Full hair is seen as an ideal of beauty, a symbol of a dynamic character, youth and success. It therefore comes as no surprise that hair loss is often experienced as disturbing by those affected. The morning glance in the mirror gives witness to the hair loss, often causing a loss in self-confidence and consequently in quality of life.
Androgenetic Alopecia in men
(from the Greek: Alopecia = hair loss, andro = male, genetica = the result of genetic factors)
Male pattern baldness or androgenetic alopecia is the most common form of permanent hair loss. This form of male baldness is for the most part attributable to hereditary factors. About one third of all men between 25 and 40 suffer from hair loss.
Androgenetic alopecia in men is classified according to the severity of baldness using the Norwood Hamilton scale. This scale allows a classification of the current stage of baldness.
Male baldness generally starts with a receding hairline at the temples as well as in the middle of the scalp. It then progresses until all that remains is a horseshoe shaped fringe of hair, sometimes referred to as a “tonsure”.
A factor contributing to baldness is the so-called dihydrotestosterone, or DHT for short. This is produced with the help of the enzyme 5α-reductase out of the male testosterone hormone. The hair on top of men’s heads is particularly sensitive to this hormone. The growth phase of individual hairs becomes shorter, with hair falling out prematurely.
This is insofar not a problem, as long as hair loss and hair growth progresses equilibrated, i.e. when similar amounts of hair fall out and regrow. Hair loss might only occur when this natural balance is in disequilibrium.
Androgenetic Alopecia in women
Although androgenetic alopecia is generally referred to as the male form of baldness, women can also suffer from it.
Androgenetic alopecia in women is classified according to the Ludwig scale. (photo)
Androgenetic alopecia in women is characterised by thinning hair, often concentrated exclusively on the top of the head. Androgenetic alopecia in women usually appears during menopause and is only seldom seen as an indication of an undetected illness.
When androgenetic alopecia appears in women before menopause is reached, it may be a sign of a hormonal disorder. In such a case – especially when the person is exceptionally hirsute or suffers from acne – an endocrinological examination is recommended to establish the cause of the hair loss.
In contrast to other forms of hair loss, androgenetic alopecia is an irreversible process – once a hair has fallen out, no new hair will grow.
In most people suffering from alopecia areata, hair is lost in certain patches, only to grow again 1 – 2 years later.
Such patches can be anywhere on the scalp and multiple, with a diameter of 2.5 – 5 cm. Hair can regrow in one patch, while again falling out in another patch.
Alopecia areata totalis results in the scalp losing all its hair. However only a small percentage of all hair loss patients suffer from this form of baldness. In most cases, hair loss is restricted to the head. There is however one form of hair loss – Alopecia areata universalis – where all body hair (including eyebrows, beard and pubic hair) is lost.
Alopecia areata is probably an auto-immune disease where the body itself attacks the hair in a destructive and sometimes irreversible manner, as if seeing hair as something alien to the body. In many cases alopecia areata is an incurable and irreversible process. This is especially the case when alopecia areata occurs when the person is still a child or when the patient suffers from other auto-immune disorders such as thyroid disease, vitiligo or allergies.
The Norwood Scale
The Norwood Scale is a set of images that depict the different stages of male pattern hair loss. Now, whether they try to avoid the situation or not, most men know what to expect when they see the early signs of hair loss, so what’s the use of such a diagram that only states the obvious?.
Well, the rate at which men lose hair varies enormously. Male hair loss can begin as early as puberty and while some men may shed rapidly in their 20’s up to a Type 3 or Type 4, others may have no detectable amount of hair loss until they are in their 50’s, only to advance to a Type 6 or Type 7 in just a few short years. Essentially, the scale is used to assess how advanced a man’s hair loss is – the higher the number, the more advanced the loss. And if you start to thin or recede early in life, there’s a good chance you’re destined to lose quite a bit of hair.