Baldness

Baldness: What it is and what it isn't

Baldness, better known as alopecia, is a condition (not a disorder) characterized by progressive thinning of the scalp. In its most common form (androgenic baldness), alopecia affects 80% of males and 50% of females at various levels, thus representing a topic of great interest both from a scientific and a commercial point of view.
Baldness can affect both sexes and the most common form, which mostly affects the male sex, is defined androgenic (or androgenetic).

Androgenetic alopecia

Androgenic alopecia - also known as hereditary genetic baldness - it is often but not constantly accompanied by seborrhea and furfuraceous desquamation.

In the initial phase, it manifests itself with a receding hairline or progressive frontal thinning and at the apex of the head, up to the alopecic involvement of the entire upper part of the scalp, with typical sparing of the nape and temporal areas above the ear. phenomenon has been codified in the Hamilton scale, with a numbering ranging from 1 (no trace of alopecia) to 7 (alopecia extended to the entire vertex and to the frontotemporal region).

Attention! This is NOT a real "loss" of the hair, but rather a structural modification of it; in practice, in androgenetic alopecia the follicles remain anchored in the scalp for a long time BUT they progressively atrophy, slowing down their life cycle, superficializing and making the stem increasingly shorter, soft and depigmented, until it becomes invisible (from terminal hair to hair of the vellus).

Telogenic Cavitias

Another form of baldness is that telogenic (more technically telogenic alopecia - telogen defluvium), which can be considered a reflection (or a symptom) of the organism to one or more particularly stressful agents, both for the body and for the mind; telogenic baldness affects proportionally more women than men BUT fortunately it is a REVERSIBLE condition.

Other forms of baldness

There are also other forms of baldness, such as those linked to infectious or medicinal agents (use of particular drugs, such as antithyroid, anorexants, hypervitaminosis A ...); then we must remember the forms of circumscribed baldness ("patchy") such as "alopecia areata or cicatricial alopecia.

Curiosity: the term alopecia derives from the Greek alopex, which means fox. This term was intended to emphasize the similarity to this animal which is known to lose its hair twice a year.

Female Baldness

As anticipated, androgenic baldness can also affect women, albeit with a different distribution of thinning. In both sexes, the incidence increases with age and is influenced by alterations in the steroid hormonal axis; in particular, it often occurs in parallel with a higher level of typically androgenic hormones (especially dihydrotestosterone) and / or in the presence of higher enzymatic concentrations of 5-α-reductase (enzyme that determines the amount of dihydrotestosterone in circulation).

Even if the etiological causes of androgenic baldness are not yet fully known, it is however conceivable that it may be the result of:

An increase in dihydrotestosterone levels (hence the term "andro-"), associated with a "genetic receptor hypersensitivity of the hair bulb to their action (hence the term" -genetics ")
An imbalance between the phases of growth (anagen) and those of involution (catagen) and rest (telogen)
An "inflammation of the scalp

Symptoms and Classification

Androgenic baldness occurs slightly differently between males and females; statistically, in men it mainly affects the temples, while in women it mainly affects the nape of the neck.

Cures and Treatments

The treatment of baldness it depends above all on the etiological cause: in "telogenic alopecia" it is often sufficient to remove the causes of stress to achieve an almost total remission.

On the contrary, in androgenic alopecia it is not possible to obtain the same results; in the male one, some drugs are applied with partial or uncertain outcome (depending on the specific case), including minoxidil(topical use) and finasteride (per os); in women drugs such as the antiandrogen spironolactone, cyproterone or the contraceptive pill are used. It is possible to limit the systemic side effects of these drugs by solubilizing some active ingredients in special lotions, to be applied directly to the scalp; this is the case of estrone sulphate (more indicated in women, however risky for men) or topical inhibitors of 5-alpha-reductase (such as Alfatradiol, however risky for women of childbearing age).

The sooner you intervene on the follicle miniaturization process, the greater the chances of stopping androgenetic baldness. The chances of therapeutic success are lower the earlier the onset of the first signs of baldness is; in other words, a male subject who already after adolescence begins to "lose his hair", in the current state of science has very few possibility of stopping the phenomenon.

There are also some natural remedies that can be useful in stopping androgenic baldness.

In case of advanced alopecia, pharmacological treatment is not recommended because it is ineffective in most cases; in this case, alternative thickening practices or hair auto-transplantation (surgical redistribution of hair bulbs) are recommended.