What you should know about baldness

The condition is more common in men than in women. The fact is that some people prefer to let their baldness run its course untreated and unhidden, while others may cover it up with hairstyles, makeup, hats or scarves.

Normal hair cycle

Human hair grows about an inch every couple of months and most people are familiar with this fact. What most people don’t know is that each and every hair grows approximately 2 to 6 years, remains at the reached length for a short period, and then falls out. The good thing is that soon  afterwards a new hair begins growing in its place. The proven fact is that at this minute about 85% of the hair on your head is in the growing phase and 15% is not. Each hair sits in a cavity in the skin called a follicle.

What are the different types of baldness?

Baldness can be classified into various types depending on the cause behind it. The most common types of baldness include the following:

Male-pattern baldness
Male-pattern baldness is usually a hereditary condition and it may begin at any age. Hair loss often begins on the front, sides, and/or on the crown of the head. Some men may develop a bald spot or just a receding hair line, while others may lose all of their hair.

Female-pattern baldness
Female-pattern baldness is less common and a bit different from male-pattern baldness In this type of baldness hair generally thins all over the head, but the frontal hairline is maintained. Female-pattern baldness rarely results in total hair loss.

Alopecia areata
This hair loss disorder is characterized by the sudden loss of hair in one particular area only and it grows back after several months. However, if all body hair is suddenly lost, regrowth may not occur.

Toxic alopecia
Toxic alopecia is not so frequent and it can occur after taking certain medications, especially thallium, high doses of vitamin A, and retinoids. Soma medical conditions, such as thyroid disease or giving birth alo may trigger toxic alopecia.
 
Scarring alopecia
Scarred areas may prevent the hair from growing back and this condition can occur from burns, injuries or x-ray therapy.
 
Trichotillomania
Hair pulling, a habit most common among children, may cause hair loss.

However, the most common types of alopecia are definitely male and female pattern baldness.

Symptoms of male pattern baldness

There are some typical places where the male pattern baldness occurs for the first time and the most common is hairline. The hairline gradually recedes to form a shape of a letter M. The area of baldness is spreading and eventually the top of the hairline meets the thinned crown, leaving a horseshoe pattern of hair around the sides of the head.

Other possible symptoms are:

• hair loss in patches,
• diffuse shedding of hair,
• breaking of hair shafts,
• hair loss associated with redness,
• scaling,
• pain,
• rapid progression

Causes of male pattern baldness

Baldness in men occurs when the follicle shrinks over time, resulting in shorter and finer hair. The end result is a very small follicle with no hair inside. Ordinarily, the hair should grow back. However, in men who are balding, the follicle fails to grow a new hair. There is still no real explanation why this is happening. The most common theory is that it could be related to male sex hormones, especially dehydroepiandrosterone, the active form of testosterone.

Other possible causes are:

• Disease

It is proven that certain conditions such as diabetes, lupus and thyroid disorders can cause hair loss and treating these conditions will often lead to hair regrowth.

• Poor nutrition

Not many people know that if someone has an inadequate intake of  protein or iron in their diet, it can cause hair loss.

• Medications

There are certain drugs which are normally used to treat gout, arthritis, depression, heart problems and high blood pressure, but also may cause hair loss in some people. 

• Medical treatments

Undergoing chemotherapy or radiation therapy may cause alopecia.

• Other conditions

Three to four months after the events such as an illness or surgery, alopecia can easily occur. 

• Infancy

The newborns often lose hair during the first several months of life. Most mothers are not aware that this baby hair is not real hair and that it will be replaced by more permanent hair.

Female pattern baldness

Symptoms of female baldness are a bit different then that of the male baldness and they usually include thinning of the hair over the entire head and hair loss at the crown or hairline. The truth is that the exact cause of the failure to grow new hair in female pattern baldness is not well understood. Most experts believe that it could be due to:

• genetic predisposition,
• aging,
• levels of endocrine hormones, especially androgens - the male sex hormones

It is proven that frequent changes in the levels of androgens can affect hair production, especially after the hormonal changes in menopause.

Treatment of alopecia

Medications

There are several medications that are commonly used to treat alopecia and some of the most common are:

Minoxidil (Rogaine®, Regaine®)
This is one of the most famous medications used to treat alopecia. It is over-the-counter medication which is approved for the treatment of androgenetic alopecia and alopecia areata. Patients should know that a new hair resulting from minoxidil use may be thinner and shorter than the previous hair.

Finasteride (Propecia®, Proscar®)
Unlike the previous medication, this medication is normally used in a form of a pill. The important thing about this medication is that for positive results patients may wait several months. It works by inhibiting the conversion of testosterone into dihydrotestosterone, a hormone that shrinks hair follicles and is an important factor in male hair loss. Finasteride is not approved for use by women. It is important thing that pregnant women must never use it because Finasteride tablets because absorption of the drug may cause serious birth defects in male fetuses.

Corticosteroids
Several researches done in the past have proven that injections of cortisone into the scalp can help alopecia areata treatment. 

Anthralin (Drithocreme®, Micanol®)
Anthralin is a synthetic, tarry substance that should be applied to the scalp and washed off daily.

Hair replacement surgery

There are a number of hair replacement techniques that are available but the problem is that none of them can help those who suffer from total baldness. The candidates for hair replacement must have a healthy growth of the hair at the back and the sides of the head. During the transplantation a cosmetic surgeon takes tiny plugs of the skin, each containing one to several hairs, from the back or side of the scalp.

There are four different basic types of hair replacement methods, including the following:

Hair transplantation
During the hair transplantation, the surgeon removes small pieces of hair-bearing scalp grafts from the back or sides of the head. These grafts are then relocated to a bald or thinning area.

Tissue expansion
In this procedure, a tissue expander is placed underneath the hair-bearing area that is located next to the bald area. After some time, the tissue expander causes the skin to grow new skin cells. Another operation is then required to place the newly expanded skin over the adjacent bald spot.

Flap surgery
This is a very effective procedure. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply

Scalp reduction
Scalp reduction is done in order to cover the bald areas at the top and back of the head. This technique involves the removal of the bald scalp with sections of the hair- connecting scalp pulled together and filling in the bald area.

Wigs and hairpieces

There are several options which stand as an alternative to medical treatment for baldness. They may also be helpful for people who didn’t respond to treatment. These patients may want to consider wearing a wig or a hairpiece. They can be used to cover either permanent or temporary hair loss. Nowadays there are quality, natural-looking wigs and hairpieces available.

Possible operation complications

There are several possible complications that could occur after the hair transplantation although they are very rare. Possible complications associated with the hair transplantation procedures may include, but are not limited to, the following:

Patchy hair growth
Sometimes though not very often, the growth of new hair has a patchy look, especially if it is placed next to a thinning area. It can look really embarrassing but it may be repaired with another operation.

Bleeding and wide scars
Although, this isn't a very common complication and it shouldn’t happen at all, the tension on the scalp resulting from the scalp reduction techniques can result in wide scars and bleeding.

Grafts not accepting
Occasionally, there is a chance that the graft may not be accepted by the body. If this is the case, the surgery must be repeated.

Infection
As with any surgical procedure, there is a risk of infection.