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FAQs on Androgenetic Alopecia (male pattern hairloss)

What is androgenetic alopecia?
Androgenetic alopecia is a common form of hairloss affecting both men and women. It is also known as male pattern baldness and female pattern baldness, respectively.

How common is androgenetic alopecia?
Androgenetic alopecia is very common and affects 40% of men and 25% of women by the age of forty years. It can begin anytime after puberty and gets more common with age.

What are the sympoms of androgenetic alopecia?
The symptoms may differ in men and women:

  • Male androgenetic alopecia (male pattern hairloss) - Begins as a receding hairline around the temples, producing an M-shaped pattern. Then thinning or a bald patch develops at the crown. In severe cases, these areas merge leaving a horseshoe rim of hair at the back and sides of the head. Doctors use the Norwood classification to grade male androgenetic alopecia from I - VII, according to increasing severity.
     
  • Female androgenetic alopecia (female pattern hairloss) - May follow the pattern in men or more commonly, as diffuse thinning which is most prominent on the top front of the scalp. Female androgenetic alopecia is graded from I - III under the Ludwig classification..
What is the cause of androgenetic alopecia?
Androgenic alopecia is caused by the effect of androgens (male hormones) on the hair follicles (roots) of genetically susceptible individuals. The genetic susceptibility may be inherited from either the mother or father.
 
What happens to the hair in androgenetic alopecia?
Hair grows through two main stages - a growth stage known as anagen lasting 2 - 4 years and a rest stage known as telogen which lasts 2 - 4 months, after which the hair falls out. This cycle is repeated. In androgenetic alopecia, the anagen stage is shortened so that the hair grows for a shorter period and is thinner, shorter and less pigmented. The anagen stage becomes shorter with each hair cycle so that only a fluff of hair is produced eventually, and in some people, the area is almost totally bald.
 
Can anything be done for androgenetic alopecia?
There are two medical treatments that have been shown to improve androgenetic alopecia. They are minoxidil lotion/gel 2 - 5% and finasteride tablets 1mg. Minoxidil prolongs the anagen or growth stage but exactly how it does this is still unknown. Finasteride works by inhibiting the 5 alpha reductase enzyme that converts testosterone (the main androgen or male hormone) to dihydrotestosterone (DHT) which scientists believe is the main androgen causing androgenetic alopecia. The results are better when the alopecia is milder and the person is younger. Finasteride cannot be used in women of child bearing age because it may affect the sexual differentiation of the male foetus. Hair transplants can be used in men with severe androgenetic alopecia (grades V - VII)). Hormone therapy is an alternative that is available to women. It cannot be used in men because of the risk of feminisation.
 
Can androgenetic alopecia be cured?
Minoxidil and finasteride can bring about cosmetically acceptable improvement but treatment must be continued or the newly grown hair will fall out. Only hair transplant can produce a permanent result but this involves surgery and a significant degree of discomfort. Many people still prefer non-surgical treatments.
Does diet have any effect on androgenetic alopecia?
There is no evidence that diet has any effect on androgenetic alopecia.
 
Does frequent shampooing xause hairloss?
Using the wrong shampoo may make the hair dry, limp or lustreless but it does not cause hairloss. The hair follicles (roots) are embedded in the dermis (deepe skin) beyond the reach of shampoos. In fact, regular shampooing may even help androgenetic alopecia by removing the androgens present in sebum (skin oil) before they can re-enter the scalp.
 
How effective are over-the-counter hair growth restorers and tonics?
The only proven remedies are minoxidil and finasteride which need to be prescribed by a doctor.
 
Does scalp massage, brushing the hair and sleeping on a slant board help?
The idea here is to improve the blood circulation. However, androgenetic alopecia is not caused by poor blood circulation. In hair transplants, for example, hair grafts are taken from back of the head and transplanted to the bald areas. The blood circulation to these grafts is suddenly cut off and it takes time for it to be re-established in transplant area and yet the transplanted hair grows.
 
Does monosodium glutamate (MSG) aggravate the hairloss?
Monosodium glutamate is a flavouring agent commonly used in Chinese restaurant cooking. It causes headaches, dizziness, burning sensation in the extremities and chest pain (Chinese reataurant syndrome) but it does not cause or aggravate androgenetic alopecia.
 
Does taking vitamin supplements help hair to grow?
Vitamins have been suggested for anything from the common cold to hairloss. However, there is no evidence vitamin deficiency causes androgenetic alopecia so taking vitamin supplements is unnecesary.
 
Does excessive oiliness cause androgenetic alopecia?
The sebaceous glands that produce oil are stimulated by androgens which you may remember is the cause of androgenetic alopecia. The two conditions may therefore occur together but one does not cause the other. The hairloss is not caused by oil clogging and suffocating the hair follicles because the follcles get all the nutrients and oxygen from the blood.
 
Does dandruff aggravate cause or aggravate the hairloss?
Dandruff is very common and it is not uncommo to find dandruf and androgenetic alopecia together. This is coincidental, dandruff does not cause or aggravate androgenetic alopecia.
 
Are bald people more intelligent?
There is a belief that people grow bald because of the heavy traffic of ideas going through the brain. This is not true and you may know of some bald people who are not very intelligent.
 
Are bald people more virile?
The main androgen that causes androgenetic alopecia is formed in the scalp. There is no overall increase in circulating andogens and therefore, no increase in virility.
 
Does shaving the scalp bald help regrowth?
No it does not and a study by Drs Lynfield and MacWilliams in the 1970 issue of the Journal of Investigative Dermatology showed no difference in the weight, thickness or rate of growth between the shaven and unshaven leg.
 
Does masturbation cause hairloss?
No it doesn't. It may be a myth perpetuated by people who feel masturbation is unnatural.
 
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