Raleigh, N.C. — When a man starts going bald, it is not unusual, but women expect to keep their hair for life. It does not always work out that way. However, there are medical options for when a woman's hair starts falling out.

Mary Van Voorhas has always been proud of her flowing blond hair, but she thought it was so distressing when it started falling out 15 years ago.

"It's like round little spots that appear and your hair sheds, and I literally thought I was going bald," she said.

Van Voorhas decided to go to a dermatologist. Dr. Tom Andrus injected cortisone into the upper layer of Van Voorhas' skin at the bald spots.

"She's fortunate in that she's one of those patients that responds to intra-lesional injections," Andrus said.

Female pattern baldness is different from that of men. Male hair loss is typically hormonal, related to testosterone levels. Van Voorhas' condition is caused by an auto-immune reaction, which was confirmed through a biopsy.

"Microscopically, there's a swarm of bees around the hair follicle and those are actually white blood cells," Andrus said.

The cortisone stops the immune reaction in the treated area. Hair grows back. However, the same problem may pop up somewhere else on the scalp.

Topical creams may help some women, but not others. Minoxidi, marketed as Rogaine, helps many men, but it will not work for those with auto-immune problems like Van Voorhas. Although, Andrus said it might help other women.

Mary could take a steroid pill like prednisone, but the localized cortisone injections have far fewer side effects, and they are not that painful.

"Even if they were horrible, I would probably still do it, because the hair loss -- it's a terrible thing for women to lose their hair," Van Voorhas said.

Andrus said stress on the body can lead to hair loss in women. That includes stress from disease, pregnancy or even moderate to severe weight loss.