Men — and women — wrestling with the dearth of hair sprouting from their noggin often wonder why they're balding, who's to blame and how they can reverse the common occurrence.
Hereditary pattern baldness, or androgenetic alopecia, affects more than half of American men by age 50, according to the American Academy of Dermatology.
And the numbers aren't much better for women. An estimated 30 million women in the United States have pattern baldness, and about 40 percent of women show visible signs by age 40, according to the AAD.
Pattern baldness is the lone culprit for more than 90 percent of hair loss in those with thinning locks — a sector of society clearly divided between those who embrace their emerging scalp and those who attempt to conceal it.
Fortunately, being bald today isn't as hard on one's self-esteem as it once was, said John Capps III, North Carolina resident and founder of Bald-Headed Men of America.
"Now you have folks that are choosing to be bald and making it an elective option instead of one that's been selected by the good Lord," said the stark bald 64-year-old.
Capps said he started the organization in 1973 after a financial institution denied him a job because of his baldness. Since then, some 30,000 people have joined the cue-ball-friendly club.
"We grow because of lack of growth," Capps joked. "We're proud of every hair we don't have."
In the years he has spent urging men to embrace their hairless heads, Capps has heard many things about baldness and admits it's hard to separate fact from fiction.
The News-Leader posed some frequently asked questions about baldness to medical professionals. Here's what they said:
Q. Does baldness come from the mother's side of the family?
A. This is one of many long-perpetuated myths about pattern baldness, and it's usually accompanied by the misconception that the maternal grandfather's head is some sort of hair-loss harbinger.
Scientists originally believed the gene for pattern baldness was linked to X chromosomes carried by women, said Colette Witkowski, an associate professor at Southwest Missouri State University with a doctorate in genetics.
But further study revealed that pattern baldness is actually polygenic, which means it results from a combination of genes passed down from branches on both sides of the family tree, Witkowski said.
Maternal grandfathers are only one piece of a larger genetic puzzle when it comes to baldness, said Dr. Steve Zeiler, an internist at Skaggs Community Health Center in Branson.
"If all the men on your mother's side of the family started going bald at age 25, then you're probably going to start going bald at 25," Zeiler said. "And the earlier it starts in life, the more complete it's going to be."
Q. Do bald men have higher testosterone levels?
A. Sorry, bald guys. There's no scientific evidence to support the theory that you're any manlier than your bushy-headed counterparts.
Doctors say that men genetically predisposed to baldness secrete more of an enzyme called type-2 5-alpha reductase. That enzyme converts testosterone into another hormone called DHT, or dihydrotestosterone.
DHT actually shrinks hair follicles, explained Dr. Maria Yadira Hurley, a dermatologist and assistant professor at St. Louis University. Over time, Hurley said, the follicles on the crown and front of the head produce thinner and fewer hairs and eventually none at all.
Capps, with Bald-Headed Men of America, likes to spin the science a little to support his argument that bald men have more to offer.
"Intelligent women know bald men don't waste their hormones growing hair," he joked.
Q. Why do hair follicles on the sides and back of the head continue to grow hair?
A. Male pattern baldness typically begins with a receding hairline followed by thinning on the crown of the head. The two bald areas often connect, exposing skin in the shape of a horseshoe.
"The hair follicles are still alive on the top of the head, but they're no longer growing hairs," Zeiler said.
Hair follicles on the back and sides of the head, however, aren't affected by DHT and continue to grow hair at a normal rate.
At any time, about 10 percent of the hair on your scalp is in a resting phase, while the remaining 90 percent is actively growing. After two or three months, hairs in the resting phase fall out and new hair starts to grow in its place.
During this growth phase, which can last from two to seven years, each hair grows about 1 centimeter per month.
Q. Can wearing caps or hats contribute to hair loss?
A. Bald men who regularly wear a baseball cap or cowboy hat may think they stifled hair growth by suffocating their poor scalp.
This, too, is folklore, experts say, reminding that pattern baldness is linked to genetics, not your wardrobe.
"It wouldn't matter if you always wore a hat as a kid," Hurley said.
People often mistakenly attribute baldness with poor blood flow to the scalp, making hats a likely scapegoat.
Some people may inadvertently pull hair out of their follicles when removing a cap or hat, Zeiler noted, but the loss would be negligible.
Q. Can a vitamin deficiency accelerate hair loss, and does zinc help preserve hair?
A. The good news is that the human body must be seriously devoid of vitamins before it will turn to hair for nutrients.
The bad news is that balding men who pop zinc pills in hopes of staving off the inevitable are going through motions that won't help.
Sailors with scurvy lost their hair because they lacked the necessary vitamins found in citrus fruits, Zeiler explained, but that's rarely a problem today.
As for supplementing your diet with zinc, doctors said there's no proof the mineral prevents hair loss or slows pattern baldness.
"They'll tell you anything at (nutrition stores), but that doesn't necessarily mean it's scientifically sound," Zeiler warned.
