What Works – And Doesn’t – For Hair Loss?

Summary

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Short Wave: "What Works – And Doesn’t – For Hair Loss?"

Date: October 27, 2025
Host: Sydney Lupkin (NPR Pharmaceuticals Correspondent)
Featured Guests: Dr. Carolyn Goh (UCLA dermatology), Allison Richards (patient), Thea Chassen (Bald Girls Do Lunch), Dr. Jessica Shepherd (hers telehealth)
Duration: ~13 minutes

Episode Overview

This engaging episode of Short Wave explores the science behind hair loss, what causes it, and which treatments are supported by evidence—and which are not. Host Sydney Lupkin guides listeners through the personal journeys of women who have experienced hair loss and consults leading experts to debunk myths, break down treatment options, and offer hope to those navigating hair loss of their own.

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Key Discussion Points & Insights

1. Personal Stories: The Emotional Toll of Hair Loss

• Allison Richards recounts a dramatic shift in her self-image as her hair began thinning and falling out, especially during COVID-19:
  • “There was one day in the shower where just I had hundreds of strands of hair, like fistfuls of hair coming out.” (00:57)
  • She describes the fear and devastation of this experience:
    • “It was a very scary experience.” (01:16)

Societal Misconceptions

• Hair loss is often seen as a “guy thing,” but statistically, half of all women experience it at some point.
  • “And if that’s you and your algorithm gets a whiff, good luck.” (01:22)

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2. The Biology of Hair Loss

• Dr. Carolyn Goh explains normal hair growth cycles—growth, transition, rest (telogen)—and why some hair loss is expected:
  • “It’s at the end of that telogen phase when your hair actually sheds...because there’s a new hair growing and pushing it out.” (04:33)
  • Events like stress, childbirth, or illness (e.g., COVID-19) can temporarily synchronize these cycles, causing noticeable shedding—but most hair will grow back:
    • “Mostly it’s time will tell...most of the time it’s fine.” (05:04)

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3. Types of Hair Loss & How to Identify Them

• Pattern Hair Loss (Androgenetic Alopecia):

  • Most common form—men see a receding hairline; women see a widening part—primarily hormonal in cause. (05:19)

• Other Types:

  • Alopecia Areata: Autoimmune; patchy hair loss.
  • Scarring Alopecias: Often have clear symptoms like smooth bald patches, itching, redness, pimples on scalp.
  • Dr. Goh cautions to look out for “smooth spots...with a lot of itching and tenderness and redness.” (05:52)

Memorable Moment

• Thea Chassen’s story: Diagnosed with alopecia areata after her hairdresser found a bald patch:
  • “Go see a dermatologist.” (06:39)
  • Despite successful treatment with steroids, her hair loss eventually progressed, and she now embraces baldness and advocates for women’s confidence.
  • “I go out bald when I want to, but it’s an option. And I’m all about putting women in the driver’s seat of their life with alopecia.” (07:06)

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4. Diagnosis Challenges & Why It Matters

• Diagnosis can be slow and frustrating:
  • Allison’s advice: “Call the doctor’s office regularly...I call them every single day and I will ask every day, ‘Did someone cancel?’” (08:14)
• Telehealth’s pros and cons:
  • Dr. Jessica Shepherd discusses online prescriptions for hormonal female pattern hair loss.
  • Thea Chassen argues telehealth isn’t enough for conditions with lookalikes: “You could have a fungal condition...and that’s treatable, but you don’t want to wait.” (09:49)

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5. Science-Backed Treatments: What’s Proven, What’s Not

• Topical Minoxidil (Rogaine):

  • The mainstay for decades, lengthens growth phase, keeps more hair on your head, but messy to use and not a cure-all.
  • “It does work, but a lot of people find it to be messy and difficult and it doesn’t work necessarily quite as well as people would like.” (10:32)

• Oral Minoxidil & Spironolactone:

  • Allison Richards uses both; they're not FDA-approved for hair loss in women, but help her. Her doctor monitors closely with regular check-ins and blood tests.
    • “My doctor...would literally go through a checklist...How are you feeling? Emotionally, physically, mentally?” (11:38)

• JAK Inhibitors:

