Plant Related Hair Loss (Androgenetic Alopecia): Symptoms, Therapy, the most common form of hair loss is androgenetic alopecia (plant-based hair loss) – in both men and women. What’s behind it and what helps
Androgenetic alopecia (plant-related hair loss)
Hair roots hypersensitive to male sex hormone
The cause of this most common form of hair loss is, in principle, the same in men and women. However, it is not a hormonal disorder, although a hormone, namely the male sex hormone dihydrotestosterone (DHT), plays a decisive role.
The biologically highly active DHT is formed in the body of men and women by means of an enzyme (5-alpha-reductase) from the male sex hormone testosterone (male sex hormones are called androgens).
However, it is a misconception that all men with baldness have an excessive amount of male hormones in their blood, or that women (with some exceptions) produce too much testosterone.
Several genes play a role
Rather, the whole thing takes place locally at the hair root in the central head area. In people with androgenetic alopecia, the hair roots are extremely hypersensitive to DHT. In addition, these hair roots contain a larger amount of the enzyme 5-alpha-reductase, as a result, more DHT is produced.
The predisposition to this is already in the genes. However, it is not automatically passed on. There are different genes at play here. Thus, it is not possible to draw an absolutely certain conclusion from the head of hair of the next of kin, whether or not and if so when your own head will clear.
Hypersensitivity to DHT leads to the fact that the growth phase of the hair is shortened. So the hair no longer lives so long, they fall out faster and become thinner from time to time until only a tiny little downy hair occupies the hair root. Sometimes this also perishes along with the hair root. Medically, this regression is called miniaturization.
How is investment-related hair loss manifested in men?
If hair loss in men proceeds according to the following pattern, then most likely it is androgenetic alopecia:
Symptoms: at first, the hair on the temples and forehead lightens. So-called receding hairline corners and a bald forehead form in the course. Furthermore, thinning hair on the upper back of the head occurs, a “tonsure” arises. The bald patches increase in size and flow together until only a ring of hair remains in the lower region of the occiput and temples.
However, this pattern does not mean that every man with a receding hairline will irrevocably develop baldness. It is difficult to predict how far hair loss in a person with a receding hairline goes. Some men can also develop baldness between the ages of 20 and 30, while some 70-year-olds have not had to endure hair loss except for receding hairline. However, the majority of men over the age of 70 (around 80 percent) are visibly affected by hair loss.
Plant Related Hair Loss (Androgenetic Alopecia): Symptoms, Therapy,
What are the signs of androgenetic alopecia in women?
Up to 50 percent of all women over the age of 50, but even younger women have at least minimal to do with it. In women with androgenetic alopecia, the processes at the root of the hair are less clear.
In some cases, however, women with thinning of the hair in the vertex area may actually have an underlying hormonal disease (androgenic alopecia). This is then usually accompanied by so-called “masculinization signs”: increased hairiness on the upper lip, chin, nipples, navel, pubic area, and thighs, as well as acne. Of course, this must be carefully medically clarified.
Symptoms: The majority of women with plant-related hair loss or a tendency to it complain of increased hair thinning in the vertex area, sometimes accompanied by increased hair loss. However, this may also be missing. A few women develop a similar pattern of hair loss as men, but not as pronounced. The first signs can be noticeable already in adolescence – in women and in men.
Therapy of androgenetic alopecia: minoxidil for men and women for application and finasteride for men for oral use
Minoxidil: solution or foam for the head: the preparation can stop androgenetically caused hair loss, and stronger hair can grow back. Here the effect is especially good in hair areas where hair is still growing in the immediate vicinity. Patience is required until an effect is achieved. The exact mechanism of action is unknown but is probably due to a factor that promotes blood circulation.
In most cases, the therapy with minoxidil initially has to deal with an unpleasant side effect: after about four to eight weeks of use, there is an increased hair loss. But this should be seen as a good sign, as it indicates a high activity of regrowing hair. The “old” hair, which still occupies the hair root, must soften and fall out for this.
The first encouraging results can be seen at the earliest after four to six or even only nine months. If the application is interrupted, there is a risk that the newly gained hair will be lost again and you will fall back to the state with which you started. Not everyone affected is worth the effort and costs in relation to the benefits.
Although minoxidil is available over the counter: Before starting treatment, detailed consultation on the advantages and disadvantages and the possible course of therapy is recommended.
Possible side effects of minoxidil: redness and flaking of the scalp, sometimes inflammation of the scalp in the sense of a contact allergy, especially in women with unwanted hair growth in the temporal region.
This is most likely to be counteracted if the prescribed dose is scrupulously observed and the preparation is used at least two hours before bedtime (avoid pillow contact!).
