Posts Tagged ‘Male Pattern Baldness’

How is Patterned Baldness Tested for?

Monday, January 3rd, 2011

Evaluation for causative disorders should be done based on clinical symptoms. A mainstream physician wont do much if any testing once they’ve determined their patient has male-pattern and female-pattern hair loss. Many readily available blood, urine and saliva tests could be done to understand metabolic, hormonal and nutritional issues in the body. Other articles will discuss these further.

These are hair tests that could be done on the scalp/hair itself:

The pull test: to evaluate diffuse scalp hair loss. Gentle traction is exerted on a group of hair (about 40–60) on three different areas of the scalp. The number of extracted hairs is counted and examined under a microscope. Normally, <3 hairs per area should come out with each pull. If >10 hairs are obtained, the pull test is considered positive.

The pluck test: In this test, the individual pulls hair out “by the roots.” The root of the plucked hair is examined under a microscope to determine the phase of growth and used to diagnose a defect of telogen, anagen, or systemic disease. Telogen hairs are hairs that have tiny bulbs without sheaths at their roots. Telogen effluvium shows an increased percentage of hairs upon examination. Anagen hairs are hairs that have sheaths attached to their roots. Anagen effluvium shows a decrease in telogen-phase hairs and an increased number of broken hairs.

Hair mineral analysis: Tests for minerals and heavy metals.

Scalp biopsy: This test is done when alopecia is present, but the diagnosis is unsure. The biopsy allows for differing between scarring and nonscarring forms. Hair samples are taken from areas of inflammation, usually around the border of the bald patch.

Daily Hair Counts: This is normally done when the pull test is negative. It is done by counting the number of hairs lost. The hair that should be counted are the hairs from the first morning combing or during washing. The hair is collected in a clear plastic bag for 14 days. The strands are recorded. If the hair count is >100/day is considered abnormal except after shampooing, where hair counts will be up 250 and be normal.

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Types of Alopecia and Overlap in their Causes

Sunday, January 2nd, 2011

Alopecia can strike anyone for any variety of reasons.  Even newborn babies can be born with this condition.  There are five most common types of hair loss, several other types of alopecia exist, the first five being the most common ones:

  • The most common form of baldness is a progressive hair thinning condition, so called Androgenic alopecia or male pattern baldness (MPB).
  • Female pattern baldness. The equivalent of MPB, and often is related to Polycystic Ovarian Syndrome (PCOS), malnutrition or wheat/gluten intolerance.
  • Alopecia areata, involves the loss of some of the hair from the head, Those with alopecia areata have scattered bald spots all over the head, or one large bald spot confined to one section of the head. It is known as “spot baldness”, it can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis). Alopecia areata, is typically associated with sudden hair loss, sometimes related to trauma, or illness, stress, abusive hair styling such as tight braids and pony tails, wigs, hairpieces or chemicals used on the hair. Alopecia areata is an autoimmune disorder. *4
  • Alopecia totalis, involves the loss of all of the head hair, typically be characterized by the complete loss of hair on the head.  The shedding of normal hair will usually occur over a certain amount of time. The sufferers of alopecia totalis will sometime have a small amount of soft Lanugo hair left over after the normal hair has completely fallen out. *7
  • Alopecia universalis, which involves the loss of all of the hair from the head and the body, from the top of the head to the legs and feet including eye brows.  Alopecia universalis is the rarest condition of the five most common forms of alopecia. It is thought that alopecial universalis is an autoimmune condition. *5

The following are are thought of as being less common, these can be confused as female/male pattern baldness:

Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force.

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Trichotillomania is the loss of hair caused by compulsive pulling and bending of the hairs. It tends to occur more in children than in adults. In this condition the hairs are not absent from the scalp but are broken. Where they break near the scalp they cause typical, short, “exclamation mark” hairs.

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Do Women Get Patterned Hair Loss?

Thursday, December 30th, 2010

Yes. It could be referred to as female pattern baldness, patterned baldness, diffused baldness, female baldness, or even as male pattern baldness (MPB)

Thirteen percent (13%) of pre-menopausal women are thought to experience some symptoms of patterned baldness, this number climbs up to 75% of women experiencing patterned baldness after the age of 65. [13]   Hair loss is increasing in both men and women, men in their early twenties are now experiencing MPB.

