Mechanism Of Androgenic Alopecia Paper

[Otis Mack]

https://sci-hub.se/10.1111/dth.13120

There is some new ground being broken here and it is interesting so far.

The relation between the Scleroderma-Fibrosis
(tighter, thicker, shinier skin) and Hair Loss has been
established by the investigators where they observed Scleroderma-Fibrosis
like conditions in hands of the subjects

They compared conditions of both scleroderma and
baldness and found similarity in conditions of both
types of skin




There is a delusion that, calcification increases with age and hence
researchers consider this as a normal aging process


However, calcification can be rampant in young adults(me---perhaps explaining balding in adolescents) and nearly absent in older ones. Itis not caused due to calcium-rich diet
. As per the investigations, the calcification and fibrosis can occur in the same areas, but are
independent of each other. And while some scleroderma patients also suffer from soft tissue calcification,
others just suffer from an overproduction of collagen

. Now the questions arises, what triggers fibrosis and calcification.
It is a well established fact that men have two times chance of getting calcified
arterial lesions as compared to that of women

 

[Armando Jose]

"DHT causes hair loss due to both calcification and fibrosis however, it cannot
cause calcification on its own. This indicates that, in scalp a combination of DHT and a
mystery factor cause hair loss by producing calcification and fibrosis like condition."


"we came to the conclusion that
imbalance in diet, life style, microbiome and scalp environment which lead to chronic
inflammation and imbalanced T:E ratio results in increased level of scalp DHT, AR and
imbalanced calcification regulators."

"hair remains retained on the occipital region of
the scalp even in the most severe form."


Clearly they don't explain the pattern of common hair loss, then, wich is the mystery factor?

 

[Otis Mack]

The pattern is that small vasculature close up faster and then eventually even the larger blood vessels will too become too calcified to let much blood thru.

This "pattern" occurs in Parkinson's patients too where micro-vasculature are first to go...

 

[Otis Mack]

check out the Danny Roddy video at about 2:45

Also pay attention at about 4:45 of what a hair transplant Doctor was quoted saying.

 

[Armando Jose]

Thank Otis, but this is not the explanation, ....

 

[Otis Mack]

Thank Otis, but this is not the explanation, ....

It is quite striking that the loss of blood flow(in the pattern area) equates to the area of hair loss. The back of the scalp is quite robust against balding UNTIL you transplant them into the pattern area. The transplant Doctor even said there is a miniaturization of even those prior robust back of scalp follicles.

The lack of blood flow is IMO the iniatiator of all the subsequent problems.

 

[Otis Mack]

I hope someday researchers do more work on adolescent Androgenetic Alopecia because this would provide new or eliminate lots of hypotheses

 

[Armando Jose]

I hope someday researchers do more work on adolescent Androgenetic Alopecia because this would provide new or eliminate lots of hypotheses

Me too.

 

[Armando Jose]

Then,..., what do you think about it?
Peter Renardo: "I had ligatures of both my temporal and both my occipital scalp arteries done 32 years ago, and I stopped losing my hair. I did not regrow any frontal hair I lost, but the recession stopped. My crown is as thick as when I was an adolescent. I’ve had absolutely no problems from this procedure. At age 56 I still have about 85-90 percent of my hair. The arterial irrigation is replaced with capillary irrigation, so the overall scalp circulation is still good, with about a 20 percent reduction, but this procedure worked for me"
Ligature of the Scalp Arteries to Prevent Hair Loss

 

[LosingHairLosingPatience]

If blood flow was the problem, any vasodilator would work, right?

 

[Otis Mack]

If blood flow was the problem, any vasodilator would work, right?

Here's what I think goes on:

if you have restricted blood flow in major arteries leading to the scalp then applying a topical vasodilator will do very little.
minoxidil topically works some..but IMO oral works better if you can tolerate it because it results in even more blood flow to the scalp.

We also know of hydralazine being reported to regrow hair and verapamil which both happen to be peripheral vasodilators.

Look at the case studies:

https://www.lewrockwell.com/2010/01/bill-sardi/the-man-who-cured-heart-disease-naturally/


Nobody has ever provided an adequate explanation of why an 80 year old man started regrowing hair AFTER ______6______
years on spironolactone. I'm not going to let this go because it is critical in understanding male pattern baldness.

1) did spironolactone directly act on the hair follicle itself? If so explain why the disparity in time between other drugs which can regrow hair in roughly 3 monthes.

2) did spironolactone somehow act as some unique anti-inflammatory? If so explain why benox can regrow hair in monthes and spironolactone in this man couldn't.


3) could spironolactone have been regressing very severe vascular calcifications and took some time? Is spironolactone good at this compared to other drugs?


https://www.ncbi.nlm.nih.gov/pubmed/23476041



Why aren't topical estrogens as effective as oral estrogens? What could be estrogens doing outside the scalp? Could it be reversing vascular calcification?


https://www.ncbi.nlm.nih.gov/pubmed/28615727

 

[Otis Mack]

Then,..., what do you think about it?
Peter Renardo: "I had ligatures of both my temporal and both my occipital scalp arteries done 32 years ago, and I stopped losing my hair. I did not regrow any frontal hair I lost, but the recession stopped. My crown is as thick as when I was an adolescent. I’ve had absolutely no problems from this procedure. At age 56 I still have about 85-90 percent of my hair. The arterial irrigation is replaced with capillary irrigation, so the overall scalp circulation is still good, with about a 20 percent reduction, but this procedure worked for me"
Ligature of the Scalp Arteries to Prevent Hair Loss

Reading these quotes has me at neutral to what ligatures "actually" do to Androgenetic Alopecia.