  • Recent breakthrough for alopecia areata (autoimmune type) with evidence for regrowth — but not helpful for typical pattern loss. (10:03)

• Alternative Remedies:

  • Rosemary oil showed some effect in one randomized controlled trial; onion juice, cucumber, and other folk remedies lack scientific backing.
    • “If that [cucumber] worked, cucumbers would probably be $50 a pop for hair loss.” – Dr. Goh (03:54)

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6. Social Media: Double-Edged Sword

• Celebrities can set unrealistic standards (many wear wigs/extensions); however, there’s empowerment and community from hair loss influencers and online groups (like Reddit). (12:05)

• Allison’s reassurance:

  • “There’s always going to be somebody to hold your hand, cheer you on. And if you ever feel like your beauty is compromised, beauty gets redefined.” (12:36)

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Notable Quotes & Segments

• Hair growth and loss explained:
  • “It’s actually because there’s a new hair growing and pushing it out.” – Dr. Carolyn Goh (04:33)
• On unproven remedies:
  • “If that worked, cucumbers would probably be $50 a pop for hair loss.” – Dr. Carolyn Goh (03:54)
• Patient advocate voice:
  • “I’m all about putting women in the driver’s seat of their life with alopecia.” – Thea Chassen (07:06)
• On beauty and community:
  • “There’s always going to be somebody to hold your hand, cheer you on...beauty gets redefined.” – Allison Richards (12:36)

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Summary Timeline

| Timestamp | Segment/Topic | |-----------|--------------------------------------------------------| | 00:16 | Allison’s story: the emotional shock of hair loss | | 01:22 | Women & hair loss: prevalence and social impact | | 03:54 | Dr. Goh debunks hair loss fads and explains the science| | 04:33 | Hair growth cycles and why some loss is normal | | 05:19 | Types of hair loss and common symptoms | | 06:39 | Thea Chassen: life with alopecia areata, acceptance | | 08:14 | Diagnosis issues & tips for seeing a specialist | | 09:20 | Telehealth: fills a gap, but has limits | | 10:03 | New treatments: JAK inhibitors for alopecia areata | | 10:32 | Minoxidil & other options for pattern hair loss | | 12:05 | Social media: pitfalls & support | | 12:36 | Redefining beauty, the power of community |

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Tone & Style

• The discussion is empathetic, science-driven, and often laced with humor.
• Quotes reflect both the struggle and the empowerment found in confronting hair loss, emphasizing scientific literacy and emotional support over miracle cures or quick fixes.

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Transcript

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[Sydney Lupkin]

You're listening to Short Wave from NPR. Hey, Short Wavers. NPR pharmaceuticals correspondent Sydney Lupkin hosting today with a story that starts with Allison Richards, who remembers when she was a little girl, the thing some people noticed most about her was her hair.

[Allison Richards]

They're like, oh, your hair is so pretty, it's so long.

[Sydney Lupkin]

Alison had long straight blonde hair.

[Allison Richards]

That was the beauty feature that people commented on.

[Sydney Lupkin]

But when Alison was in her 20s, she noticed her hair was changing, getting thinner. Then during COVID when Allison was living in New York, maybe it was stress, maybe age. She wasn't sure something scary happened.

[Allison Richards]

There was one day in the shower were just I had hundreds of strands of hair like fistfuls of hair coming out.

[Sydney Lupkin]

Even though it's not life threatening, hair loss can be devastating. It can feel like part of your identity is slipping away.

[Allison Richards]

It was a very scary experience.

[Sydney Lupkin]

And generally people think of hair loss as a guy thing. But by some estimates, half of all women will experience hair loss in their lifetime. And if that's you and your algorithm gets a whiff, good luck. Lumps in the shower like clumps, it.

[Allison Richards]

Would come out and I lost half.

[Sydney Lupkin]

Of my seed oil and minoxidil. You'll decrease hair fall, reduce hormonal hair thinning. And with everything hair loss, hair growth, hair thinning, dandruff, frizz, dryness, literally everything on my page. And while there are some solutions out there based in science, that science is still evolving. So today on the show Hair Loss, what science can tell us about the causes and how to figure out what's best for you or someone you know. You're listening to Short Wave, the Science podcast from NPR.

