Baldness involves the state of lacking hair where it often grows, especially on the head. The most common form of baldness is a progressive hair thinning condition called androgenic alopecia or 'male pattern baldness' that occurs in adult male humans and other species. The severity and nature of baldness can vary greatly; it ranges from male and female pattern alopecia (androgenetic alopecia, also called androgenetic alopecia or alopecia androgenetica), alopecia areata, which involves the loss of some of the hair from the head, and alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body.
Contents[hide]
1 Background, cause and incidence
2 Evolutionary theories of male pattern baldness
2.1 Non-human baldness
3 Approaches to baldness
3.1 Psychological effects
3.2 Preventing and reversing hair loss
3.2.1 Finasteride
3.2.2 Minoxidil
3.2.3 Low-level laser therapy
3.2.4 Surgery
3.2.5 Hair multiplication
3.2.6 Ketoconazole
3.2.7 Unsaturated fatty acids
3.2.8 Exercise
3.2.9 Stress reduction
3.2.10 Immunosuppressants
3.2.11 Saw palmetto
3.2.12 Polygonum multiflorum
3.2.13 Beta sitosterol
3.2.14 Anti-androgens
3.2.15 Hedgehog agonists
3.2.16 WNT gene related
3.2.17 Coffee Beans
3.3 Concealing hair loss
3.3.1 Head
3.3.2 Eyebrows
3.4 Embracing baldness
4 Baldness folklore
5 Etymology
6 Latest research
7 See also
8 References
9 External links
10 Footnotes
//
[edit] Background, cause and incidence
Human hair
By area
Head hair
Androgenic hair
Facial hair
Chest hair
Underarm hair
Abdominal hair
Pubic hair
Leg hair
By type
Vellus hair
Terminal hair
Lanugo
Related topics
Human hair color
Hypertrichosis
Trichophilia
Hair removal
Hair loss
v • d • e
The average human head has about 100,000 hair follicles. Each follicle can grow about 20 individual hairs in a person's lifetime.[1] Average hair loss is about 100 strands a day.
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, in central Victoria (Australia) showed the prevalence of mid-frontal hair loss increases with age and affects 57% of women and 73.5% of men aged 80 and over. In the United States the figure is around 23% of men and 10% of women.[citation needed]
Male pattern is characterized by hair receding from the lateral sides of the forehead, known as "receding hairline". Receding hairlines are usually seen in males above the ages of 25.
An additional bald patch may develop on top (vertex). The trigger for this type of baldness (called androgenetic alopecia) is DHT, a powerful sex hormone, body, and facial hair growth promoter that can adversely affect the hair on the head and prostate.[2] Eunuchs rarely go bald, possibly due to reduced hormone levels.[citation needed]
The mechanism by which DHT accomplishes this is not yet understood. In genetically-prone scalps, DHT initiates a process of follicular miniaturization. Through the process of follicular miniaturization, hair shaft width is progressively decreased until scalp hair resembles fragile vellus hair or "peach fuzz" or else becomes non-existent. Onset of hair loss sometimes begins as early as end of puberty, and is mostly genetically determined. Male pattern baldness is classified on the Hamilton-Norwood scale I-VII.
It was previously believed that baldness was inherited. While there is some basis for this belief, both parents contribute to their offspring's likelihood of hair loss. Most likely, inheritance is technically "autosomal dominant with mixed penetrance" (see 'baldness folklore' below)
There are several other kinds of baldness:
Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force.
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.
Traumas such as chemotherapy, childbirth, major surgery, poisoning, and severe stress may cause a hair loss condition known as telogen effluvium.[3]
Worrisome hair loss often follows childbirth without causing actual baldness. In this situation, the hair is actually thicker during pregnancy due to increased circulating oestrogens. After the baby is born, the oestrogen levels fall back to normal pre-pregnancy levels and the additional hair foliage drops out. A similar situation occurs in women taking the fertility-stimulating drug clomiphene.
