The
Hair Loss Process and Hair Genesis
(The DHT Theory on hair loss)
(The most widely accepted hair loss theory)
 The
speed at which hair loss occurs in androgenic alopecia is
dependant on by three things:
1) Progression in age.
2) Heredity tendency to have hair loss
3) The prevalence of dihydrotestosterone (DHT) within the
hair follicle
DHT is a highly active form of testosterone, which influences
many aspects of manly behavior, from sex drive to aggression.
DHT is a naturally occurring hormone which assists with sexual
development in males during fetal development and puberty. DHT
which is produced in the prostate, various adrenal glands,
and the scalp is produced from testosterone by two 5-alpha
reductase isoenzymes, called Type I and Type II. Type I 5AR
is much more prominent in the scalp than Type II. However,
immunostaining techniques reveal that Type I is abundant in
sebaceous glands, while significant Type II is present in
the dermal papilla itself. DHT is the androgen thought to
be most responsible for male pattern baldness.
DHT has a very high affinity for the androgen receptor and
is estimated to be five to ten times more potent than testosterone.
Other androgens that may be significant in pattern loss include
androstenedione, androstanedione and DHEA (especially in women).
All of these fall into hormonal pathways that can potentially
result in elevation of DHT downstream via various enzymes.
It is possible that certain DHT metabolites may play a role
in pattern loss as well. During hair loss, DHT begins to treat
your follicles as foreign objects in your body. Similar
to an auto-immune response, it slowly begins to reject the
follicles. During this time there typically is increased
Sebum production.
 During
hair loss, DHT begins to treat your follicles as foreign objects
in your body.
Follicles at the front, top, and upper back of the head in
most men are genetically programmed to become susceptible
to DHT at some point in the man's life. Those hairs
which cover the sides and bottom back of the head typically
are not, which is why most men do not lose hair in these areas.
This is lengthy progression, and the cycles for hair growth
are typically about 3-9 months. Without a DHT inhibitor
either systemically (in the bloodstream) or locally in the
scalp, each time your hair cycles, the follicle will become
thinner, shorter, and ultimately it will not grow back in.
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Over time, the action of DHT will cause each hair follicle
to decay and shortens the anagen phase. Some follicles will
gradually die, but most will simply shrink to the size they
were when you were born which produce weaker hairs. With a
progressively shorter anagen growing cycles, more hair is
lost, and the remaining hair becomes finer and thinner until
they are too fine to survive. The sebaceous gland (gland producing
sebum – natural oil) attached to the hair follicle remains
the same size. As the hair shafts become smaller, the gland
continues to pump out about the same amount of oil (sebum).
So as your hair thins, you will notice that your hair becomes
flatter and oilier.
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The
most common form of hair loss is determined by our genes and
largely influenced by our circulating hormones. Androgenetic
hair loss (AGA) typically called pattern hair loss is the
single most common form of alopecia and affects both men and
women. It is thought that over 60 million American men
and 20 million American women suffer from AGA. The disorder
can be inherited from either the mother's or father's side
of the family and is highly variable in its expression.
About 50% of those with a parent who has experienced AGA can
expect to inherit some degree of pattern hair loss as well.
AGA in men can start at an early age but usually will become
evident in the late 20’s to late 30’s. Interestingly,
it has been shown that approximately 20% of 20 year olds,
30% of 30 year olds 40% of 40 year olds and so on experience
some degree of pattern hair loss.
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Women with this trait develop thinning hair, but rarely become
completely bald. The condition is called androgenetic alopecia
and it can start in the teens, twenties or thirties. There is
no cure, although medical treatments have recently become available
that may help some people. One treatment involves applying a
lotion, minoxidil, to the scalp twice a day. Another treatment
for men is a daily pill containing finasteride, a drug that
blocks the formation of the active male hormone in the hair
follicle.
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