Hair loss is a common condition in which a person permanently sheds his hair. Hair can be lost from the head or other parts of the body. Unlike elective removal of excess body hair through shaving, waxing, etc., hair loss and baldness is often unwelcome and can be psychologically damaging to the person experiencing it.
Hair loss is such a common problem that a billion dollar industry has developed selling products and services aimed at helping those people who are concerned about their thinning hair to either grow it back or preserve what is remaining. In most cases, hair loss is a harmless part of the natural aging process, but at other times, hair loss can signal an underlying medical condition.
In medical terms, baldness and hair loss are broad sections of a medical description called alopecia. Hair loss can occur anywhere on the body where hair is normally found. This includes the head, arms, legs, groin, and arm pits. Hair loss that is limited to one area is called alopecia areata.
Sometimes, as in the case of cancer patients undergoing chemotherapy, the whole body sheds its hair in a condition known as alopecia universalis. The most common type of hair loss is referred to as male pattern baldness, or androgenic alopecia.
Although the name only specifically makes reference to males, females can also suffer from male pattern baldness. In men with male pattern baldness, hair loss is noticeable in a recognizable patter, starting on the temples and gradually thinning out to the crown of the head. In women with male pattern baldness, the whole head sees a thinning of the hair, although total baldness is rare.
Hair and Its Growth Cycle
What exactly is hair? Hair is a growth of strand like cells that contain a protein called keratin. These strands grow out of a special structure on the skin called a follicle. In humans, the hair on the body is in a continuous cycle, with each follicle of hair being in one of three phases.
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These phases of growth are the anagen phase, catagen phase, and the telogen phase. Human hair has a lifespan ranging from 3 years to 7 years, depending on its location and health. In the anagen phase, cells in the base of the follicles begin to divide and produce new hair. The anagen phase is the growth phase for human hair. Depending on how long a hair follicle stays in this phase determines how fast the hair grows. In catagen phase is the resting phase in which the hair follicle detaches itself from the hair strand, effectively cutting off the strand’s blood supply.
The hair is then pushed upwards. The final stage of the hair cycle is the telogen phase, which lasts from 1-4 months depending on a variety of factors. In this phase, the hair is dormant and not growing. Eventually, the anagen phase will start again and push out the old hair, resulting in normal hair loss, or shedding. For normal adult humans, 85% of the hairs on the body are in the anagen phase at any given time, while 10-15% are in the telogen phase. In people with permanent baldness, the telogen phase is not followed by a normal anagen phase to produce new hair growth.
Causes and Risk Factors
Male pattern baldness has numerous genetic and environmental causes. Genetics is thought to play a primary role in the development of male pattern baldness. Research has shown that an androgen called dihydrotestosterone (DHT) may play a pivotal role in developing baldness. An androgen is any number of hormones that causes the development of male characteristics in the body. Some men have a genetic trait that makes their hair follicles sensitive to DHT.
When the follicles come into contact with DHT, over time, they can begin to shrink which can shorten their lifespans and lead to an early cessation of hair renewal. Genetic research into the genes that control sensitivity to DTH has show that although a number of genes may be responsible for male pattern baldness, the primary cause occurs on the X chromosome, the component contributed by a person’s mother. High levels of the hormone insulin in the blood can also play a role in baldness.
Low levels of a protein called sex hormone binding globulin (SHBG) are often found in people with diabetes. SHGB binds with testosterone and prevents it from turning into DHT, which can cause hair loss.
Alopecia areata is a condition in where baldness occurs on one specific part of the body. While there is evidence of a genetic basis for alopecia areata, it is thought to be primarily an autoimmune disease. Autoimmune diseases are conditions in where the body’s immune system turns on itself and attacks the body’s own healthy cells. In a normal immune response to a foreign body such as a virus or bacterium, the body detects these invaders and sends out cells to destroy them. In an autoimmune disorder, the body gets mixed up and wrongly targets its own cells for destruction. The autoimmune response that causes alopecia areata is thought to be caused by things like extreme stress and a virus or bacteria.
