Hormones And Androgenetic Alopecia
The role of androgen in male pattern hair loss is well established. American anatomist James Hamilton observed that castrated males did not develop MAA unless they were supplemented with testosterone .
Measurements of serum androgens, testosterone, dihydroepiandrosterone sulphate , and free testosterone levels have failed to demonstrate a reproducible difference between cases and controls . A study that assessed different hormonal levels in MAA and age-matched controls measured elevated levels of cortisol and androstenedione in those experiencing MAA . This study further suggests a broad range of hormones may influence androgenetic alopecia. Even though scalp hair loss and hirsutism are essential features of hyperandrogenism in women, several investigations failed to demonstrate raised androgen levels in women . Therefore it is suggested that normal levels of androgens are sufficient to cause hair loss in genetically susceptible individuals.
The observation that eunuchoidal patients with androgen-insensitivity syndrome and 5 alpha-reductase deficiency do not go bald suggests that MAA is induced by activation of follicular androgen receptors by DHT . Patients affected by Kennedy’s disease, with a functional abnormality of the androgen receptor gene, have a reduced risk of MAA . Increased levels of DHT have been found in balding scalp compared to non-balding scalp .
Natural Methods For Hair Loss
Many people prefer using natural methods for dealing with issues such as hair loss. There are many such methods available, and well touch on a few of him here:
- Essential oils
Youll find essential oils for use in a variety of products, including those which address hair loss and hair growth. One method involves combining essential oils with a scalp massage to promote blood flow to the hair follicles.
Among the essential oils you can use are lavender, rosemary, thyme, peppermint, and cedarwood. While no scientific evidence backs up the claims of many who say the essential oil treatment stimulates hair growth, theres nothing wrong with giving it a try.
Some experts say that egg oil is helpful in preventing hair loss, as well as for treating dandruff and moisturizing hair.
Egg oils suggested use is to massage it into your scalp and leaving it on overnight. Youll wash it off in the morning, preferably with a sulfate-free shampoo. Most people see results when they repeat the process two to three times a week.
- Hot oil treatments
Hot oil applied to the hair can moisturize it and stimulate growth. Simply warm up the oil no more than 104 degrees Fahrenheit and massage it into your scalp. Put on a shower cap and let the oil sit for 30 minutes before washing it out with shampoo.
Any kind of natural oil, such as olive oil, safflower oil, or canola oil, is suitable for this treatment.
- Lifestyle changes
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Reduce Anxiety And The Hair May Come Back
The good news for anxiety sufferers is that not all anxiety related hair loss is permanent. If stress and anxiety are what caused your hair loss, then reducing that anxiety can help your hair come back when combined with vitamin and mineral supplements to aid in the process.
For more information about anxiety treatment strategies, .
Remember â not all hair comes back after itâs lost regardless of the cause, and your hair loss may be natural and not caused by anxiety at all. No matter what, you need to make sure that you are addressing your anxiety directly in order to both reduce the likelihood of anxiety related hair loss and reduce the anxiety you experience because of your lost hair.
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Treatment Options For Androgenetic Alopecia
Melissa C. Jones, PharmD, BCPSAssistant Dean for AdmissionsSavannah, Georgia
US Pharm. 2018 43:12-16.
ABSTRACT: Androgenetic alopecia , or male pattern baldness, is the most common cause of hair loss in men. There are several therapies available for the treatment of this condition, with 5-alpha reductase inhibitors and minoxidil most commonly used. Other current treatment options include laser therapy, scalp microneedling, hair mesotherapy, and hair transplantation. The development of new pharmacologic therapies has been slow however, research is currently being conducted using Janus kinase inhibitors and autologous platelet-rich plasma injections in men with AGA.
Androgenetic alopecia , or male pattern baldness, is a common condition that causes many men to seek medical attention. It is characterized by hair follicles that gradually decrease in size and lead to baldness over time. AGA affects approximately 80% of Caucasian males. Although it is common in men of different ethnic backgrounds, Caucasian males are affected more frequently.1 Traditionally, pharmacologic treatment of AGA targets decreasing dihydrotestosterone and stimulating hair follicles through the use of 5-alpha reductase inhibitors or minoxidil however, new and experimental therapies are exploring inhibition of Janus kinase and the use of platelet-rich plasma . Other therapies include laser therapy, scalp microneedling, hair mesotherapy, and hair transplantation.1
Laser Technology & Hair Growth
A more recent method for fighting hair loss is low-level laser hair therapy and its application methods include laser helmets and combs.
One of our favorites and one of the most effective for fighting hair loss is the iRestore Laser Hair Growth System which consists of a plastic helmet with lasers and lights enclosed.
True, youll look like a stormtrooper, or like you own a one-of-a-kind bicycle helmet but iRestore has the backing of many customers who report reduced hair loss and increased hair growth. It also has FDA clearance, which means its approved for safe use.
