Trichology Care for your hair - Baldness: the bare facts

Recently an article as published about an actor loosing his virility due to hair loss medicines and since then I have been flooded with anxious questions from all over India.

The most common type of hair loss in men is termed as ‘male pattern thinning’ (MPT) or ‘androgenetic alopecia’. This is where recession of the hair occurs at the temples and/or thinning of hair occurs in the front/crown areas of the scalp. The final stage of such a loss leaves a band of hair around the back and sides of the scalp and baldness over the rest of the scalp.
MPT is easily recognized by its location on the scalp and by the manner in which it occurs. It is not marked by a rapid loss of hair. What happens is that, with each new hair cycle, the affected hair does not grow as long and they become finer in diameter. Eventually, very small fine hair, termed vellus hair remains. Usually, the whole process takes at least ten years and as long as forty years.
MPT usually begins during the late teens and early 20s and affected men are well on the way to baldness by the age of 30.

IF YOU HAVE A GOOD HEAD OF HAIR AT THE AGE OF 30, YOU PROBABLY ALWAYS WILL HAVE.

There is nothing abnormal about MPT. All that such a loss indicates is that you have inherited the relevant genes from one (or both) of your parents. If some men fear suffering from MPT, it is only because they think it is considered unappealing in today’s society. However even this excuse for anxiety is becoming less and less relevant for it seems baldness is back in fashion.

BLAME YOUR FATHER OR YOUR MOTHER

The loss of hair with MPT is hereditary in nature – which means that little can be done to prevent it. It can be inherited from either parent. The other factor involved is the level of your male sex hormones; they have to be at the normal level for men for the genetic thinning to occur. Men who produce little or no sex hormones will never go bald!!
Women, of course, do not have a very high level of male sex hormones and this explains why they do not exhibit MPT. However, they can carry the genes for MPT and pass them on to their children. A son inheriting the genes for MPT from his mother will exhibit the thinning at the appropriate age.

SO, WILL YOU INHERIT GENETIC THINNING?

For a male, if his father exhibits MPT, there is at least a 50% chance he will also exhibit it. On the other hand, if both parents have full heads of hair, we know the father will not carry the genes but there is still a chance the son could inherit the MPT genes from his mother (who could have inherited the genes from her mother or father). The bottom line is the wont know whether or not you will exhibit MPT until you start exhibiting it. Just because the father is bald doesn’t mean the son will exhibit the problem AND just because both parents have wonderful hair doesn’t mean the son can’t exhibit MPT.



CAN MPT BE PREVENTED?

The preventing of MPT necessitates either interfering with the inherited genes or preventing the male hormones from influencing the relevant genes. For example, taking female sex hormones would prevent, to some extent, the male hormones from influencing the hair. However, the feminizing effects from female hormones would make such a treatment inadvisable for men.
The main cause of baldness is because of the action of the male hormones on the hair hence the anti male hormones or DHT blockers are prescribed to control MPT. These anti male hormones are available
a. in the pharmacological form
b. in the natural form

The action of both is to control the conversion of the testosterone into dyhydrotestosterone by its action on the enzyme 5-alpha-reductis. Two percent of the people using some of the above pharmacological formulations have reported a decrease in sexual libido which is regained spontaneously on stoppage of these formulations. Natural DHT blockers are used as food supplements all over the world e.g extracts of green tea & extracts of a plant called serenoa repens (berry fruit).
Hopefully, you will have realized by now that there exists no viable cure for MPT short of castration. MPT is an inherited trait, not a medical problem.

MPT thus can not be prevented. The problem is not due to poor circulation so treatments aimed at increasing the circulation of blood to the scalp will be of little value. Nor is the problem caused by a tight scalp and poor nutrition. Poor diet can cause excessive hair loss from all over the scalp which would obviously exaggerate any MPT.
Some individuals have been told that dandruff (flaking) is causing their hair loss or that their follicles are blocked up with oil which is not correct!

