About Hair Loss
Hair loss affects about 35 million men and 21 million women in the United States alone. 40% of men have noticeable hair loss by age 35 and 65% by age 60. First you need to understand why hair loss occurs. Your hair loss has little or nothing to do with shampooing, hats, or any other practices. Hair loss is largely genetic.
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There are many causes of hair loss in men and women, including disease, nutritional deficiency, hormone imbalance, and stress. By far the most common cause, however, is what is called androgenetic alopecia. Alopecia is simply the medical term for hair loss. Androgenetic refers to the fact that both genetic predispositions to balding and the influence of androgens, or male hormones, play a part in this type of hair loss.
There is a third factor, which is the passage of time, or aging.
So, in order for androgenetic alopecia to occur, there must be:
- genetic propensity for balding
- presence of androgens, or male hormones
- aging time to allow the first two factors to exert their influence on the hair follicles
Both men and women produce “male” hormones. The most common of these are testosterone, androsteinedione, and dihydrotestosterone (DHT). Androgens are produced by the testicles and adrenals in men, and by the ovaries and adrenal glands in women. These hormones are important in both sexes, but occur in different concentrations, being much more predominant in males than in females. This, in part, is responsible for the typical differences between the genders.
The exposure of hair follicles to DHT over a period of time can lead to androgenetic alopecia, male and female pattern baldness, in people who are genetically susceptible to balding. The balding process can occur at any age and move at any rate. It can start in the teen years or late in life, develop rapidly, slowly, or even stabilize.
Hair loss is not a new phenomenon; Julius Caesar used wreaths to hide his thinning, and French King Louis XIV’s elaborate 15-20 pound wigs covered proof that he, too, suffered from male pattern baldness. History is filled with interesting tales of balding cover-ups.
Other Hair Loss Causes
Hair loss due to scarring of the scalp is called scarring alopecia. Scarring can be due to a variety of causes. Traction alopecia over a period of time may lead to scarring and permanent hair loss. Trichotillomania (compulsive hair-plucking) can cause permanent scalp scarring over time.
Injury to the scalp caused by physical trauma or burns may leave permanent scars and permanent hair loss. Diseases that may cause permanent hair loss due to scalp scarring include (1) the autoimmune conditions lupus erythematosus and scleroderma, and (2) bacterial infections such as folliculitis, fungal infections, and viral infections such as shingles (herpes zoster).
Trichotillomania is the name given to habitual, compulsive plucking of hair from the scalp or other hair-bearing areas of the body. Over time, continual plucking of scalp hair will result in a hairless area-a bald spot. Long term trichotillomania can result in permanent damage to scalp skin and to scarring alopecia. It is not known whether trichotillomania should be classified as a habit or as obsessive-compulsive behavior. In its mildest form, trichotillomania is a habitual plucking of hair while a person reads or watches television. In its more severe forms, trichotillomania has a ritualistic pattern and the hair-plucking may be conducted in front of a mirror. The person with trichotillomania often has guilt feelings about his or her “odd” behavior and will attempt to conceal it.
Loose-anagen syndrome occurs most frequently in fair-haired persons. During the anagen (growth) cycle of hair, scalp hairs sit so loosely in the follicles from which they grow that they can be easily extracted by combing or brushing. The condition may appear in childhood and gradually improve or disappear over time.