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Hair Loss

Hair Loss, formally known as alopecia, can be the result of many factors, including reactions to some medications, genetics, and other medical conditions.

Male Pattern Baldness (Androgenic Alopecia)

Pattern baldness, called androgenetic alopecia, is the most common type of alopecia and is caused by heredity. This type of alopecia is permanent.

Androgenic alopecia typically begins at the hairline, causing hair to gradually recede to form an 'M' shape. This process takes place at the same time as a thinning of the hair at the crown. Eventually, the top points of the 'M' meet the thinned hair at the crown, leaving a horseshoe pattern of hair that travels around the sides and back of the head. Androgenic alopecia can be treated using topical medications such as minoxidil or Propecia (oral finasteride). These medications can be very effective in stimulating new hair growth. Minoxidit, for example, has be shown to be successful in stimulating hair regrowth on the crown, and even ceasing continued hair loss in up to 40% of men studied.

Over 65% of patients studied demonstrated an increase in hair growth on the crown with this medication. Slowing and even stopping hair loss from the crown appears to be the most significant advantage of these medications.

Alopecia Areata

A less common form of hair loss is alopecia areata. This form of hair loss is typically temporary, affecting less than 2% of the population. This condition causes hair loss from both the head and the body. The cause of alopecia areata remains unknown. The hair follicles of individuals with alopecia areata are attacked by the immune system, causing hair growth to stop. It typically begins with one or two bald patches appearing on the scalp, but can then go on to cause total hair loss on the scalp. A total loss of hair from the scalp is called alopecia totalis. Total hair loss from the body is termed alopecia universalis.

Alopecia areata can affect either sex, at any age. However, it usually appears in childhood.

Most situations where hair loss is experienced are caused by non life threatening health triggers. Having said that, only a physician can determine that the causes are not the result of potentially more serious health conditions.

Hair Loss Causes

Hair grows in two stages. Up to 90% of hair growth on the scalp takes place over a 4-5 year growth stage. The other 10% takes place over a 2-3 month resting stage, prior to being shed from the scalp. After the scalp sheds this hair, new hair growth occurs as quickly as a half inch per month. Hair loss occurs when hair is shed at a faster rate than it regrows, when hair is shed from the scalp in patches, or when hair regrowth replaces the hair shed with thinner hair.

Androgenic alopecia does not only happen in men. Although less common, women can also experience this type of hair loss. Androgenic alopecia is caused by heredity. Heredity is not only the cause, but it also impacts several aspects of androgenic alopecia, including the rate at which hair loss occurs, the pattern and degree of hair loss, and the age when hair loss begins. A history of baldness on the female or male side of a family increases the risk of balding.

The cause of Alopecia Areata is unknown, however, it is know to be an autoimmune disease. Heredity plays a role, making the likelihood of developing the disease greater when the disease is present in other family members. Alopecia Areata is typically temporary, but it can take several years for hair to grow back.

Outside of heredity, there are several other causes of temporary hair loss:

- Medications (medicines to treat high blood pressure, arthritis, depression, gout)

- Disease (diabetes, lupus, thyroid disorders)

- Medical Treatments (chemotherapy/radiation, flu treatments, surgery)

- Hair Products (hair dyes, perming, bleaching)

- Scalp Infections (ringworm)

- Childbirth

Hair Loss Treatment

There is no "cure" for baldness. Treatments are available, however, that help to slow hair loss and promote hair growth.

The medications currently available to treat hair loss have varying success rates. In addition, the success of any medicine depends on many factors, such as the cause of hair loss, how a person responds to treatment, and the degree to which hair loss has occurred. The less profound the extent of hair loss, the more likely a person is to respond to hair loss medications.

Medications available to Treat Hair Loss

Although there are many treatments available today, very few are clinically proven to achieve results. Therefore, the FDA has approved only a handful of these medications. FDA approved medications include:

1) Finasteride (Propecia, Proscar)

This medication is taken daily, in pill form. The proven outcomes of this treatment include a slowing of hair loss. For some individuals, new hair growth can result. It often takes many months for results to become apparent. Finasteride medication is effective by inhibiting the conversion of testosterone into dihydrotestosterone (DHT). DHT is a hormone that works to shrink hair follicles. This is an important variable in male hair loss. Finasteride can have the unpleasant side effect of decreased sex drive. It is not recommended for women, especially for women of childbearing age, as it has been linked to birth defects in male babies. Women should never take this medication.

2) Minoxidil (Rograine)

This is a non prescription medication and is used to treat both Androgenic Alopecia and Alopecia Areata. It is sold as a liquid which is rubbed on the scalp twice daily. It has been clinically proven to promote hair regrowth and to slow hair loss. New hair growth often exhibits increased thinness and lightness than the hair lost. Scalp irritation and dry scalp are potential side effects of Minoxidil.

Finasteride and Minoxidil quit working when the medication is halted. These products are not recommended for teens or children, or for the treatment of nonhereditary baldness.

3) Cortisone (Cortone)

Cortisone injections to the scalp may be used for treating Alopecia Areata. These injections are only slightly uncomfortable and are typically carried out once each month. Cortisone pills are another form of this treatment.

4) Surgery

Scalp reduction surgery and hair transplants are surgical techniques used to treat Androgenetic Alopecia.

a) Scalp Reduction
Scalp reduction involves limiting the area of bald skin on a person's head by removing a portion of it. This permits hair covered areas of the scalp to cover an larger part of the scalp. Some of these methods create what are called "flaps", where areas of scalp with hair are folded over bald areas. Scalp reduction is often combined with hair transplants for a more natural looking hairline.

b) Hair Transplant
Hair transplants involve using "plugs" of skin from the side or back of the scalp that contain a fair number of hairs, and implanting them on the bald sections of the scalp. Successful hair transplant typically involves several transplant sessions, carried out over time as hair loss occurs.

There are some negatives to be considered when exploring surgical procedures to treat hair loss. These include the costs associated with these methods, as well as the discomfort involved. Side effects can occur, such as infections and chronic head pain. Discuss these options with a doctor before making any decisions about hair loss surgery.

5) Wigs

Some people do not see any positive results from various types of hair loss treatments. These people can benefit from the use of wigs. It should be mentioned that wigs have changed significantly over the past many years. There now exist extremely natural looking, high quality wigs available reasonable prices.