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	=== Preventing and reversing hair loss ===		=== Preventing and reversing hair loss ===
			''See the main article on'' ]

	It is easier to prevent the aging and falling out of healthy hairs than to regrow hair in ] that are already dormant. However, there are products that have good success rates with maintenance and regrowth, including the FDA-approved ], ], and ]. Baldness may be cured through prospective treatments such as hair multiplication/hair cloning or gene therapy in the next five to ten years.		It is easier to prevent the aging and falling out of healthy hairs than to regrow hair in ] that are already dormant. However, there are products that have good success rates with maintenance and regrowth, including the FDA-approved ], ], and ]. Baldness may be cured through prospective treatments such as hair multiplication/hair cloning or gene therapy in the next five to ten years.

	The following treatments are some of the most prominent. Generic brands, often with the same active ingredients, may be (but not necessarily) equally effective and are often cheaper. Articles on potential risks in some of these products can be found at .

	Interestingly, ] treatments in studies often have high success rates, though not as high as proven products, and even similar side-effects (such as sexual dysfunction) as the FDA-approved products . Proponents of alternative and herbal medicines believe that the majority of cases of hair loss that progress despite treatments do so because the people believe no such cure can occur. In this view, this belief, which is prevailing in the modern civilised world and continuously reinforced by medical science, is the main obstacle for effectively finding and applying a cure.		Interestingly, ] treatments in studies often have high success rates, though not as high as proven products, and even similar side-effects (such as sexual dysfunction) as the FDA-approved products . Proponents of alternative and herbal medicines believe that the majority of cases of hair loss that progress despite treatments do so because the people believe no such cure can occur. In this view, this belief, which is prevailing in the modern civilised world and continuously reinforced by medical science, is the main obstacle for effectively finding and applying a cure.

	==Treatment products==
	{{sect-stub}}
	===Propecia===
	, also called by its non-brand name ], is a "DHT inhibitor" pill that is FDA approved to inhibit production of DHT through the entire body (called ''systemic''). It does this through inhibiting the conversion of testosterone to DHT. Finasteride is taken orally and has a reported 29-68% success rate (''vs'' 17-45% in patients receiving a ]). Both are effective only for as long as they are taken; the benefit is lost within 6-12 months of ceasing therapy (Rossi, 2004). In clinical studies, Propecia, like Minoxodil, was shown to be most successful in the crown area, as opposed to the hairline.

	Propecia is the same as the oral prescription drug, ''']''', used in higher doses to treat an enlarged prostate. Some users save money by buying Proscar instead of Propecia , and split the pills in quarters using a pill-splitter to ensure the same amount as is present in Propecia is taken.

	Propecia has been shown to be ineffective for treating hair loss in women, and shouldn't even be touched by pregnant or potentially pregnant women, as it causes severe birth defects in male fetuses.
	====Possible health concerns====
	The ] in March 2003 states they don’t recommend Propecia "because its long-term safety is unknown. This is disquieting, since young men are the prime candidates, and the drug has to be taken for a lifetime. If you do decide to take it, you should know that although the standard dose is one milligram, there is some evidence that one-fifth that amount also works. If you cut the pill into quarters, you will save money."

	While they point out Propecia must be taken for a lifetime to avoid losing hair, it should be counterpointed that future treatments are widely expected by baldness specialists to replace Propecia, which would end the need for continued use. Additionally, Propecia is widely cosidered safe enough to prescribe by health professionals, and is one of the only two FDA-approved baldness treatment products on the market.
	====Propecia's effects in detail====
	''Summarized from: ''

	DHT is a derivative hormone (metabolite) of testosterone that is considered to be the main cause of miniaturization and eventual destruction of hair follicles in male pattern baldness. DHT is a steroid hormone just like testosterone but more powerful.

	Many dermatologists and research scientists specializing in hair loss believe DHT molecules may diffuse into the interior of hair follicle cells (the cytoplasm or cytosol) and bind with androgen receptors. This complex, both the receptor and the DHT molecule, then enters the nucleus of the cell. In the nucleus of the hair follicle cell this complex could then alter the rate of protein synthesis in men who are genetically predisposed to baldness.

	However, DHT also plays an important role in the functioning of the central nervous system (the brain), the testicles and prostate, and almost everything but muscle tissue. In muscle tissue testosterone is the dominant hormone. (Some bodybuilders inject testosterone derivatives to gain muscle fast.)

	*Propecia and Avodart cause a rise in testosterone levels because testosterone that would normally be converted into DHT remains testosterone. Continual high levels of testosterone in the body could possibly have negative side effects.

	*Artificially low levels of DHT in the body could cause some unwanted conditions. DHT is an antagonist of estrogen. Men’s bodies also produce the female hormone estrogen in the adrenal glands although this is just one-tenth of the estrogen that premenopausal women produce in their ovaries. By reducing DHT with drugs a man’s protection from the effects of estrogen may also be reduced. Gynecomastia could be one result of this. Gynecomastia is abnormally large breasts in a male.