While the jury may still be out regarding the effectiveness of LLLT on hair growth, studies abound that give credence to the legitimacy of hair helmets and combs.
Its also said to work well in conjunction with other hair growth treatments, such as Minoxidil, Rogaine, etc., to enhance those treatments.
How does it work? IRestores Hair Growth System includes 51 medical-grade lasers and LED lights the radiate energy to hair follicles. The energy enhances cell metabolism rate while reactivating follicles to stimulate hair growth.
Moreover, iRestore is safe to use and wont burn the scalp, but users must take precaution to not look directly into the laser light.
One advantage that LLLT helmets have over laser combs is that they dont require constant hand motions that can become tiring and inconvenient.
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Genetic Testing In Androgenetic Alopecia
A gene polymorphism-based diagnostic test that will predict the chances of future androgenetic alopecia development is now in the market . For young patients concerned about hair loss, this test may help to define the value of early treatment initiation.
In males, the gene test can predict the chances for MAA by reporting the presence or absence of a specific variation in the androgen receptor gene found on the X chromosome. The variant AR gene causes changes in the hair follicleâs response to dihydrotestosterone, resulting in alterations in the hair growth cycle. A positive test result indicates a 70% chance of developing MAA, whereas a negative test result indicates a 70% chance of not developing MAA. The test is of value as a screening test in predicting the future chances of developing MAA rather than a confirmatory test.
Why Hair Falls Out
Hair grows and eventually falls out as part of its normal cycle. It can build up on hair brushes, pillows, or shower drains.
Most people will not notice the natural hair loss that occurs daily. Hair thickness and the hairline usually remain the same.
People are more likely to notice excessive hair loss, which may be due to an underlying condition. Symptoms of excessive hair loss can include:
- sudden loss of hair
- noticeable thinning
Several possible factors may cause excessive hair loss.
One of the most common causes involves genetics. According to a 2019 review, pattern baldness affects up to 50% of men and women.
Commercial products could help to slow and treat this type of balding. This includes products like minoxidil .
Pattern baldness occurs slowly with aging. Some more immediate causes of hair loss can include:
Whether hair growth can return depends on the cause of the hair loss. A dermatologist can determine whether a personâs hair may regrow on its own.
Hair loss may be temporary and reversed for the following conditions:
To help hair grow again, a dermatologist may perform a procedure such as the following:
- Corticosteroid injections into bald or thinning areas every 4 to 8 weeks. The AAD says this is the most effective treatment for alopecia areata.
- Platelet-rich plasma therapy involves a doctor drawing a small amount of blood and injecting the plasma into bald areas. The 10-minute procedure is necessary once monthly for 3 months, then once each 3 to 6 months.
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Can I Stop Hair Loss Naturally
If your hair loss is caused by your genetics, youre unlikely to be able to reverse it. Treating thinning hair with minoxidil may help slow down hair loss. Other causes of hair loss may be more treatable. Hair loss because of alopecia areata, recent childbirth, or cancer treatment usually grows back eventually. Improving your diet or taking supplements may reverse hair loss if nutrient deficiencies are the underlying cause.
Psoriasis Of The Scalp
Psoriasis is a skin condition that affects around 7.4 million people in the United States. Your immune system turns over skin cells too quickly, causing red, scaly patches and silver scales known as plaques to form on your skins surface.
If you have psoriasis, you may experience it on your scalp. At least 50 percent of people with plaque psoriasis will develop scalp psoriasis, according to the American Academy of Dermatology .
Scalp psoriasis can be mild or severe, with cases ranging from light scaling to thick plaques. The condition can appear anywhere on the scalp in the form of a small patch, or it may cover the entire area.
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Do Hair Loss Treatments Work
As mentioned previously, there is evidence that treatments such as minoxidil and finasteride can reduce the amount of hair a person loses. However, results may vary between individuals.
It can take several months before a person sees results from hair loss treatments. A person should work with a healthcare professional to find a treatment that suits their situation.
Is Stress Causing Your Hair Loss
Too much stress on the body can result in hair loss, a condition known as telogen effluvium. Find out how to reduce stress to regain your healthier, fuller head of hair.
When youre under stress, you may notice a lot of physical symptoms feeling anxious or exhausted, having trouble concentrating, and even getting sick with a headache or upset stomach. Stress can also be a cause of hair loss. When stress has you pulling out your hair, as the expression goes, you could be literally doing just that.
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Telogen Effluvium: Understanding This Cause of Hair Loss
Telogen effluvium is the term for hair loss that occurs temporarily as a result of some trauma, stress, or shock to your body. Telogen hairs are one type of hair, characterized by the end of the hair being shaped like a bulb, and effluvium means to flow out.
