Normal Hair Growth Cycles
Undisturbed, each terminal scalp hair usually grows continuously for about approximately three to 5 years. Then the hair moves to a resting state, where the part above the skin falls out. No hair grows from the follicle for 90 days. Once this point has passed, a replacement hair begins growing through the skin and continues for an additional three to 5 years at a rate of roughly 1/2 inch per month.
Common Pattern Hair Loss
Hamilton-Norwood Hair Loss Scale
For those concerned about hair loss, many myths and half-truths abound, but useful information is often difficult to get. Therefore, an objective overview of hair loss is presented here.
In healthy well-nourished individuals of both genders, the foremost common sort of hair loss is androgenetic alopecia (AGA), also referred to as pattern hair loss. The disorder affects approximately 40 million American men. Perhaps surprisingly, an equivalent disorder affects about 20 million American women. The difference between men and ladies is that a lady suffering hair loss usually retains her feminine hairline and experiences thinning behind this vanguard. In men, a definite "pattern" of loss manifests where the frontal edge recedes at an equivalent time that a thinning zone expands from the posterior crown. in additional pronounced cases, these zones meet and therefore the person is claimed to be clinically bald.
Three Triggers
Importantly, three things got to occur so as for one to be suffering from AGA. First, one must inherit the genetic predisposition. this suggests that the matter comes from one or each side of the family. Second, one must attain a particular age. Nine-year-old children don't experience pattern hair loss. And third, one must have the circulating hormones that precipitate the onset and progression of the disorder.
Hormones, Enzymes & Other Factors
Crystallography of DHT molecule
From a susceptibility standpoint, the principle hormonal trigger linked to pattern hair loss is 5-alpha dihydrotestosterone, commonly mentioned as DHT. Intriguingly, it's been shown that in persons genetically insensitive to DHT, pattern hair loss doesn't occur. DHT is synthesized from the androgen hormone testosterone and is beneficial early in life and through puberty.
In adults, DHT is assumed to cause significant harm, but little or no good. The synthesis of DHT occurs via two closely related sorts of the enzyme 5-alpha reductase. Hair loss treatment options that efficiently interfere with the interaction between 5-alpha reductase and androgen hormones like testosterone are shown to supply clinical benefit in treating pattern hair loss.
Another challenge to understanding hair loss has been the very fact that humans, alone among mammals, suffer from androgenetic alopecia. Thus, no efficient animal model exists that might otherwise tend to shed fall upon the key factors at work.
Hair Loss Variations aside from AGA
In either gender, the medical diagnosis is usually made to support the patient's history and clinical presentation. The common differentials for AGA include alopecia (AA), Trichotillomania, and telogen effluvium. Less often, the explanation for hair loss could also be related to disorders like lupus erythematosus, scabies, or other skin manifesting disease processes. Scalp biopsy and lab assay could also be useful in ascertaining a definitive diagnosis, but, in such cases, should generally only follow an initial clinical evaluation by a professional treating physician.
Pattern Hair Loss Treatment Options
It has wryly been observed that the alternatives for handling hair loss are "rugs, plugs, or drugs". This quip articulates three treatment options that are more kindly mentioned as non-surgical hair systems, surgical hair restoration, and pharmacotherapy. A fourth option has recently evolved, which can even be touched on herein. this is often non-drug based therapy.
Non-surgical Restoration
Typical Hair Piece
Hair replacement systems are in regular use a minimum of since the time of ancient Egypt. These products also pass the term hair integration systems, wigs, weaves, hairpieces, toupees, and lots of other names. All have one thing in common---they aren't growing out of one's scalp. Thus, they need to somehow be attached either with the bald skin or the perimeter of hair remaining above the ears and within the back of the scalp.
Such attachment to the living scalp is nearly never permanent, and permanently reason. apart from the very fact that the unit itself wears out, basic hygiene dictates that the wearer regularly remove the unit to wash the underlying hair and scalp. There are nearly always three basic elements to a hair replacement system. the primary is that the hair itself which can be synthetic, natural, or a mixture thereof. The second element is that the base of the unit. This brings up the third element; which is that the means of attachment. Methods include sewing the bottom to the perimeter hair, gluing the bottom to the perimeter hair, or gluing the bottom to the bald scalp.
Potential advantages to hair systems include the immediacy of achieving a full hair "look" which will appear, to the casual observer, to approximate a full head of hair. The potential disadvantages of hair systems are many and varied.
