Which Hairloss Theory Do You Believe?

[Mandar kumthekar]

There are few theories out there about hairloss ie male pattern balness. I often see a disagreement between members about various theories. People hold their view about with strong conviction. I am opening this thread to see what theories really has potential to considered. Do vote please!

 

[mryellowman]

I don't believe in skull expansion theory because i have seen a lot of small headed people who developed male pattern baldness.Yes, i agree that when you look at bald people many of them have expanded head but most of them are european so i think its related to your origin.

When you look at this video 1:38 . You'll see the guy on the Henry's right has very expanded head but even tho regarding to his age he still has a full head of hair.

 

[Cue Bald]

and anyway why would skull expansion cause such a wide expanse of slick bald head. surely skull expanding would just mean that the hair is stretched over a slightly larger area. even if the head doubled in size, you should still have 50,000 follicles which is 5 times more per square inch than the best hair transplants.

unless this skull expansion widens the follicle holes too causing all the hairs to fall out?
people have hydroceles which causes their balls to expand to 10+ their normal size, they keep every one of their ball hairs.

 

[Mandar kumthekar]

and anyway why would skull expansion cause such a wide expanse of slick bald head. surely skull expanding would just mean that the hair is stretched over a slightly larger area. even if the head doubled in size, you should still have 50,000 follicles which is 5 times more per square inch than the best hair transplants.

unless this skull expansion widens the follicle holes too causing all the hairs to fall out?
people have hydroceles which causes their balls to expand to 10+ their normal size, they keep every one of their ball hairs.

Who told you hydroceles patients keel ball hairs? 10+ expansion would mean two big coconuts hanging. At least joke with some reality touch. Plus that 10x asset could produce Hugh DHT that would make them super muscular.

 

[Jesse Navarro]

Many say that testosterone alone causes it, even if you block all dht

 

[fuDHTck]

No quantum theory? Dislike.

 

[ZenHead]

Personally I think male pattern baldness is a combination of the galea theory and the DHT theory... Different bodies have different autoimmune responses to DHT. People that are prone to male pattern baldness have an autoimmune system which triggers an inflammatory reaction to DHT. There is no muscle on the galea - just skin on bone. When the scalp is inflamed, there is a serious lack of blood supply to the follicles and therefore a lack of important growth factors and cellular reactions which regenerate the cells in the follicle. This is why I believe minoxidil, microneedling, and other treatments that improve blood flow in the scalp are somewhat successful, even if it is just for a few years. Finasteride is much more successful because there is less DHT in the body and therefore the scalp, and the scalp isn't inflamed allowing for normal conditions to restore the follicle on a cellular level. This might be against a lot of people's beliefs, but my theory is that male pattern baldness is all due to the autoimmune system's response and not primarily the amount of androgen receptors in the scalp.

 

[kiwipilu]

some highligths from a study posted in another thread

"There are various causative factors implicated in causation of male pattern baldness. Orentreich[6] proposed that minituarization of hair follicles occurs in genetically predisposed androgen-sensitive hair follicle."
...
"Few experimental studies suggested that subcutaneous blood flow in the scalp of a patient with male pattern baldness was greatly reduced as compared to controls."
...
"relative microvascular insufficiency possibly results because frontal and vertex areas are supplied by supratrochlear and supraorbital arteries, which are smaller branches of internal carotid artery, and it overlies galea aponeurotica, which is relatively less vascular as compared to the temporal and occipital areas, which overlie muscles."
..
"The androgenetic theory states that minituarization of hair follicle results from the action of DHT. Hair follicles contain 5α-reductase enzyme that is responsible for peripheral conversion of testosterone to more active DHT. There is an increased accumulation of DHT in the affected follicle and disturbed DHT to estradiol ratio due to relative microvascular insufficiency, which leads to minituarization of hair follicle."
...

So... there you have it. we have predisposed androgen-sensitive hair follicle. at some point blood flow is reduced(different causes), dht takes control (lack of competition/blood flow) and the battle begins.

who said it was complicated?

 

[Cue Bald]

but why would DHT shrink blood vessels and why only shrink them in the pattern of the galea?
and why does "donor dominance" work when it comes to hair transplants? (hair transplanted hair seems to grow fine) - or does hair-transplanted hair slowly die out over say 15 years as it succumbs to low blood levels? i thought transplanted hair would grow forever, or at least as long as the donor hair it was next to would grow for

if it is true though and this blood vessel shrinkage is the cause, it seems to me it would be incredibly difficult to cure. you would not only have to find out how to regenerate these blood vessels but you would also have to make sure they reach every single follicle in the scalp. and you would have to make sure they don't regenerate out of control and become cancerous. could this be why we may not have a cure for 50+ years ?

