Hair loss (baldness) information

Minoxidil

2005-06-08T15:06:00.000-07:00

Minoxidil dilates blood vessels, and is sometimes called a "potassium channel opener." In the brand name Rogaine (http://www.rogaine.com), it is FDA approved to stimulate regrowth and thicken hairs. Minoxidil is applied topically to the scalp, and has been shown to promote hair growth in about 25% of men and women, though it may take several months to work. New hair is usually thinner and lighter, like baby hair, and grows mostly on the top of the head, not at the hairline. Its effects may fade with time. Skin irritation is the most commonly reported side effect. Dizziness and increased heart rate have also been reported, but rarely.

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Antiandrogens

2005-06-08T15:05:00.000-07:00

Antiandrogens bock DHT already produced and present in the blood stream from binding with hair follicles. Nizoral Shampoo and Neutrogena T-Gel have been clincally shown to have antiandrogen properties and are prescribed by medical professionals.

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Revivogen

2005-06-08T15:04:00.000-07:00

Revivogen (http://www.revivogen.com) is a non-FDA approved topical DHT inhibitor treatment applied to the scalp, with many ingredients, such as types of fatty acids, that are thought, though not proven, to inhibit DHT levels in the scalp and have a positive influence in combatting hair loss. Revivogen also contains ingredients that are thought, though not proven, to function as an antiandrogen (see below) that has a positive influence in combatting hair loss. Clinical trials are reportedly underway.
Revivogen uses simple mixtures of fatty acids (gamma Linolenic acid, alpha Linolenic acid, Linolenic acid, and a few others, which are thought to be potent inhibitors of 5AR, both type I and type II[6] (http://www.hairlosstalk.com/download/study1.pdf)[7] (http://www.hairlosstalk.com/download/study4.pdf)[8] (http://www.hairlosstalk.com/download/study6.pdf)[9] (http://www.hairlosstalk.com/newsletter/article233.htm)), in their free form, that come from the bulk de-esterification of natural oils like borage and flaxseed. This methodology is considered just as effective as using purified fatty acids, but saves considerable expense. There are other products that contain fatty acids from natural oils, such as black currant oil and emu oil, but virtually all natural oils, including these two, contain only insignificant amounts of free fatty acids.

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Propecia's effects in detail

2005-06-08T15:03:00.000-07:00

DHT is a derivative hormone (metabolite) of testosterone that is considered to be the main cause of miniaturization and eventual destruction of hair follicles in male pattern baldness. DHT is a steroid hormone just like testosterone but more powerful.
Many dermatologists and research scientists specializing in hair loss believe DHT molecules may diffuse into the interior of hair follicle cells (the cytoplasm or cytosol) and bind with androgen receptors. This complex, both the receptor and the DHT molecule, then enters the nucleus of the cell. In the nucleus of the hair follicle cell this complex could then alter the rate of protein synthesis in men who are genetically predisposed to baldness.
However, DHT also plays an important role in the functioning of the central nervous system (the brain), the testicles and prostate, and almost everything but muscle tissue. In muscle tissue testosterone is the dominant hormone. (Some bodybuilders inject testosterone derivatives to gain muscle fast.)
Propecia and Avodart cause a rise in testosterone levels because testosterone that would normally be converted into DHT remains testosterone. Continual high levels of testosterone in the body could possibly have negative side effects.
Artificially low levels of DHT in the body could cause some unwanted conditions. DHT is an antagonist of estrogen. Men’s bodies also produce the female hormone estrogen in the adrenal glands although this is just one-tenth of the estrogen that premenopausal women produce in their ovaries. By reducing DHT with drugs a man’s protection from the effects of estrogen may also be reduced. Gynecomastia could be one result of this. Gynecomastia is abnormally large breasts in a male.
Even though both finasteride and dutasteride were developed to combat benign prostatic hyperplasic by reducing DHT in prostate tissue, some scientists question the wisdom of using these 5-alpha reductase inhibitors in younger men who have no problem with their prostates. A research chemist, Pat Arnold - “Evidence is mounting that the existence of a high estrogen/androgen ratio - a condition common in older men - is highly correlated with the development of benign prostatic hyperplastic.”

