Hair Loss

 

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Hair Loss Introduction

Hair loss in both men and women is defined as Alopecia. Alopecia is the termed used to describe the loss or thinning of hair. This condition is classified into varying categories, including scarring alopecia and non-scarring alopecia. Unlike scarring alopecia, whereby all hair follicles are destroyed and rendered useless, non-scarring alopecia may be reversed. The remaining categories of hair loss include;

  • Male-pattern baldness
  • Female-pattern baldness
  • Hirsutism (male-pattern hair growth affecting a minority of women)
  • Hair shaft disorders.

Hair is cyclical. In fact, most hair loss is part of our normal growth cycles. Three phases occur in the production and reproduction of body hair. These phases are referenced as the anagen growth phase, catagen involutional phase, and the telogen resting phase. [1] It is not unusual for one to lose an average of 50 to 100 hairs per day during the resting, or latent phase of the hair cycle (telogen). New hair will eventually replace these lost hairs.

A legitimate concern arises when there is noticeable thinning or baldness. The defining factors determining this type of hair loss can range from genetic pre-disposition to a particular vitamin and/or mineral deficiency. The thinning or balding of hair is not an immediate threat to ones physical health, but often adversely effects an individual’s psychological well-being.

Other causes of common hair loss may include; prescription drug therapies, skin disorders, autoimmunity, severe stress, scalp radiation, pregnancy, diseases, bacterial infections, excessive androgen production, and over processed hair. Genetic predisposition remains the greatest determinant in the balding of hair - some 95% of both men and women.

Hair Loss Symptoms

Signs and symptoms of alopecia are disorder-specific, meaning that each condition exhibits unique traits and patterns regarding the accompanying hair loss. A physician or dermatologist often evaluates a patient and determines the type and severity of a given thinning/balding pattern. [2] The following information indicates the specific signs and symptoms of categorized hair disorders:

  • Non-scarring alopecia- characterized by circular areas of hair loss, receding hair lines, a smoothness of scalp region, and inflammation. Extreme cases may also include the loss of eyebrows, lashes, and pubic hair.
  • Scarring alopecia- area specific; noted by visual abnormalities, such as violet-colored skin patterns, scaling, and lesions.
  • Hirsutism- characterized by male-pattern hair growth in women. Other symptoms include; genital abnormalities, deepening of voice, acne, and irregular and/or lack of menstruation.
  • Hair shaft disorders-usually involves hair that is excessively dry, brittle and very coarse. May also be recognized by skin and other noted irregularities.

Signs and symptoms which require immediate medical assistance include; hair which falls out in clumps, patchy hair loss, development of male characteristics in females, and redness, flaking, and scarring of the scalp where hair loss has taken place.

Types of Hair Loss:

Male-Pattern Baldness

Male-pattern baldness is also known as common baldness, hereditary baldness, and Androgenetic Alopecia. This type of baldness is distinctive and has a marked progression in the hair loss taking place on the scalp. The cause of this type of hair loss is due to genetic susceptibility (including hair follicle sensitivity), hormones, and androgens. It is agreed that there are three causal factors in this form of hair loss: age, inherited tendency to early baldness, and the most important factor, dihydrotestosterone (DHT). Persons with this condition also have a prolonged latent phase in the hair cycle, which further enhances the balding process. [3]

DHT is a potent androgen in hair follicles and is derived directly from testosterone. It causes the shrinking of hair follicles and causes these follicles to become dormant, or inactive. DHT also triggers specific growth factors and suppresses cell proliferation, causing apoptotic cell death. The inhibition of such growth factors, like TGF-beta2, paralleled with DHT suppression, has proved significant in the treatment of hair loss. [4]

Female-Pattern Baldness

Female-pattern baldness is also known as “diffused balding.” Like its counterpart of the male variety, it too is caused by age, genetic susceptibility, and androgen. Females with this conditions experience a slower progression than males, with signs of balding around the age of 30. This process may continue throughout menopause, or until a permanent degradation of hair follicles takes place. However, unlike males, female-pattern baldness rarely equates to near or complete baldness and rarely interferes with the hairline. [4]

Alopecia Areata

Alopecia areata is categorized as an autoimmune skin disease. Hair follicles are mistakenly attacked by an individual’s immune system, which results in the arrest of hair growth. Alopecia areata may initially manifest itself as bald patches on one’s head and can progress to complete loss of scalp hair (Alopecia totalis), or even the complete loss of all body hair (Alopecia Universalis). [5] Nearly two percent of the entire population suffers from this disease, despite its relative obscurity.