Iron deficiency is a common cause of thinning of the hair, though frank baldness is not usually seen.
Radiation to the scalp, as happens when radiotherapy is applied to the head for the treatment of certain cancers there, can cause baldness of the irradiated areas.
Some mycotic infections can cause massive hair loss.[4]
Alopecia areata is an autoimmune disorder also known as "spot baldness" that can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis).
Localized or diffuse hair loss may also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, postmenopausal frontal fibrosing alopecia, etc.). Tumours and skin outgrowths also induce localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
Hypothyroidism can cause hair loss, typically frontal, and is particularly associated with thinning of the outer third of the eyebrows (syphilis also can cause loss of the outer third of the eyebrows)
Hyperthyroidism can also cause hair loss, which is parietal rather than frontal.
Temporary loss of hair can occur in areas where sebaceous cysts are present for considerable duration; normally one to several weeks in length.
[edit] Evolutionary theories of male pattern baldness
There is no consensus regarding the details of the evolution of male pattern baldness. A number of other primate species also experience hair loss following puberty, and some primate species clearly use an enlarged forehead, created both anatomically and through strategies such as frontal balding, to convey increased status and maturity. The assertion that MPB is intended to convey a social message is supported by the fact that the distribution of androgen receptors in the scalp differs between men and women, and older women or women with high androgen levels often exhibit diffuse thinning of hair as opposed to male pattern baldness.
One theory, advanced by Muscarella and Cunningham[5], suggests baldness evolved in males through sexual selection as an enhanced signal of aging and social maturity, whereby aggression and risk-taking decrease and nurturing behaviours increase. This may have conveyed a male with enhanced social status but reduced physical threat, which could enhance ability to secure reproductive partners and raise offspring to adulthood.
In a study by Muscarella and Cunnhingham [5], males and females viewed 6 male models with different levels of facial hair (beard and moustache or clean) and cranial hair (full head of hair, receding and bald). Participants rated each combination on 32 adjectives related to social perceptions. Males with facial hair and those with bald or receding hair were rated as being older than those who were clean-shaven or had a full head of hair. Beards and a full head of hair were seen as being more aggressive and less socially mature, and baldness was associated with more social maturity.
[edit] Non-human baldness
Baldness is not only a human trait. Some other primates, such as chimpanzees, stump-tailed macaques, and South American nakari show progressive thinning of the hair on the scalp after adolescence. Adult stump-tailed macaques, in fact, are commonly used in laboratories for the testing of hair-regrowth treatments.
The different predecessors of Old World and New World vultures convergently evolved a bald head, preventing feathers from retaining material from the vulture's diet of rotting meat, as well as helping in heat regulation.[6]
[edit] Approaches to baldness
[edit] Psychological effects
Retired bald NASA astronaut Story Musgrave.
The psychological effects for individuals experiencing hair loss vary widely. Some people adapt to the change comfortably, while others have severe problems relating to anxiety, depression, social phobia, and in some cases, identity change.
Alopecia induced by cancer chemotherapy has been reported to cause changes in self-concept and body image. Body image does not return to the previous state after regrowth of hair for a majority of patients. In such cases, patients have difficulties expressing their feelings (alexithymia) and may be more prone to avoiding family conflicts. Family therapy can help families to cope with these psychological problems if they arise.[7]
Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms.[8]
Some balding men may feel proud of their baldness, feeling a kindred relationship with famous charismatic bald men, much of whose perceived masculinity and handsomeness derives from their most obvious distinguishing feature. Baldness has, in recent years, in any case become less of a (supposed) liability due to an increasing fashionable prevalence of very short, or even completely shaven, hair among men, at least in western countries. This is even true for women, as shown by the case of singers Sinead O'Connor and Meshell Ndegeocello, who both have a shaven head. Other female celebrities whose baldness is involuntary include Kylie Minogue (induced by chemotherapy) and Gail Porter (believed to be of psychosomatic origin).
