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Androgenetic Alopecia

What you should know about the most common cause of hair loss

20145294_xl-1We all know that suffering from hair loss can affect one’s self-esteem and confidence, but only a small group of us seek treatment. Embarrassment, cost, and uncertainty of finding the right doctor are some typical barriers. The most common cause of hair loss is androgenetic alopecia – a medical term used to describe hair loss that occurs due to androgenic miniaturisation of the hair follicles. But do you know enough of this condition?

The Hair’s Life Cycle

Let’s go back to the fundamentals and learn more about the hair’s life cycle. There are three phases in hair’s life cycle – a growth phase known as anagen, a phase of regression known as catagen, and a resting phase known as telogen. Thanks to stem cells, hair has the power to renew itself cyclically throughout life – a hair that falls out is replaced by a new hair that grows. After the telogen phase, the cycle restarts with the anagen phase.

However, each stage lasts for a different period of time. The anagen phase can last from two to six years. The catagen phase can last from two to three weeks, while the telogen phase can last from two to three months. Do you know that about 90% of our hair is in the anagen phase?

Between two life cycles, there is actually a “dormancy” period called the kenogen phase, lasting for two to 12 months, where there is no hair and the bulb is empty. The longer this period of dormancy lasts, the greater the number of empty bulbs and the more the hair loses its density.

Male Pattern Hair Loss

Male Pattern Hair Loss (MPHL) is the most common form of hair loss in men, representing close to 95% of all cases of hair loss in men. From the MPHL Asia Pacific survey conducted in 2011, results show that two in three local men are at least moderately concerned about MPHL, and Singaporean men, especially younger men, are the most sensitive about their hair condition, compared to men in the region.

The principal androgen that causes hair loss in men is Dihydrotestosterone (DHT). Men with MPHL have increased levels of DHT in their balding scalps, which contribute to the progressive shrinking of hair follicles and a decrease in the number of visible hairs.

The main characteristic of MPHL are miniaturised hair of various lengths and diameters, which translate to shorter and finer hairs. As the term MPHL suggests, male hair loss follows a pattern. According to the Norwood-Hamilton Scale, it starts when hair in the temple and in the crown area starts thinning. The frontal hairline then begins to recede, the temple grows bigger, and the crown area noticeably bald. Later on, the two bald areas at the front and back will meet at the center of the scalp, and eventually there is only a horseshoe-shaped hair that surrounds the head.

24465887_xlFemale Pattern Hair Loss

Female Pattern Hair Loss (FPHL) may be caused by conditions that are associated with high androgen levels. Often, these women would also experience menstrual disturbances. However, most women with FPHL do not show signs of androgen excess, and hereditary factors are less obvious than in men with MPHL.

According to the Ludwig Scale, FPHL occurs as overall thinning of the hair at the top of the scalp in front of the crown, without hairline recession. But many women with FPHL cannot be classified using the Ludwig classification system. Moreover, the pattern of hair loss as seen in MPHL may also be encountered in some women with FPHL, i.e. frontal hairline recession may occur.

Hair loss in women can be caused by other factors such as pregnancy, birth control pills, dramatic weight loss, stress, and chemical hair treatments. In these situations, the rate of hair loss tends to be dramatic, and the pattern of hair loss tends to be diffuse. These are different from those seen in FPHL.

Hair Loss Treatments

Conventionally, men who suffer from androgenetic alopecia seek treatment options like oral Propecia and topical Minoxidil, hair care products such as hair growth tonic and shampoo, health supplements such as vitamins, and even hair laser and hair transplantation.

Recently, with the discovery of a new molecule called Stemoxydine, there are now hair care products proven to be able to promote hair renewal. Stemoxydine is a L’Oréal-patented molecule with biomimetic action that imitates the effects of the low oxygen environment essential to the good functioning of follicle stem cells. This means that it awakens the empty hair bulbs by creating an environment that triggers growth. As the follicle stem cells recreate more quickly and abundantly, the ‘dormant’ period is shortened, and the number of hairs in the growth phase increases, as well as hair density. Compared to traditional hair loss treatments that target existing hair in the anagen, catagen and/ or telogen phases, this novel treatment tackles a yet unexploited area of ‘dormant’ follicles.

A clinical study on 101 volunteers with alopecia corresponding to stages III and IV of the Norwood-Hamilton classification was conducted by Dr Pascal Reygagne, an internationally renowned Dermatologist and Trichologist. Results show that after three months of daily dosage of Stemoxydine 5%, there was an average 1,700 new hairs counted at three months versus placebo.

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Dr Cheong Wai Kwong is a Dermatologist at the Specialist Skin Clinic, Singapore. He has been practising dermatology since 1986 in various hospitals both locally and in London before going into private practice in 1995. He has a keen interest in the treatment of hair loss, acne and atopic dermatitis. He has been instrumental in organising public educational campaigns on hair loss and lectured extensively on hair loss and other skin conditions both locally and regionally.
Posted by ezyhealth on Apr 8 2014. Filed under Aesthetics. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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