Pattern hair loss is caused by genetics. According to popular myth, it is passed down by the mother. The theory is if your grandfather on your mother’s side is bald, so will you be – but this is false. This idea came from 20-year-old studies with small sample sizes indicating that only one gene was the cause and that it was carried on the X-chromosome. However, it is much more complex than that. Recent studies have identified over 250 genes associated with hair loss and they can be passed on through either parent.
Normal hair growth has three phases. The anagen phase is the active growth stage, where hair growth occurs at approx. 1.25cm per month. Catagen phase where nutritional supply is stopped to the current strand of hair. Growth slows and it is thinner. In the telogen phase, the hair sheds, and the follicle stay dormant for a few months before a new hair begins to grow again. The growth phase for each hair can last from three to seven years.
The inherited genes that cause hair loss predispose hair follicles to be sensitive to a hormone called dihydrotestosterone (DHT). The hormone attaches to the follicle and gradually destroys it. Fewer follicles begin to enter the anagen (hair growth) phase, and fewer nutrients are received by the strands. This is when you start to see the miniaturisation and thinning, i.e.: strands of hair become shorter and finer each time a new hair grows from the follicle, and eventually stops growing from that follicle altogether.
Pattern hair loss male pattern baldness is a progressive condition that affects both men and women. Male pattern hair loss (MPHL) or androgenic alopecia is characterised by hair thinning and loss in a well-defined pattern. First at the temples and frontal hairline, then as hereditary hair loss advances further, at the top and vertex of the scalp. Female pattern hair loss (FPHL) or androgenetic alopecia typically involves diffuse hair thinning all over the scalp and usually does not involve a receding hairline.
Understandably, hair loss can cause considerable emotional stress, loss of self-confidence, and poor body image. Myths about balding abound, some of which contradict each other, and at worst blame the sufferer. E.g.: “bald men have low levels of testosterone,” “bald men are virile and highly sexually active,” “stress will make you lose your hair,” “wearing a hat/washing your hair causes hair loss,” – the list goes on.
As yet there is no cure for hereditary hair loss, but there are medications and medical interventions that can help restore or maintain the appearance of fullness.
Finasteride – Finasteride is a prescription medication that blocks the enzyme 5αR that converts testosterone to dihydrotestosterone and is used to stabilise hereditary hair loss. While on the medication approx. 80% of people maintain their current hair; 10% experience reduced hair loss, and 10% see no results.
Minoxidil – Minoxidil is available over the counter as a 2% or 5% lotion, 5% foam, or in oral tablet form. Clinical trials in patients with androgenic alopecia treated with 2% or 5% Minoxidil showed an increase in hair growth and decrease in hair loss, and with better results at the 5% dosage.
Hair Transplant Surgery
Hair transplant surgery has come a long way since the conspicuous “hair plugs” of the 1980s. Even FUT (Follicular Unit Transplantation) strip surgery, where a long strip of scalp is cut from the back of the head, follicles dissected, and implanted, is now reducing in popularity owing to the long linear scars it leaves on the back of patient’s heads. Meaning they cannot wear their hair cut short at the back without revealing the scarring.
Follicular unit extraction (FUE) extracts follicles one by one from the back of the scalp, where the follicles are unaffected by the DHT hormone and are healthy. Follicular units naturally grow in groups of one, two, three, or four hairs. Once extracted, they are divided into smaller groups, then implanted where needed to restore a natural-looking hairline. Unlike FUT, FUE scars are small and largely undetectable, ensuring a faster recovery time than FUT.