In my personal experience, I see many women, including ones in their twenties and thirties with thin hair and bald spots. In many cases when a metabolic issue exists hair loss is more likely to occur.

In women, the hair loss progresses as a diffused thinning of hair all over the top areas and crown of the head (i.e. parietal region). [5] [13] In this case, this hair loss is either referred to as male-pattern baldness, or as female-pattern baldness. [13]

I have heard of women who were very effected emotionally when their physicians told them they had “male pattern baldness” (because her doctor viewed it is a male-hormone dependent condition).

If this indeed was pure a male hormone issue then why are women experiencing hair loss at younger ages and more often? More importantly, how are some able to stop it using diet and nutrition, lifestyle and topical treatments?

I believe the use of the term male pattern baldness to describe any female hair loss is inappropriate.

Edited: 12/29/2010

Who Gets MPB & How Common is it?

Wednesday, December 29th, 2010

Both men and women do.

AGA is very common, one study mentioned that AGA affected as many as 40% of adult men and women combined. [22] Another study mentioned that AGA affected up to 50% of white men 50 years of age or older [3] and it “affects up to 80% of males by the age of 80”. [20]

Thirteen percent (13%) of pre-menopausal women are thought to experience some symptoms of AGA, this number climbs up to 75% of women experiencing AGA after the age of 65. [13]   Hair loss is increasing in both men and women, men in their early twenties are now experiencing MPB.

According to wikipedia (as of 1/1/2011) “Incidence of pattern baldness varies from population to population based on genetic background, environmental factors do not seem to affect this type of baldness greatly. One large scale study in Maryborough, Victoria, Australia showed the prevalence of mid-frontal hair loss increases with age and affects 73.5% of men and 57% of woman aged 80 and over. According to Medem Medical Library’s website, male pattern baldness affects roughly 40 million men in the United States. Approximately 25 percent of men begin balding by age 20; two-thirds begin balding by age 60. There is a 4 in 7 chance of getting the baldness gene.”

This type hair loss follows a predictable pattern (in contrast to spots of baldness or alopecia totalis), most noticeably in men, thus it is commonly referred to as male-pattern baldness (MPB). To many, the term male pattern baldness (MPB) is interchangeable with androgenic alopecia (AGA).

According to current understanding, women also experience AGA. [13] [20] [23] [26][28] In women, the hair loss progresses as a diffused thinning of hair all over the top areas and crown of the head (i.e. parietal region). [5] [13] In this case, this hair loss is either referred to as male-pattern baldness, or as female-pattern baldness. [13]

I do not use the term androgenic alopecia (AGA). Find why here: Should the Term “Androgenic Alopecia” Be Used?

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Should the Term “Androgenic Alopecia” Be Used? (Research History)

Wednesday, December 29th, 2010

About 60 years ago Hamilton made an important observation when he noticed that castrated men did not have AGA. He concluded that hair growth on the scalp was androgen-dependent.

Despite androgens causing hair loss in many men, androgens are actually crucial as they are responsible for the development of puberty; they also aid in, if not cause, male maturation, growth of muscles and the appearance of other sexual characteristics in young humans. [25]

Androgens, such as testosterone (T) and dihydrotestosterone (DHT), have been identified by researchers to be the main regulators of hair growth. Androgens contribute to the changing of vellus (tiny, un-pigmented) hairs into terminal (thicker) hair follicles. [18]

Paradoxically, androgens are also are often thought of as the main culprit behind male pattern baldness.

Androgens in the scalp of adults with androgen-dependent hair follicles seem to have two undesirable effects. The first being that they shorten the anagen phase (long growth phase). [6]

A study published in November 2002 further explained that the follicles experience a “transformation from long growth (anagen) and short rest (telogen) cycles, to long rest and short growth cycles.”  [3]

The second effect always accompanies the first and maybe the manifestation of it. This effect is manifested as the gradual changing of (thick) terminal hair follicles to (thinner) vellus hair (due to the reduction of the cellular hair matrix volume). This change in thickness has been referred to as a “progressive miniaturisation of the follicle.”[3] [5] [18] [23]

In summary, androgens shorten the long growth cycle (anagen phase) and cause follicles to enter into the resting cycle (telogen phase) faster and remain in that phase longer; this results in finer and finer hair. This process  is what we’ve identified as, or termed, AGA.

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