Hair Loss Facts
The Medical and Scientific Background
Here you can find out more: first, about the causes of hair loss and second, about some of the treatments available.
Depending on your particular interest, we invite to you open our pages on Alopecia, Trichotillomania, Genetic Thinning and Chemotherapy Hair Loss.
Baldness. Where this is particularly relevant to men it is called androgenetic alopecia. It’s also known as androgenic alopecia, alopecia androgenetica or simply male pattern baldness. This is a progressive hair thinning condition and it’s the most common form of baldness. And, by the way, whilst it most commonly affects men, it’s not just human males it affects!
Alopecia areata involves the loss of some of the hair from the head; alopecia totalis involves the loss of all head hair; and ultimately - at it’s most extreme - alopecia universalis describes the total loss of hair from both the head and body.
Some hair loss sufferers make use of clinically proven treatments such as finasteride and topically applied minoxidil (in solution) in an attempt to prevent further loss and regrow hair. As a general rule, it’s easier to maintain remaining hair than it is to regrow it; however, the treatments mentioned can, to some extent, help users suffering from Androgenetic alopecia. Plus, there are new technologies in hair replacement - mostly hair integration and volumising systems - that can be completely undetectable!
Background, Cause and Incidence
The average human head has about 100,000 hair follicles and, in a person's lifetime, each one can grow about 20 individual hairs. And in healthy conditions we lose on average about 100 strands a day.
Based on genetic background, the incidence of pattern baldness varies from one population to another. Environmental factors don’t seem to greatly affect this type of baldness but age, of course, does. And one large scale Australian study showed how mid-frontal hair loss affects 57% of women and 73.5% of men aged 80 and over.
Male pattern baldness is characterized by hair receding from the lateral sides of the forehead. It’s known as "receding hairline".
An additional bald patch may develop on top (vertex). The trigger for this type of baldness (called androgenetic alopecia) is DHT, a powerful sex hormone, body, and facial hair growth promoter that can adversely affect the hair on the head and prostate.
The mechanism by which DHT accomplishes this is not yet fully understood. In genetically-prone scalps, DHT initiates a process of follicular miniaturization. And through this process, hair shaft width is progressively decreased until scalp hair resembles fragile vellus hair or "peach fuzz". Alternatively, it becomes non-existent!
The onset of hair loss sometimes begins as early as the end of puberty, and is mostly genetically determined. In fact, it’s not just because of one parent... both can contribute to their offspring's likelihood of hair loss.
There are several other kinds of baldness:
- Traction Alopecia is most commonly found in people with ponytails or cornrows who pull their hair with excessive force.
- Traumas such as chemotherapy, childbirth, major surgery, poisoning, and severe stress may cause a hair loss condition known as Telogen Effluvium. This is characterised by sudden, diffuse hair loss caused by an interruption in the normal hair growth cycle. It causes a large number of hair follicles to enter a stage of telogen, or rest, simultaneously. After roughly 3 months of the telogen cycle, the follicles will enter the anagen cycle, a stage of growth. The old hair is forced out of the follicle by a new hair that is formed beneath it. This causes a period of diffuse hair shedding. This condition can affect people of all ages but it is Usually self-correcting.
- There is also another form of Telogen Effluvium referred to as 'Chronic'. This is essentially the same except it is on-going. A typical example of telogen effluvium is seen after pregnancy. Here, women lose a significant amount of hair a few months after delivery when the protective effect of oestrogen is removed. This shedding usually stops spontaneously and these patients will re-grow hair after 3 months.
- Some mycotic infections can cause massive hair loss.
- Alopecia Areata is an autoimmune disorder also known as "spot baldness" that can range from hair loss in just one location (Alopecia areata monolocularis) to a loss of hair on the entire body (Alopecia areata universalis).
- Localised or diffuse hair loss may also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, postmenopausal frontal fibrosing alopecia, etc.). And tumours and skin outgrowths also induce localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
- Hypothyroidism can cause hair loss, especially thinning of the outer third of the eyebrows.
- Temporary loss of hair can occur in areas where sebaceous cysts are present for considerable duration; normally one to several weeks in length.
Etymology... Where do we get the word "Alopecia" from?
The term alopecia (al-oh-PEE-she-uh) derives from the Greek αλ?πηξ (alopex), meaning fox. And the reason for that lies in the fact that the fox sheds its coat twice a year.
The term bald probably derives from the old English word balde, which means "white, pale", or the Celtic word ball, which means "white patch or blaze", such as on a horse's head.
