Perhaps no other topic in history has been riddled with more myths, misinformation, scams, and ridicule as hair loss and restoration. For this reason, it is necessary to learn as much as possible about hair and balding to protect yourself.
Let’s begin with some basic information . for instance, few people know hair is part of our skin, and it grows away from the body much as fingernails do. Another interesting fact is that although hair is basically dead, it can be damaged. Many are not aware that 16% of women suffer from hair loss or balding in varying stages, while 50% of men experience loss.
Besides being attractive, hair also serves some practical purposes: it protects the scalp, regulates body temperature, and warns against insect bites that land on the sensitive hair shafts. Just as other living things, hair has specific phases of its growth cycle. These include angene, the growth cycle; catogen, the changing stage where hairs prepare to slough off; and telogen, the sleeping phase.
Most people don’t know that a hair follicle and a shaft of hair or not the same things. Hair follicles are made up of three parts: outer sheath, inner sheath, and the bulb. The outer sheath provides a tunnel for the hair shaft during its growth; the inner sheath contains the actual hair shaft; and the bulb contains matrix cells that determine the width of the hair shaft. These occur in various layers of the scalp—epidermis, dermis, and subcutaneous.
While 90% of balding in men involves a genetic source, there are a number of non-gender specific (androgynous) causes, which, consequently, occur in both men and women. The main causes of androgynous loss are nutrition, drugs, disease, medical treatments, hair treatments, scalp infections, telogen effluvium, cicatricial alopecia, alopecia areata, and trichotillomania. Symptoms, diagnosis, treatment, and affect of each hold vital information for the person suffering from one of these conditions. So, before you run screaming in terror over all this strange terminology, know that real people suffer from these, and one may provide the answers to important questions about hair loss.
Nutrition may slow or help avoid hair loss, but it will not reverse genetic permanent balding in men or women. On the other hand, overuse or deficiencies of vitamins and minerals often cause hair loss.
One of the most popular, yet controversial, drugs which cause hair loss are anabolic steroids. Basically used for physical enhancements, they can be a major offender when it comes to hair loss. Steroids come in various forms such as human growth hormones, whey-based nutrients, DHEA hormone, and Prednisone.
Various autoimmune diseases have been linked to hair loss. Three of the most common ones include: alopecia areata, known as spot baldness which occurs suddenly and swiftly; scleroderma, which causes inflammation and thickening of skin cells; and thyroid conditions, which result from too much or too little of the thyroid hormone. Each condition has unique symptoms and treatments; also, they cause a level of stress, which can cause the onset of another condition known as telogen effluvium causing chunks of hair to fall out. Finally, of all people suffering from lupus, 50 % will develop some hair loss.
Other than autoimmune diseases the following conditions are also related to hair loss: anaemia, diabetes, malnutrition, and psoriasis. However, any form of a chronic disease can cause spikes in stress and throw off the metabolism resulting in balding.
The two most common and well-known medical treatments that cause balding are chemotherapy and radiation. The powerful drugs used in chemotherapy attack all fast growing cells. Since hair cells grow rapidly, they are destroyed along with the sick cancer cells. While radiation causes less harm to the body, other aspects of treatment—how it is administered and what other drugs are taken in tandem—can result in balding.
Popular hair treatments used to enhance physical beauty may also cause loss. Using hair sprays, mousse gels, permanent hair dyes, and conditioners, have been known to be culprits when it comes to hair. Basically, these products attack the keratin (proteins) needed to keep hair intact. Fortunately, this loss can be reversed when diagnosed in time and use of the product is discontinued.
Another leading cause of hair loss is scalp infection—bacterial, fungal, viral, or parasitic. One of the more common ones is referred to as ringworm (it has no relation to worms). Another one attacks sebaceous (fat) glands, which cause the base of the hair follicle to clog. Finally, another is often confused with lice but is really a bacterial infection, which results in nodules growing at the base of the shaft.
Stress can cause telogen effluvium or shock loss where a sudden, widespread shedding of hair occurs. This condition occurs during the telogen or resting stage of the hair shaft growth cycle. The hair usually grows back within a year; however, shock loss is the second most common cause of balding after genetic male and female balding. Two more kinds of non-genetic balding are cicatrical alopecia and alopecia areata. In the first case (cicatrical alopecia) hair follicles are replaced with scar tissue camouflaged beneath the skin making this condition hard to diagnose. Some diagnostic considerations include family history, skin components and onset of the disease. Two types are known—primary (direct) and secondary (indirect) impact to the follicle. In the second case (alopecia areata) sometimes called spot balding due to the growth of these spots over time. More serious cases involve loss of all scalp hair and loss of all body hair.
One final non-gender specific cause of balding is trichotillomania or hair pulling where the patient intentionally pulls and/or picks at healthy hair until permanent baldness occurs. The intensity can range from harmless and temporary to a severe psychiatric disorder which takes two forms—those who pull hair but don’t understand why they do and those who get sensual pleasure or relief from itching.
Let’s review some specifics about causes of hair loss in men. Some amount of hair loss occurs in 50% of men. Of these men 90-95% experience will contract genetic hair loss known as male pattern baldness. However, the other 5-10% of these men will suffer from non-genetic balding.
Contrary to myths genetic balding can be inherited from either side of the family. Doctors look past the grandparents in diagnosing. Close analysis can determine whether dying cells are being replenished, so paying attention to the stage of the growth cycle helps to give more answers. Clinicians also use the hair-pulling test. If the hair comes out too easily this is further evidence of a problem. Finally, the Hamilton/Norwood Scale helps professionals determine the degree of loss in genetic loss.