However the only additional factor that I have found can accelerate or trigger genetic hair loss is extreme stress and also taking steroids as male sex hormones (androgens such as testosterone) or cortisones. However steroids, stress and cortisones can only trigger genetic thinning in some one who has the genetic predisposition in the first place.
It is always possible that genetic thinning is accompanying a problem of diffuse hair loss in which case the cause of the latter problem must be found and corrected. Furthermore, a lack of care for the hair will only serve to emphasize the thinning.

Hair loss can be devastating to the individual affected even if others are not bothered by the problem. Friends may joke about another’s hair loss without realizing how their words can affect the individual with the hair loss. For men who are not prepared to put up with their thinning hair, the solution might be one of the methods available for camouflaging thinning hair.

Different types of hair loss and baldness require different treatment. Baldness is classified in reversible and irreversible baldness & factors discussed above can trigger off MPT where male hormones and weak inherited genes are the main causative factor. Therefore it is quite often said that bald men are sexier! (As it is a sign of high male hormone).

It is important for the readers to detect whether baldness is reversible or irreversible and that every hair fall does not lead to baldness as also the side effects of doing things under wrong influence. Hence all treatments should be done only after thorough diagnosis and under expert guidance of your Trichologist.

Fashion and hair loss

Did you know that heroes of ancient Greece used harsh soaps and bleaches to lighten and redden their hair to the colour that was identified with honour and courage? In fact even first-century Romans preferred dark hair, which was made so by a dye concocted from boiled walnuts and leeks.

Things have not changed much over centuries. More and more youngsters are experimenting with styles, going blonde or simply curling or straightening hair.

The worst hit are probably models and actresses, who being under bright lights are prone to dandruff and probably have to get their hair styled every second day. But perming, dyeing and straightening hair seem to be becoming increasingly popular and before going in for these it is best to recognise the risks involved.

Perming & Straightening

Girls with curly hair want it straight and silky and those gifted with the latter want them curled. Salons are flooded with clients making requests for weird hair-dos.

However, many people have to settle for damaged and destroyed hair.

When hair is straightened or curled, tremendous heat is applied in order to change its natural shape. This converts the protein cystine (of which the hair is composed) to cysteine and then manipulated into a certain look, before changing back. However, in the process some amount of cystic acid is generated. This process results in 20% of the hair getting destroyed. So, if you want to perm your hair or get it straightened, make sure you don’t do so too frequently.

Hair Colour

Regular streaking and dyeing can cause cumulative damage, although it may take years before there are obvious signs of hair breakage. Permanent chemical dyes may damage the hair by breaking through the cuticle shield to invade the cortex. They may also cause an autoimmune reaction leading to alopecia or a skin disease called dermatitis. Instead of using a permanent dye, try a rinse or a temporary dye.

The incidence of lawsuits seeking compensation for damage caused by chemical abuse is increasing alarmingly and the role of the Trichologist as an experts witness is increasing coming into play.

Hot Rollers And Dryers

Applying excessive heat to the hair can damage the scalp and cause the hair follicles to weaken. High heat and the time for which it is used on the hair will also impact structure of hair. While hair loses its elasticity, damage to the cuticle makes it more breakable. Steam forming inside the hair shaft causes hair breakage. It is therefore necessary to limit the amount of heat as well as the length of time you dry your hair.

If you use a blow dryer, use a moderate heat setting. Never over-dry. Cold hair dryers are the best. It is also advisable to towel dry your hair gently before blow drying.

Hair Styling

Avoid tight braids and ponytails as these may cause breakage and tearing of the hair shaft.

Diet

‘Thin may be in’ but definitely not when it comes to hair. The hair root may be too weak to sustain the pressure of the hair, leading to a form of hair loss called Anagen Effluvium. If you want to lose weight, do so under qualified supervision.

Airhostesses are prone to this as they have to continuously do the above and hence it is a occupational hazard. Always, remember if you ever notice worrying changes in your hair – such as hair loss, itchy scalp, and split ends – contact a trichologist immediately. You may be too fashionable for your hair’s liking.