Alopecia Universalis

Persons suffering from this condition are genetically predisposed to complete hair loss, and possible distortions of the nails. Alopecia Universalis is classified as both an acute and permanent disorder. Individuals with this condition are usually more susceptible to diseases of the thyroid gland and vitiligo than the general population. This form of alopecia differs from other forms which permanently damage hair follicles. The regrowth of body hair remains possible for individuals suffering from this condition regardless of time spent with the complete absence of body hair.

Other forms of hair loss Other forms and causes of hair loss:

  • Telogen Effluvium
  • Chemotherapeutic Induced Hair Loss
  • Trichotillomania

Of interest, nearly 67% of all men, and 25% of women will suffer from significant hair loss. 25% of men begin balding before age 30, with 65% balding by the age of 60. Women experience thinning hair, primarily, within the age range of 25 to 45 years of age; with complete loss after the age of 40. Pre and post-menopausal women have a significantly elevated risk for the development of alopecia.

Hair Loss Treatments

Specialists often biopsy hair to determine the integrity of a given hair follicle. This evaluation is used to establish the underlying cause of the hair thinning / balding, and to decide what treatment options are available. Traditional medicines include:

  • Minoxidil– used for hair regrowth and to inhibit any additional loss of hair
  • Tretinion- decreases dermal layers on scalp to further the penetration of applied products containing minoxidil
  • Finasteride (Propecia)
  • Hair Transplantation
  • Topical or Injectable Steroid Treatments
  • Radiation Therapy (PUVA)

Supplements helpful with Hair Loss

Nutritional Applications for Hair Loss:

Supplement Application
Essential Fatty Acids (EFAs) Improves Hair Texture
Raw Thymus Glandular Improves Functioning Capacity of Hair Glands
B-complex Vitamins Extremely Important Nutrients for the Overall Health and Growth of Hair
Biotin Deficiencies of Biotin Have Been Linked to Hair Loss
Inositol Critical for Proper Hair Growth
Methylsulfonyl-methane (MSM) Assists With Production of Keratin, a Protein Component of Hair
Vitamin C with Bioflavonoids Provides Antioxidant Action in Hair Follicles/Increases Scalp Circulation
Vitamin E Also Increases Scalp Circulation, d-alpha tocopherol Improves Health and Growth of Hair
Zinc Stimulates Hair Growth via Immune System
Coenzymes Q10, A Increases Tissue Oxygenation in Scalp
Dimethylglycine (DMG) Circulation Properties
Kelp Dense Mineral Which Assists in Hair Growth
Copper Used in conjunction with Zinc, Chelated Copper Aids in Hair Growth
Grape Seed Extract Antioxidant Properties Protect Follicles from Free Radical Damage
L-Cysteine, L-methionine, Glutathione Amino Acids which Prevent Hair Fallout/Promotes Blood Supply to Scalp
Silica Aids in the Health and Growth of Hair
L-Lysine Inhibits 5-alpha-reductase Conversion of Testosterone into Dihydrotestosterone
L-Arginine Enhances Nitric Oxide to Promote and Maintain Health and Growth of Hair
Saw Palmetto Block 5-alpha-reductase, Provides a Reduction in DHT Uptake by Follicles, Blocks Binding of DHT to Specific Androgen Receptors
Green Tea Extract Adversely Affect type I 5-alpha-reductase

[6-10]

References

1. Kligman AM. The human hair cycle. J Invest Dermatol 1959; 33:307-16.

2. Stene JJ. [Alopecia areata and treatment]. Rev Med Brux. 2004 Sep; 25(4):A282-A285.

3. Curtois M, Loussouarn G, Horseau C. Hair cycle and alopecia. Skin Pharm 1994; 7:84-9.

4. Hibino T, Nishiyama T. Role of TGF-beta2 in the human hair cycle. J Dermatol Sci. 2004 Jun; 35(1):9-18.

5. Alexis AF, Dudda-Subramanya R, et al. Alopecia areata: autoimmune basis of hair loss. Eur J Dermatol. 2004 Sep; 59(9):525-9.

6. Balch PA. Prescription for Nutritional Healing: The A-Z Guide to Supplements, 2nd Ed. Penguin Putnam, Inc. New York, NY 2002;120-121

7. Rushton DH. Nutritional Factors and Hair Loss. Clin Exp Dermatol. 2002 Jul; 27(5):396-404.

8. Shimizu Y, Sakai M, et al. Immunohistochemical localization of nitric oxide synthase in normal human skin: expression of endothelial-type and inducible-type nitric oxide synthase in keratocytes. J Dermatol. 1997 Feb; 24(2):80-7.

9. Prager N, Bickett K, et al. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med. 2002 Apr; 8(2):142-153.

10. Liao S, Hiipakka RA. Selective inhibition of steroid 5-alpha-reductase isozymes by tea epicatechin-3-gallate and epigallocatechin-3-gallate. Biochem Biophys Res Commun. 1995 Sep 25; 214(3):833-8/