Answers to frequently asked questions about hair loss
1. Is reduced blood circulation to the scalp a factor in pattern baldness?
I would like to think that less than optimal circulation in the scalp is a factor in the shrinking and eventual death of the hair follicles. This would make my approach to hair loss more credible. The truth is that decreased blood flow to the scalp does not cause pattern baldness. Many scientific studies have shown that the scalp has more than a sufficient supply of blood to nourish the hair follicles. Hair transplant surgery has also demonstrated this fact. Hair follicles taken from donor areas and placed in formerly bald areas will thrive. This means that blood is not the problem in hair loss or in hair regrowth. But there is some new research that has found that a dense capillary supply to the base of the hair follicle may be important for sustained follicle health.
2. What is the role of malnutrition in pattern baldness?
In the United States where people usually get enough proteins, vitamins, and minerals, nutrition is not the culprit. Most people, of course, could improve their diet but it is doubtful if this step would halt hair loss or grow new hair. I eat a diet rich in all the nutrients, mostly from natural sources. It would be a delusion, though, to think that this is the reason why my hair is still in good shape. Some of my friends who are health nuts and load their bodies with everything from antioxidants to zinc are completely bald.
3. Do clogged follicles contribute to pattern baldness?
Many treatments for hair loss claim that getting rid of the "sebum plugs" that clog the follicles will free up the hair that is trying to escape from the base of the follicle. This does sound plausible and it is a nice image: an imprisoned little hair trying to evade that bad old sebum plug. There is the possibility that a few follicles may be plugged up with sebum, but a few non-functioning follicles do not equal pattern baldness. Clogged follicles definitely are not even a minor contributor to hair loss.
4. Does wearing a hat have anything to do with pattern baldness?
Wearing a tight hat may abrade the hair shaft in an area where it rubs against it, but this does no harm to the follicle. The hair will grow back again with a new hat or no hat.
Some people believe that the hair needs to "breathe." They believe that the continual wearing of a hat might cut off air circulation to the hair - that the hair needs an airing out once in a while. The hair follicles are not nourished by air; they are nourished by the blood supply at the base of the follicle.
I wear a hat always when I go out in the sun. Although both ultraviolet A and B are dangerous to the skin and possibly to the hair, UVA penetrates deeply in the skin (165-250 micrometers). This could damage the DNA and cell membranes in the follicles.
5. Does shampooing too often damage the hair follicles?
My mother used to tell me that if I shampooed my hair more than once a week, I would become bald like my father. My mother had luxuriant red hair so she was the hair expert in the family, but she was wrong. Shampooing the hair, no matter how often, has no effect on the follicles that generate the hair. My opinion is that you really don't have to shampoo your hair every day though - unless you're a coal miner.
6. Does stress contribute to hair loss?
Both psychological and physical stress, especially if they are intense and prolonged, can contribute to temporary hair loss. They do this by perhaps altering the hair cycle: shortening the growing stage or lengthening the resting stage. Stress may also have a negative impact on the immune system leading to a more severe type of hair loss called alopecia areata. When the stressful situation is over or the body adjusts to it, the hair usually grows back.
7. Will vigorous brushing of the hair cause permanent hair loss?
Girls used to be told to give their hair fifty (or was it one hundred?) strokes a day. It probably didn't hurt; it certainly didn't do any good except perhaps to keep the brushing arm in shape. If a woman is extreme in the brushing ritual, however, the abrasive action of the brush against the scalp could cause permanent hair loss, but this is rare.
8. What effect does age have on the hair?
As people reach seventy the skin becomes thinner. The metabolic processes in the skin cells and the hair follicles, which are specialized skin cells, slow down. Even people who had no sign of pattern baldness in their sixties begin to show a natural thinning of the hair as they reach seventy. This is called senescent thinning.
9. What effect do the genes have on pattern baldness?
Most scientists agree that a person's genetic makeup determines whether this person becomes bald or not. This seems straightforward if not too interesting. What is interesting is the "expression" of the genes. Expression is the degree to which a gene has an effect: for example, the rate (how fast) of baldness, the age it occurs, and the extent. Geneticists do not yet fully understand the mechanism of gene expression.
10. How do drugs affect the hair follicles and therefore hair loss?
This is such a broad question that it's hard to give a satisfactory answer. Drugs like hormone pills, contraceptives, even antibiotics can cause temporary hair loss in some individuals. But the drugs used in chemotherapy for cancer can have dramatic effects. These drugs shut down the growing stage (anagen) of the hair cycle. Since ninety percent of the hair follicles are in this stage at one time, ninety percent of the hair can be lost and lost quickly. This is called anagen effluvium. The hair loss is temporary. The hair will usually grow back after the chemotherapy stops.
