Balding affects both genders | VailDaily.com
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Balding affects both genders

Dr. Drew Werner

EAGLE COUNTY – Children are not just little adults. Boys and girls are different – as the fifth-graders at Gypsum Elementary school confirmed when Dr. Crystal Rooney and I talked to them about puberty last week. Only men need to worry about balding, right? Well, two of three isn’t too bad.Dear Doc: My husband is losing his hair. It doesn’t bother me as much as it does him, but now I am losing my hair too. Is their anything we can do?- Two Bald EaglesDear Bald Eagles: Thinning hair, or alopecia, is a common condition affecting millions of Americans. In fact, it is a widespread condition affecting people of most countries, races and cultures. Perhaps surprisingly, women are affected, as well. Beginning as thinning hair, the presentation of alopecia is quite different between men and women, as is the final outcome. The facts are remarkable:n Alopecia can begin as early as the end of puberty in men.n 20 percent of men have some alopecia by their 20s.n Alopecia in men increases by about 10 percent per decade of life, beginning in the 30s.n 96 percent of Caucasian men have hair loss in the temporal areasn 6 percent of women have some alopecia before the age of 50.n Up to 38 percent of women have alopecia in their 70s, compared to nearly 70 percent of men.n Hair grows one half-inch per month and may grow for two to six years before falling out.n At any given time, 85 percent of our hair is actively growing and 10 percent is shedding.There are several types of alopecia. I am referring here to alopecia androgenic, or male pattern and female pattern baldness. Other types of alopecia include the immune disorders alopecia areata, which is patchy areas of complete baldness, and alopecia universalis, which is the complete loss of all body hair. Trauma such as chronic pulling from habit or hairstyle can cause alopecia, as well as certain drugs and hormonal diseases like hypothyroidism. Emotional stressors can cause temporary alopecia in a condition called telogen effluvium. This type of alopecia results in at times significant, but temporary hair loss beginning two to three months after a major stressful life event.Androgenic alopecia is related to the male hormones testosterone and the hormone it is converted to dihydrotestosterone (DHT). Elevated levels of DHT are associated with increased alopecia. As women pass through menopause, estrogen levels fall and there are relatively greater effects of testosterone which may be related to alopecia rising dramatically after menopause. Increased sebum or scalp oil caused by elevated DHT may also play a role in alopecia. Finally, decreasing scalp circulation may contribute to hair loss, which may explain why minoxidil, or Rogaine, works.Hair exists in three phases on our bodies. The anagen or growth phase is when the hair is doing just that. On our heads that may last several years. Following the anagen phase comes the catagen phase, which involves a brief transition between growth and resting phases. This phase may last two weeks. Finally comes the telogen phase, where the hair is shed from the follicle, allowing new hair growth to begin.While not serious or life threatening, alopecia can be one of the most emotionally significant medical conditions. While hundreds of remedies are available, few have shown evidence of success. Not including cosmetic treatments or hair replacement only three methods show promise. Minoxidil, or Rogaine, is now available over the counter for both men and women. The extra strength versions work best, and generic brands are equally effective. Finasteride, known by the brand Propecia, is a prescription available for men only. It is taken in pill form and decreases DHT production. Some shampoos and scalp products decrease sebum and may be beneficial. Minoxidil and Propecia are effective only with ongoing use and are better at decreasing the progression of hair loss than causing significant regrowth. Finally, a promising new therapy involves using a safe, FDA-approved low-level laser. Available both as a laser comb and a more effective clinic-based professional laser system, it has shown promising and in some patients significant results.Your doctor, cosmetologist and skin specialist can help with the best recommendations for you. Although the diagnosis of androgenic alopecia is easier in men, your primary care doctor or dermatologist is the best person to diagnose the condition and decide if medical testing is recommended to rule out other problems. While Minoxidil can be purchased over the counter, Propecia is only available by prescription from your doctor. Advanced low level laser therapy is available locally at Alpine Laser Clinic.Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.Vail, Colorado


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