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What one time event (that only happens around the scalp) could change hair follicles from being normal follicles to making them be susceptible to balding?
Question About The Process And Trigger Of Hair Loss
- Thread starter Jesse Wilson
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It doesn't work like this bud... You born destinated to be bald, it's only a matter of time.
DoctorHouse
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Genetics and Epigenetics
Androgen sensitivity of follicles increases over time, although I understand that this is a gradual process rather than something sudden. Once follicular androgen sensitivity and your DHT levels each reach a certain threshold, the DHT will begin to affect the follicles leading to miniaturization. Androgen sensitivity and DHT levels are mostly genetically determined.
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I said a one time effect because I assumed transplanted hairs were permanent. But if it is true that transplanted hairs fall out after a decade, then it probably isn't a pre-existing condition in the follicle. It has to be a pre-existing condition of the scalp that causes a build up in the hair follicles.
Maybe the build up that the scalp causes in the hair is androgen receptors? What causes the scalp to in turn cause the hairs to increase it's numbers of androgen receptors? It can't be blood flow or else hairs wouldn't immediately fall out. It can't be DHT because there is also "catch up" hair loss when you re-introduce DHT by coming off finasteride or by taking hormones and having grown up a eunuch.
So perhaps the part of the scalp that goes bald is genetically different and can effect androgen sensitivity on hairs over time even without testosterone.
My new question is:
What would affect the androgen sensitivity of hairs on the scalp that doesn't involve sex hormones?
Maybe the build up that the scalp causes in the hair is androgen receptors? What causes the scalp to in turn cause the hairs to increase it's numbers of androgen receptors? It can't be blood flow or else hairs wouldn't immediately fall out. It can't be DHT because there is also "catch up" hair loss when you re-introduce DHT by coming off finasteride or by taking hormones and having grown up a eunuch.
So perhaps the part of the scalp that goes bald is genetically different and can effect androgen sensitivity on hairs over time even without testosterone.
My new question is:
What would affect the androgen sensitivity of hairs on the scalp that doesn't involve sex hormones?
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How do you know they don't fall out after a decade? The longest studies have been are 3 years.
Also, the difference between balding and non-balding men isn't in the amount of DHT in a body, but rather the amount of activated androgen receptors in the hair. DHT is only necessary for hair loss. It really can't be considered the prime cause of it. What causes activates androgen receptors? Spironolactone activates some and blocks some.. Maybe people with baldness have too much of whatever activates androgen receptors? Especially too much on the scalp for some reason...
Alos, if DHT starts the process that will result in hair loss, then what causes the spike in hair loss when DHT is no longer inhibitied such as in the case of the Eunuch twin and the person quitting finasteride. Why does suddenly increasing DHT, except for during puberty (not everyone loses hair in puberty) lead to so much hair loss in much the same way stopping minoxidil does? How come some people can go bald so young and quickly? Maybe in their case the androgen receptors were already too activated before they hit puberty?
Another thing that still puzzles me is why do too many androgen receptors result in baldness, but that's the case for both balding and non-balding people I believe... anyone have a source?
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From https://perfecthairhealth.com/the-case-against-a-hair-transplant/
Is It True That Transplanted Hairs Never Thin?
Contrary to popular belief – healthy hair follicles transplanted into thinning or balding regions can eventually thin too.
This is known as “Donor Dominance” – the observation that transplanted hairs eventually take on the look of the hairs near which they’re transplanted. If those hairs happen to be thinning, your transplanted hairs will likely also miniaturize (albeit at a slower pace).
This is contrary to what most people read online and what most surgeons say. Typically you’ll hear that hairs transplanted from the back of the head are “immune” from androgenic alopecia and never miniaturize.
Then Why Do People Say That Transplanted Hairs Never Thin?
This assumption – that transplanted hairs never thin – arose from the first few decades of hair transplantation research.