 

[Ollie]

Obviously DHT theory as we know eunuchs don't lose their hair due to lack of hormones. But its obvious that there is a physical element to it further down the road. The Galea perfectly represents the shape of NW7, and like the Galea that shape is perfectly rounded. You look at a slick bald NW7 and its crazy how 1mm is the difference between perfectly healthy hair and no hair at all.

 

[disfiguredyoungman]

Many NW7s thin arround their horseshoe as well and if you transplant it the hair stays on the galea. Really not sold on that theory at all.

 

[kiwipilu]

but why would DHT shrink blood vessels and why only shrink them in the pattern of the galea?
and why does "donor dominance" work when it comes to hair transplants? (hair transplanted hair seems to grow fine) - or does hair-transplanted hair slowly die out over say 15 years as it succumbs to low blood levels? i thought transplanted hair would grow forever, or at least as long as the donor hair it was next to would grow for

if it is true though and this blood vessel shrinkage is the cause, it seems to me it would be incredibly difficult to cure. you would not only have to find out how to regenerate these blood vessels but you would also have to make sure they reach every single follicle in the scalp. and you would have to make sure they don't regenerate out of control and become cancerous. could this be why we may not have a cure for 50+ years ?

DHT doesnt shrink blood vessels according to this paper. That's other causes that reduce blood flow.. (we know there have been links between cardiovascular desease and male pattern baldness or stress which may triggers mecanism etc but thats surely a part of the possible causes like also our lifestyle.) Would that mean that with normal blood flow our hairs would not fall? Well it pretty much looks like it...But my guess is that the weaker follicles would still die even with low presence of dht (just a guess hey)

For hair transplant : the hairs in the donor area are not genetically predisposed androgen-sensitive I think that that means that even with presence of high level of dht they are not sensitive (no inflamation) so they will survive. now some people who have high norwood 7 sometimes still have some hair follicles survivors despite having a fully fibrosed scalp. so what about fibrosis?according to some the act of making a hair transplant favours angiogenesis and we know wounding is good for calcification/fibrosis (If I find the study... but you know that people who had a hair transplant keep a red scalp sometimes for months).. that's all a puzzle.. we will make it

 

[NewUser]

I tend to disbelieve DHT sensitivity of hair follicles causes:

*prostate cancer
*heart disease
*polycystic ovarian cancer
*diabetes
*hypertension
*and pattern baldness

 

[ZenHead]

but why would DHT shrink blood vessels and why only shrink them in the pattern of the galea?
and why does "donor dominance" work when it comes to hair transplants? (hair transplanted hair seems to grow fine) - or does hair-transplanted hair slowly die out over say 15 years as it succumbs to low blood levels? i thought transplanted hair would grow forever, or at least as long as the donor hair it was next to would grow for

if it is true though and this blood vessel shrinkage is the cause, it seems to me it would be incredibly difficult to cure. you would not only have to find out how to regenerate these blood vessels but you would also have to make sure they reach every single follicle in the scalp. and you would have to make sure they don't regenerate out of control and become cancerous. could this be why we may not have a cure for 50+ years ?

DHT shrinks blood vessels due to the chronic inflammation it causes. it basically puts pressure on the micro capillary in the scalp like a kink in a hose. Eventually, if there is no blood supply to the micro capillary (or any blood vessel for that matter) it will die because the body is unable to regenerate itself without proper circulation. This is exactly what many alternative new treatments are focusing on - 1. Either a method to repair the circulation in the scalp through endothelial cell migration (the cells which make up blood vessels) so that proper circulation is restored and the body's ability to properly repair the follicle through stem cells / growth factors are functional, (Brotzu, Follica, etc) or 2. A way that essentially is an injection of autologous stem cells and growth factors which is basically a shortcut around the circulation issue (Replicel, Histogen).

I don't think DHT itself will shrink blood vessels, but it is a fact that chronic inflammation will cause damage to the microcirculatory system.

 

[kiwipilu]

DHT shrinks blood vessels due to the chronic inflammation it causes. it basically puts pressure on the micro capillary in the scalp like a kink in a hose. Eventually, if there is no blood supply to the micro capillary (or any blood vessel for that matter) it will die because the body is unable to regenerate itself without proper circulation. This is exactly what many alternative new treatments are focusing on - 1. Either a method to repair the circulation in the scalp through endothelial cell migration (the cells which make up blood vessels) so that proper circulation is restored and the body's ability to properly repair the follicle through stem cells / growth factors are functional, (Brotzu, Follica, etc) or 2. A way that essentially is an injection of autologous stem cells and growth factors which is basically a shortcut around the circulation issue (Replicel, Histogen).

