- Reaction score
- 42
Nowadays we have overwhelming evidence for what causes male pattern balding: the direct, suppressive influence of androgens on human scalp follicles is a prime factor in this condition. But in past decades, there were a few rather unusual alternative theories which were popular for a while. They include the following supposed explanations for thinning (I won't elaborate on any of them, I'll just mention them briefly):
1) The "galea theory" and its ramifications.
2) A decreased blood supply to the scalp (tight-fitting hats, for example).
3) An increased tension of scalp muscles.
Last but not least, the most recent of these alternative theories would be the notorious one associated with my friend Stephen Foote:
4) Contact inhibition from scalp edema stunting the growth of follicles.
All of these oddball theories were soundly refuted with the advent of modern hair transplantation, which proved that hair follicles continue to grow (or go bald, for that matter), even if they are moved to other locations around the body. In other words, they display "donor dominance", regardless of whether or not they're located in an area of edema, tension, poor blood supply, etc. I recently came across a study which examined and proved this phenomenon even more thoroughly and convincingly than Orentreich did in his original hair transplantation experiments in 1959. This would be: "Synchronous Balding of Scalp and Hair-bearing Grafts of Scalp Transplanted to the Skin of the Arm in Male Pattern Baldness", Rolf E. A. Nordstrom, Acta Derm Venereol 1979; 59: 266-268. I'm now going to type out part of this important study right here, so that everyone can judge the plausibility of these alternative theories for themselves. Certain very important sentences I have placed in bold text:
Abstract. The author transplanted composite skin grafts from balding, non-balding, and bald areas of the scalp, to the skin of the arm. The galea aponeurotica was trimmed away from the grafts. The patient was a 29-year-old male with progressive male pattern baldness (male pattern baldness).
The transplants from the balding area became bald at the same rate as the balding donor site in the receding frontal hairline, whereas the transplants taken from the non-balding in the occiput continued to grow the same amount and quality of terminal hairs. Bald grafts taken in front of the receding hairline remained bald. This shows that the cause of male pattern baldness lies in the follicle itself or in its very close surrounding and does not depend on the galea aponeurotica, the increased tension of the scalp or of its muscles; the diminished vascular supply to the scalp or any other regional factor localized to the head area. It also shows that the "balding clock" keeps time even when the follicle is transplanted to another region of the body.
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MATERIAL AND METHODS
Hair transplantation with the punch graft method was performed on a 29-year-old male with a receding hairline due to progressive male pattern baldness. 1 cm behind the receding hairline, two tattoo marks were placed and between these a 4-mm diameter hair-bearing composite punch skin graft with subdermal fat and hair follicles was taken following the procedure described by the author. In the same way, two additional grafts were taken; one 1 cm in front of the receding hairline (which since the 20th year of life had already receded about 4 cm), and one from the occipital region, unaffected by male pattern baldness. The galea aponeurotica and excess fat under the follicles were trimmed away. These grafts were transplanted to the forearm.
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RESULTS
The hairs in the hair-bearing grafts gradually fell off over a couple of weeks and started to grow again after about 3 months as is normally seen in punch hair grafting.
5, 10 and 21 months after transplantation the numbers of hairs in the transplants were counted. The grafts were then excised for histological examination. In the graft taken from the occipital region the number and macroscopical quality of the hairs remained unchanged, whereas in the graft taken from between the tattoo marks placed 1 cm behind the receding hairline, the number of hairs diminished rapidly and the hairs grew macroscopically much thinner. The hair at the level of the tattoo marks in the receding hairline became much more sparse and the distance to the hairline had diminished to about 2 mm. The graft from the denuded area...remained bald.
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DISCUSSION
In the receding hairline and in the graft taken from it the loss of hairs remains synchronous even though the latter is translplanted to a remote skin area. In male pattern baldness the "balding clock" in the follicle or in its very close surrounding keeps time even when the follicle is transplanted to the skin of the forearm. The presence or absence of the galea aponeurotica does not influence the balding process in male pattern baldness. Nor does any supposed increased tension of the scalp or its muscles or a diminished vascular supply to the scalp have an effect on balding. Neither do any other factors localized to the head cause balding. The cause seems to lie in the follicle itself or its very close surrounding. The graft taken from the denuded area did not grow new hairs, and so the male pattern baldness process of the hair follicle is not reversed by a change in its location on the human body.
Graft #1: from non-balding occipital scalp
Graft #2: from bald follicles 1 cm in front of hairline
Graft #3: from thinning follicles 1 cm behind hairline
Table 1. Number of hairs in each transplant
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Graft number................................... 1 .. 2 .... 3
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5 months after transplantation..... 13 .. 0 ... 12
10 months after transplantation... 13 .. 0 ... 10
21 months after transplantation... 14 .. 0 ..... 4
1) The "galea theory" and its ramifications.
