthly injections. The cost is pay-out of pocket and is not covered by insurance.

  • Prior to your first injection, you will be expected to pay 50% of the treatment cost.
  • The remaining 50% of the treatment cost is due PRIOR to the second injection.

Contact us at to find out if you are a good candidate for PRP.

Preparing for Your Visit

  • Prior to your first consultation with an alopecia specialist at MGH, you will be asked to complete a patient intake form (available on Patient Gateway) regarding the history of your hair loss.  It is very important that this form is completed thoughtfully and completely since this information is central to helping your dermatologist understand your hair loss condition.  This intake form should be mailed or emailed to you prior to your appointment.  If you do not receive this packet prior to your appointment please call us at : 617-726-2914.
  • Ensure that your hair is washed, dry, and free of product. 
  •  Wash your hair the NIGHT BEFORE your appointment; DO NOT wash your hair on the day of the appointment as this can affect some of the tests that are performed in the office.
  • Bring all reports that you have, if any, of blood work and/or scalp biopsy results done in the recent past.
  • Have a list of your current medications and approximate start dates (month and year suffice).
  • Have a list of the hair loss treatments you have tried and for how long.

During Your Visit


hairloss;

The dermatologist will review your completed intake form; any recent lab results (blood work), and/or biopsy results that you may have; a list of your recent medications; and any hair loss treatments that you have tried.  Additionally, the dermatologist will ask follow up questions during your visit.

The dermatologist will then examine your scalp and hair, and may perform tests including a hair pull test where a handful of hair is grasped and gently pulled to evaluate for over-shedding.  If needed, further blood work or a scalp biopsy might be recommended.

Photographs will be taken and uploaded directly into your medical record for comparison purposes. Baseline photographs are taken for your medical record.  These are an important part of the periodic evaluation process as they provide an objective way of measuring your progress.

Your dermatologist will review the diagnosis and cause for the hair loss condition with you and provide recommendations for the best-individualized treatment, and answer any questions you may have.

Based on the patient's history and overall condition, a personalized treatment plan is recommended based on:

hairloss;

 

1.    Manifestations of disease in hair or nails
2.    Results of skin biopsy and blood analysis
3.    The patient’s overall health and lifestyle

Patient Education

Expectations of Hair Loss Treatment

Q. How long will it take for me to see results?
A. Hair growth TAKES TIME First, it takes time to stimulate follicles to regrow hair. Then, once the hair starts to grow, it grows at a rate of about 1 centimeter a month. Changes to hair are gradual. It is like watching grass grow. Looking in the mirror every day patients often do not notice the slow, but consistent improvement. Be consistent about treatment for at least a year. You cannot expect any treatment to show improvement in a month or two. Being able to really tell if a treatment is making a noticeable difference takes time. Hair is very different this way than other conditions.

Q. If I am started on treatment for my hair loss, how long do I have to be on it?
A. Any treatment that you start for a hair loss condition often needs to be continued long term. Any hair that you have not shed and held onto as a result of treatment and any hair grown as a result of treatment will be lost if treatment is stopped. This is important when considering the best treatment regimen, and is why in some patients one or two treatments are recommended over diving in and doing every possible treatment all at once. If you start a number of treatments all at once, you won’t know if just one or two treatments might have helped just as much, and then you’re stuck doing all of them long term.

Q. There are a lot of products that promise to grow hair fast and reverse hair loss immediately, should I try these?
A. Many products do not have the scientific research to back up their claims. Before spending lots of money on a treatment that is not known to be effective, ask your dermatologist.

Q. Is it safe to color my hair?
A. TLC or tender loving care is something that all hair needs. Perming, coloring, heat styling can all damage hair and make it more difficult to obtain the results that you want. For more tips on how to care for your hair, please visit the American Academy of Dermatology’s tips for healthy hair.


