Hair loss: Hair loss is the thinning of hair on the scalp. The medical term for hair loss is alopecia. Alopecia can be temporary or permanent. The most common form of hair loss occurs gradually and is referred to as “androgenetic alopecia,” meaning that a combination of hormones (androgens are male hormones) and heredity (genetics) is needed to develop the condition. Other types of hair loss include alopecia areata (patches of baldness that usually grow back), telogen effluvium (rapid shedding after childbirth, fever, or sudden weight loss); and traction alopecia (thinning from tight braids or ponytails).

Hair loss normally occurs gradually with age in both men and women, but is typically more pronounced in men.

HAIR LOSS - PREVENTION AND RESTORATION

By the age of fifty; hair loss affects approximately fifty percent of males and thirty percent of females to a cosmetically problematic degree.  The vast majority of these hair loss cases are genetic in basis.  The minority of cases may be due to underlying illnesses, endocrine problems, scalp disease, medications, or other more rare causes.

The medical therapy of androgenetic alopecia (male pattern alopecia, female pattern alopecia) currently produces favorable responses in over fifty percent of those treated.  Early therapy is critical to the success.  The highest response rates occur with combination therapy consisting of 2% or 5% Minoxidil topically applied twice daily and Finasteride 1 mg daily.  Some individuals feel that Nizoral shampoo, because of its anti-androgen effect is worthwhile as well.  The combination of Minoxidil topically and Finasteride orally produces a synergistic response in experimental animals of approximately forty percent greater hair growth than the sum total of these products used individually.  For that reason, those seriously interested in retaining or improving their hair growth should combine therapy for a minimum of one year and then evaluate the response.  Shorter time courses of therapy do not permit appropriate evaluation of response.  Photographs before and every twelve months after initiation of therapy are highly advisable. 

For those who do not respond to therapy, three options remain:  Accept the genetic fate dealt, wear hair systems, or proceed to hair restoration by transplantation.  The use of naturally-occurring follicular groupings in the restoration process referred to as follicular unit transplantation methodology has made it possible to transplant virtually any case with a resultant natural and undetectable result.  The only limiting factor is the availability of donor hair and the emotional and financial commitment to the process.  Over ninety percent of the hair follicles transplanted survive the relocation process and produce normal hair growth for the remainder of the individual's life.  The process of transplantation works equally effectively in males and females.  Because the follicular unit grafts are placed in very small needle stick sites (19-22 gauge needles), the healing process is complete within seven days.  Follicular unit transplantation is also effective for other hair loss problems including loss of eyebrows, traumatic, surgical, or radiation scars, and a very effective repair method to improve the appearance of plug graft cases from prior methodology. 
On the future horizon lie a number of interesting possibilities.  The first of these is medical therapy Dutasteride (Avodart).  The side effect profile in relation to sexual dysfunction has prevented most physicians from off-label prescribing of this drug.  A number of ongoing research projects involving the use of stem cells of follicular and perifollicular origin offer promise, but such research is relatively embryonic at this point, and initial attempts utilizing such methods have met with little success to date.  However, because this field represents a substantial market, expect to hear more about these research areas in the coming years.

Dr. Bobby Limmer/jac

Hair Loss Facts and Myths

Myth:The gene for male pattern baldness comes only from the mother.
Fact: The truth is that the gene may be passed to a child from either parent, not just the mother.

Myth:Losing an average of a hundred hairs per day is normal. Don't worry about it.
Fact: It's true only if you don't have MPB. The hairs that fall out will soon be replaced by new hairs sprouting from the hair follicles. If you are experiencing MPB hair loss, however, even losing the "normal" hundred hairs a day can be a concern because many of those hairs are being shed by follicles that are in the process of shrinking, and therefore the new hairs those follicles make will be progressively thinner until the follicles are only capable of making fine hairs. Eventually those follicles will die and no longer produce any hairs at all.

Myth:You can increase the number of hair follicles by using drugs or other methods.
Fact: No. The number and diameter of your hair follicles is completely out of your control--it's hereditary. Nothing you do will alter the quantity of hair follicles.  You can alter the quality  (length and diameter) by medical therapy with finasteride and minoxidil.

Myth:Cutting or shaving hair can make it grow back faster and thicker.
Fact: No. Hair grows at an average rate of half an inch per month. Because each hair shaft is slightly thicker at its base compared to its tip, hair can temporarily appear thicker for about a week after it has been significantly cut. But cutting hair has absolutely no effect on each strand's thickness or on the number of hairs that will sprout from follicles.

Myth:If left uncut, my hair will just keep growing and growing.
Fact: No. Length depends on your hair's natural cycle, which is unique to you. The longer the hair's growth phase, the longer the hair will grow. If you have a naturally long growth phase, you can grow your hair to well below your waist. If you have a naturally shorter growth phase, your hair will be shed before it grows that long and only grow to a certain length. The duration of your particular growth phase is based on heredity and is affected by nutrition.

Myth:Wearing a hat causes hair loss.
Fact: As long as you don't regularly wear a hat that's so tight that it restricts circulation--blood flow to the hair follicles--this will not cause hair loss. It can, however, damage hair because of the effects of sweat, dirt, and mechanical rubbing.

Myth:Blow-drying can causes hair loss.
Fact: No. But it can dry, burn, and damage hair that may then break off, to be replaced by new hair that will sprout from the follicle.

Myth: Bald men are sexier.
Fact: There is rarely any evidence of excess levels of testosterone or related hormones in bald men; the belief that baldness makes you more virile than a man with a full head of hair is, unfortunately, without scientific foundation.  Baldness may however be attractive to others so it is not necessarily a negative.

Myth: If you wash your hair too often you will go bald.
Fact: Frequent shampooing itself has no effect, positive or negative, on hair loss.