About Hair Loss

Each and every follicle on your head possesses its very own and specific genetic program. This program determines hair's qualities and behavior. Because it is genetically encoded (inherited), it is, therefore, inescapable.

For men and women, this hereditary hair loss condition is called androgenic alopecia. If one or both of your parents, their siblings or other family members have experienced hair loss, you will be prone to inherit this hair-losing tendency as well.

Predisposition to hair loss may manifest itself even in teenage years. In fact, hair loss will be continuous and relentless in its nature, regardless of when it started.

Hair loss in men is often referred to as male pattern baldness and may progress, in severe cases, to the familiar horseshoe-shaped fringe of hair. This is typically classified as Norwood 7.

In women, it is referred to as female pattern baldness and usually takes the form of thinning hair over the entire top of the scalp. Nevertheless, some females with hair loss may display the "male" pattern.

Besides the genetic etiology, which makes up over 90%, there are many other reversible (reversible causes) and irreversible forms of hair loss. Some examples of these other types of hair loss may include but are not limited to stress, iron deficiency, thyroid disease, traction alopecia, trauma and medication. A proper diagnosis to figure out what is causing the hair loss is key to selecting a proper treatment choice.

Hair Growth Cycle
In order to understand hair loss better, we must examine the hair cycle. During its lifetime, hair usually cycles through different phases (anagen, catagen and telogen). It is quite normal for an individual to lose approximately 150 hairs every day because of the normal hair cycle. However, these fallen hairs will only re-grow several months later.

Hair growth cycle:

This hair cycling is normal and can account for up to 150 hairs lost on a daily basis. These hairs are replaced by the new anagen hairs. The number of hairs on the scalp will stay the same for a person who is not experiencing hair loss.

The duration of each cycle varies for terminal hairs and vellus hairs. Terminal hairs are defined as strong, mature and fully-developed hairs. Vellus hairs are smaller, miniaturized hairs that don't grow longer than a few centimeters and are less pigmented.

Male Pattern Baldness:

Female hair loss
As psychologically stressful as hair loss is for men, it is even more stressful for women. This process is also less scientifically understood.

The most common cause is of hereditary nature, androgenetic alopecia, but the hormonal influences present in females may differ from those that are present in males.

THE LUDWIG SCALE FOR WOMENS HAIR LOSS

Other causes of Hair Loss:
There are many other causes of hair loss that are treatable but occur less frequently. These include thyroid disease, iron deficiency, high fever, surgery, traction alopecia, trichotillomania (a psychological condition that makes a patient pull their own hair), anesthesia, crash diets, post pregnancy and some medications (such as chemotherapy). Various scalp conditions can also cause hair loss. These include alopecia areata, lupus and lichen plano pilaris.

Common Myths
It is vital to note that hair loss is not caused by common myths, such as clogged hair follicles, frequent shampooing, wearing of hats/helmets or the presence of mites.

Any person facing hair loss must meet with a specialist, such as Dr Rahal, and have a thorough assessment, which may include physical examination and laboratory investigations. The information gathered can provide a diagnosis and help plan treatment options.



Medication Propecia

Propecia ® is an FDA-approved prescription medication for men. It effectively treats genetic hair loss. The active agent in Propecia is a drug called finasteride. Finasteride works by blocking the type II 5 alpha reductase enzyme. This lowers the DHT level and thus decreases its effect on susceptible follicles. Finasteride has been in use for prostate enlargement since 1984 at a 5 mg dose. The dosage for hair loss is 1 mg and this has been approved since 1997.

The benefit of using this medication will only last for as long as it is being taken.
Clinical studies on finasteride have shown a benefit of reducing hair loss in over 90% of patients to a certain degree. It is a perfect complimentary treatment for those patients who undergo hair transplantation, and especially the younger ones.

Medication Rogaine

Rogaine® was the first FDA-approved hair loss treatment for both men and women. The active agent in Rogaine® is a drug called Minoxidil. Minoxidil (2% and 5%) is a solution/foam that is applied topically to the scalp twice a day. Although the exact mechanism of its effect is not fully understood, it has shown to be clinically effective to combat hair loss. Again, it is only effective as long as it is being used. Due to their different mechanisms of action, both minoxidil and finasteride can be used together.