Q. Can certain hair products or grooming habits accelerate hair loss?
A. Combing, brushing, shampooing and — for the younger fellas — gelling shouldn't result in hair loss. Vigorous brushing can cause trauma to hair shafts, but that's rare, Zeiler said.
Grooming habits that cause extreme hair damage and split ends, like frying the hair in some way, can keep locks from growing longer, Hurley added.
"In general, what you do to your hair may determine how long your hair grows, but it doesn't affect if your hair grows or not," she said.
People typically have about 100,000 hairs on their head and may lose between 50 and 100 each day. If hair loss is significant, it could be a side-effect of something more serious, physicians said.
Besides balding, hair loss can be caused by thyroid disorders, iron deficiency and rheumatoid problems, such as lupus, chemical exposure to the scalp and fungal infections.
"Then you have to explore more (to find the cause)," Zeiler said.
Q. Do products like Rogaine and Propecia actually grow new hair?
A. There are two products widely recommended by doctors for men or women who want to wage war on their hair loss.
One is over-the-counter Rogaine, generically known as minoxidil. The topical cream must be applied to the scalp twice a day.
Minoxidil was originally prescribed for blood pressure, then patients noticed that hair growth was a side-effect, Zeiler said.
"It does help grow new hair, but it's not 100 percent effective," he said. "Almost everybody (who uses minoxidil) will grow some hair."
Hurley estimated one out of every three balding patients who uses minoxidil gets good cosmetic results.
Finasteride — commonly sold by prescription as Propecia — inhibits the enzyme that converts testosterone in DHT. Propecia pills are taken once a day.
"It's effective in preventing further hair loss, but really doesn't work very well in terms of bringing hair back," Hurley noted.
Each drug posts about $100 million domestically in annual sales, according to a recent Associated Press report.
Q. How far away is a cure for baldness?
A. Witkowski at SMS said the possibility of curing baldness is still "a ways down the road."
Studies involving mice have helped scientists understand how hair grows and develops, as well as the different genetic defects that lead to hair loss, she said.
Continued research may lead scientists to identify the sequence of genes required for hair growth, but only time will tell.
University of Pennsylvania researchers who implanted "blank slate" stem cells in the hair follicles of bald mice enabled the critters to grow hair.
They also identified 150 different genes implicated in hair growth — a finding that could lead to more drugs for those who want their hair back.
As for Capps, he'll pass.
"Baldness is an attitude," he said. "It's an attitude about oneself, and baldness is just mind over matter. It's just accepting ... who you are."
http://springfield.news-leader.com/life ... theba.html
Hereditary pattern baldness, or androgenetic alopecia, affects more than half of American men by age 50, according to the American Academy of Dermatology.
And the numbers aren't much better for women. An estimated 30 million women in the United States have pattern baldness, and about 40 percent of women show visible signs by age 40, according to the AAD.
Pattern baldness is the lone culprit for more than 90 percent of hair loss in those with thinning locks — a sector of society clearly divided between those who embrace their emerging scalp and those who attempt to conceal it.
Fortunately, being bald today isn't as hard on one's self-esteem as it once was, said John Capps III, North Carolina resident and founder of Bald-Headed Men of America.
"Now you have folks that are choosing to be bald and making it an elective option instead of one that's been selected by the good Lord," said the stark bald 64-year-old.
Capps said he started the organization in 1973 after a financial institution denied him a job because of his baldness. Since then, some 30,000 people have joined the cue-ball-friendly club.
"We grow because of lack of growth," Capps joked. "We're proud of every hair we don't have."
In the years he has spent urging men to embrace their hairless heads, Capps has heard many things about baldness and admits it's hard to separate fact from fiction.
The News-Leader posed some frequently asked questions about baldness to medical professionals. Here's what they said:
Q. Does baldness come from the mother's side of the family?
A. This is one of many long-perpetuated myths about pattern baldness, and it's usually accompanied by the misconception that the maternal grandfather's head is some sort of hair-loss harbinger.
Scientists originally believed the gene for pattern baldness was linked to X chromosomes carried by women, said Colette Witkowski, an associate professor at Southwest Missouri State University with a doctorate in genetics.
But further study revealed that pattern baldness is actually polygenic, which means it results from a combination of genes passed down from branches on both sides of the family tree, Witkowski said.
Maternal grandfathers are only one piece of a larger genetic puzzle when it comes to baldness, said Dr. Steve Zeiler, an internist at Skaggs Community Health Center in Branson.
"If all the men on your mother's side of the family started going bald at age 25, then you're probably going to start going bald at 25," Zeiler said. "And the earlier it starts in life, the more complete it's going to be."
Q. Do bald men have higher testosterone levels?
A. Sorry, bald guys. There's no scientific evidence to support the theory that you're any manlier than your bushy-headed counterparts.
Doctors say that men genetically predisposed to baldness secrete more of an enzyme called type-2 5-alpha reductase. That enzyme converts testosterone into another hormone called DHT, or dihydrotestosterone.
