All about hair loss…
When you think about it, humans have a complex and bizarre relationship with our hair.
We spend thousands of dollars in expensive treatments, and hours of time ridding ourselves of unwanted but perfectly natural hair growth on various parts of our bodies, usually led by conventional ideas of what is culturally attractive or socially acceptable. Armpit or leg hair on women, back hair on men … “unsightly growth” is a phrase we’ve all heard and come to be afraid of.
But move a few inches to other areas of the body and we’re fiercely loyal and nurturing of our tufts. We’ll spend hours encouraging and conditioning healthy growth of head hair, beards, and eyelashes which are then precisely manicured, dyed or styled so we can show off our luscious locks and swarthy strands to their best advantage.
But a universal truth about hair that gets almost everyone a bit nervous is loss of head hair.
In reality, it happens to all of us to some degree in our lives. Be assured… we all shed. Anyone who has ever used a hairbrush can see that for themselves. But premature or excessive hair loss, or thinning hair, can be a very distressing reality for both men and women.
What is it that causes it? Why is it important? Let’s kick off by understanding a bit more about how hair works.
Understand your strands… what is hair and why do we have it?
Hair is actually a lot more complicated than you might think. It is made of a protein called keratin (also in your nails and skin), which gives it its structure. That name will likely sound familiar to you because it’s used in a number of products that claim to promote the strength and health of hair (in actual fact, some of these products can be damaging to your hair due to their formulation with other ingredients like formaldehyde!).
The hair that we see growing from bodies isn’t in fact living tissue. Unlike skin, which is very much made of living and active cells, hair can’t heal, which is why it’s a big challenge to repair your hair if you damage it through heat or chemical exposure or other forms of mistreatment.
Your shafts of hair are anchored to tiny, very-much-living cells called follicles that cover the entirety of your body (about half a million of them!), with the exception of the palms of your hands, the soles of your feet and your lips. At its base, the roots of hair also are attached to a tiny muscle called the arrector pili – which causes hair to stand up straight when the body asks it to (you’ll see the results of these little muscles in action whenever you get goose-pimples).
Most follicles are so small you won’t actually see the hair protrudes from the upper layers of your skin, called the epidermis. In other places, you’ll see very light growth, called ‘vellus’ hair, resembling merely a light covering of fuzz (the kind that a woman might typically see on her stomach or cheeks).
The areas with the highest density are what we call ‘terminal’ hair, most heavily found on your scalp, armpits, legs and crotch region and, more so for men, on the face, front of chest and back. These hairs are the thickest, strongest and most pigmented (colored) hairs on your body. The density of growth is determined by your gender and genetic factors, which is why some people have hair on areas on their body that others won’t find it.
We have hair for a number of reasons. Firstly it helps us to regulate and maintain body temperature; think of it as an insulating layer on top of your skin to keep it either cooled or heated. It also helps our perspiration to evaporate (ever notice that you sweat more in the areas where hair occurs more densely? That’s why).
So if hair actually plays a role in human anatomical function, why do we lose it?
Hair today… gone tomorrow. What exactly causes hair loss?
Let’s restate the facts–we ALL lose hair. Head hair alone typically sheds between 50-200 strands a day as part of its natural cycle. Hairs are typically pushed out of the follicle then replaced with new shafts, at a rate that differs by individual and area of the body. In a “normal” cycle of hair growth, a process occurs over a few years in which a hair grows, rests and is eventually replaced.
So what stops hair from growing back or thinning, known as ‘permanent hair loss’?
You’ve probably heard all sorts of myths about wearing hats, hair-washing or over-stimulation of the head, and all kinds of scary ideas that keep us from doing things that really, have no effect on the natural growth and replacement cycle described above.
While there are many theoretical reasons for hair loss (such as disease, adverse medication reactions or in extremely rare cases – stress), the real cause of hair loss is hereditary. It’s in your genetic make-up, and there really isn’t a lot to be done about it. (Despite all the hair loss companies and products claiming they can reduce or prevent hair loss, only two products are actually even approved by the FDA, and their efficacy is still uncertain.)
We call this form of permanent hair loss and thinning ‘androgenetic alopecia’, or more commonly, male pattern baldness (MPB). According to the American Hair Loss Association (AMLA), male pattern baldness (MPB) is the cause of more than 95% of cases of hair loss in men. By the age of fifty, around half of all men will suffer from MPB to some significant degree, although a much higher 85% will show significant signs of thinning hair. About a quarter of men with MPB will begin the thinning process before they hit 21.
The process of hair loss typically starts above the temples at the side of the head, and at the crown, and spreads from those places. The hair will recede at the front as the bald patch at the back also grows larger.
What is actually happening to cause this is an inherited genetic sensitivity of the hair follicles to a by-product of testosterone called Dihydrotestosterone (DHT). Dr David Kingsley, President of the World Trichology Society, explains that the development of genetic hair loss is associated with the “shortening of the anagen (growing) phase of the hair cycle and consequently with an increase in the proportion of telogen (resting) hairs”. The effective follicles eventually reduce in size and consequently so do the diameters of the strand of hair they produce, a process known as hair miniaturization.
“Some research has suggested that a reduction in the activity or amount of an enzyme called aromatase (which converts certain male hormones in the scalp into female hormones) may also contribute to female pattern hair loss”, according to Dr Kingsley. This could account for the difference in clinical appearance between male pattern alopecia and female pattern hair loss, which affects up to 55% of women.
What can be done to prevent it?
The AMLA states that genetic alopecia causes sufferers extreme unhappiness, affecting both the “interpersonal relationships as well as the professional lives of those suffering”. They strongly advise against researching your options through the yellow pages or commercial websites. There are hundreds of products and services being sold to the vulnerable hair loss consumer, but currently, there are only two FDA approved products that have been clinically proven to stop or prevent hair loss. In addition, only a handful of surgeons are performing surgical hair restoration to state of the art standards.
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