Category: Blog

Male Pattern Hair Loss

IMG_2877

Male Pattern Hair Loss or Androgenetic Alopecia is the most common type of hair loss found in men. Up to 80% of men will experience some level of hair loss by their 70s. Most will discover their hair loss in their 30s and 40s however, quite a number may start long before in their teens.

So what causes Male Pattern Hair Loss?

Male Pattern Hair Loss is due to the activity of a hormone Dihydrotestosterone, a potent androgen (male hormone). The hair follicle in affected men is more sensitive to this hormone. There are several genes responsible for the condition and they can be inherited from either the mother, father, or both.   This hormone is made from Testosterone under the action of the enzyme, 5-alpha reductase. Dihydrotestosterone latches onto the receptors in the hair follicle and causes a decreased anagen (hair growth) along with  reduction in the size of the hair follicle. The hairs become progressively thinner and more vellus-like.

Stages of Male Pattern Hair Loss

There are several stages of Male Pattern Hair Loss.  The main staging system used is the Norwood Hamilton Scale for Hair Loss in men.

norwood-hamilton

Which stage do you fall under?

Next month: Treatment options

 

 

 

Crazy black hair growth myths

I have heard some crazy things uttered from people, including  hair stylists,  with respect to Afro-textured hair. Black hair growth myths are so pervasive and some so outlandish, leaving me dumbfounded that I simply refuse to believe that stylists were not taught otherwise at beauty school. Here are some of the craziest black hair growth myths I’ve heard:

 

1. Natural hair doesn’t get split ends

This was told to me in a salon many years ago when I revealed I had cut my hair due to split ends. I don’t know on which planet people live on, but, on Earth, everyone no matter the race will get split ends. As hair exits the scalp it is dead. As the hair gets longer, the hair fibre will begin to disintegrate due to both the natural weathering processes as well as from the general handling of the hair. The ends of the hair will start to lose the cuticle exposing the inner cortex therefore cause the hair to split more easily. This property does not differ if you are Asian, European or African.

2. Natural hair will not take hair rinses.

I was flabbergasted when the sales person told me this. Yes relaxed and permanently dyed hair are more porous, and technically the hair rinse should stay on better, but as someone who has used a hair rinse in the past, I  was a bit put off by this statement.  Again, hair is a fibre, just like cotton, wool, and mohair. There are plenty of persons who I’ve told to switch to hair rinses due to the issues experienced with their scalps when they use permanent dyes. Yes the rinse goes faster especially on the grey hair, but it does deposit on natural hair.

3. That style can’t be done on natural hair.

Nothing irks me more than these words. In this age of the internet where millions of videos exist detailing style after style on natural hair, it is painful to have this said to you. If I had the ability to make my hair look like I stepped out of a salon I would stop going to stylists all together. Hair is a fibre. It has physical  and chemical properties that can be manipulated. Natural hair can be manipulated into any shape that you want to put it in.

4. You must be mixed with X race in you for your hair to be so long!

Luckily I don’t personally get this said to me anymore. I guess my hair is too kinky for anyone to say this. However, this statement always diminishes the efforts taken to actually grow natural hair. Not until my hair care practices improved did I manage to get my hair to significantly longer lengths. When I explain to persons that deep conditioning will make that much of a difference to length retention, they refuse to believe. I swear on my mother’s grave, my hair has never been this long in my life.

5.  The 3 or 4 different textures on the scalp is due to mixed heritage

This is so far from the truth. This has to do with the property of curly textured hair. Persons of all races complain of this issue. It doesn’t matter what race you are, most persons with curly hair have at least 2 textures. The reason for this is unknown.

 

Pattern Hair Loss

First in our series on non-scarring hair loss is the ever pervasive Pattern Hair Loss or Androgenetic Alopecia. It is mostly an inherited condition affecting up to 40% of women by menopause, and up to twice that amount in men by age 50.

Pattern Hair Loss presents differently between men and women. Women tend to have generalised thinning to the top and sides, whilst men start off with thinning at the temples eventually ending with the “horse shoe” shape that is often dreaded.

The cause of Pattern Hair Loss, though largely known, is still being determined. In men it is due to excessive sensitivity to the male hormone dihydrotesterone. In women, male hormones are not seen as a major factor, however, the exact mechanism is yet to be determined. In fact, it has been postulated that there are other non-hormonal factors which may contribute to Pattern Hair Loss in both men and women.