Evolutionary theories of male pattern baldness
There is no consensus on the evolution of male pattern baldness. Most theories suggest it results from sexual selection. A number of other primate species also experience hair loss following puberty. And some primate species clearly use an enlarged forehead, created both anatomically and through strategies such as frontal balding, to convey increased status and maturity. The assertion that MPB is intended to convey a social message is supported by the fact that the distribution of androgen receptors in the scalp differs between men and women, and older women or women with high androgen levels often exhibit diffuse thinning of hair as opposed to male pattern baldness.
One theory suggests baldness evolved in males through sexual selection as an enhanced signal of ageing and social maturity, whereby aggression and risk-taking decrease and nurturing behaviours increase. This may have conveyed a male with enhanced social status but a reduced physical threat, which could enhance his ability to secure reproductive partners and raise offspring to adulthood.
In a study by Muscarella and Cunningham, males and females viewed 6 male models with different levels of facial hair (beard and moustache or clean-shaven) and cranial hair (full head of hair, receding and bald). Participants rated each combination with a choice of 32 adjectives related to social perceptions. Males with facial hair and those with bald or receding hair were rated as being older than those who were clean-shaven or had a full head of hair. Beards and a full head of hair were seen as being more aggressive and less socially mature: baldness was associated with more social maturity.
The psychological effects for individuals experiencing hair loss vary widely. Some people adapt to the change comfortably, while others have severe problems relating to anxiety, depression, social phobia and, in some cases, identity change.
Alopecia induced by cancer chemotherapy has been reported to cause changes in self-concept and body image. Body image does not return to the previous state after regrowth of hair for the majority of patients. In such cases, patients have difficulties expressing their feelings (a condition called alexithymia) and may be more prone to avoiding family conflicts. Family therapy can help families to cope with these psychological problems if they arise. Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms.
Preventing and reversing hair loss
At the moment, there’s unfortunately no cure for hair loss! You can use a variety of treatments, but none of them guarantees success. Many companies dealing with hair loss promise you a definite cure. Various hair integration and hair volumising companies also sell products supposedly curing hair loss, and claim their systems will contribute to it as well. We can assure you - they are not telling you the truth! And if you’d like more information, please check the U.S. based site www.hairlossscams.com.
Below, you'll find a list of treatments that can contribute to improving a case of hair loss but, once again: none of them is a cure for baldness.
Merck Pharmaceuticals sought to find the smallest effective quantity of finasteride and to test its long-term effects on men aged between 18 and 41 with mild-to-moderate thinning hair. Based on their research, 1mg daily was selected and, after 2 years of daily treatment, some of the male patients have regrown parts of their hair.
Minoxidil was first used in tablet form as a medicine to treat high blood pressure, but it was noticed that some patients being treated with Minoxidil experienced excessive hair growth (hypertrichosis) as a side effect. Further research showed that by applying Minoxidil in solution form directly to the scalp, it could prove to be beneficial to those experiencing topical hair loss.
In controlled clinical studies of women aged 18-45, some women with moderate degrees of hereditary hair loss reported re-growth after using 2% minoxidil. Initial results occur at 4 months with maximum results occurring at 8 months.
Low-level laser therapy
A low level laser is shone directly on the scalp to stimulate hair growth through "Photo-Biostimulation" of the hair follicles. One product of these low-level laser therapies is the "Hairmax Lasercomb". There is no peer-reviewed evidence to support this claim. The Lasercomb is FDA approved only with regard to safety. The Leimo laser was recently approved by the TGA (Therapeutic Goods Administration) of Australia as a Class IIa Medical Device that regrows hair. Its ARTG number is 139 456.
Surgery is another method of reversing hair loss and baldness, although it may be considered somewhat extreme. The surgical methods used include hair transplantation, whereby hair-producing follicles are taken from the back and sides of the head and injected into bald or thinning areas.
Looking forward: one prospective treatment currently in development is that of hair multiplication/hair cloning. And it has been shown to work on mice!
It involves extracting self-replenishing follicle stem cells, multiplying them many times over in the lab, and microinjecting them into the scalp. It is expected by some scientists to be available to the public in 2009–2015. Subsequent versions of the treatment are expected by some scientists to be able to cause these follicle stem cells to simply signal the surrounding hair follicles to rejuvenate.
In October 2006, UK biotechnology firm, Intercytex, announced they had successfully tested a method of removing hair follicles from the back of the neck, multiplying them and then reimplanting the cells into the scalp (Hair multiplication). The initial testing resulted in 70% of male patients regrowing hair. This treatment method is expected to be available to the public by 2009.
