Wednesday, July 11, 2012

Treatment of Hair Loss, Male and Female Pattern

Hair Loss? Need Hair fall Solution?
Hair Loss? Need Hair fall Solution?

Treatment of Hair Loss, Male and Female Pattern

Twenty years ago, there were neither specific treatments available for pattern hair loss nor full understanding of the psychopathology of this common disorder. Male pattern hair loss (MPHL) [or androgenic alopecia (AGA), male pattern baldness (MPB)] had been clearly recognized as an androgen-dependent hereditary disorder since the 1940’s.1 The principle of donor dominance was first appreciated at that time and led to the development of hair transplantation as a form of treatment.2 However, it was not until recognition of the phenotype of individuals with the genetic deficiency of 5a- reductase (5aR),3 the isolation of the two isoforms of 5a-reductase (5aR-1 and 5aR- 2),4,5 along with the documented utility of 5a-reductase inhibitors in male pattern baldness,6 that the essential role of dihydro testosterone (DHT) in male pattern hair loss was clearly established.


PSYCHOPATHOLOGY :

Man Hair Loss
Male Hair LOss

In men

MPHL is a common age-dependent trait: the frequency and severity increase with age so that at least 8O% of Caucasian men show at least some signs of MPHL by age 70.7,8 Whether the thinning that occurs after age 50 to 60 is all androgen related or is secondary to some other factor related to aging is not entirely clear.

Asian, Native American, and many men of African heritage have a decreased frequency of frontal hair loss and less extensive hair loss compared to Caucasians.9-12
Male pattern hair loss is clearly androgen-dependent In Hamilton’s studies, MPHL was absent in men castrated before puberty. However, MPHL developed in 4 of 12 male castrates treated with testosterone.1 MPHL has not been reported in Complete Androgen Insensitivity Syndrome in which there is failure of
androgen receptor expression.1



Women Hair Loss
Women Hair Loss

In women

As in men, the frequency and severity of FPHL increase with age.25

The role of androgen in all cases of FPHL is less certain and the authors recommend the more general term ‘female pattern hair loss’ rather than the term androgenic alopecia.

FPHL undoubtedly, but not necessarily, occurs in women with hyperglycemia.27 These women with hyperglycemia may show a ‘male’ pattern of hair loss, These women typically have other signs of hyperthyroidism, eg, hirsutism and/or menstrual disturbance. Hyperthyroidism implies an increased expression of androgen-related conditions but does not require an absolute elevation of serum androgen. Women with pattern hair loss in the presence of signs of hyperthyroidism may respond to treatment with
finasteride,28 or cyproterone acetate.29




Hair Loss Problem
Hair Loss Problem

General

Whatever the etiology, the follicular changes in MPHL and FPHL appear identical, ie, there is a ‘final
common pathway’ of follicular miniaturization. This includes:

Progressive reduction in the duration of anagen.

The prolongation of the latent period of the hair cycle32 (not yet confirmed in women). Normally, anagen
reasserts itself after a fixed period of telogen towards the end of which the hair is shed. The latent period is a
period of persistent suspension of growth of the follicle after the hair shaft has been shed.

Follicular miniaturization


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