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[Sydney Lupkin]

This message comes from Charles Schwab. When it comes to managing your wealth, Schwab gives you more choices like full service, wealth management and advice when you need it. You can also invest on your own and trade on thinkorswim. Visit schwab.com to learn more support for NPR and the following message come from Warby Parker, the one stop shop for all your vision needs. They offer expertly crafted prescription eyewear plus contacts, eye exams and more for everything you need to see. Visit your nearest Warby Parker store or head to warbyparker.com we're talking about hair loss and Dr. Carolyn Goh, a clinical professor of dermatology at UCLA Health, has kind of seen and heard it all. She says patients have come to her with all kinds of alleged, quote, you know, solutions they've seen on social media, from onion juice to rosemary oil. By the way, Carolyn says there is one randomized controlled study of a hundred people showing rosemary oil could work. There's also a lot of misinformation.

[Allison Richards]

Somebody asked me about cucumber today and I said, you know, I think if that worked, cucumbers would probably be $50 a pop for hair loss. You know, someone would figured, you know, a way to monetize it.

[Sydney Lupkin]

She's also had alopecia areata herself since she was three years old. So she knows what she's talking about on like every level, including when she says that to understand hair loss, it's important to understand hair growth. So here's the deal. Each hair on your head goes through cycles of growth, transition and rest. The rest phase is called telogen.

[Allison Richards]

So it's at the end of that. Telogen phase is when your hair actually sheds. And when the hair's shedding, it's actually because there's a new hair growing and pushing it out.

[Sydney Lupkin]

And usually each strand does this at different times so all of your hair isn't falling out and regrowing at the same time. Translation? Some hair loss is totally normal. Sometimes, however, stress, like having a baby or even Covid, can cause the hair cycles to sync up and that causes a bigger shed. But it's temporary.

[Allison Richards]

Mostly it's time will tell and that's really difficult to deal with. You know, you see all this hair coming out and it's this huge change and it seems like the world is ending, but in fact, most of the time it's fine.

[Sydney Lupkin]

That also means that some of the time when people try to remedy it and it seems to work, the temporary hair loss may just be resolving on its own. Maybe you wasted some money or time, but on the whole, good news. That said, sometimes hair loss doesn't resolve on its own. Most of the time it's pattern hair Loss or androgenetic alopecia, that's the receding hairline in men. For women, it actually starts with a widening part. Most of the time, it's hormonal. There are a bunch of other kinds of alopecia, though, and they have different.

[Allison Richards]

Symptoms like alopecia areata, or there's these scarring types of hair loss. For the most part, those become very obvious that there's something else going on. So, for example, scarring alopecia is often. They can also cause smooth spots. They also often happen with a lot of itching and tenderness and redness, sometimes pimples on the scalp. And so, again, it is not always obvious to people who are going through. They might not realize the extent of it, but usually there's some other signs.

[Sydney Lupkin]

For Thea Chassen, the founder and CEO of the nonprofit Bald Girls Do Lunch, she was in her 20s when a hairstylist first pointed out the round, completely bald patch.

[Allison Richards]

My hair was long, was in the back of my head. I had no idea it was there. And she said, oh, you have a patch, bald patch in the back of your head. You know, go see a dermatologist.

[Sydney Lupkin]

She did, and eventually got a diagnosis of alopecia areata and autoimmune disease. Her immune system was attacking the hair follicles, so it wasn't female pattern hair loss. She wound up getting some steroid injections, and it cleared up. A decade later, though, there was another bald patch, and now she's completely bald.

[Allison Richards]

And there's ways to live beautifully with this. We're not saying that everybody should reach this stage where they just are so comfortable going out bald. It's an option. It's just another option that should become as normal for women as it is for men. If we want to, and I do, I go out bald when I want to, but it's an option. And I'm all about putting women in the driver's seat of their life with alopecia.

[Sydney Lupkin]

In the last few years, there have been some breakthroughs. New prescription drugs that weren't available when she was going through this. When it comes to trying to treat hair loss, it's important to get a formal diagnosis because different kinds of hair loss respond to different treatments. What works for one kind might be useless for another and waste valuable time saving the hair you do have. But that diagnosis of alopecia areata or androgenetic alopecia or one of the others can be tricky to get. Sometimes primary care doctors are dismissive, and it can be hard to get an appointment with a Dermatologist.