2) A decreased blood supply to the scalp (tight-fitting hats, for example).
3) An increased tension of scalp muscles.
Last but not least, the most recent of these alternative theories would be the notorious one associated with my friend Stephen Foote:
4) Contact inhibition from scalp edema stunting the growth of follicles.
All of these oddball theories were soundly refuted with the advent of modern hair transplantation, which proved that hair follicles continue to grow (or go bald, for that matter), even if they are moved to other locations around the body. In other words, they display "donor dominance", regardless of whether or not they're located in an area of edema, tension, poor blood supply, etc. I recently came across a study which examined and proved this phenomenon even more thoroughly and convincingly than Orentreich did in his original hair transplantation experiments in 1959. This would be: "Synchronous Balding of Scalp and Hair-bearing Grafts of Scalp Transplanted to the Skin of the Arm in Male Pattern Baldness", Rolf E. A. Nordstrom, Acta Derm Venereol 1979; 59: 266-268. I'm now going to type out part of this important study right here, so that everyone can judge the plausibility of these alternative theories for themselves. Certain very important sentences I have placed in bold text:
Abstract. The author transplanted composite skin grafts from balding, non-balding, and bald areas of the scalp, to the skin of the arm. The galea aponeurotica was trimmed away from the grafts. The patient was a 29-year-old male with progressive male pattern baldness (male pattern baldness).
The transplants from the balding area became bald at the same rate as the balding donor site in the receding frontal hairline, whereas the transplants taken from the non-balding in the occiput continued to grow the same amount and quality of terminal hairs. Bald grafts taken in front of the receding hairline remained bald. This shows that the cause of male pattern baldness lies in the follicle itself or in its very close surrounding and does not depend on the galea aponeurotica, the increased tension of the scalp or of its muscles; the diminished vascular supply to the scalp or any other regional factor localized to the head area. It also shows that the "balding clock" keeps time even when the follicle is transplanted to another region of the body.
-----------------------------------------------------------------------
MATERIAL AND METHODS
Hair transplantation with the punch graft method was performed on a 29-year-old male with a receding hairline due to progressive male pattern baldness. 1 cm behind the receding hairline, two tattoo marks were placed and between these a 4-mm diameter hair-bearing composite punch skin graft with subdermal fat and hair follicles was taken following the procedure described by the author. In the same way, two additional grafts were taken; one 1 cm in front of the receding hairline (which since the 20th year of life had already receded about 4 cm), and one from the occipital region, unaffected by male pattern baldness. The galea aponeurotica and excess fat under the follicles were trimmed away. These grafts were transplanted to the forearm.
-------------------------------------------------------------------------
RESULTS
The hairs in the hair-bearing grafts gradually fell off over a couple of weeks and started to grow again after about 3 months as is normally seen in punch hair grafting.
5, 10 and 21 months after transplantation the numbers of hairs in the transplants were counted. The grafts were then excised for histological examination. In the graft taken from the occipital region the number and macroscopical quality of the hairs remained unchanged, whereas in the graft taken from between the tattoo marks placed 1 cm behind the receding hairline, the number of hairs diminished rapidly and the hairs grew macroscopically much thinner. The hair at the level of the tattoo marks in the receding hairline became much more sparse and the distance to the hairline had diminished to about 2 mm. The graft from the denuded area...remained bald.
------------------------------------------------------------------------
DISCUSSION
In the receding hairline and in the graft taken from it the loss of hairs remains synchronous even though the latter is translplanted to a remote skin area. In male pattern baldness the "balding clock" in the follicle or in its very close surrounding keeps time even when the follicle is transplanted to the skin of the forearm. The presence or absence of the galea aponeurotica does not influence the balding process in male pattern baldness. Nor does any supposed increased tension of the scalp or its muscles or a diminished vascular supply to the scalp have an effect on balding. Neither do any other factors localized to the head cause balding. The cause seems to lie in the follicle itself or its very close surrounding. The graft taken from the denuded area did not grow new hairs, and so the male pattern baldness process of the hair follicle is not reversed by a change in its location on the human body.
Graft #1: from non-balding occipital scalp
Graft #2: from bald follicles 1 cm in front of hairline
Graft #3: from thinning follicles 1 cm behind hairline
Table 1. Number of hairs in each transplant
-------------------------------------------------------------
Graft number................................... 1 .. 2 .... 3
-------------------------------------------------------------
5 months after transplantation..... 13 .. 0 ... 12
10 months after transplantation... 13 .. 0 ... 10
21 months after transplantation... 14 .. 0 ..... 4