Some hair loss is normal, but telogen effluvium results in excessive hair loss due to a disruption in the natural growth and rest cycle of hair. Generally, between 80 and 90 percent of hair follicles on the scalp are actively growing, with the other 10 to 20 percent in the resting phase. Many events can disrupt this balance and result in temporary hair loss, typically seen as hair that falls out in clumps when you brush, wash, or style your locks.
Stress is known to be a trigger for telogen effluvium and risk factors that can cause this type of stress include:
Stopping Telogen Effluvium
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How To Stop Hair Thinning
What To Do If You Are Going Bald
The timeline in pretty much most guys hair loss is quite similar.
You start to notice a bit of thinning hair in your late teens or early 20s.
Then its a few years of trying to play clever with hairstyles, hats and any other way to make sure no one notices your balding.
Thereafter, it becomes quite hard to hide it.
You start accepting the fact that hair loss is inevitable, and you grab the clippers and shave your head to a number 4, then a number 2 and then a number 0.
And finally, after years of it being a constant issue in your life, you grab the shaving cream and razor and let go.
This process can be made a lot easier.
We both took the scenic route, and waited years and years until finally shaving our heads.
Knowing what we know now, we really wish we did it sooner.
Ask every single guy who shaves his head, and he will tell you the same thing.
And no one regrets shaving their heads.
So what do we say when guys ask us our opinion on what to do when going bald?
We normally recommend guys to seriously consider shaving their heads.
It really is the most freeing feeling you can have.
I know it isnt easy at all. But it should be considered seriously!
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Treatment Options Include Medication And Surgery
If shedding is caused by illness, hair often grows back once the underlying problem is resolved. For male-pattern hair loss, there are two FDA-approved medications for female-pattern hair loss, theres only one. The most effectiveand only permanenttreatment, however, is a hair transplant: a dermatologist harvests healthy follicles from areas of dense growth and implants them where theyre needed. NYU Langones Hansjörg Wyss Department of Plastic Surgery offers an approach that is less invasive, extracting follicles with air pressure and suction rather than incisions. Says Dr. Shapiro: The results can be dramatic.
Ketaconazole Spironolactone And Prostaglandin F2 Analogues
Ketaconazole shampoo has been considered as an agent to aid in the treatment of AGA as combination therapy with oral finasteride.1 The mechanism is unclear however, ketaconazole inhibits the DHT pathway, conferring antiandrogenic properties. In addition, it may reduce inflammation in the skin. Clinical trials need to be conducted in order to validate its effectiveness.1,5
Spironolactone is a potassium-sparing diuretic that has antiandrogenic properties it blocks androgen receptors and decreases testosterone levels. Most of the clinical data using 50 to 200 mg/day of spironolactone have been in women with AGA, and the results have been variable.1
Patients using the prostaglandin F2 analogue latanoprost to treat glaucoma experienced the side effect of elongation of eyelashes and eyebrows as a result, a randomized, double-blind, placebo-controlled trial was conducted in 16 men using lantanoprost 0.1% daily versus placebo to evaluate scalp hair growth. The 24-week study resulted in a significant increase in hair density from baseline when compared with placebo. Different concentrations of bimatoprost, another prostaglandin F2 analogue, are currently being studied in men with AGA.1 Although these results appear positive, the study populations are too small to extrapolate results. Additional studies need to be conducted in a larger patient population for a longer period of time to determine efficacy of the therapy.
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Genetics And Androgenetic Alopecia
These data suggest that other autosomal genes may also be contributing to the phenotype. Several studies have examined the other candidate genes and chromosomal regions that can contribute to the hair loss.
Genetic association studies of 5 alpha reductase genes SRD5A1 on chromosome 5 and SRD5A2 on chromosome 2, using dimorphic intragenic restriction fragment length polymorphisms in 828 families, failed to show an association between these genes and MAA . However the role of the 5 alpha reductase enzyme in MAA is evident from its role in the metabolism of testosterone to dihydrotestosterone and the effect of 5 alpha reductase inhibitors in treating hair loss. The cytochrome p450 alpha aromatase enzyme has also been found to contribute to androgenetic alopecia. Aromatase diminishes intra-follicular testosterone by catalysing the conversion of testosterone to estradiol. Differences exist in the expression of aromatase in balding and non-balding scalp . Yip et al suggest that the aromatase gene might predispose to hair loss in women .
Consider Your Hair Type And Texture
The good news is that we havent seen a difference in efficacy between patients with fine or textured hair, says Dr. Goldman. However, more research needs to be done. And while medications like minoxidil will work on all hair types, how you use it may differ. The biggest rule of thumb, according to Dr. Kash, is to make sure you apply the products to the scalp where the hair follicles are and not only on the hair shaft itself. Additionally, if you have fine hair, apply the product at night, let it dry overnight, and then brush it through, she says. Applying it in the morning may weight down fine hair and make it look greasy. On the flip side, if you have textured hair, make sure to really massage it into your scalp, since some products like minoxidil can leave textured hair dry.
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