Common Baldness
This type of baldness is dependent on the male sex hormones and heredity. It is inherited from the parents and most people who manifest male-type baldness inherit this tendency from the father or the mother. Sometimes the father may not manifest the baldness but other male members in the father’s family may have this type of baldness. The member manifesting the male-type baldness may be the father, the father’s brothers or the paternal grandfather. On the other hand, the tendency may have been inherited from the mother but since females do not manifest this type of baldness, the affected members in the mother’s family are likely to be the mother’s brothers and the maternal grandfather. The other members having the baldness may be the patient’s brothers. Thus, the presence of male members having baldness among the family members on the paternal and/or the maternal side is enough indication that the person may have inherited the tendency for this type of baldness.
This type of baldness does not however, manifest itself before the age of puberty because it is dependent on the male sex hormones, which are produced only after puberty. Under the influence of these hormones the coarse and long hairs on the scalp are progressively replaced by finer and shorter hairs. With time, the person tends to have less and less coarse hairs. It is interesting to know that the same male sex hormones are responsible for the growth and maintenance of coarse hairs on the moustache and the beard, and all over the body, but on the scalp they become responsible for the loss of hair.
The maximum effect of these hormones is on a specified area of the scalp-the frontal and the parietal regions. This leads to a backward recession of the frontal hair-line with widening of the forehead and a decrease in the number of hairs on the central part of the top of the head. A circular area on the upper part of the back of the head also starts becoming bald and both these areas ultimately merge with each other. In its severest form, the central part of the head, from the frontal region to the back of the head may become completely devoid of hair but still, the person maintains a rim of hair along the sides and the back of the head. This type of baldness does not lead to loss of all the hairs on the entire scalp.
Treatment
A variety of shampoos and hair oils are being marketed for preventing baldness and many of them are based on ayurvedic formulations, but, most of these products have never been subjected to unbiased scientific evaluation. Claims of success on their usage are based on misconcepts and ignorance. The truth is that no shampoo can lead to baldness (hair loss) or to growth of hair. There is only one medical product, which has been confirmed to lead to growth of hair and to interfere with the progression of the male type of baldness. This preparation is based on minoxidil, which is used for treating hypertension and was found to lead to growth of hairs in patients under treatment with this drug. It is now available in the form of a 2 per cent solution for topical use. It has to be used in a proper quantity and in a proper manner to obtain the maximum benefit-l ml of the solution is to be applied and massaged into the skin twice a day.
The hair should be shampooed daily or as frequently as possible. The medicine is a pplied after the shampoo in the morning, and again at night without shampooing the hair. The use of hair oils has to be strictly prohibited. In addition, one has to remember that a hair which falls today was ordained to do so some three months previously. Thus, the number of hairs which have to fall off during the next three months has already been decided when the treatment is initiated. Thus, it would be futile to expect any results within the first three months. And since the medicine cannot be effective on the very first day of the treatment, it is advisable to assess the first results only after a minimum period of six months. After six months the rate of loss of hair should decrease to the normal level so that the baldness does not increase further.
Regrowth of the hairs or rather the conversion of fine hairs into coarse hairs can take a year or two. This will however, depend upon whether the root of the hair is still preserved or it has already been destroyed. In areas where the hair roots have been de stroyed, the hair cannot be expected to regrow. We usually recommend patients to get close-up photographs of the scalp hair and compare the degree of baldness at one-yearly intervals when the new hairs may become visible in the areas of baldness. Needless to say that success of the treatment depends on the regularity of the use of the medicine. The medicine has to be continued routinely throughout the rest of his life or as long as the hair are important to him because whenever the treatment is interrupted, the process of balding will start all over again.
There are by and large, no oral medicines available so far, which can control or reverse the process of baldness. Recently, an anti-androgen medicine, by the name of Finasteride, has been developed which can counter the effect of excess male hormones. The drug however, has to be used under medical supervision only.
Filed under: Diseases & Conditions