Baldness is a common problem faced by a lot of men and women around the world. In this guide, we will learn more about baldness in both men and women. The guide discusses the causes and treatment/management of male and female baldness.
Humans shed between 50 and 100 strands of hair per day. Hair shedding is a normal aspect of life. Some hair falls out, while others develop new growth. Hair loss occurs when this balance between hair growth and hair fall is disrupted. It is known as “alopecia” in medical science.
Male Pattern Baldness
Male pattern baldness, formally androgenetic alopecia, is a genetically predetermined disorder due to an excessive response to androgen hormones. The condition is marked by progressive loss of terminal hair of the scalp after puberty.
In males, hair loss is most prominent at the crown and frontotemporal regions. The progression is marked by thinning of hair and miniaturizing of the follicle.
The average hair growth cycle consists of four phases: anagen (growth), catagen (involution), telogen (resting), and exogen (shedding of hair). 80% to 90% of hair is in the anagen phase, which lasts 2 to 6 years and determines the hair length; less than 5% of hair is in the catagen phase, and the rest is in the telogen phase. Shedding of 100 hair a day (exogen) is standard.
Individuals with androgenetic alopecia have a higher level of androgen receptors that shorten the anagen (growth cycle) resulting in a ratio of 5:1 of anagen to telogen where the normal ratio is 12:1.
Treatment will be more effective if sought early in the process.
Treatment/Management
The FDA has approved two drugs for androgenetic alopecia.
- Topical minoxidil
- Finasteride
They need to be applied for a 4-6 month period to show improvements. Thereafter, they need to be used continuously to be effective.
Only hair loss that happens due to sickness or traumatic events, etc can be reversed as the follicles are still active. But in androgen alopecia, the hair loss is permanent. Therefore, it is advisable to start the treatment at the earliest. The treatment delays the time to balding by a few years by slowing down the shedding and follicle thinning.
If the hair loss is advanced, a hair transplant can be effective and cosmetically satisfactory to restore the hair. However, individuals need good donor plugs (greater than 40 follicular units/cm2).
Other proposed treatments include saw palmetto extract (Serenoa Repens), platelet-rich plasma, and adipose-derived stem cells.
Hair loss doesn’t usually signal any medical problem and it doesn’t harm your health. But worrying about one’s looks is common. An alternative to all the treatments is to just keep it short or take things in your hands like Vin Diesel, Rock, Michael Jordan, Bruce Willis and more. You are in good company! 🙂
Alopecia in Women
Androgenetic alopecia involves the action of hormones called androgens, and this is the most common type of hair loss that affects women.
It is similar to male pattern baldness but women can lose their hair in a different pattern than men and it begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head.
Patterns of Female Hair Loss
Clinicians use the Ludwig Classification to describe female pattern hair loss.
Type I is minimal thinning that can be camouflaged with hair styling techniques.
Type II is characterized by decreased volume and noticeable widening of the mid-line part.
Type III describes diffuse thinning, with a see-through appearance on the top of the scalp.
Reasons for Female Pattern Baldness
The exact reason for female pattern baldness is not well understood, but may be related to:
- Aging.
- Changes in the levels of androgens (hormones that can stimulate male features).
- Family history of male or female pattern baldness.
- Heavy loss of blood during menstrual periods.
- Certain medicines, such as estrogenic oral contraceptives.
Diagnosis
Female pattern baldness is usually diagnosed based on:
- Ruling out other causes of hair loss, such as thyroid disease or iron deficiency.
- The appearance and pattern of hair loss.
- Your medical history.
There is no known prevention for female pattern baldness. Female pattern baldness is usually not a sign of any underlying medical disorder. There may be many potential causes of hair loss in women, including medical conditions, medications, and physical or emotional stress.
If you notice unusual hair loss of any kind, it’s important to see your primary care provider or a dermatologist, to determine the cause and the appropriate treatment.
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Authors:
Pankaj Narsain (INFS Faculty)
Asmita Shah (INFS Faculty)
Reference
https://www.ncbi.nlm.nih.gov/books/NBK430924/
