by Geri Walton ~ August 22nd, 2008
affects roughly 50% of
men and perhaps as
many women who are
older than 40 years.
Balding is a common problem and does not just affect men. There are several reasons for hair loss in both sexes. For example, hypothyroidism and hyper-thyroidism cause hair loss because the thyroid is either under producing thyroid hormone or over producing thyroid hormone, but the most common reason for hair loss is related to some form of alopecia, and that’s what I wanted to talk about in this article.
One common form of alopecia is Alopecia areataor “spot baldness.” It is an immune disease, and a mere two percent of the American population is affected. Hair losses from alopecia areata can range from small bald patches distributed over the scalp to complete loss of all body hair. This form of alopecia typically affects the scalp, but one-third of men also show some hair loss in their beards. Only seven percent of people who develop this disease ever experience a complete loss of all body hair, which is called alopecia universalis.
The second type of hair loss is known as androgenetic alopecia. Ninety-five percent of all hair loss cases are attributed to this form of alopecia. It is a hereditary condition acquired from the genes of both parents. People with this condition begin to exhibit hair loss between 12 and 40 years old. Teasing, dying, and frequent hair washing does not worsen the condition. According to eMedicine hair loss of this type “affects roughly 50% of men and perhaps as many women [who are] older than 40 years.” After a woman reaches 65, hair loss problems affect close to 75 percent of them.
To understand how androgenetic alopecia works, you need to understand how hair growth is accomplished. Each person has about 100,000 hair follicles on his or her head and the hair follicles are nurtured by blood vessels. It is the each hair follicle’s responsibility to repeatedly grow and shed a single hair, as shown in the normal hair cycle illustration below. In normal hair growth patterns, at any one time, 80 to 90 percent of the hair follicles are growing new hair, and a person is losing about 75 follicles a day.
In a person with androgenetic alopecia, a hormonal change occurs, and the person begins to suffer sensitivity to dihydrotestosterone (DHT), which is a potent byproduct of testosterone and a powerful sex hormone. The result is the hair follicles undergo a process called follicular miniaturization which causes them to develop shorter growth cycles and produce thin, weak, short hairs, until there is just peach fuzz or nothing at all on a person’s head, as shown in the illustration below depicting follicular miniaturization.
According to the BMJ Medical Journal’sSeptember 1998 issue, “white men are four times more likely to [prematurely go bald] than black men … and by the age of 30, 30% of white men have androgenetic alopecia; by the age of 50, 50 percent do.” In men, the average hair loss is about five percent a year. There are similar rates of hair loss for women, but about 13% of women also suffer a significant increase in hair loss during menopause.
Both men and women show similar patterns of hair loss when balding. The hair loss begins gradually and over time thins and recedes. It is first observed in the temporal, crown, and frontal scalp regions, and, as time passes, it continues to progress. The main difference between men and women’s hair loss is women usually retain their frontal hairline, their hair loss is usually more diffused, they suffer less bi-temporal recession, and they rarely experience a complete loss of all scalp hair as some men do.
Current treatment options have been established for some forms of alopecia, and both men and women can use Minoxidil, better known as Rogaine®. Minoxidil is available in a foam or spray and is applied twice daily to the affected scalp area. It is used initially for three to four months to determine whether or not it will encourage new hair growth. Not everyone benefits from Minoxidil, but if they do, the person must continue with Minoxidil treatments to mantain hair growth.
Men also have another prescription option to reverse baldness. It is a drug called Finasteride but is, perhaps, better known as Propecia®. Finasteride is a pill that decreases dihydrotestosterone levels. In many patients once the dihydrotesterone levels are decreased, new hair growth occurs. However, the results were less than stellar in women. When Finasteride was used on menopausal women it did not slow down or stop hair loss, and manufacturer’s have found it so toxic to pregnant women, they warn them not to touch the pills.
