Alopecia Facts And Information

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Alopecia Facts And Information

Alopecia, commonly known as baldness, is a set of disorders which involves the state of lacking hair where it would normally grow, especially on the head. The most common form of baldness is a progressive hair thinning condition called androgenic alopecia or 'male pattern baldness' that occurs in adult human males and some primate species. Nonetheless, the severity and nature of baldness can vary greatly; it ranges from male and female pattern alopecia (androgenetic alopecia, also called androgenic alopecia or alopecia androgenetica), alopecia areata, which involves the loss of some of the hair from the head, and alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body. Treatment for alopecia has limited success. The more hair lost, the less successful the treatment will be.

Male pattern baldness is thought to occur in varying forms in about 66% of adult males at some point in their lives. 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 (called androgenic alopecia because it is caused by male hormones or androgens) is DHT, a powerful sex hormone. The mechanism by which DHT accomplishes this is not yet understood. In genetically-prone scalps, DHT initiates a process of follicular miniaturization. Through the process of follicular miniaturization, hair shaft width is progressively decreased until scalp hair resembles fragile vellus hair or "peach fuzz" or else becomes non-existent. 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.

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 classified on the Ludwig scale I-III.

It was previously believed that baldness was inherited from a person's maternal grandfather. While there is some basis for this belief, both parents contribute to their offspring's likelihood of hair loss.

There are several other kinds of baldness. Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force. Wearing a hat shouldn't generally cause this, though it is a good idea to let your scalp breathe for 7 hours a day. 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).

Etymology

The term Alopecia (al-oh-PEE-she-uh) is formed from the Greek αλώπηξ (alopex), meaning fox. The origin of this usage is because this animal sheds its coat twice a year.

The term "bald" derives from the English word balde, which means "white."

Evolutionary theories of male pattern baldness

There is no consensus regarding the details of the evolution of male pattern 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. This is supported by the fact that the distribution of androgen receptors in the scalp differs between men and women, and older women or women with high androgen levels often exhibit diffuse thinning of hair as opposed to male pattern baldness.

One theory, advanced by Muscarella and Cunningham, 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. 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 and 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.

Approaches to baldness

Psychological implications

The psychological implications for individuals experiencing hair loss vary widely. The most significant effect is a loss of self-confidence. This is enhanced by an insecure or ambivalent attachment pattern.

Alopecia induced by cancer chemotherapy has been reported to cause changes in self-concept and body image. Body image does not return to the previous state after regrowth of hair for a majority of patients. In such cases, patients have difficulties expressing their feelings (what is called alexithymia) and may be more prone to avoiding family conflicts. Family therapy can help families to cope with these psychological problems if they arise. Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms. Some balding men may feel proud of their baldness, feeling a kindred relationship with famous charismatic bald film actors such as Yul Brynner, Vin Diesel, Michael Chiklis, Telly Savalas, Ben Kingsley, Patrick Stewart, Bruce Willis and politicians such as Abe Beame, who have been considered masculine and handsome in part because of their most obvious distinguishing feature.

Preventing and reversing hair loss

It is easier to prevent the aging and falling out of healthy hairs than to regrow hair in follicles that are already dormant. Finasteride (marketed in the U.S. as Propecia) and minoxidil (marketed in the U.S. as Rogaine, and some places as Regaine) have shown some success in partially reversing loss. In a one one-year study of finesteride, evaluation after one year showed five of 21 subjects (23.8%) had two-grade improvement in MNHS grade on a modified Norwood/Hamilton scale and 12 of 21 subjects (57.1%) had one-grade improvement; the others remained at the same grade. However such treatments are generally ineffective at treating extreme cases of hair loss.

The prospective treatment of hair multiplication/hair cloning, which extracts self-replenishing follicle stem cells, multiplies 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.*

Topical application of ketoconazole, which is both an anti-fungal and a potent 5-alpha reductase inhibitor, is often used as a supplement to other approaches.

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.

Regular aerobic exercise can help keep androgen levels naturally lower while maintaining overall health and lowering stress, though weight training may have a detrimental effect on hair by increasing testosterone levels.

Stress reduction can be helpful in slowing hair loss.

Immunosuppresants applied to the scalp have been shown to temporarily reverse hair loss, though the possibly lethal side effects of this treatment make it untenable.

Saw Palmetto (Serenoa repens) is an herbal DHT inhibitor often claimed to be cheaper and have fewer side effects than finesteride and dutasteride. Unlike other 5alpha-reductase inhibitors, Serenoa repens induces its effects without interfering with the cellular capacity to secrete PSA. Saw palmetto extract has been demonstrated to inhibit both isoforms of 5-alpha-reductase unlike finesteride which only inhibits the (predominant) type 2 isoenzyme of 5-alpha-reductase.

Polygonum Multiflorum is a traditional Chinese cure for hair loss. Whether the plant itself is useful, the general safety and quality control of herbs imported from China can be questionable.

Beta Sitosterol, which is a constituent in many seed oils, can help to treat BHP by lowering cholesterol. If used for this purpose, an extract is best. Consuming large amounts of oil to get at small quantities of beta sitosterol is likely to exacerbate male pattern baldness.

Resveratrol, from grape skins, is a lipase inhibitor. By decreasing the body's ability to absorb fat through the intestine walls, it reduces the total fat and calorie content of a person's diet.

While drastic, broad spectrum anti-androgens such as flutamide are sometimes used topically. Flutamide is potent enough to have a feminizing effect in men, including growth of the breasts.

Concealing hair loss

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 Wigs for Kids 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

Embracing baldness

Of course, instead of concealing hair loss, one may embrace it. A shaved head will grow stubble in the same manner and at the same rate as a shaved face. Many celebrities and athletes shave their heads. They spread 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. Websites such as Curtis Bickham's www.Head-Liner.com proclaim, "Let the Skin Proceed When the Hair Recedes", as a way of dealing with hairloss.

Treatment Of Male Pattern Baldness With Propecia Prescription Medication Propecia is a prescription medicine available from online pharmacies taken in tablet form that partially blocks the effects of the male hormones which cause male pattern baldness. Propecia is used in a higher dose to reduce the size of the prostate gland in men with benign prostatic hypertrophy. Propecia has been shown to halt further male hair loss and promote re-growth of scalp hair in approximately 80 per cent of men after three to six months use. Treatment with Propecia must be continued to sustain the improvement in hair growth.

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