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Propecia health concerns

2005-06-08T15:02:00.000-07:00

The UC Berkeley Wellness Letter in March 2003 states they don’t recommend Propecia "because its long-term safety is unknown. This is disquieting, since young men are the prime candidates, and the drug has to be taken for a lifetime. If you do decide to take it, you should know that although the standard dose is one milligram, there is some evidence that one-fifth that amount also works. If you cut the pill into quarters, you will save money."[5] (http://www.berkeleywellness.com/html/ds/dsAvacor.php)
While they point out Propecia must be taken for a lifetime to avoid losing hair, it should be counterpointed that future treatments are widely expected by baldness specialists to replace Propecia, which would end the need for continued use. Additionally, Propecia is widely cosidered safe enough to prescribe by health professionals, and is one of the only two FDA-approved baldness treatment products on the market.

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Propecia

2005-06-08T15:01:00.000-07:00

Propecia (http://www.propecia.com), also called by its non-brand name Finasteride, is a "DHT inhibitor" pill that is FDA approved to inhibit production of DHT through the entire body (called systemic). It does this through inhibiting the conversion of testosterone to DHT. Finasteride is taken orally and has a reported 29-68% success rate (vs 17-45% in patients receiving a placebo). It is effective only for as long as it is taken; the hair gained or maintained is lost within 6-12 months of ceasing therapy (Rossi, 2004). In clinical studies, Propecia, like Minoxodil, was shown to work on both the crown area and the hairline,[4] (http://www.hairlosstalk.com/download/finfront.pdf) but is most successful in the crown area. For those in the early stages of hair loss, it is generally recommended to start slow, using propecia alone for at least a year, as it has very good maintenance rates, then adding other products, such as minoxidil, if regrowth is desired.
Propecia is the same as the oral prescription drug, Proscar, used in higher doses to treat an enlarged prostate. Some users save money by buying Proscar instead of Propecia , and split the pills in quarters using a pill-splitter to ensure the same amount as is present in Propecia is taken.
Propecia has been shown to be ineffective for treating hair loss in women, and shouldn't even be touched by pregnant or potentially pregnant women, as it causes severe birth defects in male fetuses.

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Baldness treatment products

2005-06-08T14:59:00.000-07:00

Since the 1980s, drug therapy has increasingly become a realistic management option for baldness for men and women, as increased understanding of the mechanisms of normal and pathologic hair growth has pointed the way to improved treatments. Scientifically proven baldness treatments continue to be an area of research that receives a large amount of funding. It's estimated to be a US $1 billion per yer industry.
General concerns
It is easier to prevent the aging and falling out of healthy hairs than to regrow hair in follicles that are already dormant. Propecia is the only treatment that has been demonstrated as an effective maintainer. There are products that have good success rates with regrowth, including the scientifically proven Propecia, Rogaine, and Tricomin. Without preventive treatment, in three double-blind, placebo-controlled, randomized studies, 72% of the balding men on placebo had lost hair compared to baseline by 24 months. This is compared to %83 of participants on Propecia experiencing either no more hair loss or regrowth. See Prevent Hair loss, don't Regrow? (http://www.hairlosstalk.com/newsletter/article127.htm)
The prospective treatment of hair multiplication'/hair cloning, which extracts self-replenishing follicle stem cells, multiples them many times over in the lab, and microinjects them into the scalp, has been shown to work in mice, and is currently under development, 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.
The below treatments are some of the most prominent. Generic brands, often with identical chemical structure or the same active ingredients, may be equally effective and are cheaper.
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.[2] (http://www.hairlosstalk.com/download/finfront.pdf) Proponents of alternative therapies believe that the majority of cases of hair loss that progress despite treatments do so because the people believe no such cure can occur. In this view, this belief, which is prevailing in the modern civilised world and continuously reinforced by medical science, is the main obstacle for effectively finding and applying a cure.
While treating hair loss most successfully is a multi-faceted, ongoing experiment for the individual, there are three principles, sometimes called The Three P's that are considered important to help produce success and avoid the somewhat common mistakes that can sabotage treatments.[3] (http://www.hairlosstalk.com/discussions/viewtopic.php?t=12638) The Three P's are: proven treatments first, take pictures, and be patient. The most recommended teatments, in order of proven effectiveness, greatest to least, is as follows: (1) Propecia (2) Rogaine (3) Tricomin (4) Topical Spiro 5% (5) Revivogen (6) Crinagen (7) Folligen (8 ) Everything else.
The average hair loss treatment takes a minimum of 6 months to begin working, and sometimes up to 24 months to truly see optimal results. Treating hair loss takes time because of hair cycles. The process of hair loss is the process of "miniaturization," which takes many years. Hairs grow in, cycle into dormancy, and then grow in again several months later. Each time they re-emerge, they do so thinner, shorter, and less pigmented. In time, they become so small that they are no longer noticeable. This can take many years. New hairs only grow in 2 or 3 a year, which is why it can take a year or more to be able to detect the success of a treatment.
This difficulty can be increased because many (scientifically proven) treatments often cause initial periods of shedding, as some resting hair follicles are ejected and a new cycle of growth begins, hopefully with a thicker follicle. Discontinuing treatments can also cause periods of shedding, though this hair loss is generally considered to be temporary, not affecting the baseline.

