Hair loss

My two older brothers probably won’t read this, so I can say this with impunity: they’re losing their hair, and so far, I’m not. I’m not saying this to brag, merely to illustrate…oh, who am I fooling. Of course I’m saying it to brag!

Holding on to one’s hair, however, isn’t really anything much to brag about. It all boils down to genetics: every hair follicle in your scalp is programmed for a certain lifespan, determined largely by the genes you inherited from your parents. And, yes, that’s “parents,” plural; the notion that baldness is passed down from the mother’s side of the family only is a myth (one I admit I’ve been telling people for years). So-called “male pattern baldness” can be inherited from either side of the family, and afflicts women, too, although their hair is more likely to thin than to completely disappear.

A typical head has about 100,000 hairs on it at puberty (blondes have more, redheads have fewer), and it’s all downhill from there. By the time men reach their 80s, almost all of them are balding.

Balding occurs when follicles, which produce hair, die or, more commonly, shrink to the size they were when we were infants. They still produce hair, but it’s “vellus” hair–often invisible without a microscope–rather than the full-bodied “terminal” hair we expect to have on our heads.

There are three common patterns of balding. “Vertex” baldness, the most common, produces a bald spot at the crown of the head. “Frontal recession” is the classic receding hairline. The third pattern is an accelerated combination of the first two.

Exactly why follicles die or shrink is not entirely understood. It has generally been believed that the prime culprit is the hormone dihydrotestosterone, or DHT, a highly active form of testosterone. When a follicle reaches the end of its genetically programmed lifespan, it suddenly becomes receptive to DHT, which causes it to shrink.

New research indicates that estrogen, the “female” hormone, may also be involved. Dr. Robert Smart at North Carolina State University in Raleigh, N.C., recently came across an interesting phenomenon while studying the effects of a pesticide on skin cancer. Shaved mice to whose skin an estrogen blocker had been applied sprouted hair, which would seem to indicate that estrogen, too, could be triggering the shrinking of follicles.

Of course, it’s a long way from a shaved mouse to a bald human, but you can bet there’ll be lots of research following up on Dr. Smart’s discovery, because a cure for baldness would be a gold mine for whomever discovered it. Rogaine, for example, which is made from a powerful anti-high-blood-pressure drug called minoxidil, doesn’t really work that well, although it can promote more hair growth in some people (nobody’s sure why). Despite its flaws, its manufacturer, Upjohn, sells more than $150 million worth of it annually.

There are other drugs being explored. Proscar, for example, blocks the action of DHT–but can have unfortunate side-effects in some men, including smaller semen quantities and a loss of libido. Tricomin is a peptide-copper compound (peptides are small chains of amino acids, the building blocks of the body; copper is essential to the health of tissue) that, in a French study a couple of years ago, increased new hair growth by 40 percent in most of the participants.

And, of course, there are toupees, hair transplants (in which plugs of follicle-bearing skin are transferred from the sides and backs of the head, which seldom go bald, to the areas that do), and even Hair-in-a-Can, a cosmetic that colors the scalp.

There’s nothing new in this frantic search to prevent hair loss. Ancient Egyptians smeared their heads with oils from ibex, lions, crocodiles, serpents, geese and hioppopatamuses. Hippocrates, in 400 B.C., concocted his own remedy: opium, horseradish, pigeon droppings, beetroot and spices. Hannibal wore a toupee into battle. As recently as the 1800s, English nobles were rubbing their scalps with Indian tea and fresh lemon–commoners had to make do with chicken droppings, or scalp waxes made of camel dung and bear grease.

Today’s efforts at least have a bit more scientific knowledge behind them, and who knows? They could lead to a complete cure for baldness over the next couple of decades. At the very least, they should offer better ways to fight it.

In light of my family history, I’m keeping my fingers crossed. It might not be scientific, but it can’t hurt–and it sure beats chicken droppings.

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