* Will I end up bald like my father? Are male and female alopecia the same? Who should I see to treat hair loss? Is hair transplant effective?
* There are thousands of queries and even more myths with which popular wisdom tries to answer them.
We have asked the most outstanding experts in the field of hair care and hair loss. They have helped to clarify queries and dismantle false myths.
We continue with our series of questions and answers about hair with scientific explanations.
Male pattern baldness affects approximately 50 % of males at some point of their lives. Probably as a consequence of their genetic base, it affects different populations with a different frequency. Up to half of white males will experience a certain degree of baldness at age 50, while other population groups, like Japanese and Chinese males, will not be so affected by it.
Hair colour is due to a pigment called melanin. Melanin comes in 2 different forms: eumelanin, which is the dark pigment that predominates in dark and brown hair, and pheomelanin, a slightly lighter pigment which is found in blond and red hair. The different hair colours are hereditary.
DHT (Dihydrotestosterone) is a derivative of testosterone, which is ultimately responsible for hair loss in men. DHT contributes to shortening the growth phase in hair (anagen) and reduces it so much that the new hairs do not reach the length or thickness of their predecessors, becoming almost invisible.
Androgenetic alopecia is a common problem that affects both men and women, and in both sexes, genetics plays a role in its development. In general, women tend to present a diffuse alopecia that affects the whole scalp, though it is more visible in the top part, or affects that area more, while men have male pattern baldness, which causes a receding hairline and affects the crown of the head. As well as a genetic origen and the presence of DHT, other factors can trigger alopecia or accelerate its progression. Such is the case of the menopause. The loss of oestrogen which occurs during this period may explain why the hair is thinner at this age and it may in some cases even trigger/accelerate the development of androgenetic alopecia.
Yes, indirectly, since greasy hair and baldness somehow have the same cause. Male hormones act in individuals predisposed genetically, producing hair loss and raising sebaceous secretion. However, there is no direct relation between the two (excess of grease – alopecia).
Stress may encourage greater hair loss and accelerate the progress of the baldness. This is one of the factors that we have commented on before as being triggers or accelerators of alopecia.
Yes, alopecia makes men feel “a loss of confidence in themselves, it makes them feel less attractive and older” and “it makes their social and family relationships more difficult”. These are some of the conclusions reached in the sociological study carried out by the Gallup Institute among more than 1,500 men in France, Germany, Italy, Great Britain and Spain, to analyse the psychological effects associated with male alopecia and the impact that this has on the state of mind, self-esteem and the relationship with their partner of the men that suffer it.
Of the 300 Spaniards consulted, 35% confess that they are afraid of the possibility of going bald; 37% affirm that they feel older with the loss of their hair, and 33.5% say that they are losing an important part of their physical attractiveness. At present, in spite of all this evidence, a mere 6.4% of the Spaniards who have this problem are treated for it, though in most cases, they have recourse to products that have neither been prescribed by a dermatologist, nor had their scientific efficacy proved.
We should go to the dermatologist. The dermatologist will study each case. First, he/she will carry out a clinical history, noting the point when the hair started to fall out, during the fall, the way in which it falls, etc. He will study the family and personal antecedents. He will examine the hair, the scalp, the nails, the skin in general, etc. He will also run all the analyses and complementary tests that he deems necessary and with all this information he will make the correct diagnosis and begin the appropriate treatment.The Dermatologist is the medical practitioner best suited to reach the right diagnosis and recommend the best treatment for each case. The ACADEMIA ESPAÑOLA DE DERMATOLOGÍA (www.aedv.es; the Spanish Academy of Dermatology) is the official body of Spanish dermatologists.
At present, dermatologists apply 3 treatments that have demonstrated their efficacy in strict clinical tests: Finasteride, Dutasteride and Minoxidil. There is no conclusive data on other types of treatment. On occasion, other treatments are applied as a complement, such as plasma rich in platelets, vitamins taken by mouth … One must beware false treatments or those of doubtful scientific efficacy. Normally, they are very expensive and are applied with no safeguards. They may even make health problems worse by putting off the correct diagnosis.
No. The efficacy of any treatment for hair loss should be based on thoroughness, regularity and constancy. The dermatologist will tell you how to administer the treatment and follow it up according to how the process evolves.
Hair transplant is at present the only treatment that has definite results in the case of androgenetic alopecia. Transplanting the hair by the FUE technique (“Follicular Unit Extraction”) is at the head of the advances seen in capillary surgery in recent years. Hair transplant should be accompanied by medical treatment (Finasteride, Dutasteride and/or Minoxidil), in order to avoid the loss of the remaining hair and, therefore, the progress of the baldness.
Let us study your case. Our specialists at the Capillary Dermatology Unit, HC Marbella, will evaluate your case and will tell you if you can benefit from any of the treatments available. There are many different treatments for alopecia. Don’t give up hope!
Sources: Dra. Mota / Dr. Alcaide / Dra. Meyer.
Dermocapillary Unit HC Marbella.
May 9, 2019
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