Understanding Baldness (Alopecia), and Treatment

10 months ago

My friend usually complain about fear for his hair loss and he is always concerned about it. As a female, I really do not get myself worried but worries a lot but you see, the funniest thing is that he began to notice sign of hair loss and that was when it looked like his greatest fear was becoming a reality. He began to ask me if he should cut his hair off or he should begin to treat it. I know that the later can be difficult especially if it will be done without visiting the hospital so I will be looking at what causes hairloss, and what can be done based on research to slow down hair loss and to restore lost hair.

In males, the most common type of hairloss is the male pattern hair loss or androgenic alopecia where "alopecia" refers to hair loss, and Adrogenic refers to androgen hormones meaning that it is a hairloss caused by the presence of the hormone androgen which is important for producing the masculine characteristics. It isn't like females don't produce androgens, they produce androgens in little amounts and they can suffer androgenic alopecia but this is not common and it is known as female pattern hair loss.

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Hair follicles are a downward growth of the epidermis that develops when infant. During the development of the follicle, it pushes into a nipple-like structure known as the dermal papilla. The Dermal Papilla is made up of tiny little blood vessels which is responsible for providing nutrients to the cells at the base of the follicles. The hair follicle have different phases of growth which are the active phase (anagen phase), the regression phase (catagen phase) where the follicle base pulls away from the pappila, and the resting phase (telogen phase).

Hairs on the scalp have their resting phase lasting for 3 months after which the follicle enters another active phase. With this process, people can lose 70 to 100 hairs daily but when it comes to progressive hair loss, the resting phase is not the point of concern rather it is the growth phase. The growth phase for different part of the body differs such as that of the head lasting very long while that of the body very short. When it comes to hair loss, the growth phase start to get shorter. We cannot talk about hair loss without mentioning the androgen Dihydrotestosterone.

Dihidrotestosterone is a metabolite of testosterone and it is converted in the hair follicles of the scalp by 5 alpha reductase. The DHT binds with the androgen receptors in the follicle at the level of the dermal papilla by activating genes that causes the transformation of the large terminal hair follicle into a small hair follicle. Terminal hairs are thicker longer pigmented hairs but when they are converted into smaller vellus hair, it is transparent. With hair loss, the vellus hairs are very fine and soft that they do not make it to the surface of the skin and this leads to baldness appearance in a process known as follicular miniaturization.

It is important to know that not everyone losses their hair in the form of baldness, it has more of genetics playing than other factors. Study showed that people who have fathers that are bald are 5 times more likely to be bald than people who do not have bald fathers. What would people with hair loss do?

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The best thing is to prevent further hair loss, and restore the hairs that have already been lost. Using drugs like Minoxidil which is a vasodilator that maintain the vascularity and the size of the dermal papilla allowing it to promote hair growth by increasing the duration of the growth phase and shortening the resting phase as well as enlarging miniature follicles.

Finasteride is another drug that inhibits the five alpha reductase enzyme which converts testosterone to DHT. Some studies show that Finasteride is more effective than minoxidil but have also shown that a combination of both treatment is more effective that using them singularly. Studies have showed that finasteride may decrease fertility in men with reports of sexual dysfunction, decreased libido, erectile dysfunction,and gynecomastia.

Another form of treatment low level laser therapy (photobiomodulation) where the scalp is exposed to infrared light with a mechanism of action that deals with acceleration of cellular mitosis thereby increasing ATP production and enhancing blood flow by minimizing inflammation.

Understanding the causes of hair loss empowers individuals to make informed decisions about potential treatments. While drugs like Minoxidil and Finasteride show promise, it's crucial to weigh their benefits against potential side effects. Low-level laser therapy presents a non-invasive alternative, emphasizing the importance of personalized choices in addressing the complex issue of hair loss.