[Allison Richards]

Now, in today's climate of American healthcare, sometimes it can be frustrating and difficult to get in to see your doctor. So I have a, I have a method. What I do and the fact that I did it this morning, as a matter of fact, call the doctor's office regularly. Sometimes I'll ask ahead of time. When do you do your calls to remind people of their appointment? So you have some idea of what time of day they're getting notified of cancellations? And I call them every single day and I will ask every day, did someone cancel?

[Sydney Lupkin]

It sounds pretty frustrating. That's where telehealth companies are stepping in. You can answer a few quick questions online and talk or message with a provider. Then you get a prescription for medication which is then mailed to your home. Dr. Jessica Shepherd, Chief medical officer of hers, says the company takes women's hair loss seriously. The company knows it's filling a gap elsewhere in the health care system.

[Allison Richards]

We are going to be there, you know, when you're scrolling your phone, you know, on commercials, that's really how we.

[Sydney Lupkin]

Are exposed or how we introduce ourselves to our community. But hers is mainly prescribing products including gummies for people with hormonal female pattern hair loss, androgenetic alopecia. So Thea Chassen says telehealth isn't always the answer. She says a telehealth visit alone wouldn't have gotten her doctor diagnose this. Right.

[Allison Richards]

They don't know because even with alopecia areata there are lookalike conditions that are completely different. For example, you could have a fungal condition and yeah, and that's treatable, but you don't want to wait.

[Sydney Lupkin]

New drugs to treat alopecia areata were approved in just the last few years. They're called JAK inhibitors. They target the part of the immune system that has become overactive and attacks the hair follicles. A recent review of several studies published in the medical journal JAMA Network Open found that patients had more hair regrowth compared with placebo. But something like that likely wouldn't work for someone with run of the mill pattern hair loss. Androgenetic alopecia. Here's Dr. Carolyn Goh at UCLA again.

[Allison Richards]

In the past we haven't had a whole lot of options. Topical minoxidil has been around for I think 30 years or so now and does work, but a lot of people find it to be messy and difficult and it doesn't work necessarily quite as well as people would like.

[Sydney Lupkin]

She's talking about what we would normally know as Rogaine, the foam you can buy at the drugstore. It works by lengthening that phase of the hair cycle before it rests and falls out. So you keep more of the hair on your head at any one time, but you're not supposed to use it if you're pregnant or nursing, for example. As for Allison Richards, who first noticed hair loss in the shower, she considers herself lucky. She was able to get to a dermatologist in person who took her seriously. She was diagnosed with androgenetic alopecia, which is pattern hair loss. Now Allison Richards takes oral minoxidil, the same compound in Rogaine topical foam, but in a pill, and spironolactone. Both are being prescribed off label, meaning they weren't approved by the Food and Drug Administration to treat hair loss. But they're working for her, and her doctor monitors her for side effects.

[Allison Richards]

So my doctor, in the beginning, it was not uncommon for her to spend 45 minutes or an hour with me. And she would literally like go through a checklist. Like, you know, and it was also, it was all like, we would go through. She'd be like, how, you know, how are you feeling? Like, emotionally, physically, mentally? Are you noticing you're going to the bathroom more? Do you have muscle cramps?

[Sydney Lupkin]

She also gets regular blood work done to monitor for things like kidney damage. For her, social media has been a mixed bag. On the one hand, she thinks celebrities have created an unrealistic expectation for how much hair women think they should have, when in reality they're wearing wigs or extensions. On the other hand, she's found that there are hair loss influencers who make her feel seen and platforms like Reddit where she can connect with other women who have alopecia. Allison Richards mostly wants other women like her to know they're not alone.

[Allison Richards]

There's always going to be somebody to hold your hand, cheer you on. And if you ever feel like your, your beauty is compromised, beauty gets redefined.

[Sydney Lupkin]

This episode was produced by Rachel Carlson and edited by Brent Baughman and Rebecca Ramirez. Tyler Jones checked the facts. Kwesi Lee was the audio engineer. Beth Donovan is our vice president of podcasting. Thanks for listening to Short Wave from npr.

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