Thinning hair or hair loss can be a very stressful experience. As your hair loss becomes more noticeable, you may lose confidence in your appearance. Fortunately, Dr. Erin Adams and Stacy Romero, PA-C at Midlothian Dermatology in Midlothian, Virginia have several treatments, medications and hair products to help you. In fact, Dr. Adams trained under a hair loss expert, Dr. Leonard Sperling.

Causes of Hair Loss

Hair loss, also called alopecia, is a common occurrence that happens to all of us at some point in our lives. If you comb, wash, or dry your hair and some strands fall out, that's your hair's natural shedding process. On average, we shed up to 300 strands of hair per day. With healthy growth, we barely notice these since the hair is growing at its expected rate.

However, if your hair is not growing as it should, you will notice thinning hair or a receding hairline. Some people lose larger clumps of hair. If this is consistently happening and making you conscious of your hair loss, you may have an underlying reason such as genetics, hormonal changes including menopause, stress, medical conditions, or certain medications.

According to an American Hair Loss Association research study, about one-half of men over the age of 50, 40% of women beyond age 40 and 25% of women in their 20s are suffering from hair thinning/hair loss.

Common Types of Hair Loss

Androgenetic Alopecia

This is the most common type of gradual hair loss, which is genetically linked. You may hear the terms male-pattern baldness or female-pattern hair loss. In women, this condition can be accelerated by hormonal changes during menopause when estrogen levels decline and androgen effects become more prominent.

Telogen Effluvium

Telogen effluvium is a common cause of temporary hair loss due to the excessive shedding of resting or telogen hair after some shock to the system. Telogen effluvium is commonly due to factors like stress, pregnancy, surgery, and significant illness and vitamin deficiencies. New hair typically continues to grow. Telogen effluvium can take up to two years to recover and can become chronic in nature.

Anagen Effluvium

This type of hair shedding is due to interruption of active or anagen hair growth by drugs, nutritional deficiencies, toxins, inflammation or physical/psychological stress.

Scarring Alopecia

Inflammation or underlying health conditions destroy the hair follicles. This term covers a range of conditions, including central centrifugal cicatricial alopecia (CCCA) which is mostly seen in black women; however, it can also include frontal fibrosing alopecia (FFA) or lichen planopilaris (LPP) which often affects whites and often postmenopausal women.

Alopecia Areata

The immune system attacks the hair follicles, resulting in significant hair loss or baldness, often characterized by bald patches or spots. In some cases, the condition can affect eyebrows and body hair.  This condition can be associated with underlying thyroid disorders.

Hair Loss Treatment Options

Medical Therapy

Prescription oral and topical medications can be of significant benefit to combat hair loss. The risks and benefits of each medication will be thoroughly reviewed at your appointment. Dr. Adams and Stacy may prescribe various medications depending on your specific type of hair loss and medical history.

Common prescription, mostly off-label, medications for hair loss include:

• Spironolactone - An anti-androgen medication that can be particularly effective for women with androgenetic alopecia by blocking the effects of hormones that contribute to hair loss

• Corticosteroids - Anti-inflammatory medications that can be used to treat autoimmune-related hair loss conditions such as alopecia areata

• Finasteride/ Dutasteride - Oral medications that block the conversion of testosterone to DHT, helping to prevent further hair loss in men and postmenopausal women

• Minoxidil – An oral medication FDA approved for high blood pressure but used often now for its side effect of hair growth

• Topical treatments - Various compounded formulations that may include minoxidil combined with other active ingredients for enhanced effectiveness

• Janus kinase inhibitors – a newer class of drugs FDA approved for cases of substantial autoimmune hair loss or significant alopecia areata

In-Office Treatments

Midlothian Dermatology offers an in-office treatment to help stimulate hair growth and help maintain the hair you have:

Plexr Plasma with Exosomes Treatment

Plasma Pen with Exosomes treatment combines advanced plasma technology with regenerative science to support hair health. Using the Plexr Plasma Pen, we create precise micro-channels on the surface of the scalp. These channels act as pathways, allowing exosomes—tiny extracellular vesicles naturally involved in cell communication and repair—to penetrate beyond the skin's outer barrier. Because the channels are so fine, the procedure is generally very well tolerated with minimal discomfort. Immediately afterward, the scalp may appear slightly damp from the exosome application, but this absorbs quickly and leaves no residue.  Patients should expect to apply the exosome serum again at home after the treatment and avoid washing their hair until the next day.

Exosomes contain a rich concentration of growth factors, proteins, and signaling molecules that play a key role in tissue regeneration. When delivered into the scalp through the plasma-created micro-channels, these exosomes can stimulate cellular activity, improve follicular health, and support new hair growth. Over the weeks and months that follow, patients often notice improvements in the thickness, density, and overall quality of their hair.

