Normal hair growth and common hair loss are both conditions that can occur.
Hair growth cycles are normal in most people.
Without interruption, each terminal scalp hair will typically continue to grow for around three to five years if left alone. The hair then changes into a resting stage, during which the visible part of the hair above the skin sheds. For the next 90 days, no hair will develop from the follicle. A new hair begins to grow through the skin once this period has gone, and this process continues for another three to five years at a pace of roughly 1/2 inch each month for the next three to five years.
Approximately 100 genes are estimated to be involved in the regulation of the formation, development and cycling of scalp hair. To yet, only a small number of these genes have been discovered.
Hair Loss in a Common Pattern
The Hamilton-Norwood Scale of Hair Loss
Many misconceptions and half-truths abound in the world of hair loss, and it may be difficult to find accurate and valuable information. As a result, the next section provides an impartial summary of pattern hair loss.
Pattern hair loss is the most frequent kind of hair loss in healthy, well-nourished adults of both sexes. Androgenetic alopecia (AGA) is also known as male pattern hair loss. Approximately 40 million American males are affected by this disease. Interestingly, over 20 million American women are affected by the same condition, which is unexpected. When it comes to hair loss, the main difference between men and women is that a woman generally keeps her feminine hairline while experiencing thinning below this leading edge. The frontal border of the beard recedes at the same time that a thinning zone grows from the posterior crown of the beard in males, resulting in an unique “pattern” of loss. When these zones come together in more prominent occurrences, the person is said to as clinically bald.
There are three triggers.
It is important to note that three events must occur in order for one to be influenced by AGA. First and foremost, one must be born with a genetic predisposition. This indicates that the issue originates on either one or both sides of the family tree. Second, one must reach a particular age in order to participate. When children are nine years old, they do not have pattern hair loss. The presence of circulating hormones that trigger or accelerate the development or course of the disease is also essential, as previously stated.
AGA often manifests itself in the late stages of adolescence or the early stages of adulthood. Generally speaking, the sooner hair loss begins, the more severe it is likely to become in the subsequent years.
Hormones, enzymes, and other environmental factors
The structure of the DHT molecule was determined.
If we look at it from the perspective of susceptibility, the most important hormonal trigger associated with pattern hair loss is 5-alpha dihydrotestosterone, often known as DHT. It has been demonstrated that pattern hair loss does not occur in those who are genetically resistant to DHT, which is intriguing. DHT is a hormone that is produced from the androgen hormone testosterone and is beneficial throughout the early stages of life and puberty.
In adults, it is believed that DHT causes substantial damage while providing little benefit. DHT is responsible for the onset of disorders as different as benign prostatic hyperplasia and pattern hair loss, among others. The enzyme 5-alpha reductase is responsible for the production of DHT. There are two closely similar versions of the enzyme. Hair loss therapy approaches that effectively interfere with the interaction between 5-alpha reductase and androgen hormones such as testosterone have been proven to be clinically beneficial in the treatment of pattern hair loss in clinical trials.
Given the fact that hair development is controlled by a large number of genes and associated metabolic pathways, the underlying variables are very complicated. Another obstacle to understanding hair loss has been the fact that humans are the only animals who suffer from androgenetic alopecia, which is a kind of male pattern baldness. As a result, there is no effective animal model available that would otherwise be able to provide light on the fundamental elements at play.
In addition to AGA, there are other types of hair loss.
In either gender, the differential diagnosis is generally determined based on the patient’s medical history and clinical presentation, among other factors. Alopecia areata (AA), Trichotillomania, and telogen effluvium are among of the most prevalent differential diagnoses for AGA. Only in rare cases, the reason of hair loss may be related with diseases such as lupus, scabies, or other skin-implanting disease processes such as psoriasis. Scalp biopsy and laboratory testing may be beneficial in determining a conclusive diagnosis; however, in such situations, they should typically be performed only after a thorough clinical assessment by a trained treating physician has been completed.
Hair Loss Treatment Options for Pattern Hair Loss
When it comes to coping with hair loss, it has been sarcastically remarked that the options are “rugs, plugs, or medications.” Non-surgical hair systems, surgical hair restoration, and medication, to give them their proper names, are the three treatment choices discussed in this joke. A fourth alternative has just emerged, and it will be discussed more in this section. This is a non-drug based kind of treatment.
Non-surgical Restorative Treatment
Typical Hair Accessory
It is believed that hair replacement methods have been in continuous use since the time of the ancient Egyptians. These items are also known by a variety of other names, including hair integration systems, wigs, weaves, hair pieces, toupees, and a variety of other terms. All of them have one thing in common: they are not coming out of the person’s head. As a result, they must be connected in some way, either with the bare skin or with the fringe of hair that still exists above the ears and at the rear of the head.