In January 2007, Italian stem-cell researchers announced that they had developed a new technique for curing baldness. Pierluigi Santi of a Genoa clinic said stem cells could be used to "multiply" hair roots. He said the clinic would be ready to perform its first hair transplants on priority patients - those who have lost their hair in fires or other accidents - within a few months. “After that” he said "we'll open our doors to paying customers". Santi's approach works by splitting roots and growing new follicles.
Topical application of ketoconazole, which is both an anti-fungal and a potent 5-alpha reductase inhibitor, is often used as a supplement to other approaches.
Unsaturated Fatty Acids
Particular unsaturated fatty acids such as gamma linolenic acid are 5 alpha reductase inhibitors if taken internally.
Interestingly, placebo treatments in studies often have reasonable success rates, though not as high as the products being tested, and even similar side-effects as the products. For example, in Finasteride (Propecia) studies, the percent of patients with any drug-related sexual adverse experience was 3.8% compared with 2.0% in the placebo group.
Regular aerobic exercise can help keep androgen levels (particularly free testosterone levels) naturally lower while maintaining overall health, lowering stress and increasing SHBG.
Weight training without aerobic exercise may increase testosterone. One study suggests that both heavy exercise and increased fat intake, in combination, are required for increased free testosterone in strength trainers. Increased total or free testosterone would help them build and repair muscle, but may cause susceptible individuals to lose hair.
However, there is at least one study that indicates a decline in free testosterone combined with an increase in strength due to an (unspecified) strength training regime.
Stress reduction can be helpful in slowing hair loss.
Immunosuppressants applied to the scalp have been shown to temporarily reverse alopecia areata, though the side effects of some of these drugs make such therapy questionable.
Saw Palmetto (Serenoa repens) is a herbal DHT inhibitor often claimed to be cheaper and to have fewer side effects than finasteride and dutasteride. Unlike other 5alpha-reductase inhibitors, Serenoa Repens induces its effects without interfering with the cellular capacity to secrete PSA. Saw Palmetto extract has been demonstrated to inhibit both isoforms of 5-alpha-reductase unlike finasteride which only inhibits the (predominant) type 2 isoenzyme of 5-alpha-reductase.
Polygonum Multiflorum is a traditional Chinese cure for hair loss. P. multiflorum contains stilbene glycosides similar to resveratrol.
Beta Sitosterol, which is a constituent of many seed oils, can help to treat BHP by lowering cholesterol. If used for this purpose, an extract is best. However, consuming large amounts of oil to get at small quantities of Beta Sitosterol is likely to exacerbate male pattern baldness.
While drastic, broad spectrum anti-androgens such as flutamide are sometimes used topically. Flutamide is potent enough to have a feminizing effect in men, including growth of the breasts.
In March 2006, Curis announced that it had received the first preclinical milestone, a $1,000,000 cash payment, in its hair growth program with Procter & Gamble Pharmaceuticals, a division of The Procter & Gamble Company. The programme is focused on the potential development of a topical Hedgehog agonist for hair growth disorders, such as male pattern baldness and female hair loss. The Curis hair loss research program was shut down in May 2007 because the process did not meet the proper safety standards.
WNT Gene Related
In May 2007, US company Follica Inc, announced they have licensed technology from the University of Pennsylvania which can regenerate hair follicles by reawakening genes which were once active only in the embryo stage of human development.
Concealing Hair Loss
One method of hiding hair loss is the "comb over", which involves restyling the remaining hair to cover the balding area. It’s usually only a temporary solution, useful only while the area of hair loss is small. As the hair loss increases, a comb over becomes less effective. When this reaches a stage of extreme effort with little effect — it can make the person the object of teasing or scorn.
Another method is to wear a hat or a hairpiece — a wig or toupee. The wig is a layer of artificial or natural hair made to resemble a typical hairstyle. In most cases the hair is artificial. Wigs vary widely in quality and cost. They're often uncomfortable, don't fit well, wearers perspire in them, and most of all - they must be taken off before going to bed, swimming, exercising etc. And they always look like a wig!.
That's why the best and most efficient way to conceal hair loss is a hair integration or hair volumising system. These are custom-made pieces designed to fit the shape of your head – perfectly!
Hair systems surround just the areas affected by hair loss so, if you have just a few bald patches, you don't need to wear a heavy wig and stick your remaining natural hair under it. Systems incorporate your hair by threading it through holes in a light, non-allergic mesh material onto which natural hair components are then applied.
There are various systems available, however we believe that HAIR SOLVED Enhancer system is the ultimate.
So, please take time to read about the Enhancer system here and, if you're familiar with hair replacement systems in general, or, if you've had a consultation with another company, please open our Enhancer page on this website, and read the section How we compare.
Click here to learn more about our treatments.