Over fifty years ago, researchers published a study highlighting an attempted hair transplant. Scientists took thick healthy hairs from non-bald regions in the back of the scalp and transplanted them to balding regions. These hairs continued to grow normally for the duration of the study, and so scientists concluded that these hairs would continue to grow in perpetuity because they were protected, for reasons unknown, from male pattern baldness (male pattern baldness).
Following studies showed similar results. During each study’s duration, most hair follicles that survived transplantation tended not to miniaturize.
The key term here is study duration. The majority of these studies ranged from six months to three years. Is that long enough to gauge whether transplanted hair is thinning? Let’s look at our end points.
It takes infants over half a decade to grow hair. It takes adults multiple decades to lose hair. So a three year observation period probably isn’t long enough to say whether transplanted hairs are forever protected from male pattern baldness. In fact, basing my opinion off of anecdotes, I think the opposite is true – that transplanted hairs do thin.
I’ve provided email and video support to dozens of hair transplant recipients. Of the ones who received a transplant five to ten years ago, nearly all of them claim most of their transplanted hairs have already fallen out. I also have a friend with a hair transplant who’s experiencing the same thing. That’s not very encouraging.
So the studies conflict with the anecdotes – or at least the anecdotes I’ve been told. My guess is that this discrepancy exists due to too-short study durations. But I’ve also read surgeons say this could be caused from transplanting follicles from too close to the vertex – thereby transplanting hairs already susceptible to baldness.
Why Do Many Hair Transplant Recipients Report Their Transplanted Hairs Are Thinning Years After Surgery?
The reason why isn’t yet 100% clear. But based on the evidence, my theory is this:
Healthy donor hairs are transplanted into balding regions of the scalp. And if you’ve read other articles on this site, you know that balding scalp regions have elevated tissue DHT, fibrosis, calcification, excess sebum/dandruff build-up, collagen remodeling, a fused galea, and a host of other symptoms stemming from chronic, localized inflammation.
These conditions starve the follicles of nutrients and proper blood flow. This results in follicle miniaturization, and over a series of hair cycles, baldness.
These scalp conditions tend to precede hair loss. They kick start the balding process. But the process in which hairs miniaturize still takes decades.
By that same logic, if you transplant thick healthy hair follicle units into balding regions, it might also take decades for those transplanted follicles to thin from reduced nutrient and blood supply. These hairs eventually miniaturize too, but since they’re starting out thick and healthy, it takes a long time.
Contrary to popular belief – healthy hair follicles transplanted into thinning or balding regions can eventually thin too.
This is known as “Donor Dominance” – the observation that transplanted hairs eventually take on the look of the hairs near which they’re transplanted. If those hairs happen to be thinning, your transplanted hairs will likely also miniaturize (albeit at a slower pace).
This is contrary to what most people read online and what most surgeons say. Typically you’ll hear that hairs transplanted from the back of the head are “immune” from androgenic alopecia and never miniaturize.
Then Why Do People Say That Transplanted Hairs Never Thin?
This assumption – that transplanted hairs never thin – arose from the first few decades of hair transplantation research.
Over fifty years ago, researchers published a study highlighting an attempted hair transplant. Scientists took thick healthy hairs from non-bald regions in the back of the scalp and transplanted them to balding regions. These hairs continued to grow normally for the duration of the study, and so scientists concluded that these hairs would continue to grow in perpetuity because they were protected, for reasons unknown, from male pattern baldness (male pattern baldness).
Following studies showed similar results. During each study’s duration, most hair follicles that survived transplantation tended not to miniaturize.
The key term here is study duration. The majority of these studies ranged from six months to three years. Is that long enough to gauge whether transplanted hair is thinning? Let’s look at our end points.
It takes infants over half a decade to grow hair. It takes adults multiple decades to lose hair. So a three year observation period probably isn’t long enough to say whether transplanted hairs are forever protected from male pattern baldness. In fact, basing my opinion off of anecdotes, I think the opposite is true – that transplanted hairs do thin.