DHT actually shrinks hair follicles, explained Dr. Maria Yadira Hurley, a dermatologist and assistant professor at St. Louis University. Over time, Hurley said, the follicles on the crown and front of the head produce thinner and fewer hairs and eventually none at all.
Capps, with Bald-Headed Men of America, likes to spin the science a little to support his argument that bald men have more to offer.
"Intelligent women know bald men don't waste their hormones growing hair," he joked.
Q. Why do hair follicles on the sides and back of the head continue to grow hair?
A. Male pattern baldness typically begins with a receding hairline followed by thinning on the crown of the head. The two bald areas often connect, exposing skin in the shape of a horseshoe.
"The hair follicles are still alive on the top of the head, but they're no longer growing hairs," Zeiler said.
Hair follicles on the back and sides of the head, however, aren't affected by DHT and continue to grow hair at a normal rate.
At any time, about 10 percent of the hair on your scalp is in a resting phase, while the remaining 90 percent is actively growing. After two or three months, hairs in the resting phase fall out and new hair starts to grow in its place.
During this growth phase, which can last from two to seven years, each hair grows about 1 centimeter per month.
Q. Can wearing caps or hats contribute to hair loss?
A. Bald men who regularly wear a baseball cap or cowboy hat may think they stifled hair growth by suffocating their poor scalp.
This, too, is folklore, experts say, reminding that pattern baldness is linked to genetics, not your wardrobe.
"It wouldn't matter if you always wore a hat as a kid," Hurley said.
People often mistakenly attribute baldness with poor blood flow to the scalp, making hats a likely scapegoat.
Some people may inadvertently pull hair out of their follicles when removing a cap or hat, Zeiler noted, but the loss would be negligible.
Q. Can a vitamin deficiency accelerate hair loss, and does zinc help preserve hair?
A. The good news is that the human body must be seriously devoid of vitamins before it will turn to hair for nutrients.
The bad news is that balding men who pop zinc pills in hopes of staving off the inevitable are going through motions that won't help.
Sailors with scurvy lost their hair because they lacked the necessary vitamins found in citrus fruits, Zeiler explained, but that's rarely a problem today.
As for supplementing your diet with zinc, doctors said there's no proof the mineral prevents hair loss or slows pattern baldness.
"They'll tell you anything at (nutrition stores), but that doesn't necessarily mean it's scientifically sound," Zeiler warned.
Q. Can certain hair products or grooming habits accelerate hair loss?
A. Combing, brushing, shampooing and — for the younger fellas — gelling shouldn't result in hair loss. Vigorous brushing can cause trauma to hair shafts, but that's rare, Zeiler said.
Grooming habits that cause extreme hair damage and split ends, like frying the hair in some way, can keep locks from growing longer, Hurley added.
"In general, what you do to your hair may determine how long your hair grows, but it doesn't affect if your hair grows or not," she said.
People typically have about 100,000 hairs on their head and may lose between 50 and 100 each day. If hair loss is significant, it could be a side-effect of something more serious, physicians said.
Besides balding, hair loss can be caused by thyroid disorders, iron deficiency and rheumatoid problems, such as lupus, chemical exposure to the scalp and fungal infections.
"Then you have to explore more (to find the cause)," Zeiler said.
Q. Do products like Rogaine and Propecia actually grow new hair?
A. There are two products widely recommended by doctors for men or women who want to wage war on their hair loss.
One is over-the-counter Rogaine, generically known as minoxidil. The topical cream must be applied to the scalp twice a day.
Minoxidil was originally prescribed for blood pressure, then patients noticed that hair growth was a side-effect, Zeiler said.
"It does help grow new hair, but it's not 100 percent effective," he said. "Almost everybody (who uses minoxidil) will grow some hair."
Hurley estimated one out of every three balding patients who uses minoxidil gets good cosmetic results.
Finasteride — commonly sold by prescription as Propecia — inhibits the enzyme that converts testosterone in DHT. Propecia pills are taken once a day.
"It's effective in preventing further hair loss, but really doesn't work very well in terms of bringing hair back," Hurley noted.
Each drug posts about $100 million domestically in annual sales, according to a recent Associated Press report.
Q. How far away is a cure for baldness?
A. Witkowski at SMS said the possibility of curing baldness is still "a ways down the road."
Studies involving mice have helped scientists understand how hair grows and develops, as well as the different genetic defects that lead to hair loss, she said.
Continued research may lead scientists to identify the sequence of genes required for hair growth, but only time will tell.
University of Pennsylvania researchers who implanted "blank slate" stem cells in the hair follicles of bald mice enabled the critters to grow hair.
They also identified 150 different genes implicated in hair growth — a finding that could lead to more drugs for those who want their hair back.
As for Capps, he'll pass.
"Baldness is an attitude," he said. "It's an attitude about oneself, and baldness is just mind over matter. It's just accepting ... who you are."
http://springfield.news-leader.com/life ... theba.html