Baldness may be caused by an underlying medical condition. Thyroid problems such as hyperthyroidism and hypothyroidism can both cause hair loss. Also diabetes and the autoimmune disease lupus can cause hair loss in humans. Fungal infections of the follicles and scalp are responsible for hair loss in some people, but can be alleviated with anti-fungal medications. Anemia caused by an iron deficiency can also lead to baldness. Correcting any underlying medical condition may reverse the hair loss, although some may be permanent.
Finally, baldness can be caused by trauma to the head or body. Putting too much strain on the hair, such as in elaborate hairdos or pulling of the hair, can result in baldness. For people undergoing chemotherapy, baldness is one of the most common side effects of the treatment. Stress can also cause hair to fall out. Once the traumas and stresses on the body are removed, hair growth will usually start again.
Cures and Remedies
Male pattern baldness is a medically harmless process, but to the person experiencing it, baldness can have damaging psychological consequences. In modern society, hair is thought to be a symbol of youth, beauty, and vitality. Losing one’s hair can be a sign of frailty and weakness.
A multi-billion dollar industry has grown over the last few decades offering services and products that help people to prevent hair loss. Many of these products claim to help a person grow hair or prevent old hair from falling out, but results for some of these products are mixed at best. However, some medications have proven effective for many people and are available with a doctor’s prescription.
Finasteride is a first line drug used in an effort to preserve current hair and cause regrowth. In the United States, finesteride is sold under the trade names Propecia and Proscar, which are manufactured by Merck. Originally developed to combat prostate gland conditions, Finesteride is a DHT inhibitor that works by binding with an enzyme in the body called 5-alpha-reductase, which is responsible for converting testosterone to DHT.
Finesteride works well for approximately 50% of its users. In studies, 48% of men regrew hair and 42% were able to maintain their current hair with no further hair loss. Finesteride works on all areas of the scalp, but works best on the crown of the head. Its effects will last for as long as a person takes the drug, however once treatment is stopped, hair loss will continue as before after several months of being off the medicine. Finesteride has not been shown to work well in women, however doctors sometimes prescribe it to them.
Women who are pregnant or may become pregnant cannot take finesteride as it may cause birth defects. Sexual dysfunction is the major side effect of finesteride, occurring in up to 18% of those taking it. Finesteride treatments can be expensive, with 30 day supplies costing several hundreds of dollars depending on the strength.
Like Finesteride, Minoxidil was a drug used originally to treat another disease rather than hair loss. Minoxidil is a drug that belongs into a larger class of drugs called vasodilators. Vasodilators are medications used to treat high blood pressure by making arteries and veins open wider, allowing for easier blood flow within them. While it was being developed, researchers discovered that Minoxidil had the side effect of causing hair growth and darkening in some people.
Minoxidil used for high blood pressure comes in the form of pills, but when it was discovered to have hair growth properties, a topical foam was created to take advantage of this side effect. This foam was marketed around the world under the brand name Rogaine, which is today synonymous with hair growth products. Scientists do not fully understand how or why minoxidil works. One hypothesis says that since minoxidil is a vasodilator, it increases blood flow to hair follicles.
When this happens, the hair follicles enter the telogen phase prematurely, causing old hair to fall out and new hair to grow in its place. Several studies have been done to show the efficacy of minoxidil. What they show is that minoxidil can increase hair count by nearly 30% in those taking it, in contrast to almost no hair growth in placebo groups. Minoxidil is sold in a topical solution of 5% for men and 2% for women. It works best on the crown of the head, although it can cause hair growth on all surfaces of the scalp. It also works best for small spots rather than large areas of baldness.
Application of Minoxidil
Minoxidil, when applied to the scalp must be left on the hair for a long period of time and applied once or twice daily. An hour is the minimum, with recommended times of up to 4 hours. Once treatment is stopped, the effects of minoxidil wane and baldness will occur again. Side effects of topical minoxidil are relatively mild, consisting of itchy scalp and dandruff. Patients treated with minoxidil may also experience hair loss as part of the shedding process in the telogen phase, however, the manufacturers of minoxidil do not guarantee that new hair will replace it. Costs of minoxidil vary widely, depending on the manufacturer and the strength of the solution.