Despite the potential for long-term connection, such attachment to a live scalp is virtually never successful, and for good reason. Aside from the fact that the unit itself wears out, basic hygiene demands that the wearer remove the unit on a regular basis in order to clean the hair and scalp beneath the unit. When it comes to hair replacement systems, there are usually always three fundamental components. The first is the hair itself, which can be synthetic, natural, or a mix of the two types of fibers. The second element serves as the unit’s foundation. Typically, the hair is braided into a foundation that resembles cloth and is then connected to the scalp in some way. As a result, the third element, which is the method of connection, is brought into play. Sewing the base to the fringe hair, gluing the base to the fringe hair, or gluing the base to the bald scalp are all methods of attaching the base.
One of the potential benefits of hair systems is the speed with which they may be used to get a complete hair “look” that might appear to the untrained eye to be similar to having a full head of hair. It is possible that hair systems will have a number of negative consequences.
Individuals who are actively losing hair, as opposed to those who are completely bald, may experience a fast acceleration of the balding process due to the hair system itself. There is however one drawback, which is the firm leading edge, which may be used to detect whether or not someone is using a hair system. For a long time, this problem was solved by the use of delicate lace front fake hairlines, which appear fairly natural but are notoriously fragile due to their delicate nature.
Hair systems must be repaired and eventually replaced because they are non-living devices. The expenditures of servicing and maintaining a hair replacement system are not insignificant—in fact, they can be significantly greater than the initial purchase price.
Reconstructive Surgery for Hair Loss
Hair transplantation, often known as surgical hair restoration, is a procedure that takes use of a phenomena that was originally reported in the 1950s. Known as donor dependence, this phenomenon describes the observation that hair-bearing tissue that has been transplanted to an area of the same person’s scalp that had previously been balding continues to produce viable, vigorous hair that persists in its new location as it would have otherwise, had the tissue not been “relocated.” Surgical hair restoration can be a successful treatment option for pattern hair loss in people who are properly chosen.
When it comes to hair transplantation, there are certain significant considerations. The first of these is concerned with supply and demand. In order to avoid inducing a florid and destructive foreign body response in the recipient, it is currently not possible to transplant hair from one person to another at this time. Consequently, both the surgeon and the patient are confined to the permanent hair bearing tissue that already exists. As a result, it is critical to protect and strategically position this valuable resource in the most effective manner possible.
The second significant snag in hair transplantation is the inability to achieve clinically favorable endpoint results in most cases. A hair line that is patchy or overly abrupt may appear worse after it has been repaired than it did before to the restoration. The same may be said about hair behind the leading edge that has not been restored in a manner that results in relevant density (e.g. 1 hair per mm/sq) and so does not resemble a complete head of hair in many cases. Consequently, when selecting a transplant surgeon, aesthetic quality should be given at least as much consideration as fundamental surgical expertise.
In addition, there is an issue known as “chasing” a receding hair line, which should be considered before undergoing hair transplantation. Considering that hair loss is a gradual and relentless process, it is likely that donor hair restored and integrated into a seemingly undamaged region of scalp hair will end up becoming an island of hair since the hair behind it continues to erode. Due to the nature of the condition, patients are forced to enhance hair growth behind the restoration zone in order to maintain a natural-looking appearance. This works quite well until either the hair stops thinning or one runs out of donor hair, at which point it becomes ineffective.
The inclusion of a therapy option that safely and efficiently slows down or stops the course of hair loss would be beneficial for those undergoing transplant surgery since it would free them up from the worry of chasing a receding hair line after their hair transplant procedure.
Options for Hair Loss Treatment Using Pharmaceuticals
In terms of therapy, topical minoxidil and oral finasteride have been the two most commonly utilized therapeutic treatments against pattern hair loss in recent years.
Minoxidil, first commercially available under the brand name Rogaine(TM), was originally developed as an oral antihypertensive medication called Loniten (TM). It has been noticed that unexpected hair growth on the face and scalp has occurred in certain individuals who have been prescribed minoxidil to treat blood pressure issues. The werewolf effect was a term that was used to refer to this phenomenon informally. Following this finding, topical formulations containing minoxidil were tried on balding scalps and were shown to be effective. Rogaine(TM) (2 percent minoxidil) was the first hair loss treatment medication authorized by the FDA for use in males, and it continues to be the most widely used. Finally, Rogaine(TM) (2 percent minoxidil) was authorized for treatment in females with alopecia. Extra Strength Rogaine(TM) (5 percent minoxidil) was authorized by the FDA for use only in males and has since become widely available.