How Does the Plexr Treatment Work?

The Plexr plasma device is “cat scratched” in a grid patter across the thin haired areas of the scalp creating microchannels that allow for better absorption and action of topical products.

Who Should Not Get Plexr Treatment?

Plexr plasma therapy is not for patients with autoimmune disease, sepsis, some acute and chronic diseases, pregnancy, breastfeeding, chronic liver disease, and anticoagulant therapy.

How Should I Prepare for Plexr Treatment?

• Shampoo and condition your hair before the procedure. This way, the scalp is clean and free from grease and dirt particles. It provides a sterile environment on your scalp before the injections.

• Do not take aspirin or aspirin-related medications such as nonsteroidal anti-inflammatory drugs, such as Aleve® or Advil®, for one week before your therapy. You should discuss any changes to your medications with your physician.

You should not have Plexr therapy if you have:

• Active systemic or local infection

• Active cancer or significant actinic damage of the scalp

How Long Does Plexr Treatment Take?

Patients are usually in the office for about 30 minutes.

Does Plexr Treatment Hurt?

The frontal portion of the scalp can be a little sensitive, but distraction techniques like vibration and squeeze balls help patients manage any mild discomfort. Otherwise, patients report that it is a very tolerable procedure.

What Is Recovery Like for Plexr Treatment?

Patients undergoing Plexr treatments for hair loss may experience the following side effects:

• Mild stinging at the treatment site

• Itching

• Few small scabs

What Should I Keep in Mind After Plexr Treatment?

• Your hair will appear wet, and a second application of topical product is needed 1-2h after treatment while at home.

• Avoid washing your hair until the next day.

• Do not color your hair or get a perm for at least 72 hours after Plexr treatment.

When Will I See Results of Plexr treatment for Hair Loss?

Although you may start to see some results sooner, it typically takes three to six months from your initial treatment to see measurable results.

How Many Plexr Treatments Are Required?

For hair growth, we recommend 3-4 monthly treatments followed by maintenance treatments every 6-12 months. This can vary from person to person, and oftentimes, a customized treatment plan is created. There may be some other topicals or supplements recommended for the best results to support healthy hair growth.

Plexr plasma treatment with exosomes is great for women and men who want to use a noninvasive method to rejuvenate their hair and prompt natural hair growth.

In addition, if a patient does not want exosomes delivered to the scalp, Plexr plasma technology could enhance the application and absorption of other active topicals such as compounded products or peptides.  Please ask about these at your consultation if you’d rather a different topical used in your treatment protocol.

Another option available in the community (though we do offer the addition of PRP to our facial treatments at Midlothian Dermatology, Midlothian, VA):

PRP for Hair Loss Midlothian VA

There are many different types of hair loss. Data primarily supports the use of PRP to treat androgenetic hair loss in men and women. Results have also been seen when used for scarring hair loss and telogen effluvium. Traditionally, there have only been oral and topical treatments available for hair loss. In the last several years, minimally invasive procedures have also become available for hair loss, including PRP.

PRP helps with hair loss by the following mechanisms:

• increasing blood supply to the follicle

• increasing hair shaft thickness

• triggering and maintaining the growth phase of the hair cycle

• assisting with control of the growth cycle

• decreasing hair loss

How Does PRP Treatment Work?

Obtaining Platelet-Rich Plasma (PRP) begins with a simple blood draw. Your blood is then spun in a centrifuge, which works to separate out the platelet-rich portion. This portion is then isolated for use. This entire process is performed in our office just prior to your treatment.

Is PRP Treatment Safe?

Since the PRP solution is isolated from the patient's own blood, it is considered very safe without risk of an allergic reaction.

Who Should Not Get PRP Treatment?

PRP therapy is not for patients with platelet dysfunction, critical thrombocytopenia, hemodynamic instability, autoimmune disease, sepsis, acute and chronic diseases, pregnancy, chronic liver disease, and anticoagulant therapy.

How Should I Prepare for PRP Treatment?

• Shampoo and condition your hair before the procedure. This way, it is clean and free from grease and dirt particles. It provides a sterile environment on your scalp before the injections.

• Eat a healthy breakfast and drink at least 16 ounces of water. This way, you will not likely experience dizziness, fainting, or nausea.

• Do not take aspirin or aspirin-related medications such as nonsteroidal anti-inflammatory drugs, such as Aleve® or Advil®, for one week before your therapy. You should discuss any changes to your medications with your physician.

• Don't smoke or drink heavily beforehand, if at all.

You should not have PRP therapy if you have:

• Abnormal platelet function

• Active systemic infection

• Active cancer

• Low-platelet count

• Severe anemia

How Long Does PRP Treatment Take?