Many companies have built a successful business selling products that reverse baldness, by allegedly regrowing hair, transplanting hair or selling hairpieces. There is very little evidence that any of those which claim hair regrowth actually work
Contents[hide]
1 Background, cause and incidence
2 Evolutionary theories of male pattern baldness
2.1 Non-human baldness
3 Approaches to baldness
3.1 Psychological effects
3.2 Preventing and reversing hair loss
3.2.1 Finasteride
3.2.2 Minoxidil
3.2.3 Low-level laser therapy
3.2.4 Surgery
3.2.5 Hair multiplication
3.2.6 Ketoconazole
3.2.7 Unsaturated fatty acids
3.2.8 Exercise
3.2.9 Stress reduction
3.2.10 Immunosuppressants
3.2.11 Saw palmetto
3.2.12 Polygonum multiflorum
3.2.13 Beta sitosterol
3.2.14 Anti-androgens
3.2.15 Hedgehog agonists
3.2.16 WNT gene related
3.2.17 Coffee Beans
3.3 Concealing hair loss
3.3.1 Head
3.3.2 Eyebrows
3.4 Embracing baldness
4 Baldness folklore
5 Etymology
6 Latest research
7 See also
8 References
9 External links
10 Footnotes
//
[edit] Background, cause and incidence
Human hair
By area
Head hair
Androgenic hair
Facial hair
Chest hair
Underarm hair
Abdominal hair
Pubic hair
Leg hair
By type
Vellus hair
Terminal hair
Lanugo
Related topics
Human hair color
Hypertrichosis
Trichophilia
Hair removal
Hair loss
v • d • e
The average human head has about 100,000 hair follicles. Each follicle can grow about 20 individual hairs in a person's lifetime.[1] Average hair loss is about 100 strands a day.
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, in central Victoria (Australia) showed the prevalence of mid-frontal hair loss increases with age and affects 57% of women and 73.5% of men aged 80 and over. In the United States the figure is around 23% of men and 10% of women.[citation needed]
Male pattern is characterized by hair receding from the lateral sides of the forehead, known as "receding hairline". Receding hairlines are usually seen in males above the ages of 25.
An additional bald patch may develop on top (vertex). The trigger for this type of baldness (called androgenetic alopecia) is DHT, a powerful sex hormone, body, and facial hair growth promoter that can adversely affect the hair on the head and prostate.[2] Eunuchs rarely go bald, possibly due to reduced hormone levels.[citation needed]
The mechanism by which DHT accomplishes this is not yet understood. In genetically-prone scalps, DHT initiates a process of follicular miniaturization. Through the process of follicular miniaturization, hair shaft width is progressively decreased until scalp hair resembles fragile vellus hair or "peach fuzz" or else becomes non-existent. Onset of hair loss sometimes begins as early as end of puberty, and is mostly genetically determined. Male pattern baldness is classified on the Hamilton-Norwood scale I-VII.
It was previously believed that baldness was inherited. While there is some basis for this belief, both parents contribute to their offspring's likelihood of hair loss. Most likely, inheritance is technically "autosomal dominant with mixed penetrance" (see 'baldness folklore' below)
There are several other kinds of baldness:
Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force.
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.
Traumas such as chemotherapy, childbirth, major surgery, poisoning, and severe stress may cause a hair loss condition known as telogen effluvium.[3]
Worrisome hair loss often follows childbirth without causing actual baldness. In this situation, the hair is actually thicker during pregnancy due to increased circulating oestrogens. After the baby is born, the oestrogen levels fall back to normal pre-pregnancy levels and the additional hair foliage drops out. A similar situation occurs in women taking the fertility-stimulating drug clomiphene.
Iron deficiency is a common cause of thinning of the hair, though frank baldness is not usually seen.
Radiation to the scalp, as happens when radiotherapy is applied to the head for the treatment of certain cancers there, can cause baldness of the irradiated areas.