IMO, Peter Renardo goes out of his way MULTIPLE MULTIPLE times repeating the same comment about 20x. This is usually an agenda driven guy but he doesnt seem so but has the actions of a shill or something.






Here is another quote from the hairlosscure 2020 thread:

Hi, I’m another who has had ligation of the scalp arteries. Specifically the superficial temporal arteries on both sides. In my case, the reason for doing so was that they were both extremely prominent and visible running up the sides of my forehead and I did not like the appearance.

Coincidentally, I do suffer from both male pattern baldness and seborrheic dermatitis. Neither of which were reasons that I had this procedure done.

Unfortunately the procedure does not seemed to have alleviated either in any noticeable way. The dermatitis persists and the male pattern baldness continues to progress at about the same pace as before, which was fairly slow. I’m about a Norwood 2-2.5 with diffuse thinning throughout the scalp.

While the appearance of the prominent temporals was removed, I now have a prominent and pulsating artery running up the middle of my forehead, emerging from my right eyebrow and running up my forehead and disappearing into my hairline. I’ve come to learn this is my right supratrochlear artery and should not normally be visible. Whether it grew in response to the blood flow being cut off in the superficial temporals or not is in question.

I had this procedure done in July 2013. The new artery appeared just late last year 2016.

Well that’s my story, don’t know if it will be of use to anyone.




Here was another quote from that thread:

:Ras comments:
They did a check up. If you read to the end of the article you will see a histologist study which showed the operation improved the cellular life of hair follicles a year after surgery.

 

[Otis Mack]

from the "New Treatment for Seborrheic Alopecia: The Ligature of the Arteries of the Scalp"

12 months after the surgery:


The capillary system becomes clearly more abundant and open.


Sectioning the arteries has also interrupted the periarterial sympathetic system, which can interfere with relative vasodilation.

The hair sheath, poor in epithelial cells before the operation, becomes enriched with important young and thick cellular populations, increasing mitosis.


The sebaceous glands, functioning abundantly before the operation, become reduced, less dense, and show spaces empty of all cellular elements.

This signifies a necrobiosis devoid of lipid inclusions. These histologic images show that the circulatory slowing obtained by the arterial ligatures at the level of the scalp is a treatment of primary value in reducing the sebum production which improves the cellular life of the dermis, epidermis, and hair follicle.

 

[Armando Jose]

I think that oxidation of sebum is related to this, as a first event

 

[Otis Mack]

I think that oxidation of sebum is related to this, as a first event

Until all is known...it cant be ruled out.

But my bias for now is that vascular problems come first

I think Merck tried the type 1 inhibitor which turned sebum production off but did nothing for regrowth. That's why the went with type 2 5AR inhibitor as we know is finasty.

Oral spironolactone reduces sebum and improves acne status but it does it quickly. The 80 year old spironolactone guy would have seen quick hair growth if it
was just sebum related.

 

[Armando Jose]

The 80 year old spironolactone guy

This guy is the excerpt of the norme,

 

[Armando Jose]

Until all is known...it cant be ruled out.

+1

My idea can be, "Bacterials in oxidized sebum are able to synthesize many enzymes involved in the metabolism of porphyrins that, once activated, may contribute to oxidation and follicular inflammation"

 

[Otis Mack]

I want to include this paper because it talks about scleroderma which was talked about in post 1:

http://www.jpp.krakow.pl/journal/archive/06_19/articles/01_article.html


Also about hair specifically:

"There are some studies indicating the potential role of aldosterone and MR in hair loss.

Postnatal MR overexpression in keratinocytes in mice has resulted in delayed alopecia, hair follicle dystrophy, and abnormalities of the hair cycle, without alternation of the interfollicular epidermis (19).

Moreover, clinical studies have shown that both male and female patients with androgenic alopecia have higher aldosterone serum levels (108-110).

The mechanism underlying this process may be associated with the skin microinflammation found in those patients (111).

Despite the potential role of aldosterone, there is only one study evaluating the influence of MR blockade on hair. This showed that spironolactone treatment reduced hair shaft size and weight resulting in softer, finer hair and a slower growth rate in patients with hirsutism (112). In this study, the action of spironolactone was mainly associated with its antiandrogenic activity. Nevertheless, the potential role of MR blockade cannot be excluded (112)."

 

[Armando Jose]

Moreover, clinical studies have shown that both male and female patients with androgenic alopecia have higher aldosterone serum levels

Then aldosterone concentration in scalp hairs is diferent at sides?

Probably aldosterone is not the cause, only a effect.

 

[Otis Mack]

Aldosterone is tough on microvasculature is the take on this and that checks alot of the boxes of Androgenetic Alopecia.


The subsequent problems of Androgenetic Alopecia are first initiated by some substance which disrupts microvessels. We know aldosterone levels are higher in both male and female Androgenetic Alopecia

https://www.ahajournals.org/doi/full/10.1161/01.hyp.0000201443.63240.a7

"Aldosterone may affect endothelium-dependent dilatory or constrictor mechanisms, either directly or indirectly via angiotensin II (Ang II)–induced effects.
Ang II induces endothelial dysfunction as a result of increased oxidative stress, which may scavenge NO resulting in decreased NO bioavailability.

MR blockade with spironolactone improved the impaired acetylcholine-induced relaxation in Ang II–infused rats, suggesting that aldosterone induces actions attributed to direct effects of Ang II"


More information about microcirculation can be found here:

https://www.hairlosstalk.com/intera...atic-hyperplasia-with-a-focus-on-etio.126133/