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Common baldness myths

2005-06-08T14:58:00.000-07:00

There are many myths regarding the possible causes of baldness and its relationship with one's virility, intelligence, ethnicity, job, social class, wealth etc. Most of them can be dismissed by the existence of many counterexamples or by a lack of sufficient scientific research.
Some of these myths are:
"Intellectual activity or psychological problems can cause baldness."
This myth probably was inspired by the fact that the human brain is located inside the skull, very close and just below where hair grows, and so it was thought that the use and abuse as well as mental diseases could have negative effect on hair growth and number.
This is sometimes used as a stereotype in movies, where the more intellectual or rather frustrated characters are most usually portrayed as bald and generally unattractive, as opposed to the main characters which are usually portrayed as attractive, fit, mentally stable and generally with no apparent hair problems.
This same myth normally extends to considering people having intellectual jobs more prone to baldness problems compared to manual laborers, sometimes further extending the myth to male college or university students when compared to workers of the same age. The myth is suspect because counterexamples can be found in any case.
"Baldness can be caused by emotional stress, sexual frustration etc."
While emotional stress can have a part in causing baldness, again it is easy to find counterexamples like non-frustrated and non-stressed people with hair loss problems as well as stressed and/or frustrated people with no hair loss problem at all. This myth also suggests that a vicious circle between hair loss and emotional stress/sexual frustration can take place, although only one part of it can be scientifically explained (hair loss causing low esteem and then frustration, but not vice versa).
"Bald men are more "virile" or sexually active than others."
This myth probably stems from the fact that some forms of baldness in some predisposed individuals are caused by androgens, and removal of androgens (by castration) prevents baldness or stops it from progressing further. Yet counterexamples can be found, like men with perfect hairlines and similar levels of androgens or men with sensitivity to androgens causing hair loss but which are not very sexually active.
"Shaving hair makes it grow back stronger"
Proposed as a popular remedy against baldness, it's very probably just an illusion similar to the one perceived after shaving one's beard or mustache. Shaving one's head doesn't increase the number of healthy hair present on the scalp, and, when the remaining hair has grown a few millimeters, no enhancement in thickness or overall quality can be observed.
"Some human races or ethnic groups are less prone to baldness problems then others."
It is true that by observing many pictures of men of European descent and then comparing them to pictures of men of Asian or American Indian descent it is very likely that a random observer will deduce that baldness problems seem to be much more frequent among the "European" group than in the "Asian" one.
Similar observations can be done regarding the people living in most Western countries when compared to people living in "underdeveloped" or Third World countries, but lacking any official anthropological, medical and scientific research to back them up, such observations degenerate into a racial/social stereotype.
A very similar stereotype exists even between the various European ethnic groups, when comparing people of Southern European descent with those of Northern European, Germanic or Slavic origins, with the stereotype summarily describing the "Southern Europeans" as darker-skinned, with more body hair, with the women more prone to cellulite problems and the men more prone to baldness, a stereotype probably developed under times of war or diplomatic tensions between European countries.

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Embracing baldness

2005-06-08T14:57:00.000-07:00

Of course, instead of concealing hair loss, one may embrace it. Many celebrities and athletes shave their heads. The St. Baldrick's Foundation (http://www.stbaldricks.org/) spreads the message of baldness by shaving the heads of adults to raise money for curing childhood cancer, which often causes children to lose their hair.

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Concealing hair loss

2005-06-08T14:55:00.000-07:00

One method of hiding hair loss is the comb-over, which involves restyling the remaining hair to cover the balding area. It is usually a temporary solution, useful only while the area of hair loss is small. As the hair loss increases, a comb-over becomes less effective.
Another method is to wear a hairpiece - a wig or toupee. The wig is a layer of artificial or natural hair made to resemble a typical hair style. In most cases the hair is artificial. Wigs vary widely in quality and cost. The best wigs - those that look like real hair - cost up to tens of thousands of dollars. Organizations such as Locks of Love (http://www.locksoflove.org/) and Wigs for Kids (http://www.wigsforkids.org/) collect individuals' donations of their own natural hair to be made into wigs for young cancer patients who have lost their hair due to chemotherapy or other cancer treatment.