Watch this video to learn about hair loss and what to expect

MGH Hair Loss Clinic- Dr. Maryanne Senna

Research Publications

Selected Publications

 1.   Tan S & Senna MM. Hair and Nail Manifestations of Systemic Disease. Curr Derm Rep (2017).
 2.  Xu L, Liu KX, Senna MM. A Practical Approach to the Diagnosis and Management of Hair Loss in Children & Adolescents , Front Med, 24 July 2017
 3.  Penzi LR, Manatis-Lornell AJ, Saavedra A, Fisher D, Senna MM. Hair repigmentation associated with use of Brentuximab. JAAD Case Reports 2017; 3: 563-5.
 4.  Manatis-Lornell AJ, Nikolskaia OV, Senna MM. Facial Papules in a Patient with Lichen Planopilaris. JAMA Dermatology. January 3, 2018. doi:10.1001/jamadermatol.2017.5291
 5.  Penzi LR, Manatis-Lornell AJ, Saavedra AS, Senna MM.  Long-standing Pili Torti in Two Patients with Chronic Graft Versus Host Disease. JAAD Case Reports 2018 Jan; 4(1): 44–46.
 6.  Azzawi S, Penzi LR, Senna MM. Immune Privilege Collapse and Alopecia Development: Is Stress a Factor?  Skin Appendage Disorders. 2017 December 20. doi: 10.1159/000485080
 7.  Rajabi F, Drake LA, Senna MM, Rezai N. Alopecia Areata: a review of disease pathogenesis. Br J Dermatol.  2018 May 23. doi: 10.1111/bjd.16808.
 8.  Naftulin JS, Penzi LR, Manatis-Lornell AJ, Yasuda MY, Porter ML, Saavedra A, Senna MM. Longstanding alopecia and nail dystrophy are associated with more severe overall chronic graft-versus-host disease in adults. Bone Marrow Transpl. 2018 Sept. doi: 10.1038/s41409-018-0309-z.
   
 

Research Presented at Professional Meetings

 1.  Penzi LR, Manatis-Lornell AJ, Senna MM. Retrospective review of stress as a trigger for hair loss in patients diagnosed with alopecia areata seen in a specialty alopecia clinic. The 10th World Congress for Hair Research. Kyoto, Japan, November 1-4, 2017 
 2.  Porter M, Penzi LR, Manatis-Lornell AJ, Senna MM. Retrospective review of triggers, demographics, and stress of patients diagnosed with telogen effluvium at a specialty alopecia clinic. Selected for oral presentation. The 10th World Congress for Hair Research. Kyoto, Japan, November 1-4, 2017.
3. Manatis-Lornell AJ, Porter M, Yasuda MR, Senna MM. Histopathological and Immunohistochemical Assessment of Patients with Lichen Planopilaris and Frontal Fibrosing Alopecia. The 10th World Congress for Hair Research. Kyoto, Japan, November 1-4, 2017.
4. Manatis-Lornell AJ, Porter M, Yasuda MR, Drake L, Senna MM.  The use of a target area in measuring disease activity in patients with lichen planopilaris. The 10th World Congress for Hair Research. Kyoto, Japan, November 1-4, 2017.
5.  Penzi LR, Porter M, Manatis-Lornell AJ, Senna MM. Hair disorders associated with autoimmune connective tissue diseases. Selected for oral presentation. The American Academy of Dermatology Annual Meeting, San Diego, CA. February 16, 2018.
6. Naftulin JS, Manatis-Lornell AJ, Penzi LR, Yasuda MR, Saavedra A, Senna MM. Categorization of long lasting hair changes in patients after hematopoietic stem cell transplant. Selected for oral presentation. The American Academy of Dermatology Annual Meeting, San Diego, CA. February 16, 2018.
7. Manatis-Lornell AJ, Penzi LR, Hagigeorges D, Yasuda MR, Senna MM. Patient Reported Stress Caused by Hair Loss Using A Numeric Rating Scale. The American Hair Research Society Summit Meeting, Orlando, FL. May 14-16, 2018.
8. Penzi LR, Manatis-Lornell AJ, Hagigeorges D, Yasuda MR, Senna MM. A Case Series of Spironolactone as An Effective Treatment for Female Pattern Hair Loss. The American Hair Research Society Summit Meeting, Orlando, FL. May 14-16, 2018
9.

Hagigeorges D, Penzi LR, Manatis-Lornell AJ, Yasuda MR, Senna MM. The Prevalence of Misdiagnosis of Scarring Alopecia from A Facebook Scarring Alopecia Support Group Member Survey. The American Hair Research Society Summit Meeting, Orlando, FL. May 14-16, 2018.



 

Contact

Contact Us

Dermatology Hair Loss Clinic

50 Staniford Street

Suite 80750 Staniford Street Boston, MA 02114
  • Near Public Transit
  • Accessible
  • Phone: 617-726-2914
  • Fax: 617-726-7768

Call the hair loss clinic at 617-726-2914

Visit the H.A.I.R. Research Unit

H.A.I.R Clinical Trials

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