Hair loss is more than skin deep

Male pattern baldness (also known as androgenic or androgenetic alopecia) is the most common type of hair loss in men.

According to NIH statistics, it may occur in men or women but is much more common in men, affecting 35 million men in the United States and at least half of white men by age 50.

A Mayo Clinic Proceedings of October 2005 states that although MPB does not appear to cause direct physical harm on its own, hair loss may result in physical harm because hair protects against sunburn, cold, mechanical injury and ultraviolet light. Hair loss also is capable of psychologically affecting the balding individual and the perceptions of others.

Dr. Sarah Baker is a board-certified dermatologist at Dermatology Specialists at North of the Willis-Knighton Health System in Shreveport.

Baker said, “Male pattern baldness is a common condition that may start at any point after puberty and increases in incidence and severity with aging.

“It typically presents as thinning of the hairline on the front of the scalp and temples as well as the hair on top of the scalp. It is caused by genetic factors as well as an increase in androgen hormones, mainly dihydrotestosterone or DHT, produced in the hair follicle.

“These hormones cause the hair follicle to produce finer, lighter hairs and also lead to increased hair shedding and a shortening of the hair growth phase. ” Baker said, “The pattern of hair loss is quite distinct with male pattern baldness. The hairline on the front of the scalp and temples gradually recedes, and one also develops thinning of the hair on the top of the scalp. It should not be itchy or otherwise symptomatic and is typically more gradual in onset.

“Patchy hair loss, rapid or widespread hair loss or hair loss in association with a rash or other symptoms may be due to other factors such as autoimmune disease, certain medications, nutritional disorders or underlying inflammatory conditions of the skin.”

Besides the characteristic hairline patterning, the NIH informs patients that when they undergo diagnosis they may need to have a skin biopsy, blood tests or other procedures to diagnose other potential disorders that also cause hair loss.

“There are no proven environmental or behavioral factors that cause or contribute to male pattern baldness,” Baker said. “Brushing your hair, shampooing, blowdrying or wearing hats will not make this worse.

“Although there is no cure for male pattern baldness, two medications have been approved by the Food and Drug Administration to help slow its progression and promote hair regrowth.

“Minoxidil is a topical preparation that helps to thicken individual hairs. Finasteride is a pill that inhibits an enzyme called 5-alpha-reductase, which is necessary for the production of DHT. Both of these medicines have been demonstrated to improve hair regrowth and decrease further loss, especially if used in combination with one another. It may take several months for their effectiveness to be apparent, and once therapy is discontinued, hair loss will resume. Minoxidil may be purchased over the counter in both 2 percent and 5 percent formulations, whereas a prescription from your doctor is required for finasteride.

“Surgical hair restoration (hair transplantation) consists of removing very small plugs of hair from areas where the hair is growing normally and placing them in the areas that are balding.

“This procedure may also yield excellent results in select patients. All treatments have potential risks and benefits, so consult with your physician to decide what therapy is right for you.”

The NIH urges men to call their doctors if: • Hair loss occurs in an atypical pattern, including rapid hair loss, widespread shedding, hair loss in patches or hair breakage.

• Hair loss occurs with itching, skin irritation, redness, scaling, pain or other symptoms.

• Hair loss begins after starting a medication.

• Hair loss is a condition they want to treat.

Baker said, “The biggest myth that I would like to dispel is that this is not a ‘real problem’ or a ‘big deal.’ Although not bothersome to everyone, hair loss triggers a significant emotional reaction – anxiety, sadness, loss of self-esteem, decreased confidence or social withdrawal – in many affected individuals and should not be taken lightly.

“Patients should not be embarrassed to discuss this issue with their physician – the earlier, the better. This is when patients have the best chance to intervene and slow further hair loss as well as potentially develop hair regrowth. ”