I’ve provided email and video support to dozens of hair transplant recipients. Of the ones who received a transplant five to ten years ago, nearly all of them claim most of their transplanted hairs have already fallen out. I also have a friend with a hair transplant who’s experiencing the same thing. That’s not very encouraging.
So the studies conflict with the anecdotes – or at least the anecdotes I’ve been told. My guess is that this discrepancy exists due to too-short study durations. But I’ve also read surgeons say this could be caused from transplanting follicles from too close to the vertex – thereby transplanting hairs already susceptible to baldness.
Why Do Many Hair Transplant Recipients Report Their Transplanted Hairs Are Thinning Years After Surgery?
The reason why isn’t yet 100% clear. But based on the evidence, my theory is this:
Healthy donor hairs are transplanted into balding regions of the scalp. And if you’ve read other articles on this site, you know that balding scalp regions have elevated tissue DHT, fibrosis, calcification, excess sebum/dandruff build-up, collagen remodeling, a fused galea, and a host of other symptoms stemming from chronic, localized inflammation.
These conditions starve the follicles of nutrients and proper blood flow. This results in follicle miniaturization, and over a series of hair cycles, baldness.
These scalp conditions tend to precede hair loss. They kick start the balding process. But the process in which hairs miniaturize still takes decades.
By that same logic, if you transplant thick healthy hair follicle units into balding regions, it might also take decades for those transplanted follicles to thin from reduced nutrient and blood supply. These hairs eventually miniaturize too, but since they’re starting out thick and healthy, it takes a long time.
So perhaps they last forever and if they do, then the underlying problem with hair loss is a pattern in the follicles. If not, then it's an underlying problem in the scalp that affects the hairs by making them too susceptible to DHT.
In my mind, the fact they can start to be negatively affected by DHT is the important issue. DHT is good. I like it. My hairs are what is falling out. They were programmed to eventually be corrupted or the scalp somehow corrupted them (also due to genetics).
Right, but at this point it's just preventing further collateral damage by keeping the corrupted follicles alive hence why the hair falls out so rapidly when DHT is reintroduced. It would be nice if we could find out how to "deactivate" the androgen receptors in the hair follicles so they behave like normal hairs. The best we have right now is trying to block them with antiandrogens.
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Hi Jesse,
Good point with the study regarding recipient site and hair trasplant.
You seem a good guy interested in common hair loss, please take this important key of it. All scalp hairs have DHT years before puberty in both sexes, they make it inside the hair because pilosebaceous unit have an operative sebaceous gland.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835896/
"the pilosebaceous unit is the main factory for hormone production"
Good point with the study regarding recipient site and hair trasplant.
You seem a good guy interested in common hair loss, please take this important key of it. All scalp hairs have DHT years before puberty in both sexes, they make it inside the hair because pilosebaceous unit have an operative sebaceous gland.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835896/
"the pilosebaceous unit is the main factory for hormone production"
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Thank you! I just want to know what is causing it so I can pick the best treatments and know where to look for future treatments. Hopefully humanity can find a treatment that works 100% within the 5 years before I lose too much hair. haha
From the study I took away some interesting things:
We still don't know why DHT expresses baldness when too much of it binds to the DPC receptors.
It really is likely that the extra androgen receptors are a true cause which can probably build up before puberty.
It really is likely that the extra androgen receptors are a true cause which can probably build up before puberty.
"A recent genome wide study even casted doubt on the omnipotent role of androgen in male Androgenetic Alopecia.103"
This study is referring to instances of baldness in pre-pubic boys. This would align with why eunuchs and people who get off propecia lose hair to where it would have been if they had never reduced DHT. Maybe these boys had over expressive pilosabaceous glands and well as extra androgen receptors.
This study is referring to instances of baldness in pre-pubic boys. This would align with why eunuchs and people who get off propecia lose hair to where it would have been if they had never reduced DHT. Maybe these boys had over expressive pilosabaceous glands and well as extra androgen receptors.
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Great read. Interesting stuff.