Baldness Causes and Treatment On first blush, hair loss may seem more like an issue for self-image

rather than wellness. But the causes of baldness can have real healthcare implications. All of us shed hair on a daily basis. At times the hair goes into a resting or non-growth period, and can fall out naturally at that time. High rate of hair loss with progressive baldness is not part of the normal hair growth cycle. Male-pattern baldness is by far the most common form of hair loss in men. Typically, this occurs over years and the onset is frequently not noticed. Male-pattern baldness is inherited from either your mothers or fathers side of the family. The pattern typically begins as an M shaped receding hairline at the forehead and temples. Over time this can progress to involve much of the central area of the scalp. Male pattern baldness can affect both men and women. The cause is both genetic and related to increased levels of certain male hormones. Specifically a hormone called dihydrotestosterone (DHT) which is created as testosterone is changed in the body to a less active form. DHT is the hormone which is thought to cause enlargement of the prostate gland as well. One medicine originally used to help treat prostate enlargement, finasteride (Propecia), has been shown to help treat male pattern baldness. But be aware, this medication has been associated with loss of libido and sexual dysfunction in some men. Similar to the drug finasteride, the herb saw palmetto has been shown to decrease the activity of the enzyme that helps make the change from testosterone to DHT go faster. Saw palmetto has been used to treat benign growth of the prostate, but no clear evidence has shown it to be of benefit for hair loss. Theoretically, saw palmetto will bring a similar type of benefit. Because prostate enlargement may have some relationship to prostate cancer, some researchers in Australia looked into the possible connection between baldness and prostate cancer. Their study involved nearly 3000 men.i The researchers found a definite association between baldness at the very top of the head and the development of prostate cancer. So if you happen to have this type of baldness, you will want to be aware of the potential increased risk you may have for the development of prostate cancer. Other forms of baldness, while common, are not so specific to men. Alopecia areata is a common form of baldness that affects small areas of the scalp. The exact cause is unknown, but typically will occur as dime or quarter size circles of hair loss in one or two areas of the scalp. This disorder tends to affect children more frequently than adults, and can be similar to fungal infections of the scalp. Your primary healthcare provider can be helpful in many cases. Temporary hair loss, called telogen effluvium occurs when the body undergoes certain kinds of stresses. During or after the period of stress, a large amount of hair can be lost from the

whole scalp. This type of hair loss is usually short-lived, and the scalp returns to normal after the stressful period. Types of stress that can cause this type of hair loss include: Fever Emotional stress or grief Severe illness Surgery

Infrequent causes of hair loss may be related to hormone changes like low thyroid, or diabetes; or from situations where the hair gets chronically pulled, as in an emotional condition called trichotillomania. In this disorder, anxiety occurs which is relieved by twisting and wrapping the hair around a finger. Over time, small spots of baldness begin to occur, which can expand in size if the problem is not managed correctly. Options for treatment include some of the medicines and herbs listed above. Additionally, the drug minoxidil (Rogaine) has been used. Minoxidil is a medicine for high blood pressure that was associated with hair growth as a side effect. Because of this effect, a topical form was developed specifically for hair loss. The blood pressure lowering effect is lessened because the topical form contains less of the medicine. Some dietary supplements may also be helpful. Silica is a trace mineral that is one of the important chemical ingredients in hair formation. Some integrative physicians feel that silica deficiency due to poor quality food can lead to more breaking of hair and hair loss. There is no recommended dosing of silica, but you might consider using the herb horsetail, also called equisetum, which has a high amount of silica. B vitamins, vitamin D, and Iron may also have some importance in maintaining healthy hair growth. Additionally, some integrative providers also recommend adequate intake of zinc and selenium which are powerful antioxidants to help slow the aging process. More aggressive approaches to hair loss include surgical options. The most common surgical technique is through transplantation of hair from other parts of the body. These procedures can often been involved and expensive, but can produce an excellent result when done properly. You have many options in dealing with baldness. Please remember that the causes of baldness need to be explored to ensure you do not have any underlying hormone disorders. Your primary healthcare provider is an excellent resource for helping you determine if there is any additional problem.

Graham G. Giles, Gianluca Severi, Rod Sinclair, Dallas R. English, Margaret R. E. McCredie, Warren

Johnson, Peter Boyle, and John L. Hopper. Androgenetic Alopecia and Prostate Cancer: Findings from an Australian Case-Control Study. Cancer Epidemiol Biomarkers Prev June 2002 11; 549.

This is an original work authored by Todd A. Hoover, MD, DHt.