I don't think DHT itself will shrink blood vessels, but it is a fact that chronic inflammation will cause damage to the microcirculatory system.

DHT shrinks blood vessels due to the chronic inflammation it causes. Source?

I have never read this and the study I talk about does not mention that. The inflammation is local because of presence of dht which is the cause of lack of blood flow. that's a cascade...
If you remember there was a paper on a chirugical operation to restore blood circulation to the scalp and they said it may reverses male pattern baldness.. I think that enough to say blood flow might be a thing to take care of.
Also Look at the "botox thread"
"Injection of botulinum toxin relaxes the muscle, which reduces pressure on the musculocutaneous and perforating vasculature, thereby potentially increasing the blood supply and transcutaneous pO2."
but we see that results are not 100% positive. So that means dht can still f*** with follicles if they are too sensitive OR restoring blood flow only work if its not fibrosed/calcified? F*** know

 

[verne2k]

3rd answer.

the DHT theory is just stupid. think about it. hair follicles genetically programmed to die under the influence of a natural body hormone. doesn't explain why minoxidil works, and explains hair loss on the temples as just "a normal process of aging".

high DHT in the follicles is just a consequence of something else, probably just lack of blood flow

 

[Ollie]

3rd answer.

the DHT theory is just stupid. think about it. hair follicles genetically programmed to die under the influence of a natural body hormone. doesn't explain why minoxidil works, and explains hair loss on the temples as just "a normal process of aging".

high DHT in the follicles is just a consequence of something else, probably just lack of blood flow

No the DHT theory is correct. Which is why people who have a missing 5areductase enzyme never lose their hair, euneuchs etc..
DHT is used by the body as an anti inflammatory and does damage blood flow thus halting required nutrients to the follicle. Minoxidil works because for the time that it works it sort of 'overrides' the blood flow problem with increased blood flow. We can also observe that those with bad circulation in their limbs due to diabetes also lose their leg and arm hair followed by blistering.

Though im sure there are more mechanical physiologies that exist alongside the DHT problem.

 

[verne2k]

No the DHT theory is correct. Which is why people who have a missing 5areductase enzyme never lose their hair, euneuchs etc..
DHT is used by the body as an anti inflammatory and does damage blood flow thus halting required nutrients to the follicle. Minoxidil works because for the time that it works it sort of 'overrides' the blood flow problem with increased blood flow. We can also observe that those with bad circulation in their limbs due to diabetes also lose their leg and arm hair followed by blistering.

Though im sure there are more mechanical physiologies that exist alongside the DHT problem.

wrong. the reason people with low dht tend to not have male pattern baldness is just because without DHT tissues tend to be feminized, thus the skin having more fatty tissue, and muscles to be weaker. which means less mechanical stress is compressing the galea.

proof is that females with PCOS and hirsutism (basically masculinization) typically develop Androgenetic Alopecia even with very very low DHT.

 

[ZenHead]

DHT shrinks blood vessels due to the chronic inflammation it causes. Source?

I have never read this and the study I talk about does not mention that. The inflammation is local because of presence of dht which is the cause of lack of blood flow. that's a cascade...
If you remember there was a paper on a chirugical operation to restore blood circulation to the scalp and they said it may reverses male pattern baldness.. I think that enough to say blood flow might be a thing to take care of.
Also Look at the "botox thread"
"Injection of botulinum toxin relaxes the muscle, which reduces pressure on the musculocutaneous and perforating vasculature, thereby potentially increasing the blood supply and transcutaneous pO2."
but we see that results are not 100% positive. So that means dht can still f*** with follicles if they are too sensitive OR restoring blood flow only work if its not fibrosed/calcified? F*** know

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723236/

“The consequence of chronic inflammation is endothelial dysfunction that sets in and we can define it as an integrated marker of the damage to arterial walls by classic risk factors”.
Endothelial cells are what blood vessels are made of. I agree with everything you’re saying, maybe I phrased thatpoorly. I should’ve said “the inflammation from DHT puts pressure on the blood vessels and causes a lack of blood flow to the follicles”.

 

[Ollie]

wrong. the reason people with low dht tend to not have male pattern baldness is just because without DHT tissues tend to be feminized, thus the skin having more fatty tissue, and muscles to be weaker. which means less mechanical stress is compressing the galea.

proof is that females with PCOS and hirsutism (basically masculinization) typically develop Androgenetic Alopecia even with very very low DHT.

Thats pure speculation. Not having DHT doesn't automatically pre dispose everyone to those changes. I remember idealforehead talking about the Galea and fatty tissue, however if we look at women who have zero subcutaneous body fat (Berardinelli–Seip syndrome ) they still have healthy full heads of hair.

Also if the Galea area induced these changes then transplanted hair wouldn't be able to survive either - but it does.