Baldness

Baldness involves the state of lacking hair where it often grows, especially on the head. The most common form of baldness is a progressive hair thinning condition called androgenic alopecia or 'male pattern baldness' that occurs in adult male humans and other species. The severity and nature of baldness can vary greatly; it ranges from male and female pattern alopecia (androgenetic alopecia, also called androgenic alopecia or alopecia androgenetica), alopecia areata, which involves the loss of some of the hair from the head, and alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body. Treatments for the various forms alopecia have limited success, but typical male pattern baldness is now a very preventable, and reversible (to a certain extent) condition. Thousands of individuals today make use of proven treatments to show noticeable regrowth and prevent any further loss. As a general rule, the more hair you've lost the harder it is to restore, but the treatments will help the vast majority of users.

Background, cause and incidence

The average human head has about 100,000 hair follicles. Each follicle can grow about 20 individual hairs in a person's lifetime. Average hair loss is about 100 strands a day.

Incidence of pattern baldness varies from population to population based on genetic background. Environmental factors do not seem to affect this type of baldness greatly. One large scale study in Maryborough, in central Victoria (Australia) showed the prevalence of mid-frontal hair loss increases with age and affects 57% of women and 73.5% of men aged 80 and over.

Male pattern baldness is characterized by hair receding from the lateral sides of the forehead, known as "receding hairline".

An additional bald patch may develop on top (vertex). The trigger for this type of baldness (called androgenetic alopecia) is DHT, a powerful sex hormone and hair growth promoter that can adversely affect the hair and prostate.

The mechanism by which DHT accomplishes this is not yet understood. In genetically-prone scalps, DHT initiates a process of follicular miniaturization. Through the process of follicular miniaturization, hair shaft width is progressively decreased until scalp hair resembles fragile vellus hair or "peach fuzz" or else becomes non-existent. Onset of hair loss sometimes begins as early as end of puberty, and is mostly genetically determined. Male pattern baldness is classified on the Hamilton-Norwood scale I-VIII.

It was previously believed that baldness was inherited. While there is some basis for this belief, both parents contribute to their offspring's likelihood of hair loss. Most likely, inheritance is technically "autosomal dominant with mixed penetrance" (see 'baldness folklore' below)

There are several other kinds of baldness:

• Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force. Wearing a hat shouldn't generally cause this, though it is a good idea to let your scalp breathe for 7 hours a day.
• Traumas such as chemotherapy, childbirth, major surgery, poisoning, and severe stress may cause a hair loss condition known as telogen effluvium.
• Some mycotic infections can cause massive hair loss.
• Alopecia areata is an autoimmune disorder also known as "spot baldness" that can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis).
• Localized or diffuse hair loss may also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, postmenopausal frontal fibrosing alopecia, etc.). Tumours and skin outgrowths also induce localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
• Hypothyroidism can cause hair loss, especially thinning of the outer third of the eyebrows
• Temporary loss of hair can occur in areas where sebaceous cysts are present for considerable duration; normally one to several weeks in length.

Etymology

The term alopecia (al-oh-PEE-she-uh) is formed from the Greek αλώπηξ (alopex), meaning fox. The origin of this usage is because this animal sheds its coat twice a year.

The term bald likely derives from the English word balde, which means "white, pale", or Celtic ball, which means "white patch or blaze", such as on a horse's head.

Evolutionary theories of male pattern baldness

There is no consensus
regarding the details of the evolution of male pattern baldness. Most theories regard it as resulting from sexual selection. A number of other primate species also experience hair loss following puberty, and some primate species clearly use an enlarged forehead, created both anatomically and through strategies such as frontal balding, to convey increased status and maturity. The assertion that MPB is intended to convey a social message is supported by the fact that the distribution of androgen receptors in the scalp differs between men and women, and older women or women with high androgen levels often exhibit diffuse thinning of hair as opposed to male pattern baldness.

One theory, advanced by Muscarella and Cunningham, suggests baldness evolved in males aggression and risk-taking decrease and nurturing behaviours increase. This may have conveyed a male with enhanced social status but reduced physical threat, which could enhance ability to secure reproductive partners and raise offspring to adulthood. through sexual selection as an enhanced signal of aging and social maturity, whereby

In a study by Muscarella and Cunnhingham, males and females viewed 6 male models with different levels of facial hair (beard and moustache or clean) and cranial hair (full head of hair, receding and bald). Participants rated each combination on 32 adjectives related to social perceptions. Males with facial hair and those with bald or receding hair were rated as being older than those who were clean-shaven or had a full head of hair. Beards and a full head of hair were seen as being more aggressive and less socially mature, and baldness was associated with more social maturity.

Approaches to baldness

Psychological effects

The psychological effects for individuals experiencing hair loss vary widely. Some people adapt to the change comfortably, while others have severe problems relating to anxiety, depression, social phobia, and in some cases, identity change.

Retired NASA Astronaut Story Musgrave.

Alopecia induced by cancer chemotherapy has been reported to cause changes in self-concept and body image. Body image does not return to the previous state after regrowth of hair for a majority of patients. In such cases, patients have difficulties expressing their feelings (what is called alexithymia) and may be more prone to avoiding family conflicts. Family therapy can help families to cope with these psychological problems if they arise.

Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms.

Some balding men may feel proud of their baldness, feeling a kindred relationship with famous charismatic bald men such as Telly Savalas, Patrick Stewart, Sean Connery, Yul Brynner, Billy Corgan, Vin Diesel, Michael Chiklis, Michael Stipe, Ross Kemp, Jason Alexander, Larry David, Danny De Vito, Ben Kingsley or Bruce Willis; or politicians such as Ed Koch, John Reid, Menzies Campbell and James Carville; or sportsmen such as wrestler Stone Cold Steve Austin, footballers Zinedine Zidane, Bobby Charlton or tennis star Andre Agassi. Much of these celebrities' perceived masculinity and handsomeness derives from their most obvious distinguishing feature. Baldness has, in recent years, in any case become less of a (supposed) liability due to an increasing fashionable prevalence of very short, or even completely shaven, hair among men, at least in western countries. This is even true for women, as shown by the case of singer Sinead O'Connor who has a shaven head. Other female celebrities whose baldness is involuntary include Kylie Minogue (induced by chemotherapy) and Gail Porterpsychosomatic origin).

In today's modern fast-paced lifestyle and demand for fashion, our scalp and hair have been submitted to constant abuse by chemical through processes such as colouring, perming, rebonding. And use of shampoo containing excessive chemicals, detergents. Just like our face, our scalp will require maintenance care therapy for health and beauty.