Some mycotic infections can cause massive hair loss.[4]
Alopecia areata is an autoimmune disorder also known as "spot baldness" that can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis).
Localized or diffuse hair loss may also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, postmenopausal frontal fibrosing alopecia, etc.). Tumours and skin outgrowths also induce localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
Hypothyroidism can cause hair loss, typically frontal, and is particularly associated with thinning of the outer third of the eyebrows (syphilis also can cause loss of the outer third of the eyebrows)
Hyperthyroidism can also cause hair loss, which is parietal rather than frontal.
Temporary loss of hair can occur in areas where sebaceous cysts are present for considerable duration; normally one to several weeks in length.
[edit] Evolutionary theories of male pattern baldness
There is no consensus regarding the details of the evolution of male pattern baldness. A number of other primate species also experience hair loss following puberty, and some primate species clearly use an enlarged forehead, created both anatomically and through strategies such as frontal balding, to convey increased status and maturity. The assertion that MPB is intended to convey a social message is supported by the fact that the distribution of androgen receptors in the scalp differs between men and women, and older women or women with high androgen levels often exhibit diffuse thinning of hair as opposed to male pattern baldness.
One theory, advanced by Muscarella and Cunningham[5], suggests baldness evolved in males through sexual selection as an enhanced signal of aging and social maturity, whereby aggression and risk-taking decrease and nurturing behaviours increase. This may have conveyed a male with enhanced social status but reduced physical threat, which could enhance ability to secure reproductive partners and raise offspring to adulthood.
In a study by Muscarella and Cunnhingham [5], males and females viewed 6 male models with different levels of facial hair (beard and moustache or clean) and cranial hair (full head of hair, receding and bald). Participants rated each combination on 32 adjectives related to social perceptions. Males with facial hair and those with bald or receding hair were rated as being older than those who were clean-shaven or had a full head of hair. Beards and a full head of hair were seen as being more aggressive and less socially mature, and baldness was associated with more social maturity.
[edit] Non-human baldness
Baldness is not only a human trait. Some other primates, such as chimpanzees, stump-tailed macaques, and South American nakari show progressive thinning of the hair on the scalp after adolescence. Adult stump-tailed macaques, in fact, are commonly used in laboratories for the testing of hair-regrowth treatments.
The different predecessors of Old World and New World vultures convergently evolved a bald head, preventing feathers from retaining material from the vulture's diet of rotting meat, as well as helping in heat regulation.[6]
[edit] Approaches to baldness
[edit] Psychological effects
Retired bald NASA astronaut Story Musgrave.
The psychological effects for individuals experiencing hair loss vary widely. Some people adapt to the change comfortably, while others have severe problems relating to anxiety, depression, social phobia, and in some cases, identity change.
Alopecia induced by cancer chemotherapy has been reported to cause changes in self-concept and body image. Body image does not return to the previous state after regrowth of hair for a majority of patients. In such cases, patients have difficulties expressing their feelings (alexithymia) and may be more prone to avoiding family conflicts. Family therapy can help families to cope with these psychological problems if they arise.[7]
Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms.[8]
Some balding men may feel proud of their baldness, feeling a kindred relationship with famous charismatic bald men, much of whose perceived masculinity and handsomeness derives from their most obvious distinguishing feature. Baldness has, in recent years, in any case become less of a (supposed) liability due to an increasing fashionable prevalence of very short, or even completely shaven, hair among men, at least in western countries. This is even true for women, as shown by the case of singers Sinead O'Connor and Meshell Ndegeocello, who both have a shaven head. Other female celebrities whose baldness is involuntary include Kylie Minogue (induced by chemotherapy) and Gail Porter (believed to be of psychosomatic origin).
Many companies have built a successful business selling products that reverse baldness, by allegedly regrowing hair, transplanting hair or selling hairpieces. There is very little evidence that any of those which claim hair regrowth actually work
