Causes and Symptoms of Hereditary Baldness
The main cause of hereditary baldness is, as its name says, genetic. However, some people believe that losing hair is the result of poor circulation in the scalp, elevated stress, wearing hats and long hair or masturbation, which obviously is not true. Such rumours are also spread by the marketers of hair scams, who are trying to exploit our lack of knowledge. They often tell us that hair loss is due to the blocking and malnutrition of hair follicles or that scalp inflammation and a diet poor in essential nutrients cause baldness in order to sell us scalp cleansers and vitamin pills.
But how does genetics cause hair loss? Hereditary baldness in both men and women is caused by dihydrotestosterone (DHT) attacks on our hair follicles. This happens in all of us but only some people are born with hair follicles that are vulnerable to these attacks, which results in hair loss. The exact mechanism by which DHT acts on our follicles is, however, not yet known.
DHT is a metabolite of the male hormone testosterone, which plays a key role in the development of an enlarged prostate. In addition to making the prostate swell, it causes the hair follicles to shrink and produce finer and thinner hair with each hair growth cycle until they refuse to produce another hair and die. Hence, the balding process is actually hair miniaturisation. DHT is able to shut off only those hair follicles that have a genetic predisposition to baldness. They are usually located on the front and the top of our scalp, which gives us the typical horseshoe balding pattern called male pattern baldness. This pattern is less pronounced in women, who usually lose hair on their entire scalp, which leads to diffuse hair loss.
Hence, hair loss is actually hair miniaturisation. This explains why so many hair loss sufferers do not notice that they are losing hair until it becomes obvious to everybody. In the initial stage, only a doctor can tell you whether you are suffering from hereditary baldness, by performing a miniaturisation test. In some instances increased hair fall (more than 100 hairs a day for an extended period of time) can lead to baldness but more often than that hair loss goes on unnoticed until we lose 50% of our hair.
In people suffering from hereditary baldness the balding process can be greatly accelerated during the shedding periods. Those of us living in a temperate zone go through a shedding period twice a year - once in spring and once in autumn. Each shedding period lasts between four and six weeks. Somebody who suffers from hereditary baldness may, during this period, lose a substantial portion of their hair but many of them will not be replaced by new budding hair. This situation leads to the visible worsening of the hair loss condition within a few months. However, for people not suffering from hereditary baldness, increased shedding is normal and no reason for concern.
The most effective treatments for hereditary baldness are those that address its main cause - DHT attacks on our hair follicles. Such drugs are called antiandrogens and they either prevent the creation of DHT in the scalp or block the activity of DHT in the scalp by binding to the receptor sites in the follicle or blocking activity in the androgen receptor itself. Propecia (brand name for finasteride) is the best-known and the most powerful antiandrogen currently approved to treat male pattern baldness.