As it is a genetic disorder, there is no permanent cure for Pattern Hair Loss. Gene therapy, ideally the perfect treatment,  has not been developed for the condition. The best that is available today is hair transplantation. In the near future, stem cell therapy will likely lead the way. For most, topical Minoxidil is the best option in addition to oral therapy with Finasteride and other anti-androgen medications are useful.

Next month: Male Pattern Hair Loss- Cause and Staging

Hair Loss Disorders

So, after discussing the basic properties of hair, the next in the blog series will be on Hair Loss Disorders. There are two main types:

1. Non Scarring

These hair loss disorders may be due to hormonal or inflammatory processes which causes hair loss with hair follicles not being affected. Once the process resolves, or is treated, the hair will grow back. Examples of non-scarring hair disorders include: Female and Male Pattern Hair Loss (Androgenetic Alopecia), Alopecia areata, and Telogen Effluvium. Traction Alopecia is also non-scarring in its early stages.Extremely inflamed Psoriasis, Seborrhoeic Dermatitis and Contact Dermatitis have been causes of temporary non-scarring hair loss.

 

2. Scarring Alopecia

Scarring type alopecias usually result from an inflammatory process whereby the body, for whatever reason, attacks the hair follicle, destroying it in the process. The hair follicle is replaced by scar tissue, and as such, hair will not grow back. Most of these scarring hair loss disorders, if treated from very early, can have favourable outcomes with the hair growing back. Examples include: Traction alopecia, Lichen Planopilaris, Central Centrifugal Cicatricial Alopecia, Dissecting Cellulitis, Folliculitis Decalvans, Chronic Discoid Lupus Erythematosus.

 

5 Myths about Hair Loss in Men

From time to time during my discussions with male patients, I come across general misconceptions about hair and hair loss. Some of this information may have been gathered from the internet or derived from basic folklore that has survived the test of time. These are some of the myths about hair loss in men that I’ve encountered.

1. Hair Loss is inherited from the mother

This is not true. The genes for hair loss are quite numerous and are inherited from both parents. The severity of your hair balding has more to do with the number of genes you inherited. If you have hair loss on both sides of your family, you are more likely to suffer from hair loss than a person who has no known family member with hair loss.

2. Only older men are affected

Though Male Pattern Hair Loss is seen in more middle-aged to elderly men, young men are also capable of being affected by the condition. A lot of men start as early as in their teen or early twenties.

3. If I take testosterone pills I will grow more hair

We all know that  testosterone is the predominant androgen (male) hormone that is responsible for the sexual characteristics of men. So because of this, there is some belief that if I take more testosterone then it would make me more virile and youthful. Losing one’s hair is thought to make some men feel less youthful. Unfortunately, this myth needs to quit while it’s ahead. Testosterone is converted to the more potent Dihydrotesterone which is the hormone responsible for binding to the receptors in the hair follicle and causing the hair to miniaturise. Taking more testosterone just adds fuel to the fire.

 

4. Hard physical exercise decreases conversion of Testosterone to DHT

I’m not sure how this myth came about but this is so far from the truth. Testosterone is usually converted to the more potent Dihydrotestosterone in all men. Individuals with Male Pattern Hair Loss are more sensitive to DHT because of their genetics.  So technically speaking they may have the same level of DHT as another man, but because of their greater sensitivity of their hair follicles to the hormone DHT, they lose more hair. Yes, there have been studies indicating that extremely hard exercise may cause a decrease in testosterone and therefore should theoretically decrease DHT. However, for all the athletes who are hitting the gym for hours on end but yet are still balding, this belief should be shelved quickly. Usain Bolt anyone?

5. Men who are balding have more testosterone.

Most studies show that most men have the same levels of testosterone across the board. Its production generally slows a bit as you get older, hence why some men’s libido and energy decrease as they get older. Those men who have genetic hair loss are more susceptible to the effects of the hormone DHT than those who don’t suffer from the condition.

 

Dr. Llorenia Muir-Green is a practising dermatologist in Jamaica.  She graduated from the UWI, first obtaining a double major in Chemistry and Biochemistry. She then went on to pursue a career in Medicine. Having obtained her Medical degree from UWI, she went on to pursue postgraduate specialisation in Clinical Dermatology at Cardiff University, for which she got distinction.  She was a recipient of the 2013 Fellowship in Hair and Scalp Disorders at the University of British Columbia.  She is a member of the North American Hair Research Society, International Society of Hair Restoration Surgery,  Dermatology Association of Jamaica as well as an Associate Member of the Caribbean Dermatology Association. She currently works at the Dermatology Clinic at National Chest Hospital where she recently established a Hair Clinic.