	*Even though both finasteride and dutasteride were developed to combat benign prostatic hyperplasic by reducing DHT in prostate tissue, some scientists question the wisdom of using these 5-alpha reductase inhibitors in younger men who have no problem with their prostates. A research chemist, Pat Arnold - “Evidence is mounting that the existence of a high estrogen/androgen ratio - a condition common in older men - is highly correlated with the development of benign prostatic hyperplastic.”
	===Revivogen===
	is a non-FDA approved topical "DHT inhibitor" treatment applied to the scalp, claimed to inhibit DHT levels (only in the scalp). Revivogen is claimed to also function as an antiandrogen (see below).
	===Antiandrogens===
	] bock DHT already produced and present in the blood stream from ''binding'' with hair follicles.
	] and Neutrogena ] have been clincally shown to have antiandrogen properties and are prescribed by medical professionals.
	===Minoxidil===
	] dilates blood vessels, and is sometimes called a "potassium channel opener." In the brand name , it is FDA approved to stimulate regrowth and thicken hairs. Minoxidil is applied topically to the scalp, and has been shown to promote hair growth in about 25% of men and women, though it may take several months to work. New hair is usually thinner and lighter, like baby hair, and grows mostly on the top of the head, not at the hairline. Its effects may fade with time. Skin irritation is the most commonly reported side effect. Dizziness and increased heart rate have also been reported, but rarely.
	===Copper peptides===
	Copper peptides are topical, and shorten the resting phase of hairs, resulting in more hair follices on the scalp being in the growing phase (as opposed to the resting or falling out phase) at one time. Brand name: .
	===Others===
	* ]
	* Retin-A (]; chemical peel stimulation of scalp)
	* ] - discredited


	==Non-pharmacological measures==		==Non-pharmacological measures==

Revision as of 09:07, 18 May 2005

Baldness (formally alopecia) is the state of lacking hair where it usually would grow, especially on the head. The most common form of baldness is a progressive hair-thinning condition that occurs in adult humans and many other ape species. Stress factors such as a regular lack of sufficient sleep may be able to accelerate the onset of hair loss in genetically prone individuals.

Male pattern baldness is thought to occur in varying forms in about 50% of adult males. It is characterized by hair receding from the lateral sides of the forehead, known as "receding hairline" or "receding brow." An additional bald patch may develop on top (vertex). The trigger for this type of baldness, which is also known as androgenic alopecia, is currently believed to be 5-alpha reductase, an enzyme that converts the hormone testosterone into dihydrotestosterone (DHT), which inhibits hair growth. 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-VIII.

Female pattern baldness, in which the midline parting of the hair appears broadened, is less common. It is believed to result from a decrease in estrogen, a hormone that normally counteracts the balding effect of testosterone, which normally occurs in women's blood. Female pattern baldness is being classified on the Ludwig scale I-III.

There are several other kinds of baldness. Traction alopecia is commonly found in women with ponytails or cornrows that pull on their hair with excessive force. Traumas such as chemotherapy, childbirth, major surgery, poisoning, and severe stress may cause a hair loss condition known as telogen effluvium. Some mycotic infections can cause massive hair loss. 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).

Approaches to baldness

Psychological implications

The psychological implications for individuals experiencing hair loss vary widely. There can be a general societal anxiety surrounding the process of hair loss, but some individuals view it as nature taking its course.

Some balding men may feel proud of their baldness, feeling a kindred relationship with famous charismatic film actors such as Yul Brynner, Telly Savalas and Patrick Stewart, who have been considered masculine and handsome.

Preventing and reversing hair loss

See the main article on Baldness treatment products

It is easier to prevent the aging and falling out of healthy hairs than to regrow hair in follicles that are already dormant. However, there are products that have good success rates with maintenance and regrowth, including the FDA-approved Propecia, Rogaine, and Tricomin. Baldness may be cured through prospective treatments such as hair multiplication/hair cloning or gene therapy in the next five to ten years.

Interestingly, placebo treatments in studies often have high success rates, though not as high as proven products, and even similar side-effects (such as sexual dysfunction) as the FDA-approved products . Proponents of alternative and herbal medicines believe that the majority of cases of hair loss that progress despite treatments do so because the people believe no such cure can occur. In this view, this belief, which is prevailing in the modern civilised world and continuously reinforced by medical science, is the main obstacle for effectively finding and applying a cure.

Non-pharmacological measures

Hair transplant

Surgery is another method of reversing hair loss and baldness, although it may be considered an extreme measure. The surgical methods used include hair transplants, where patches of skin with hair are moved from one part of the head to another. Another method is scalp reduction, where parts of the scalp are removed, the skin is stretched over the area that had been removed, and everything is stitched back together. Hair transplants generally cause scarring, sometimes severe, which may be especially visible ihair loss continues over the rest of the scalp.