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In persons who are actively losing hair, vs. those that are essentially bald, the hair system itself may rapidly accelerate the method of going bald. Another disadvantage is that the hard vanguard which will divulge the very fact that an individual is wearing a hair system. In the past, this problem has been addressed by using delicate lace front artificial hairlines that look quite natural but tend to be extremely fragile.
Because they're nonliving, hair systems must be serviced and eventually replaced themselves. the prices of servicing and maintaining a hair replacement system aren't insubstantial--and such costs can dramatically exceed the initial price of the acquisition.
Surgical Hair Restoration
Surgical hair restoration, commonly referred to as hair transplantation, exploits a phenomenon first described within the 1950s. This phenomenon, donor dependence refers to the observation that hair-bearing tissue, when relocated to a previously balding area of an equivalent person's scalp, continues to supply viable, vigorously hair that persists in its new location because it otherwise would, had it not been "relocated".
There are important caveats to hair transplantation. the primary concerns supply and demand. At this time, one might not transplant hair from one person to a different without causing a florid and destructive foreign body response within the recipient. Thus, both the operator and patient are relegated to whatever permanent hair-bearing tissue is in situ. Accordingly, it's highly important to conserve and strategically place this precious resource appropriately.
The second major caveat of hair transplantation relates to achieving beneficial results. A hairline that's spotty or too abrupt may look worse than it did before it had been restored. By an equivalent token, hair behind the vanguard that's not restored during a fashion that yields meaningful density (e.g. 1 hair per mm/sq) often fails to approximate a full head of hair. Therefore, in selecting a transplant surgeon, artistic excellence is a minimum of equal importance to basic surgical skills.
The third caveat to hair transplantation refers to a drag referred to as chasing a receding hairline. Because hair loss is progressive and relentless, it's possible that the donor's hair restored integrated into an apparently intact area of scalp hair may find yourself as an island of hair because the hair behind it continues to erode. during this situation, patients are compelled to reinforce hair behind the restoration zone so as to retain a full appearance. This works well until the hair stops thinning.
Ideally, for persons undergoing transplant surgery, it might be helpful to include a treatment option that safely and effectively arrested the progression of hair loss, allowing the treating surgeon to fill within the thin areas without the priority of chasing a receding hairline.
Drug-based Hair Loss Treatment Options
From a treatment perspective, the 2 most generally used therapeutic interventions against pattern hair loss are topical minoxidil and oral finasteride.
Minoxidil
Minoxidil, first sold under the trade-name Rogaine(TM) was initially developed because of the oral antihypertensive, Loniten(TM). In some patients who used minoxidil to treat vital sign problems, it had been observed that unusual hair growth occurred on the face and scalp. This was somewhat colloquially mentioned because of the werewolf effect. >From this observation, topical compositions containing minoxidil were successfully tested on balding scalps. Rogaine(TM) (2% minoxidil) was the primary hair loss treatment drug approved by the FDA to be used in men. Eventually, Rogaine(TM) (2% minoxidil) was approved to be used in women. Extra Strength Rogaine(TM) (5% minoxidil) was approved by the FDA to be used solely in men.
The advantages of Rogaine(TM) include the power to arrest, and possibly reverse pattern hair loss. supported Pfizer's own marketing materials, Rogaine(TM) has primarily been shown to be effective in treating hair loss within the vertex and posterior scalp, but not the anterior hairline. Minoxidil may be a potent drug with potential side effects that include hypotension and skin irritation.
Finasteride
Finasteride, a selective type II 5-alpha reductase inhibitor was originally developed, in 5 mg oral dosage, under the brand name Proscar(TM) to treat benign prostatic hyperplasia (BPH). Because BPH is linked biochemically to equivalent metabolic pathways that trigger pattern hair loss, it had been hypothesized that finasteride might be clinically useful in both pathologies. From this work, Propecia(TM) (1 mg finasteride) was developed. In placebo-controlled studies on men with mild to moderate hair loss, Propecia(TM) was shown to supply clinically relevant benefits in arresting, and in some cases, reversing the progression of the disorder. Propecia(TM) isn't indicated to be used in women. Noted side effects include reduced libido, also as reduced ejaculate volume. Gynecomastia (male breast enlargement) is another potential side effect. Finasteride also can artificially lower the amount of a key protein (PSA) wont to screen for prostatic adenocarcinoma. Finasteride is taken into account a teratogen (may cause feminizing birth defects) and will not be handled by pregnant women or maybe those persons who may inherit contact with pregnant women.
At this time, dutasteride is approved to treat BPH. Potential side effects noted with the utilization of dutasteride include gynecomastia, changes to PSA levels, teratogenic effects et al. that closely parallel the negative side effect profile described by the manufacturers of finasteride.