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Stem cells

2005-06-08T14:54:00.000-07:00

Stem cells have been discovered in hair follicles and some researchers predict research on these follicle stem cells may lead to successes in treating baldness through hair multiplication within three or four years (as of November 2004). This treatment is expected to initially work through taking stem cells from existing follicles, multiplying them in cultures, and implanting the new follicles into the scalp. Later treatments may be able to simply signal follicle stem cells to transmit chemical signals to nearby follicle cells which have shrunk during the aging process, which respond to these signals by regenerating and once again making healthy hair.

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Hair transplant

2005-06-08T14:53:00.000-07:00

Surgery is another method of reversing hair loss and baldness, although it may be considered an extreme measure. The surgical methods used include hair transplants, where patches of skin with hair are moved from one part of the head to another. Another method is scalp reduction, where parts of the scalp are removed, the skin is stretched over the area that had been removed, and everything is stitched back together. Hair transplants generally cause scarring, sometimes severe, which may be especially visible if hair loss continues over the rest of the scalp.

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Preventing and reversing hair loss

2005-06-08T14:52:00.000-07:00

It is easier to prevent the aging and falling out of healthy hairs than to regrow hair in follicles that are already dormant. However, there are products that have good success rates with maintenance and regrowth, including the scientifically proven Propecia, Rogaine, and Tricomin. The prospective treatment of hair multiplication/hair cloning, which extracts self-replenishing follicle stem cells, multiples them many times over in the lab, and microinjects them into the scalp, has been shown to work in mice, and is currently under development, 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.*
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.[1] (http://www.hairlosstalk.com/download/finfront.pdf) Proponents of alternative therapies believe that the majority of cases of hair loss that progress despite treatments do so because the people believe no such cure can occur. In this view, this belief, which is prevailing in the modern civilised world and continuously reinforced by medical science, is the main obstacle for effectively finding and applying a cure.

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Psychological implications

2005-06-08T14:50:00.000-07:00

The psychological implications for individuals experiencing hair loss vary widely. There can be a general societal anxiety surrounding the process of hair loss, but some individuals view it as nature taking its course.
Some balding men may feel proud of their baldness, feeling a kindred relationship with famous charismatic bald film actors such as Yul Brynner, Telly Savalas and Patrick Stewart, who have been considered masculine and handsome in part because of their most obvious distinguishing feature.

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Evolutionary theories of baldness

2005-06-08T14:49:00.000-07:00

There's no consensus regarding the details of the evolution of baldness. Most theories regard it as resulting 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.
One theory, advanced by Muscarella & Cunnhinham, suggests baldness evolved in males through sexual selection as an enhanced signal of aging and social maturity, whereby aggression and risk-taking decrease and nurturing behaviours increase.(1) This may have conveyed a male with enhanced social status but reduced physical threat, which could enhance ability to secure reproductive partners and raise offspring to adulthood.
In a study by Muscarella & Cunnhingham, males and females viewed 6 male models with different levels of facial hair (beard and moustache or clean) and cranial hair (full head of hair, receding and bald). Participants rated each combination on 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, and baldness was associated with more social maturity.

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Female pattern baldness

2005-06-08T14:47:00.000-07:00

Female pattern baldness, in which the midline parting of the hair appears broadened, is less common. It is believed to result from a decrease in estrogen, a hormone that normally counteracts the balding effect of testosterone, which normally occurs in women's blood. Female pattern baldness is being classified on the Ludwig scale I-III.
There are several other kinds of baldness. Traction alopecia is most commonly found in women with ponytails or cornrows that pull on 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. Some mycotic infections can cause massive hair loss. Alopecia areata is an autoimmune disorder also known as "spot baldness" that can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis).

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Male pattern baldness

2005-06-08T14:46:00.000-07:00

Male pattern baldness is thought to occur in varying forms in about 50% of adult males. It is characterized by hair receding from the lateral sides of the forehead, known as "receding hairline" or "receding brow." An additional bald patch may develop on top (vertex). The trigger for this type of baldness, which is also known as androgenic alopecia, is currently believed to be 5-alpha reductase, an enzyme that converts the hormone testosterone into dihydrotestosterone (DHT), which, in genetically-prone hairs on the scalp, inhibits hair growth. Onset of hair loss sometimes begins as early as end of puberty, and is mostly genetically determined. Male pattern baldness is classified on the Hamilton-Norwood scale I-VIII.

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Baldness

2005-06-08T14:43:00.000-07:00

Baldness (formally alopecia) is the state of lacking hair where it usually would grow, especially on the head. The most common form of baldness is a progressive hair-thinning condition that occurs in adult humans and other primate species.

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