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Why and How of Hair Loss

Hair loss can be psychologically devastating and can cause loss of self-esteem. Although, there are more than 300 causes of hair fall and hair loss, by far the commonest cause in both men & women is Androgenetic Alopecia. In fact, this entity alone is responsible for over 95% of all hair loss cases. It is so common that more than 50% of adult middle aged men have hair loss due to androgenic alopecia.

Why Does Hair Loss Occur?

Hair loss is a complex process and all the aspects of this problem are not clear yet. However, basic cause of male pattern baldness has been understood. As the name implies, androgenetic baldness must have two components,

1) Testosterone, male Hormone: Testosterone is the primary male sex hormone. It is also found in trace amounts in all women as well. During metabolism in liver, it gets changed to DHT or di-hydro Testosterone by action of enzyme 5-alpha-reductase. DHT is the primary cause of follicular injury in both men and women.

2) Genetic predisposition to balding: Although DHT forms in every male, not all men go bald. This is because our hair roots' susceptibility to get injured by DHT metabolites differs. This difference in susceptibility is inherited like other traits such as hair colour, texture and curl. The inheritance is usually polygenic, meaning multiple genes and their expressions play a role in development of baldness.

As the side and back hairs are resistant to the effects of DHT, they stay behind while hairs on front and top gradually get destroyed. In advanced stages only a horse shoe shaped area of healthy, growing hair remains. It is these healthy, DHT resistant hairs that are used for hair transplantation.

How Does Hair Loss Occur?

During routine hair 'fall' the hair root goes in sleeping stage when a hair is shed. This hair loss is not permanent and after a brief period of rest, the hair root gives rise to a new hair once the conditions are appropriate.

On the other hand, the hair loss occurring via androgenic alopecia is permanent. This is so because there is cellular damage to hair follicle caused by DHT induced inflammation. During each phase of growth the hair becomes progressively smaller and thinner. This process called 'miniaturisation of hair' is irreversible.

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