Another option for women is called Spironolactone or Aldactone. It blocks the hormone aldosterone, which is a steroid hormone. Then by creating an antiandrogenic effect, Spironolactone prevents baldness in women suffering from androgenetic alopecia. It is also sometimes used to treat women with excessive facial hair. It is not consider a good remedy for men because it causes adverse reactions, such as breast development or impotence.
If a person tries medications and they fail to produce good results, or if a person does not want to take medication, the third option available to both sexes is surgery . There are three types of surgery—transplantation, scalp flaps, and scalp reduction. Transplantation surgery involves transplanting healthy follicles, called plugs, into problem regions, and, when done correctly, the results are amazing. Scalp flaps is the second surgical procedure. It is similar to a plug transplant in that good hair follicles are moved to balding areas, but scalp flaps allow the hair transplant to be accomplished at a faster rate and uses hair strips rather than hair plugs. Scalp reduction is the third option. It involves removing bald areas and then pulling and sewing the remaining skin together.
I also wanted to point out medication and hair transplantation options are often not as successful on women as they are on men. Part of the reason is medications seems to work more successfully on the top back part of the hair rather than the front. The problem with transplants are that women usually want a fuller head of hair than a transplant can provide, and sometimes transplantations can harm hair follicles in the immediate region where the transplant occurs, although in some cases this can be reversed.
For More Information
You can obtain more information about baldness or hair loss, from the web. The last time I checked there were over 3.7 million sites providing information related to baldness. If you are interested in wigs there are even more, some 14,200,000 web sites. You can also talk to your doctor, your hair stylist, or call the American Cancer Society at 1-800-ACS-2345 to see if they can recommend a wig manufacturer.
More information about the latest surgical procedures is also available from the New Hair Institute, a medical group that specializes in hair loss and surgical hair restoration. They are particularly sensitive to women with hair loss and have been featured on Good Morning Americaand the Discovery Channel. They also recognize the important aesthetical differences between the two sexes, and they offer a free complimentary copy of “The Patient’s Guide to Hair Restoration.” They also have a list of drugs and new treatments, such as hair cloning, that may be of particular interest to those people who want to know what’s new on the horizon.
There are many things you can try on your own. For instance, Progaine hair products are available for people with thinning hair. They offer shampoos, volumizers, and conditioners to help improve the hair’s texture and fullness. There are also numerous books on hair loss, and they cover everything—how to regrow you hair, how to prevent hair loss, what products to use, or how to style your hair so it looks fuller. Books I recommend are listed below.
One book for both men and women is Grow Hair Fast: 7 Steps to a New Head of Hair in 90 Days,by hair expert Riquette Hofstein. According to Amazon.com, “Riquette’s [book offers] recipes for the best homemade hair-care products with special herbs, oils and mixtures that she has developed, plus important information on chemical and surgical hair-loss solutions.”
Another highly rated book for men is The Bald Truth : The First Complete Guide To Preventing And Treating Hair Loss.It was first published in 1998 and covers propecia, hormonal effects of diet, herbal treatments, surgical solutions, hair systems, cover-up products, and hair-loss treatments. Although it is ten years old and some information might be out of date, it could still offer valuable information to men about balding and hair loss.
There are two new books released in 2008 just for women. The first is Christopher Hopkin’s book titled, Staging Your Come-back: A Complete Beauty Revival for Women Over 45.In the book he provides a chapter titled “Hair Ovations,” which offers information about hair loss and styling tips. Gracefully: Looking and Being Your Best at Any Ageis the second book I recommend. It is by Valerie Ramsey and Heather Hummel and this book offers special advice for women with thinning hair in the chapter titled “Finishing Touches.”
An older book might also prove helpful for women. It is Hair Savers for Women: A Complete Guide to Preventing and Treating Hair Loss.It is by Maggie Greenwood-Robinson who holds a PhD in nutrition. Her book was released in 2000 and it provides information on the pros and cons of wigs and hair pieces. Her treatment ideas are not just the typical prescription medication and surgery suggestions either. She provides ideas related to natural supplements and natural remedies.