In December 2006, GlaxoSmithKline began a replacement phase III clinical trial, a six-month study in Korea to check the security, tolerability, and effectiveness of a once-daily dose of dutasteride (0.5mg) for the treatment of AGA within the vertex region of the scalp (types IIIv, IV and V on the Hamilton-Norwood scale). the longer-term impact that this study will wear the FDA's approval or disapproval of Avodart for the treatment of male pattern baldness within us is yet to be determined.
Other Drugs
On occasion, but specifically in female patients drugs including spironolactone & flutamide have, once in a while been used off-label to treat various sorts of hair loss. Each drug comes with a number of potential side effects, and none has been approved by the FDA for the treatment of pattern hair loss.
Non-drug based Hair Loss Treatment Options
botanically derived substances have come under serious investigation as potentially useful tools against AGA. This effort has been largely pioneered by the manufacturers of HairGenesis(TM). After the creation of HairGenesis(TM) variety of other products came on the market. Some incorporated drugs like minoxidil. Others used variations on the theme of non-drug based formulations. However, apart from HairGenesis(TM), none has been supported with a 3rd party, IRB monitored, placebo-controlled, test study--published within the peer-reviewed medical literature. This makes HairGenesis(TM) unique within the category. For those wishing to ascertain how HairGenesis(TM) is assumed to match to other hair loss treatment options, a review of the HairGenesis(TM) Comparison Page is inspired.
Inasmuch because the bulk of this website focuses on the advantages related to HairGenesis(TM), the various points in favor of HairGenesis(TM) treatment won't be reiterated herein. Two points are relevant to this discussion, however, and can be concisely articulated.
First, the complex of naturally derived active substances utilized in HairGenesis(TM) are shown to work through pathways and mechanisms that are unique form each other, also as separate and aside from those within which drug-based treatments work. Suffice to mention that this observation has presented a singular opportunity to develop HairGenesis into a "cocktail" treatment wherein formulation synergy would presumably occur.
In plain English, this suggests that HairGenesis(TM) has been designed to be greater than the sum of its parts.
The second key point is that research is actively underway by the manufacturers of HairGenesis(TM) to develop new, more advanced and stronger, versions. Such improvements are going to be reported as appropriate.
In December 2006, GlaxoSmithKline began a replacement phase III clinical trial, six-month study in Korea to check the security, tolerability and effectiveness of a once-daily dose of dutasteride (0.5mg) for the treatment of AGA within the vertex region of the scalp (types IIIv, IV and V on the Hamilton-Norwood scale). the longer-term impact that this study will wear the FDA's approval or disapproval of Avodart for the treatment of male pattern baldness within us is yet to be determined.
Other Drugs
On occasion, but specifically in female patients drugs including spironolactone & flutamide have, once in a while been used off-label to treat various sorts of hair loss. Each drug comes with a number of potential side effects, and none has been approved by the FDA for the treatment of pattern hair loss.
Non-drug based Hair Loss Treatment Options
Recently, botanically derived substances have come under serious investigation as potentially useful tools against AGA. This effort has been largely pioneered by the manufacturers of HairGenesis(TM). After the creation of HairGenesis(TM) variety of other products came on the market. Some incorporated drugs like minoxidil. Others used variations on the theme of non-drug based formulations. However, apart from HairGenesis(TM), none has been supported with a 3rd party, IRB monitored, placebo-controlled, test study--published within the peer-reviewed medical literature. This makes HairGenesis(TM) unique within the category. For those wishing to ascertain how HairGenesis(TM) is assumed to match to other hair loss treatment options, a review of the HairGenesis(TM) Comparison Page is inspired.
Inasmuch because the bulk of this website focuses on the advantages related to HairGenesis(TM), the various points in favor of HairGenesis(TM) treatment won't be reiterated herein. Two points are relevant to this discussion, however, and can be concisely articulated.
First, the complex of naturally derived active substances utilized in HairGenesis(TM) are shown to work through pathways and mechanisms that are unique form each other, also as separate and aside from those within which drug-based treatments work. Suffice to mention that this observation has presented a singular opportunity to develop HairGenesis into a "cocktail" treatment wherein formulation synergy would presumably occur.
In plain English, this suggests that HairGenesis(TM) has been designed to be greater than the sum of its parts.
The second key point is that research is actively underway by the manufacturers of HairGenesis(TM) to develop new, more advanced and stronger, versions. Such improvements are going to be reported as appropriate.
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