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The Mars and Venus of Hair Loss!

  • 21st May 2018
  • 493

If there is one problem that seems to be ubiquitous and equally troubling to both sexes, it is hair loss. However, the way hair loss occurs in men differs slightly from the way it afflicts women, both physiologically and emotionally. Let us look at some of the significant differences in the way men and women lose hair.

Hair Loss in Men: When we think of hair loss in men, the predominant impression is one of balding. This is scientifically known as Androgenic Alopecia or Male pattern hair loss. Both are fairly descriptive titles, with androgenic underscoring the role of male hormones, notably dihydrotestosterone or DHT and pattern signifying the classic pattern in which men lose hair.

When DHT binds to certain receptors in the hair follicles of the scalp it causes them to shrink. Over time, this results in the production of hair that is both shorter and finer than before. Eventually, the affected scalp follicles go from producing large, thick, pigmented terminal hairs to thinner, shorter, indeterminate hairs and finally to short, wispy, non-pigmented vellus hairs before they ultimately stop producing hair altogether.

While this reaction to DHT is almost always present in cases of male pattern hair loss, it is sometimes noticeably absent in female cases, suggesting that more research needs to be done before the underlying cause of female pattern baldness can be conclusively determined. The most obvious difference is, however, the physical appearance and progress of the hair loss. In men, the pattern begins at the hairline. Hair loss at the temples causes the hairline to gradually move backward, or recede, to form an “M” shape. As the hair becomes finer, shorter, and thinner, hair loss increases at the crown, eventually leaving only a U-shaped (or horseshoe) pattern of hair around the sides of the head. This has been graded by various scales including the most often used Hamilton Norwood scale

Hair Loss in Women: Hair loss in women is almost always of two types and occasionally a combination of the two. The shedding type of hair loss, also known as telogen effluvium, descriptively refers to the shedding of the hair from a follicle in the shedding phase or the telogen phase. This can happen due to a multitude of causes that include poor nutrition, stress or following any other major illness. This disorder, while debilitating psychologically, is often self limiting and responds well to treatment.

The second common type of hair loss in women can also be referred to as androgenic alopecia or female pattern hair loss. While there are similarities with this variant and the male pattern hair loss, there are also significant differences. Women, generally lose hair diffusely over the crown of the head, producing a gradual thinning of the hair rather than an area of marked baldness. This usually begins with a widening of the midline part in the centre, which leaves very good density in the back and fairly good density on the sides while preserving the frontal hairline. If left untreated, the thinning often spreads to the side areas of the scalp in the temples and above the ears, but it is very rare for women to experience complete baldness. This has been well outlined in the often followed Ludwig scale, where there are three stages from diffuse thinning to widespread thinning that are described. Of course, not everyone is the same, and different people may exhibit different patterns of hair loss.

Also, while women do have trace amounts of testosterone, the influence of female hormones like estrogen, progesterone and non sex hormones like thyroxin also play a role. Given the stages of a woman’s menstrual history, events like pregnancy and menopause also play a role in hair loss.

Some common factors like poor nutrition, inter current illness, genetics and stress are gender neutral may contribute to hair loss in both sexes and are perceived to be gender neutral. The important message, of course, is that all hair loss is not the same and it makes sense to seek expert help in order to understand and treat your specific type of hair loss effectively.

Men

  • Male Pattern
  • Hamilton scale
  • DHT major role
  • Can result in complete hair loss
  • Response to treatment predictable and good

Women

  • Female Pattern and Telogen Effluvium
  • Ludwig Scale
  • DHT role still being studied
  • Rarely results in complete hair loss
  • Response to treatment unpredictable

– Dr. Aparna Santhanam, Consultant, Livon Hair Gain

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