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About hair loss

MALE HAIR LOSS & PATTERN BALDNESS IN MEN

Hair loss in men is likely to occur primarily between late teen-age years and age 40-50, in a generally recognizable "male-pattern" baldness known as androgenetic alopecia.

Norwood -Hamilton Scale of Male Pattern Baldness.

 Although the density of hair in a given pattern of loss tends to diminish with age, there is no way to predict what pattern of hair loss a young man with early male pattern baldness will eventually assume. In general, those who begin losing hair in the second decade are those in whom the hair loss will be the most severe. In some men, initial male-pattern hair loss may be delayed until the late third to fourth decade.

Hamilton first noted that androgens (testosterone, dihydrotestosterone) are necessary for the development of male pattern baldness. The amount of androgens present does not need to be greater than normal for male pattern baldness to occur.


If androgens are present in normal amounts and the gene for hair loss is present, male pattern hair loss will occur, male pattern hair loss are dependent on dihydrotestosterone (DHT). Testosterone is converted to DHT by the enzyme, 5¤ -redctas. 

The hair growth cycle is affected in that the percentage of hairs in the growth phase (anagen) and the duration of the growth phase diminish resulting in shorter hairs. More hairs are in the resting state (telogen) and these hairs are much more subject to loss with the daily trauma of combing and washing. The hair shafts in male pattern baldness become progressively miniaturized, (see hair follicle miniaturization illustration) smaller in diameter and length, with time. In men with male pattern baldness all the hairs in an affected area may eventually (but not necessarily) become involved in the process and may with time cover the region with fine (vellus) hair. Pigment (color) production is also terminated with miniaturization so the fine hair becomes lighter in color. The lighter color, miniaturized hairs cause the area to first appear thin. Involved areas in men can completely lose all follicles over time.


Male pattern hair loss (Androgenetic Alopecia) is an inherited condition manifested when androgens are present in normal amounts. The gene can be inherited from the mother or father’s side. The onset, rate, and severity of hair loss are unpredictable. The severity increases with age and if the condition is present it will be progressive and relentless.

 WOMEN HAIR LOSS

Most people think hair loss is a medical problem only impacting men. The truth is women make up about forty (40) percent of hair loss patients.
For many women their hair is a defining physical attribute that defines character and personality. Hair loss affects one’s self image and emotional well-being

But what exactly causes a woman to lose her hair? To understand that, it's important to know a basic understanding about hair growth.

Scale of Women Pattern Baldness

Hair grows at one-half inch per month and the growth phase lasts two to six years. With yet-to-be discovered physiologic signals, the hair goes into a resting phase for a period of time, then the hair follicle falls out and a new follicle starts the process all over again.

In some patients with a genetic predisposition to hair loss, a group of hormones called androgens interferes with the growth cycle of the hair. These androgen hormones-testosterone, Androsteinedione, and Dihydrotestosterone (DHT) - are dominant hormones in men, but are present in women to a lesser degree. In many women, hair loss is due to the action of androgens on the hair follicles.

In women who are genetically susceptible, when the testosterone comes in contact with enzymes residing in the hair cell, it is converted into the more potent androgen DHT, which then binds with receptors deep within the hair follicle. Over time, DHT in the hair follicle alters the natural resting and growth phases of the hair. Some of the hair follicles eventually die, while others stop continuing healthy hair growth.
The term 'androgenic alopecia' in women is often referred to “female pattern hair loss.” It is a broader term that encompasses many possible causes of hair loss in women. Androgenic alopecia is caused by factors related to the actions of hormones, e.g., ovarian cysts, use of high androgen index birth control pills, pregnancy, and menopause.

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