HOW DOES HAIR LOSS OCCUR?
Hair loss can have many different causes. The most common cause of hair loss in men and women is hereditary hair loss, or androgenetic alopecia. This involves a genetically determined sensitivity of the hair follicles to the hormone dihydrotestosterone (DHT), causing the hair’s growth cycle to shorten and eventually stop. Besides hereditary baldness, (hair) diseases, hormone fluctuations, stress and medication use can also cause hair loss.
IS IT HEREDITARY HAIR LOSS?
A hair growth cycle normally lasts two to five years and follows three phases: first, hair growth is active, followed by a period of rest, after which hair finally falls out. Excessive natural hair loss occurs when this growth phase is disrupted. In hereditary baldness, DHT is that disruptor. Around 80% of men who experience hair loss are affected by this hereditary form of hair loss.
Miniaturisation of hair
Typically with hereditary hair loss, hairs become increasingly thin. DHT, which binds to the receptors (´antennae´) of hair follicles, causes hair follicles to shrink and shortens the hair’s growth phase. The follicles remain, but develop increasingly shorter and thinner hairs: the so-called miniaturisation of hair. Thus, androgenetic alopecia develops gradually: each hair cycle ends with thinner hair. Eventually, the hair falls out permanently and does not grow back.
A recognisable pattern
In hereditary baldness, the hairs on both sides and the back of the head do not fall out. This area is also called the ‘Hippocratic wreath’. This is because these hairs are not sensitive to the hormone DHT. Hairs above the wreath, however, can be sensitive to DHT. This causes (in men) a recognisable pattern of a receding hairline, inlets and hair loss from the crown.
PATTERNS OF BALDNESS
Although hereditary baldness is also called ‘male pattern baldness’, it occurs in men and women. It does have a different manifestation: in men, it can be recognised by hair diminishing on the crown or near the inlets. A process that can start as early as puberty. In women, androgenetic alopecia usually begins as a thinner hairline, often starting from the hairline.
Genetic cause
Strictly speaking, androgenetic alopecia is not a disease or disorder, but an ageing phenomenon that is largely genetic. Variations in the dna that cause it have been discovered in the androgen receptor, but not all the responsible genes have yet been identified.
People who experience it (early) usually experience baldness as very unpleasant. For example, (young) women in whom baldness is highly visible. It can also be very stressful for men in whom baldness starts at an early age. Baldness often has a major impact on quality of life.
Step one: a medical diagnosis
Hereditary baldness is easy for a professional to diagnose because it follows a set pattern. If this is not the case, then hair loss can have several other causes, for instance hair disease, hormones, cosmetics and various other external factors. Therefore, comprehensive medical examination and proper diagnosis is always the first step of a treatment programme.
HAIR DISEASE - ALOPECIA AREATA
Another common hair problem is alopecia areata, or patchy baldness. This is an autoimmune condition that often starts with bald patches on the head that can spread to the rest of the body. A well-known problem in men are bald patches in the beard, but the condition can also cause complete baldness. This hair disease usually occurs suddenly. Stress often plays a role.
FREQUENTLY ASKED QUESTIONS ABOUT HAIR LOSS
Many people, of all ages and both sexes, notice increased hair loss or show various degrees of thinning (androgenetic alopecia) or suffer from diseases of the hair and skin of the scalp, which lead to changes in the hair shaft or complete atrophy of it trichosebaceous follicle.
Hair loss is a symptom of a large group of diseases and special expertise is required for its correct diagnosis and effective treatment. Correct and timely diagnosis is of particular importance, as many times it is the underlying disease that needs immediate treatment, and not just the symptom of hair loss. In all patients, personal and family history is recorded in detail, health status and possible diseases of other organs that may affect hair growth are discussed.
The examination carried out is analytical, in order to identify the various factors that contribute to the development of the problem in each person. In all, personal and family history is recorded in detail and health status and possible diseases of other organs that may affect hair growth are discussed.
If deemed necessary, some general biochemical blood tests are carried out, which aim to find possible disorders (anemias, hormonal deviations, etc.) or to detect vitamins, trace elements, amino acids or other factors (e.g. microorganisms, such as Candida) , which collectively or separately affect the hair.
This is followed by examinations of the scalp and hairs with dermatoscopy, hirsutogram, hair examination with polarized light or other methods, and biopsy, when required.
Androgenetic alopecia causes hair thinning, with or without an increase in hair loss. This phenomenon is due to a time reduction in the growth phase or anagen phase of the hair life cycle. This reduction causes hair follicles to shrink, which leads to shorter and finer hair.
Research has shown that there is increased hair loss in the Fall compared to other seasons. This increase in hair loss is due to the fact that an increased number of hairs enter the resting or otherwise telogen phase of their life cycle in the month of July. This stage takes place about 100 days before hair loss. This variation in the rate of hair loss may be due to an evolutionary advantage, whereby hair falls out only after keeping the scalp warm in winter and protecting it from the sun during summer.
