PHILADELPHIA (WPVI) -- Many people keep their hair loss secret, even from loved ones.
The causes can be complex, and the hair re-growth market is filled with false promises.
A Philadelphia woman explains how she found help.
"No woman wants to be bald. Our hair is like, sacred to the woman," says Zugey Rodriguez of Kensington.
She had noticed a little hair loss three years ago.
By last summer, the pace really picked up.
"Then I started seeing bald spots," she recalls.
Her first doctor seemed more focused on an unrelated skin condition.
"By the time he treats my hair loss, I'm gonna be bald," she said of her frustration.
Zugey says Temple dermatologist Dr. Afton Metkowski was more driven to find a solution.
Dr. Metkowski says normally we lose about 100 hairs a day.
"When we start to become concerned about alopecia is when it's exceeding that amount," says the doctor.
Alopecia has many causes, such as medications, stress, anemia, thyroid or autoimmune conditions, and overdoing it with hairstyling.
Androgenetic alopecia is the thinning that occurs with hormone changes as we get older.
Hair follicles don't actually die.
"We tend to still see hair. It's just not the thick, grown-up hair that we're used to seeing. It's actually become finer," says Dr. Metkowski.
Treatment is aimed at flipping that switch back.
Over-the-counter Minoxidil, applied directly on the scalp, is usually the starting point.
"The earlier that you start to use the product, the more robust the response tends to be," she notes.
If those fail, oral medications, platelet-rich plasma, or even laser treatments may help.
Dr. Metkowski is skeptical of the heavily advertised nutritional supplements.
"The take-home is - what is in the vitamin should be going in your mouth in the form of food," she says,
Zugey realized prolonged stress had triggered her hair loss.
Dealing with that, and Minoxidil, are bringing her hair back.
"That was bald. All this was bald. All this right here was bald."
Dr. Metkowski says if the thinning bothers you, see a dermatologist specializing in hair loss. They are trained to explore all the potential causes and treatments.