Speculative treatments

Stem cells

Stem cells have been discovered in hair follicles and some researchers predict research on these follicle stem cells may lead to successes in treating baldness through hair multiplication within three or four years (as of November 2004). This treatment is expected to initially work through taking stem cells from existing follicles, multiplying them in cultures, and implanting the new follicles into the scalp. Later treatments may be able to simply signal follicle stem cells to transmit chemical signals to nearby follicle cells which have shrunk during the aging process, which respond to these signals by regenerating and once again making healthy hair.

Stem Cell Research Update (March 2004) - Covers a study by Dr. George Cotsarelis and his team of researchers at the University of Pennsylvania. Also here

Concealing hair loss

One method of hiding hair loss is the comb-over, which involves restyling the remaining hair to cover the balding area. It is usually a temporary solution, useful only while the area of hair loss is small. As the hair loss increases, a comb-over becomes less effective.

Another method is to wear a hairpiece - a wig or toupee. The wig is a layer of artificial or natural hair made to resemble a typical hair style. In most cases the hair is artificial. Wigs vary widely in quality and cost. The best wigs - those that look like real hair - cost up to tens of thousands of dollars. Organizations such as Locks of Love and Wigs for Kids collect individuals' donations of their own natural hair to be made into wigs for young cancer patients who have lost their hair due to chemotherapy or other cancer treatment.

Embracing baldness

Of course, instead of concealing hair loss, one may embrace it. Many celebrities and athletes shave their heads. The St. Baldrick's Foundation spreads the message of baldness by shaving the heads of adults to raise money for curing childhood cancer, which often causes children to lose their hair. See Head shaving.

Common baldness myths

There are many myths regarding the possible causes of baldness and its relationship with one's virility, intelligence, ethnicity, job, social class, wealth etc. Most of them can be dismissed by the existence of many counterexamples or by a lack of sufficient scientific research.

Some of these myths are:

"Intellectual activity or psychological problems can cause baldness."

This myth probably was inspired by the fact that the human brain is located inside the skull, very close and just below where hair grows, and so it was thought that the use and abuse as well as mental diseases could have negative effect on hair growth and number.

This is sometimes used as a stereotype in movies, where the more intellectual or rather frustrated characters are most usually portrayed as bald and generally unattractive, as opposed to the main characters which are usually portrayed as attractive, fit, mentally stable and generally with no apparent hair problems.

This same myth normally extends to considering people having intellectual jobs more prone to baldness problems compared to manual laborers, sometimes further extending the myth to male college or university students when compared to workers of the same age. The myth is suspect because counterexamples can be found in any case.

"Baldness can be caused by emotional stress, sexual frustration etc."

While emotional stress can have a part in causing baldness, again it is easy to find counterexamples like non-frustrated and non-stressed people with hair loss problems as well as stressed and/or frustrated people with no hair loss problem at all. This myth also suggests that a vicious circle between hair loss and emotional stress/sexual frustration can take place, although only one part of it can be scientifically explained (hair loss causing low esteem and then frustration, but not vice versa).

"Bald men are more "virile" or sexually active than others."

This myth probably stems from the fact that some forms of baldness in some predisposed individuals are caused by androgens, and removal of androgens (by castration) prevents baldness or stops it from progressing further. Yet counterexamples can be found, like men with perfect hairlines and similar levels of androgens or men with sensitivity to androgens causing hair loss but which are not very sexually active.

"Shaving hair makes it grow back stronger"

Proposed as a popular remedy against baldness, it's very probably just an illusion similar to the one perceived after shaving one's beard or mustache. Shaving one's head doesn't increase the number of healthy hair present on the scalp, and, when the remaining hair has grown a few millimeters, no enhancement in thickness or overall quality can be observed.

"Some human races or ethnic groups are less prone to baldness problems then others."

It is true that by observing many pictures of men of European descent and then comparing them to pictures of men of Asian or American Indian descent it is very likely that a random observer will deduce that baldness problems seem to be much more frequent among the "European" group than in the "Asian" one.

Similar observations can be done regarding the people living in most Western countries when compared to people living in "underdeveloped" or Third World countries, but lacking any official anthropological, medical and scientific research to back them up, such observations degenerate into a racial/social stereotype.

A very similar stereotype exists even between the various European ethnic groups, when comparing people of Southern European descent with those of Northern European, Germanic or Slavic origins, with the stereotype summarily describing the "Southern Europeans" as darker-skinned, with more body hair, with the women more prone to cellulite problems and the men more prone to baldness, a stereotype probably developed under times of war or diplomatic tensions between European countries.

Trivia

John D. Rockefeller had an extreme case of alopecia that caused him to lose all of the hair on his face, including his eyebrows and eyelashes. Another famous person who suffers from similarly severe alopecia is Italian football referee Pierluigi Collina.
Eunuchs do not go bald.
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.

Reference

Rossi S (Ed.) (2004). Australian Medicines Handbook 2004. Adelaide: Australian Medicines Handbook. ISBN 0-9578521-4-2

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