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The existence of the Norwood hair loss pattern and the fact that it has not yet been possible to develop drugs that completely "cure" pattern hair loss or prevent it from occurring in the first place suggest that anatomy may play an important role in the development of hair loss.
Looking at the facial and masticatory muscles, it seems obvious at first glance that these (in combination with the galea aponeurotica) are the decisive component. However, just because a connection seems obvious at first glance does not mean that there is a connection – just as there is no connection between wearing a cap and pattern hair loss, even though a connection seems obvious at first glance.
Visualisation of the facial and masticatory muscles in the faces of men with pattern hair loss:
Figure 1,2: Hair loss pattern and location of the facial and masticatory muscles, the galea aponeurotica and potential tension pattern (markings)
Figure 3,4: Norwood hair loss pattern and facial and masticatory muscles
Hypothesis on the effects of muscle tension:
As can be seen in the Dissection photos (Figure 5,6), blood vessels supplying the scalp penetrate the facial and masticatory muscles. If the facial and masticatory muscles are chronically tense or hardened, this can put pressure on the blood vessels and impair blood flow. This can lead to stagnation or slowing of the blood flow. If the veins and thinner venules that carry blood away from the scalp are in particular continuously squeezed by the facial and masticatory muscles, this would lead to an accumulation of metabolic and waste products in the scalp, which may be the cause of a degeneration process that is said to lead to pattern hair loss.
Figure 5,6: Dissection: Blood vessels that penetrate the facial and masticatory muscles (?)
This hypothesis would imply the following:
The following investigations could be carried out to refute the hypothesis:
Hypotheses on the cause of the chronic tension
The following 4 hypotheses show possible causes for the described chronic tension of the facial and masticatory muscles, which is assumed to be the cause of pattern hair loss.
Hypothesis A – Craniofacial development:
Simplified summary: Genetic factors and an unsuitable diet lead to poor craniofacial development. The consequences include chronically tense facial and masticatory muscles. If the skull is not developed symmetrically, for example, this can affect the position and functionality of the facial muscles. Such asymmetry can lead to certain muscles being overactive or overused, while others are underactive or weakened. The overactivated facial muscles must constantly work to compensate for the imbalances. This can lead to chronic tension and tightness.
Figure 7: Examples of craniofacial development
Figure 8: Effects of asymmetric craniofacial development on the function of the facial and masticatory muscles (?)
Related/original hypothesis:
https://tmdocclusion.com/home/connection-to-other-diseases-and-syndromes/hair-loss/
https://tmdocclusion.com/2018/07/14/more-on-hair-loss/
Hypothesis B – Stimulus-response pattern (conditioning):
Simplified summary: Due to interpersonal mimic and verbal interaction, humans are conditioned since birth to have their facial expressions under control so as not to provoke unwanted/wrong interpretations and associated reactions from their fellow humans. This results in a stimulus-response pattern, which results in chronic tension of the facial and masticatory muscles.
Figure 9: Compilation to illustrate the importance of facial features as a tool for interaction and identification
Related/original hypothesis: https://open.substack.com/pub/user2...-is?r=288hhe&utm_campaign=post&utm_medium=web
Hypothesis C – Malocclusion:
Simplified summary: Malocclusion results in a continuous malposition of the lower jaw. This results in chronic tension of the masticatory muscles and parts of the mimic musculature.
Figure 10: Chronic tension of the facial and masticatory muscles due to malocclusion (?)
Related/original hypothesis:
Hypothesis D – Skull shape:
Simplified summary: The shape or expansion of the skull leads to chronic tension in the facial and chewing muscles.
Figure 11: Skull shape and Expansion
Disproving the Hypotheses:
It would be helpful to show how the hypotheses mentioned can be disproved and which studies would be necessary/suitable for this. If the proponents of a hypothesis are of the opinion that a disproof is not possible, they should explain why this is not possible.
Looking at the facial and masticatory muscles, it seems obvious at first glance that these (in combination with the galea aponeurotica) are the decisive component. However, just because a connection seems obvious at first glance does not mean that there is a connection – just as there is no connection between wearing a cap and pattern hair loss, even though a connection seems obvious at first glance.