Patients are usually in the office for about an hour. It takes about 30 minutes to draw blood and process the platelets, and it takes the practitioner about 10-30 minutes to complete the procedure.

Does PRP Treatment Hurt?

The blood draw is a quick, painless procedure. In general, PRP injections are not painful. This may vary by the patient or by the area of the body in which the injection is being made.

What Is Recovery Like for PRP Treatment?

Patients undergoing PRP treatments for hair loss may experience the following side effects:

• mild pain at the injection site

• scalp tenderness

• swelling

• a headache

• itching

• temporary bleeding at the injection site

• bruising

What Should I Keep in Mind After PRP Treatment?

• Resume your normal activities but avoid strenuous activity for 1-2 days

• Wash your hair on your normal schedule unless the site of the injections is especially irritated or painful

• Do not color your hair or get a perm for at least 72 hours after the PRP injections. The harsh chemicals will irritate the site of the injections and possibly cause complications

When Will I See Results of PRP for Hair Loss?

Although you may start to see some results sooner, it typically takes three to six months from your initial treatment to see measurable results.

How Many PRP Treatments Are Required?

For hair growth, we recommend 3-4 monthly treatments followed by maintenance treatments every 6-12 months. This can vary from person to person and oftentimes, a customized treatment plan is created. For facial PRP treatments, we suggest 2-3 treatments about every 4 – 6 weeks.

PRP treatment is great for women and men who want to use a natural method to rejuvenate their skin and prompt natural hair growth.

Oral Supplements for Hair Loss

Dr. Adams strongly believes in the benefit of the oral supplement, Xtressé, for hair loss. Xtressé is powered by a proprietary X3-BioActive Blend born from regenerative medicine and formulated by the nation’s leading hair restoration dermatologists to support hair follicle health on a cellular level.  Featuring plant-based extracts and nutraceuticals, it is clinically proven to repair and nourish hair follicle health on a cellular level. It is free from biotin which actually has no scientific evidence to support hair growth. It is sugar-free, gluten-free and vegan and tastes great!  Dr. Adams had her thyroid removed in March 2025 after a bout of micro thyroid cancer, and through taking it every day, she has not experienced any shedding despite surgery with general anesthesia and now having to replace her thyroid hormone!

Other Ways to Help Your Hair

Minoxidil

Minoxidil (also known as Rogaine) can slow hair loss and stimulate hair growth. It's available in topical formulations and may be compounded with other topical hair growth agents like spironolactone, metformin, tretinoin or finasteride.  It takes 6-9 months of regular use to see real results.  Indefinite application is needed for maintenance.

Finasteride

Finasteride (Propecia) is a prescription oral medication that helps improve hair growth but must be taken indefinitely to see results. One must weigh the risks and benefits of this oral medication as there have been reports of decreased libido and mental health changes, such as increased depression and suicidal thoughts, with this medication.

Lifestyle changes

Lifestyle changes can help with your hair's overall health. This includes assessing your diet, water intake, and vitamins. Deficiencies of iron and zinc can contribute to hair loss, so supplements may be recommended under Dr. Adams' or Stacy’s guidance.

Get enough protein. 

Aim for 80-100gm per day. You need the building blocks for strong hair. Premade protein shakes such as Fairlife (whey based) and Owyn (plant based) taste pretty good.

Minimize trauma to hair.

This includes minimizing heat, chemicals and tight hairstyles.

Low level laser therapy

Many of these are FDA cleared meaning they demonstrate some positive effect on hair.  Each have their own regimen and protocol.  Patients must analyze whether they can comply with the protocol for best results. Some popular brands incluce Hairmax (discount code LASER345), Capillus, Theradome, Revian, iRestore, brands from Costco).

Camouflage

Hair fibers such as those from Toppik are available to give the appearance of thicker hairs.  Patients should purchase the color that matches their hair and apply to their scalp.  It masks the contrast between their hair color and scalp color to give the appearance of full hair.

Schedule an Appointment for Hair Loss Treatment in Midlothian, VA

If you have concerns about hair loss or the health of your hair, we recommend you schedule a dedicated appointment with Dr. Erin Adams, our board-certified dermatologist, or Stacy Romero, PA-C by calling us at (804) 378-3048. Through a dedicated appointment, we perform a thorough history and examination to help determine the cause of your hair loss. Sometimes, a history and clinical evaluation is all that is needed to determine the cause. However, a scalp biopsy may also be indicated. This is a simple in-office procedure utilizing local anesthetic only. Lab tests/bloodwork may also be recommended. Once the cause of hair loss is elucidated, an appropriate treatment protocol can be designed especially for you.