There are two surgical methods of correcting hair loss. One is called scalp reduction and the other hair transplantation. Scalp reduction is a painful procedure in which a bald area of the scalp is surgically removed. The remaining hair covered areas are then sutured together to cover the hole. Hair transplantation involves moving hair follicles from one spot on the body to another. It is generally done by means of taking small grafts of 1 to 4 hair follicles and transplanting them to areas that need hair. This method provides natural looking results. Hair is harvested in two different ways.
The first method involves the surgeon cutting a long strip of scalp with hair attached to it, from which many grafts can be taken. The second method involves cutting tiny plugs out of the scalp and harvesting hairs individually. They can then be placed in the desired location via small cuts to the area. Hair transplants can be very expensive, with costs ranging from $3 to $12 per graft. Depending on how many grafts are done, prices can therefore reach into the tens of thousands of dollars very quickly, as the typical transplant surgery requires approximately 6000 grafts to be removed and implanted.
Side effects include pain, itching, swelling, and bleeding at the site of the operation. Also, risks associated with general surgery are also present. These include infection and possibly death. Hair transplants usually last for several years, but over time, they may also fall out, leading a patient to have more grafts implanted.
Impact of Your Diet
Diet can have an impact on hair loss in people with a genetic predisposition to male pattern baldness. It has been show that high insulin levels, like those found in type 2 diabetics and people with metabolic syndrome may exacerbate hair loss. High levels of insulin in the blood can cause the levels of SHBG to fall. SHBG is a protein that binds to testosterone, preventing it from being converted into DHT. Diets that maintain strict glycemic control can therefore help to prevent hair loss.
Maintaining control of insulin in the blood is dependent on controlling the amount of glucose in the blood. Glucose is a simple sugar that the body uses for energy. For those wishing to combat hair loss with diet, it is important to eat foods low on the glycemic index, such as while grains and vegetables. Eating omega 3 fatty acids may also help to prevent hair loss. These fatty acids are found in foods like salmon, tuna, and flax seeds.
Several natural remedies have been touted to help combat male pattern baldness. These herb and supplements can be found in health food stores and specialty nutritional centers.
Iron is an important mineral for preventing anemia due to an iron deficiency. Anemia is a medical condition where there is a drop in the number of oxygen-carrying red blood cells. One of the symptoms of iron deficient anemia is hair loss. Iron can be taken in pill supplements or obtained from ingesting iron rich foods such as broccoli and organ meats.
B vitamins may also help in preventing hair loss. B vitamins, particularly biotin, are necessary for producing hair and maintaining its health. 3 mg of biotin per day is adequate for aiding in hair loss and health.
Zinc may help to reduce the amounts of DHT in the blood. It is important to take only the daily recommended value of zinc, because taking too much may cause the formation of dangerous free radicals and a copper deficiency.
Saw Palmetto & Green Tea
The herb saw palmetto has been the subject of much research. Like finesteride, it has been shown to help with certain prostate conditions. Because of this, scientists believe it may also have similar effects on hair growth.
Green tea has been shown in studies to increase levels of SHGB, which can bind with testosterone and prevent it from being converted into hair damaging DHT. Green tea also has powerful antioxidants and anti-cancer properties.
While hair loss may be a traumatic experience for many people, it need not be. Images of beauty change constantly and in modern years, a shift towards accepting that bald can be beautiful has been occurring. Balding men now routinely shave their heads and proudly display their bald heads, taking control of the situation and making the best of it. For those who are uncomfortable with embracing their baldness, they can try wigs or hats to disguise their hair loss.
Medical advancements have made it possible to regrow or at least salvage what is left of a person’s hair, but treatments need to be continuous or the hair loss will return. These treatments can be time consuming and expensive, and in the case of hair transplantation, painful. Fortunately, for people suffering from baldness, there are choices. In the end, it comes down to personal preference and a person’s self image.bat