Family Doctor 2007 - (Page 143) BALDNESS Baldness: Missing a strand or two So you’re leaving more hair than usual in your brush. And clumps of your crowning glory are hitting the shower drain. Are you losing your hair? The short answer — yes. By Ray Formanek, Jr. R elax. Everyone loses scalp hair! At birth, the average head is covered with about 100,000 follicles — pouch-like sacs that produce individual hairs. Although the number never type of hair loss. Others think several genes play a role. The gene is more likely to affect men and result in typical male-pattern baldness because of the role of testosterone in hair loss. Androgenetic alopecia in women, called female-pattern hair loss, is a more general thinning of the hair throughout the scalp. Ray Formanek, Jr., is a science and medical writer in Gaithersburg, Md. changes, the activity of each follicle varies as we age. About 90% of the hairs on your scalp are growing right now — during a phase that will last an average of 5 years. The remaining 10% of them are “resting.” After 60 to 90 days, these strands will fall out, making way for new hair to grow in their place. It’s normal to shed about 100 scalp hairs a day. Treatment is in your hands What causes hair loss? Anyone, including children, can experience hair loss, called alopecia by doctors. Baldness refers to excessive loss of hair from your scalp. It can result from heredity, a medical condition or even medication. The most common type of baldness is called androgenetic alopecia. It’s responsible for about 95% of the cases of hair loss in the United States. Androgenetic alopecia occurs much more frequently in men than in women. Two factors must be present for it: A genetic predisposition and the male hormone testosterone (yes, women have a low level of testosterone in their bodies). Normally, an enzyme in hair follicles converts testosterone to dihydrotestosterone (DHT). DHT stimulates the growth of body and beard hair, but also shrinks hair follicles on the scalp, resulting in finer, fuzzier growth. A genetic predisposition, along with higher levels of testosterone and DHT, increases the likelihood that scalp hair growth may be adversely affected. Baldness occurs when the rate of hair shedding exceeds the rate of regrowth, or when the regrowth is finer — and shorter — than the hair that is shed. A ndrogenetic alopecia isn’t considered a medical disorder; it’s more of a cosmetic issue. Treatment is up to you. The U.S. Food and Drug Administration (FDA) has approved 2 options: Minoxidil (Rogaine): This topical solution can be applied twice daily to treat male-pattern and female-pattern baldness. Trials show it can slow the rate of hair loss for up to 90% of those who use it. It helps regrow hair in 10% to 20%. Regrown hair falls out when application is stopped. Finasteride (Propecia): Taken daily in a pill form, finasteride inhibits the conversion of testosterone to DHT, thereby helping to prevent the shrinking of hair follicles. Finasteride must not be taken by women because it may cause birth defects. A variety of surgical treatments involving hair follicle transplantation and other procedures also are available. You should discuss these options — or any concerns you have about hair loss — with your family doctor. ADDITIONAL INFORMATION American Academy of Family Physicians http://familydoctor.org/081.xml National Library of Medicine http://www.nlm.nih.gov/medlineplus/ency/article/003246.htm Mayo Clinic http://www.mayoclinic.com/health/hair-loss/DS00278 MedicineNet, Inc. http://www.medicinenet.com/hair_loss/article.htm How many genes? The causes of androgenetic alopecia are not completely understood. Many researchers believe one gene is responsible for this familydoctor 2007 143 http://familydoctor.org/081.xml http://www.nlm.nih.gov/medlineplus/ency/article/003246.htm http://www.mayoclinic.com/health/hair-loss/DS00278 http://www.medicinenet.com/hair_loss/article.htm
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