Top news: Hair loss is containable

Anyone would be tense (short of tearing one’s hair) if he/she starts losing his/her crowning glory It could be a hair-raising problem and quite emotional to come to terms with it. They use all means and schemes to hide their problem. They spend forever in the bathroom grooming their hair.

Hair is the fastest growing tissue of the body made up of proteins called keratins. Every strand of hair is made up of three layers which determine the strength, texture, and color of hair. Below this layer of skin is a very important structure, the dermal papilla. Only this part lives, the visible part of hair is actually dead tissue so that it is unable to heal itself once damaged. Losing the dermal papilla means losing that hair forever. Expensive treatments that claim to treat the visible part of hair and nourish it therefore are usually no more than bogus claims made to sell products.

Here, I want to discuss the most common type of hair loss in men which is androgenetic alopecia (AA).   AA affects between 50% and 80% of Caucasian men. A rule of thumb is for men in their 30s, 30 percent has AA. For men in their 40s, 40 percent has AA, and so on until 80 percent of men are affected at 80 years old and up. Genetically predisposed men initially develop bitemporal recession. Next. they develop diffuse frontal loss and thereafter a bald patch over the vertex of the scalp. Ultimately, all the hair over the crown is lost.

In order to interpret the biological role of heredity in hair loss, it is necessary to differentiate between heredity and predisposition. Heredity is the genetic potential you are born with: eye color, skin color, hair color. These are the biological givens. On the other hand, predisposition is the tendency of the body to acquire certain disorders: obesity, diabetes, hair loss. 

Can you reverse predisposition? You cannot eliminate the predispositions of the body, but you can often contain them. For example, it you have the predisposition to obesity or diabetes, you can elect to change your lifestyle. You can go on a low-calorie diet rich in fruits and vegetables. You can also exercise every day or at least keep active.

The common question being asked is why is baldness so prevalent among men, and relatively rare among women, especially premenopausal women.

Here, we need to look at how hormones affect hair. Estrogens promote they growth of scalp hair, while they inhibit the growth of hair elsewhere on the body, DHT , the strong form of testosterone, promotes the growth of body hair and facial hair, but appears to inhibit scalp hair growth. The amount of DHT produced in the skin in turn depends on the amount of the enzyme 5 alpha reductase that is available for the conversion of testosterone to DHT. Men, for example, with congenital deficiency who are lacking in the 5 alpha reductase enzyme, have small prostates, do not develop prostate cancer, have little body hair, and do not grow bald.

Research shows that men produce a lot more DHT than women do, since obviously men produce a lot more testosterone than women do (although dehydroepiandrosterone {DHEA} converts to testosterone and can also serve as raw material for DHT). But it’s not the serum level of DHT that seems to matter, but the local conversion of androgens to DHT in the scalp. Most women, on the other hand, are protected by having less testosterone, less 5 alpha reductase, and more of aromatase, the enzyme that converts testosterone to estradiol and not DHT.

Knowledge of factors that may lead to the development of AA helps one to contain the predisposition to develop AA:

• Sensitivity of androgen receptors

• Age (androgens promote the development of pubic hair in teenagers but decrease rate by early 20s)

• Location of hair on the body — hair on top of scalp is sensitive and responds by gradual development of AA; hair follicles of the beard, chest, and upper back respond to the same androgens with accelerated growth.

• Increased insulin levels

• Immunological

• Vascular (atherosclerosis — lining of vessels produces nitric oxide and other growth factors — when damaged, less nitric oxide is produced).

• High-fat diets may influence baldness in susceptible individuals.

• Low body fat depresses insulin production which increases SHBG     (sex hormone binding globulin) production.   Increased fat leads to increased insulin, which leads to increased levels of androgen and results in balding.

• Testosterone supplements accelerate pattern baldness.

• Smoking may possibly promote hair loss by increasing the production          of androgens.

• Birth control pills (synthetic progesterone) can promote AA as they may artificially increase a woman’s testosterone level.

• Hormonal imbalance, as in after menopause (there is a net drop in the androgen antagonist estrogen)

• Conditions like PCOS (hypersecretion of androgen hormones plus subnormal production of SHBG)

• Adrenal hyperactivity

• Production defects of the enzyme steroid sulfatase (enzyme that produces DHEA)

• DHEA supplements can lead to AA.

• Obesity, the tendency to develop ischaemic heart disease.              

• Prostate cancer directly correlates with development of AA.

• Iron Ferritin levels may have a part to play in hair loss

Drugs that cause vasodilatation, reduction of 5 alpha reductase and cortisol, 5 alpha reductase receptor inhibitors, and androgen receptor antagonists would help in the management of AA. Avoiding the above triggers also prevents the development of AA. And of course, if AA has already set in, hair transplants with one’s own natural hair is now available.

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For comments or inquiries, call 414-5880, 373-1558, 484-7821, 0917 5711992, 09205647635; e-mail gc_beltran@yahoo.com.