Male pattern baldness is still not fully understood by the medical profession. It is believed, however, the cause is related to an excess of two male hormones—testosterone and dihydrostestosterone (DHT). Men take DHT-blockers (Propecia) to help alleviate the problem, but this increases the testosterone levels. Many men use anabolic steroids to enhance strength and energy; however, these have been associated with hair loss too.
When considering hair loss in women, many are surprised to learn that women do bald. Contrary to popular myths, as much as 50% of women experience temporary and/or permanent loss; although, permanent female pattern balding is less often the cause. In women hair loss is diffuse (less obvious) rather than localized, and only rarely does it totally disappear as in men. Most often early symptoms are a see-through quality of hair and styling challenges . fortunately, women have more options for concealing hair loss by using hair extenders or hair styling.
Unlike men, genetic causes of balding in women, is inherited from female ancestors–mothers, grandmothers and aunts. Female pattern balding is uncommon in women and causes are more often due to certain underlying medical conditions: thyroid disease, anaemia, iron deficiency, weight loss from sever dieting or overeating, and autoimmune diseases. In diagnosing, checking for underlying medical or hormonal causes during pregnancy and postpartum, is vital with women. Women may also suffer from increased levels of the male hormones—testosterone and DHT—just as men do. When female pattern balding (genetic cause) the Ludwig Classification System is used in determining the type of permanent loss: mild where loss can still be camouflaged; moderate where a significant widening of the midline part occurs; and extensive where the hair takes on a thin, see-through appearance. The good news is that often hair loss in women can be reversed with the help of a certified professional.
What can be done about balding? There are both non-surgical and surgical solutions to consider. This section will address non-surgical options: minoxicil (Rogaine), finasteride, ketoconazole, scalp pigmentation, platelet rich plasma (PRP), stem cell treatment, and hair replacement systems (wigs). Most people are surprised to find out how many possible solutions are available.
- Rogaine (minoxidil) is one of the first products proven beneficial for pattern balding, and is the most popular over-the-counter product. It, however, does not grow hair, but it nurtures weakened follicles.
- Propecia (finasteride) actually grows hair in men with male pattern baldness. It acts as a DHt-blocker to reduce the amount of a male hormone believed to cause hair loss. women do not appear to benefit from this drug.
- Ketoconazole is a synthetic drug used as an anti-fungal, anti-dandruff shampoo, topical cream, and oral tablet. Some experts believe it also acts as a DHt-blocker; others believe it works by reducing and unclogging the amount of fatty waxes collected at the base of the hair follicle.
- Micro Scalp Pigmentation is one of the hottest new, non-surgical ways men deal with pattern baldness. Since it requires shaving the head, women don’t benefit from this aid. Scalp pigmentation is similar to applying a tattoo, but is far more sophisticated. It must be administered by a professional in the field of micro-hair technique (MHT). The professional draws hair with ink into the scalp. This relieves men from the need for pills, concealers, hair systems, and hair transplant.
- Platelet rich plasma (PRP) has received mixed reviews from the experts. It may work by waking up dormant follicles through a protein- rich blood source. It is extracted from blood by centrifugal force.
- Low laser light therapy (LLLt) holds out hope for the balding. High-powered lasers have been used for years to remove unwanted hair. But, it is believed that a low-powered laser nurtures hair cells. It is gentle and non-invasive.
- Hair replacement systems include wigs, toupees, rugs, units, or hairpieces. They all contain a base required to attach hair fibres onto; hair strands of varying qualities; and attachment systems that hold the piece in place. Their advantage is the low cost and immediate results. They are perfect for the temporary baldness related to illnesses and treatments.
Before the mid-1990s hair transplants resulted in sub-par results such as the pluggy doll-head look, hairline problems, unrealistic coverage attempts, ridging, scarring, or hair wastage. With today’s advancements, though, the most common result of modern transplants is a totally natural-looking head of hair that cannot be distinguished from a non-restored hair. Thanks to modern techniques, two greatly improved, common harvesting techniques—strip harvesting and follicular unit extractions—have revolutionized transplants. Both include the use of microscopic equipment, which prevents doctors from having to work blind, decreases the number of lost grafts, fewer complications, quicker healing, and a great look. The primary drawback is the amount of time it takes, requiring the surgeon to have to focus for long durations.
When considering surgical options to hair restoration, it’s best to be pro-active. Once a patient considers all non-surgical options, it’s time to look into possible surgical solutions. Another important point to consider: if in doubt, do nothing. Surgical options are permanent solutions, so if you’re not sure, don’t do it. Just as with any other surgery, complications can occur. But the good news is that today many mistakes can be corrected in capable hands.
Also, keep in mind that taking matters into your own hands can go a long way to ensuring satisfaction. It’s important to have a face-to-face consultation with your surgeon who outlines a plan with your input. For best results be clear about what you want. Don’t be fooled by a beautiful, modern building and friendly nurses. These can mask unethical practices going on in the operating rooms. Then, educate yourself regarding pricing and costs. This book covers some of the more popular scams out there that steal from desperate people.
With self-education, face-to-face consultations with your doctor or a physician’s assistant, and follow through with an outlined plan (pre and post-surgical), you can look forward to the excitement of running your hands through a natural-looking, full head of hair that takes years off your appearance, allows enjoyment of improved social interactions, and increases your career potential. We hope this information has been informative, helpful, and encouraging. There are solutions to hair loss out there, and you’re now well on your way to making an informed decision.