- For men with androgenetic alopecia, there is also finasteride for oral use: this drug can also stop androgenetic hair loss, but probably unlike minoxidil: the active ingredient affects the male hormone balance: testosterone is produced by taking the drug (dose: one milligram) less dihydrotestosterone (DHT). As a result, finasteride prevents or slows down the increase in hair loss, the existing hairs have a chance to grow back more densely.
The following also applies here: the user must be patient. It takes a few months for an effect to be noticeable. As soon as the intake is interrupted, hair loss resumes here as well. The active substance is subject to prescription. In higher dosages, the drug is used for benign prostate enlargement.
- Known side effects of finasteride include loss of libido and impotence. Sometimes these disorders persist for a long time even after discontinuation of the drug, while hair loss resumes. There have also been reports of increased breast growth (“men’s breasts”) and changes in breast tissue such as lumps, pain, and discharge from the nipple.
Plant Related Hair Loss (Androgenetic Alopecia): Symptoms, Therapy
Those affected should be examined by their doctor immediately in the event of such symptoms, as they can also occur in connection with breast cancer. Instructions for use of preparations with finasteride also indicate possible mental disorders such as depression, rarely also with suicidal thoughts, and anxiety. Those affected should then stop the therapy, but in any case, also seek medical advice. Even before taking it, you should definitely get detailed information from the doctor.
- Also, the combined use of finasteride 1 mg per day and minoxidil solution 2% to 5% for applying 2-x per day can be considered for men.
- Finasteride is not approved for women. Pregnant women need to avoid contact with finasteride especially carefully, as it leads to the feminization of a male fetus.
- There are currently no recommendations for various internal hormone treatments in women without existing hormonal disorders or for the diuretic substance spironolactone.
- Dermatologists sometimes also use tinctures with a drug called alfatradiol, a kind of estrogen doppelganger. It has no estrogen-like effect but is supposed to suppress the effect of DHT at the root of the hair. There are preparations for women and men. The study situation is currently considered to be less well-established compared to minoxidil. It is best to let your dermatologist inform you about the current status.
- There are currently no recommendations by professional societies for various dietary supplements or hair growth products for men and women, such as thiocyanate.
Hair transplant (hair transplantation)
In the case of plant-related hair loss, men usually do not get complete baldness, but a ring of hair remains at the back of the head. This is because the hair roots in this region are resistant to male sex hormones such as DHT compared to the rest of the head hair. If hair roots are transplanted from the back of the head to lighter places, there are therefore good chances that these hair roots will survive in their new place and let hair sprout.
For an autologous hair transplant, the doctor either removes a hairy strip of skin, for example from the hair ring. From this, he prepares the naturally grown small “composites”, the hair root groups or hair follicle units (FU), under a high-resolution microscope, and inserts them into the appropriately prepared scalp. The technique is called FUT (follicular unit transplantation). In the extraction area, linear scars are formed.
Further development is the FUE (abbreviation for the English name Follicular-Unit-Extraction). Many hair root clusters are removed individually with a fine hollow needle, temporarily stored in a nutrient solution, and replanted in the desired area after appropriate preparation (perforations or slits). In the target area, only punctate scars are formed, in the removal area, the hair density thins out somewhat. The newer method is suitable, for example, if there is still enough donor’s hair. Both types of scars can be combed over depending on hair length, hair density, and hair type.
In principle, the hair roots can be transplanted into bald or thinned areas of the scalp, eyebrows, beard or pubic area. Most of the experiences are with head hair.
Doctors who perform hair transplants must be well versed in the various techniques and circumstances of the patient. A prerequisite is an operative specialist with special advanced training. Only in this way can you optimally treat even pronounced forms of hair loss. The procedure is usually performed on an outpatient basis. The transplanted hairs usually fall out first, in order to then grow out of the root again. It may take a few months to see success. The result is individually different.
Hair transplantation can also be considered in women with pronounced androgenetic alopecia, but enough donor’s hair. In advance, detailed consultation on possible complications, costs, and achievable success should take place.
Other areas of application of autologous hair transplantation: non-inflammatory-active scarring (“burnt-out inflammation”) on the scalp (see chapter: “Hair loss: special forms and causes”), congenital hairlessness of certain areas such as triangular temporal alopecia, for scarred alopecia after injury, burns or surgery.
- From research
For men with plant-related hair loss, the remedy Latanoprost is tested. Currently, it is used exclusively in the form of eye drops as a remedy for increased intraocular pressure or glaucoma (glaucoma).
- Certain combination treatments, which include minoxidil for application, are also currently being tested for men and women.
Plant Related Hair Loss (Androgenetic Alopecia): Symptoms, Therapy
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