Rogaine(TM) has a number of advantages, including the potential to stop and perhaps reverse pattern hair loss in certain people. According to Pfizer’s own marketing materials, Rogaine(TM) has been found to be most successful in treating hair loss in the vertex and posterior scalp, but not in addressing hair loss in the anterior hairline. Minoxidil is a powerful medication with a number of possible adverse effects, including hypotension and irritation of the skin.
A selective type II 5-alpha reductase inhibitor known as finasteride (trade name Proscar(TM)) was initially designed to treat benign prostatic hyperplasia (BPH). Finasteride is available in 5 mg oral dose under the brand name Proscar(TM) (BPH). Because BPH is biochemically related to the same metabolic pathways that produce pattern hair loss, it was predicted that finasteride would be therapeutically beneficial in both conditions. Propecia(TM) (1 mg finasteride) was created as a result of this research. When tested in placebo-controlled studies on men with mild to severe hair loss, Propecia(TM) was shown to provide clinically significant benefit in terms of slowing, and in some cases, reversing, the development of the condition, according to the manufacturer. Propecia(TM) is not recommended for usage in females, according to the manufacturer. Reduced libido and decreased ejaculate volume are two of the most commonly reported adverse effects. Gynecomastia (male breast enlargement) is another possible adverse effect of the medication. It can also artificially reduce the levels of a crucial protein (PSA), which is used to test for prostate cancer, when taken orally. It is recommended that pregnant women, as well as anyone who may come into contact with pregnant women, avoid handling finasteride, which is considered a teratogen (may cause feminizing birth abnormalities) and should not be handled.
It was originally intended for the treatment of BPH, much as finasteride had been. At the same time, however, dutasteride inhibits both isoforms of 5-alpha reductase, in contrast to the fact that finasteride inhibits only type II 5-alpha reductase. A clinical research conducted by GlaxoSmithKline, known as the EPICS trial, revealed that dutasteride was not more effective than finasteride in the treatment of BPH.
Dutasteride is now authorized for the treatment of benign prostatic hyperplasia (BPH). Clinical studies for dutasteride as a hair loss medication were conducted, but were terminated in late 2002 due to a lack of results. Gynecomastia, changes in prostate-specific antigen (PSA) levels, teratogenic effects, and other adverse effects have been reported with the use of dutasteride. These side effects are quite similar to the negative side effect profile outlined by the manufacturers of finasteride.
As recently as December 2006, GlaxoSmithKline began a new Phase III, six-month trial in Korea to evaluate the safety, tolerability, and efficacy of an oral once-daily dosage of dutasteride (0.5mg) for the treatment of alopecia areata (AGA) in the vertex region of the scalp (types IIIv, IV and V on the Hamilton-Norwood scale). It is yet unclear what influence this research will have on the FDA’s decision on whether or not to approve or disapprove of Avodart for the treatment of male pattern baldness in the United States in the near future.
On occasion, but particularly in female patients, medications such as spironalactone and flutamide have been used off-label to treat a variety of hair loss-related conditions. No FDA-approved medication has been authorized for the treatment of pattern hair loss, and each medicine carries with it a long list of possible adverse effects.
Treatments for Hair Loss that are not dependent on drugs
Recently, botanically derived compounds have been the subject of extensive research as potentially effective weapons in the fight against AGA. The creators of HairGenesis have played a significant role in advancing this cause (TM). Several more products were introduced to the market following the introduction of HairGenesis(TM). Some of them included medications such as minoxidil. Others utilized variants on the subject of non-drug based formulations, while still others did not. In contrast, with the exception of HairGenesis(TM), none has been backed by a third-party, IRB-monitored, placebo-controlled, double-blind research that has been published in the peer-reviewed medical literature, save for HairGenesis(TM). This distinguishes HairGenesis(TM) from other products in the category. A visit to the HairGenesis(TM) Comparison Page is recommended for anyone interested in learning how HairGenesis(TM) is considered to compare to alternative hair loss treatment options.
Because the majority of this website is devoted to the advantages of HairGenesis(TM) therapy, the various arguments in favor of HairGenesis(TM) treatment will not be repeated here. Two ideas, however, are pertinent to the current debate and will be succinctly explained.
First and foremost, the complex of naturally derived active chemicals utilized in HairGenesis(TM) has been proven to function through routes and mechanisms that are distinct from one another, as well as distinct and apart from the pathways and mechanisms that are used by drug-based therapies to work. For the time being, suffice it to state that this finding has offered an exciting new possibility to transform HairGenesis into a “cocktail” therapy in which formulation synergy is most likely to occur.
For the uninitiated, this implies that HairGenesis(TM) has been created in such a way that it is more than the sum of its parts.
The second important point to mention is that the developers of HairGenesis(TM) are actively engaged in research to produce new, more improved, and more effective versions of the product. Improvements of this nature will be reported when necessary.