This should not cause any concern and is completely normal. This white bulb is the part of the hair closest to the root. This means that the hair fell from its base and did not break along its shaft. These hairs are in the resting or telogen phase of the hair cycle and it is normal for them to fall out.
Could my hair loss be due to anxiety and high stress levels?
Male or female alopecia (baldness) is the most common cause of hair loss. This condition is also known as “androgenetic alopecia” because hair loss is caused by two main factors: androgens (male hormones) and genetic predisposition.
Androgen production increases after the onset of puberty. Therefore, the first visible signs of androgenetic alopecia usually begin in adolescence. The most important hormone for the development of this form of hair loss is dihydrotestosterone (DHT), which is a very strong androgen. DHT is produced locally in the hair follicle by converting testosterone. The conversion of testosterone to DHT is regulated by the enzyme 5-alpha-reductase. This enzyme is the target of drugs used to treat hair loss called finasteride and dutasteride. Follicles that are predisposed to androgenetic alopecia produce greater amounts of DHT, compared to follicles that do not show such a predisposition.
Baldness is hereditary, but the exact genes that predispose to baldness are unknown. We know that baldness is polygenic, which means it is affected by many different genes. It is impossible to know for sure whether a person will develop baldness based on the presence of baldness in specific blood family members. However, increasing the number of balding family members puts one in a higher risk category. Greater hereditary predisposition puts one at increased risk of developing severe baldness at a young age.
We could summarize by saying that many genes from both the father and the mother influence hair growth. Men are influenced more, not exclusively, by their mother’s family and women by their father’s family. Therefore, prognostically we should look, respectively, at the male members of the mother’s family for men and the female members of the father’s family for women.
Androgenetic alopecia affects only certain areas of the scalp called “androgen-dependent areas”. These are areas that have high levels of androgen hormone receptors in hair follicle cells and are therefore particularly prone to baldness. These areas are found in the frontal hairline and the top of the head.
Certain areas of the scalp are resistant to androgenetic alopecia and do not lose hair even in cases of severe baldness, namely the occiput and peripheral scalp. These areas are used by hair transplant surgeons to harvest hair follicles.
We do not have the ability to cure androgenetic alopecia, but treatment can stop the progression, promote hair growth and thicken the tiny hair follicles.
Hair transplantation can achieve excellent cosmetic results in many of the patients.
A vegetarian or vegan diet includes the possibility of insufficient iron intake. Iron deficiency can have a number of negative health effects, including hair. You can take an iron supplement, or eat iron-rich foods to make sure your diet contains enough iron. Foods rich in iron are spinach, lentils, quinoa and broccoli.
Lysine supplements can help improve iron absorption. Ask your doctor to assess your iron levels in case you think they may be insufficient.
Yes, your thyroid can be a cause of hair loss. Thyroid function (TSH, T3, T4) is always checked in patients suffering from hair loss. Telogen effluvium is for example one of the types of hair loss that can be caused by some thyroid dysfunction.
Hypothyroidism can also lead to dull, brittle hair. Before having the above tests, tell your doctor if you are taking a biotin supplement.
Biotin may affect the results of these tests and you may be required to stop taking biotin for about 2 days before the test day.
This comprehensive examination and the data gathered lead to the individualized selection of treatment methods, which include:
the local application of minoxidil and other medicinal substances and growth factors (PRP etc.), in concentrations and combinations specially prepared for each individual,
the introduction of these preparations deeper into the hair follicles by iontophoresis, without pain or even by local injection,
the autologous platelet-rich plasma (PRP) mesotherapy, which includes growth factors and the parallel administration of oral trace elements and amino acids, which hairs use to grow,
the administration of medicinal substances orally with a local effect on the hair follicles without adverse effects,
the use of lasers and other types of phototherapy, which can even be applied at home and also
hair transplantation with all methods. The two oldest methods are FUT (Follicular Unit Transplantation) and FUE (Follicular Unit Extraction).
In FUT, a strip of skin with hairs is removed from the occipital area (donor area), which are properly prepared and implanted in the parietal and frontal areas of the head, while in FUE, one sebaceous follicle is removed and implanted in the areas with less and finer hairs. Small scars remain, however, when the hairs are removed from the donor area.
It would be better to know if there is any anemia, so a general blood test is necessary. It is also good to know the levels of iron and ferritin, the levels of thyroid hormones and, in women, the levels of certain androgen hormones.
We have also developed with a specific biopathological laboratory a special urine test, during which we check all the amino acids that are necessary for hair growth, so that if there is any deficiency we can deal with it.
GET THE BEST INFORMATION
For many forms of baldness, a hair transplant offers a definitive solution. Of all the hair transplant options, treatment using the HST method gives the most beautiful, natural result. A professional diagnosis by a doctor is always step one when exploring treatment options.
In a free consultation with one of our doctors, we thoroughly discuss your personal situation and wishes. Based on this intake, we will give you a tailored advice and a transparent quotation.
