Hair loss

Male pattern baldness in 40 year old man.

John D. Rockefeller, who had alopecia universalis, with toupee

Hair loss, also known as baldness, is a condition in which an individual lacks hair in areas where it typically grows, particularly on the scalp. The most prevalent form of hair loss is androgenic alopecia, commonly referred to as male pattern baldness. This progressive hair thinning condition affects adult human males and some primate species. However, hair loss can take various forms and manifest with differing severity, from male and female pattern alopecia (androgenetic alopecia), alopecia areata, alopecia totalis, to the most extreme form, alopecia universalis.

Alopecia

Treatment for hair loss has limited success; the greater the amount of hair lost, the less effective the treatment is likely to be.

Causes and Types of Hair Loss

• Pattern baldness - The incidence of pattern baldness varies among populations, influenced by factors such as diet and personal habits. Male pattern baldness is characterized by hair receding from the lateral sides of the forehead and the possible development of an additional bald patch on top. This type of baldness, androgenic alopecia, is triggered by dihydrotestosterone (DHT), a potent sex hormone. Female pattern baldness is less common and typically results from a decrease in estrogen, which counteracts the balding effect of testosterone.
• Traction alopecia - Commonly found in individuals with ponytails or cornrows who apply excessive force to their hair. Wearing a hat is not generally a cause, but it is advisable to let the scalp breathe for at least 7 hours a day.
• Telogen effluvium - Traumas such as chemotherapy, childbirth, major surgery, poisoning, and severe stress can cause this hair loss condition.
• Fungal infections - Some mycotic infections can lead to massive hair loss.
• Alopecia areata - An autoimmune disorder, also known as "spot baldness," which can result in hair loss ranging from a single location to the entire body.
• Cicatricial alopecia - Localized or diffuse hair loss may occur in cases of cicatricial alopecia, which is related to conditions like lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, and postmenopausal frontal fibrosing alopecia.
• Hypothyroidism - This condition can cause hair loss, especially thinning of the outer third of the eyebrows.

Alopecia areata

Etymology

The term "alopecia" comes from the Greek word "alopex," meaning fox, as foxes shed their coats twice a year. The term "bald" is derived from the English word "balde," which means "white."

Treatments for Hair Loss

His receding hair-line illustrates the hair-loss caused by stress

A variety of treatments are available to help manage hair loss. Effectiveness varies depending on the individual, the type of hair loss, and the severity of the condition. Some common treatments include:

• Minoxidil (Rogaine): An FDA-approved topical treatment for hair loss. It is a vasodilator that increases blood flow to the hair follicles, promoting hair growth. It works best in the early stages of hair loss.
• Finasteride (Propecia): A prescription medication that inhibits the production of DHT, thus slowing down the progression of male pattern baldness. It is not approved for use in women.
• Dutasteride (Avodart): Similar to finasteride, it blocks the production of DHT but is more potent. It is not approved by the FDA for treating hair loss but has been used off-label.
• Spironolactone (Aldactone): A diuretic drug that has anti-androgenic effects and is sometimes used off-label to treat female pattern baldness.
• Corticosteroids: Used to treat alopecia areata, these can be injected directly into the affected areas or taken orally.
• Anthralin (Dritho-Scalp): A topical medication used to treat psoriasis that may also stimulate hair growth in people with alopecia areata.
• Hair Transplant Surgery: A surgical procedure that involves removing hair follicles from a part of the scalp with healthy hair growth and transplanting them to areas with thinning hair or baldness.
• Scalp Micropigmentation: A cosmetic tattooing procedure that creates the appearance of hair stubble or a fuller head of hair by injecting pigment into the scalp.
• Low-Level Laser Therapy (LLLT): A non-invasive treatment that uses red light or near-infrared light to stimulate hair growth. The effectiveness of LLLT for hair loss is still debated.

Coping with Hair Loss

The psychological implications of hair loss can significantly impact an individual's self-confidence, with the most severe effects typically occurring at the onset of symptoms. However, some people embrace their baldness, drawing inspiration from charismatic bald celebrities, politicians, or sportsmen who are considered masculine and attractive. Various companies have built successful businesses selling hair loss reversal products, such as hair regrowth treatments, hair transplants, and hairpieces.

Preventing and Reversing Hair Loss

Preventing healthy hairs from falling out is easier than regrowing hair in dormant follicles. Finasteride (Propecia) and minoxidil (Rogaine) have shown some success in partially reversing hair loss, although they are generally ineffective in treating extreme cases. Hair multiplication or hair cloning, a treatment under development, shows promise in mice and could become available to the public in the near future.

Hair loss Resources
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