On the pillow when you get up, in the drain when you shower, on the brush when you wash… they are always there, hairs! Then you remember your parents, how your mother began to have thinner hair with age, and your father had to start combing his hair in a different way to hide the inevitable. You see pictures of your grandparents and how shiny their heads are. You can't help it. You are doomed to baldness! Or maybe not?
Wearing a shiny bald head has undoubtedly a genetic factor, but it is not the only factor behind why some people leave their ideas airier than others. Many myths and legends are associated with this phenomenon that can affect a person's self-esteem so much due to the aesthetic change it produces. Because of this affectation and the large percentage of the population that suffers from it, there are or are being developed different drugs and treatments to prevent or stop hair loss. In some cases, even regenerate it!
Different types of alopecia are distinguished depending on the factors causing it since some of these factors are genetic, and others are environmental. This post will talk about androgenic alopecia, alopecia areata, and Telogen and Anagen Effluvium.
Androgenic alopecia
This type of alopecia affects 31% of the population between 40-50 years old and 53% of those over 65. It occurs in both men and women. In women, hair loss is not total. It does not have a specific pattern (the hair disappears evenly throughout the hair, giving the appearance of having less volume and finer hair). In contrast, in men, the hair usually disappears in specific areas like the crown or the "entrances," being able to arrive at the hair's total loss.
The gene responsible for hair loss in this type of alopecia is partially the AR gene, which codes for an androgen receptor. Androgen receptors allow the body to respond well to hormones such as testosterone and are very important in developing secondary sexual characteristics during puberty. Besides, they have many other functions throughout the individual's life, such as the regulation of maintenance and gain of muscle mass or the regulation of libido.
There are variants of the AR gene that can produce an increased number of androgen receptors in the hair's hair follicles. Also, it has been seen that testosterone contributes to the reduction of the size and miniaturization of hair follicles. Specifically, testosterone is metabolized by the 5α-reductase enzyme: dihydrotestosterone, which is ten times more powerful.
What happens then is that, as there are more androgen receptors due to the AR gene variants, more dihydrotestosterone can act in the hair follicle's surroundings. This is what causes the progressive miniaturization of the hair follicle until, finally, it disappears.
The process by which a hair follicle ends up disappearing in this type of alopecia is explained in several hair growth cycles. A hair goes through several phases from its growth to its loss, since some hair loss is normal. After falling out, the remaining bud forms a new hair follicle. If it has been affected by dihydrotestosterone, the hair follicle that will form the yolk will be smaller than the previous one.
All this has been confirmed by analyzing individuals with variants of the AR gene and less efficient variants of the gene for 5α-reductase. Individuals with this enzyme with reduced efficacy had less hair loss, as less testosterone was converted to dihydrotestosterone, which is more potent. Despite these studies, it has been observed that drugs that inhibit 5α-reductase only partially stop hair loss and do not regenerate hair follicles that have already been lost or thicken existing ones.
Individuals who are drug-resistant to this medication can opt for hair transplantation or even tattoos that mimic a shaved haircut.
Alopecia areata
It can have numerous causes (multifactorial), although it is mainly considered an autoimmune process with a certain genetic factor since in 30% of diagnosed cases, there is a family history.
It is characterized by hair loss in patches or circular areas, both on the scalp and the rest of the body. It can appear at any time in life, although it is usually more common in children.
The autoimmune process is caused by CD8 T lymphocytes' presence, a type of white blood cell, near or around the hair follicles that make up the circular plate.
It also has several clinical forms: opiatic (bald spots located on the hairline), total (affects the entire scalp), and universal (affects all the hair on the body).
The Biochemical Report Card (BRC)
Dr. Robert Nettles, AACS, A4M, ISHRS, MD, a doctor based in California understands that the genetic proponent in hair loss. He has developed a testing model, called the Biochemical Report Card which can detail an individual’s complete biochemistry profile. Dr. Nettles is a doctor and entrepreneur, the founder of Robert Nettles MD Medical Practice, Stop and Regrow Hair, and the scientifically proven cure for hair loss worldwide.
The BRC allows a person to understand their medical ancestral history and take significant steps to rectify the chronic pattern baldness effects.