Visualisation of the facial and masticatory muscles in the faces of men with pattern hair loss:
Figure 1,2: Hair loss pattern and location of the facial and masticatory muscles, the galea aponeurotica and potential tension pattern (markings)
Figure 3,4: Norwood hair loss pattern and facial and masticatory muscles
Hypothesis on the effects of muscle tension:
As can be seen in the Dissection photos (Figure 5,6), blood vessels supplying the scalp penetrate the facial and masticatory muscles. If the facial and masticatory muscles are chronically tense or hardened, this can put pressure on the blood vessels and impair blood flow. This can lead to stagnation or slowing of the blood flow. If the veins and thinner venules that carry blood away from the scalp are in particular continuously squeezed by the facial and masticatory muscles, this would lead to an accumulation of metabolic and waste products in the scalp, which may be the cause of a degeneration process that is said to lead to pattern hair loss.
Figure 5,6: Dissection: Blood vessels that penetrate the facial and masticatory muscles (?)
This hypothesis would imply the following:
- Excessive tension of the scalp is not the cause of pattern hair loss.
- The extent of the accumulation of metabolic and waste products (the alleged cause of pattern hair loss) in a scalp region depends on the length of the supplying blood vessel squeezed by the facial and masticatory muscles and on the intensity of the squeezing of the blood vessels. The lower half of the head (including eyebrows and beard hair) is not affected by hair loss because the atrial and venous network is still too extensive up to these regions of the scalp and the extent of squeezing is not yet sufficient to produce the extent of a metabolic disorder that leads to hair loss.
- Heavy bleeding of the scalp reported by surgeons after an incision would say nothing about the quality and quantity of blood flow to the scalp if it is assumed that the problem is an obstruction to the outflow of blood from the scalp in the lower part of the head.
The following investigations could be carried out to refute the hypothesis:
- Dissection: Review existing literature and perform targeted Dissection to show that the described mechanism of blood vessel squeezing by facial muscles and masticatory muscles does not exist or that it has no influence on the quality and quantity of blood flow to the scalp.
- Doppler ultrasound: A doppler ultrasound can be used to monitor blood flow in veins and venules and detect any changes. This non-invasive examination method uses sound waves to detect blood flow and visualise possible abnormalities such as stagnation or slowing of the blood.
- Laser Doppler flowmetry: This method makes it possible to measure the blood flow in small blood vessels. By using laser light, the speed of blood flow in the veins and venules of the scalp can be measured to detect changes or abnormalities.
Hypotheses on the cause of the chronic tension
The following 4 hypotheses show possible causes for the described chronic tension of the facial and masticatory muscles, which is assumed to be the cause of pattern hair loss.
Hypothesis A – Craniofacial development:
Simplified summary: Genetic factors and an unsuitable diet lead to poor craniofacial development. The consequences include chronically tense facial and masticatory muscles. If the skull is not developed symmetrically, for example, this can affect the position and functionality of the facial muscles. Such asymmetry can lead to certain muscles being overactive or overused, while others are underactive or weakened. The overactivated facial muscles must constantly work to compensate for the imbalances. This can lead to chronic tension and tightness.
Figure 7: Examples of craniofacial development
Figure 8: Effects of asymmetric craniofacial development on the function of the facial and masticatory muscles (?)
Related/original hypothesis:
https://tmdocclusion.com/home/connection-to-other-diseases-and-syndromes/hair-loss/
https://tmdocclusion.com/2018/07/14/more-on-hair-loss/
Hypothesis B – Stimulus-response pattern (conditioning):
Simplified summary: Due to interpersonal mimic and verbal interaction, humans are conditioned since birth to have their facial expressions under control so as not to provoke unwanted/wrong interpretations and associated reactions from their fellow humans. This results in a stimulus-response pattern, which results in chronic tension of the facial and masticatory muscles.
Figure 9: Compilation to illustrate the importance of facial features as a tool for interaction and identification
Related/original hypothesis: https://open.substack.com/pub/user2...-is?r=288hhe&utm_campaign=post&utm_medium=web
Hypothesis C – Malocclusion:
Simplified summary: Malocclusion results in a continuous malposition of the lower jaw. This results in chronic tension of the masticatory muscles and parts of the mimic musculature.
Figure 10: Chronic tension of the facial and masticatory muscles due to malocclusion (?)
Related/original hypothesis:
Hypothesis D – Skull shape:
Simplified summary: The shape or expansion of the skull leads to chronic tension in the facial and chewing muscles.
Figure 11: Skull shape and Expansion
Disproving the Hypotheses:
It would be helpful to show how the hypotheses mentioned can be disproved and which studies would be necessary/suitable for this. If the proponents of a hypothesis are of the opinion that a disproof is not possible, they should explain why this is not possible.
