Microvascular insufficiency and local tissue hypoxia (male pattern baldness)

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1: Med Hypotheses 2002 Apr;58(4):261-3

Hormone-induced aberrations in electromagnetic adhesion signaling as a developmental factor of androgenetic alopecia.

Matilainen VA, Keinanen-Kiukaanniemi SM.

Department of Public Health Science and General Practice, University of Oulu, Finland.

In androgenetic alopecia, overactivation of the androgen hormone cascade in genetically predisposed persons leads to miniaturization of the dermal papilla of the hair follicle and to reduction in the number of papilla cells in the scalp, but the mechanisms explaining this miniaturization have remained unclear. According to our hypothesis, the increase of dihydrotestosterone (DHT) production in the overactive androgen state inhibits cell mitosis in the dermal papilla and contributes to the induction of programmed cell death (apoptosis). Normally, DNA molecules have a negative charge, which doubles in every cell mitosis. In the catagen and telogen phases, the sulphur-rich hair moves upwards, dehydrates and develops an increasing positive charge. In a normal hair-growth cycle, the epithelial column shortens and the secondary germ is formed and it invaginates the dermal papilla by electromagnetic attraction. In the mitotic inhibition state induced by DHT, the negative charge decreases, leading to a weakening of the electromagnetic adhesion forces and weaker electrical attraction between the undifferentiated germ cells and the dermal papilla. Insulin resistance has an additional pathogenic role in the excessive miniaturization of the hair follicle. The vasoactive substances associated with endothelial dysfunction in insulin resistance induce microcirculatory disturbance, perifollicular vasoconstriction and stimulation of smooth muscle cell proliferation in the vascular wall. This leads to microvascular insufficiency and local tissue hypoxia and progressive miniaturization of hair follicles.


1: Plast Reconstr Surg 1996 May;97(6)1109-16; discussion 1117

Transcutaneous PO2 of the scalp in male pattern baldness: a new piece to the puzzle.

Goldman BE, Fisher DM, Ringler SL.

Department of Plastic Surgery, Butterworth Hospital, Grand Rapids, Mich., USA.

Our study was designed to measure the transcutaneous PO2 of the scalp to determine if there was a relative microvascular insufficiency and associated tissue hypoxia in areas of hair loss in male pattern baldness. A controlled prospective study was performed at Butterworth Hospital, Grand Rapids, Michigan. Eighteen nonsmoking male volunteers aged 18 years and older were studied. Nine men had male pattern baldness (Juri degree II or III), and nine were controls (no male pattern baldness). Scalp temperature and transcutaneous PO2 were obtained at frontal and temporal sites in each subject. Peripheral circulation was assessed from postocclusive transcutaneous PO2 recovery time by means of maximum initial slope measurements. Statistical significance was assessed at p < 0.05. There was no significant difference in scalp temperature between male pattern baldness subjects and controls. Temporal scalp blood flow was significantly higher than frontal scalp blood flow in male pattern baldness subjects; however, there was no significant difference in controls. Transcutaneous PO2 was significantly lower in bald frontal scalp (32.2 +/- 2.0 mmHg) than in hair-bearing temporal scalp (51.8 +/- 4.4 mmHg) in men with male pattern baldness. In controls, there was no significant difference in transcutaneous PO2 of frontal scalp (53.9 +/- 3.5 mmHg) and temporal scalp (61.4 +/- 2.7 mmHg). Transcutaneous PO2 also was significantly lower in the frontal scalp of male pattern baldness subjects (32.2 +/- 2.0 mmHg) than in either frontal or temporal scalp of controls (53.9 +/- 3.5 mmHg and 61.4 +/- 2.7 mmHg, respectively). There is a relative microvascular insufficiency to regions of the scalp that lose hair in male pattern baldness. We have identified a previously unreported tissue hypoxia in bald scalp compared with hair-bearing scalp.
 

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BrightonBaldy

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did we learn anything useful here?

great study if true. sadly however, unless we can amount it to anything, that's all it can ever be
 

odalbak

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"There is a relative microvascular insufficiency to regions of the scalp that lose hair in male pattern baldness. We have identified a previously unreported tissue hypoxia in bald scalp compared with hair-bearing scalp."

Does this Finnish study give any credit to the galea theory ?

- - - Updated - - -

"There is a relative microvascular insufficiency to regions of the scalp that lose hair in male pattern baldness. We have identified a previously unreported tissue hypoxia in bald scalp compared with hair-bearing scalp."

Does this Finnish study give any credit to the galea theory undirectly ?
 

benjt

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The question is, is this insufficiency a precursor to male pattern baldness, or a result of the processes that lead to male pattern baldness?

Because, as we all know, hair falling out and never regrowing is the last step in the chain of events leading to male pattern baldness. The step right before is local fibrosis. This fibrosis could also lead to microvascular insufficiency. In this case, microvascular insufficiency would not contribute to male pattern baldness, but be a result of the fibrosis in male pattern baldness. I guess in fact the latter is the case, and we did not learn anything new here.

The local microvascular insufficiency would also support my understanding of how minoxidil works, i.e., by its vasodilatory function.

It would furthermore explain why own-blood injections prove successful in treating male pattern baldness: you temporarily supply follicles with the blood (and thus stem cells required in follicle life) they otherwise lack.
 

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bboy4

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The question is, is this insufficiency a precursor to male pattern baldness, or a result of the processes that lead to male pattern baldness?

I think it's quite clear that it's a precursor. Just going on what it's saying here it looks as though it's like a parallel process. So it would't be the same pathogenesis of male pattern baldness as we think of it. Quite why it effects the male pattern baldness area I don't know. Perhaps there is some kind of threshold of male pattern baldness where it only comes into play afterwards, perhaps it's something else and the whole thing is separate. Either way brute forcing vasodilation with something like minoxidil I imagine would have diminishing returns. Is there more of an upstream way to approach it?
 

odalbak

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I remember reading somewhere that low level of oxygen increases T to DHT conversion locally.

That raises the question of why is minoxidil effective on male pattern baldness and not other vasodilators, fundamentally, is it the NO effect of minoxidil?
 

theRA

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[video=youtube;gqQX55ofm-4]http://www.youtube.com/watch?v=gqQX55ofm-4[/video]

still waiting for the "results" video...
 
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