Thanks to the continuous scientific progress, hair transplantation with F.U.E. technique is nowadays the best solution for the treatment of baldness.
Baldness or androgenetic alopecia is the most common hair problem: during their lifetime, about 80% of males and 50% of females display some signs of baldness.
Alopecia refers to the absence or the lack of hair in the areas of skin in which they are normally present: the term alopecia includes both hypotrichia, which indicates the deficiency of hair, and the “baldness”, which indicates the irreversible loss of hair.
Importance of heredity
As you can tell from the term itself, androgenetic alopecia has two necessary and concomitant causes:
• andro = androgens – male hormones
• genetic = hereditary predisposition
Androgenetic alopecia does not appears if there are no male hormones and thus it never develops before puberty. Women as well produce androgen hormones, although in lower concentrations than men. For this reason, androgenetic alopecia is not a male genre’s exclusive, but is also observed in women. Alopecia is a polygenic problem, that is caused by many different genes.
More predisposing genes are present, the more serious is baldness. Women, who physiologically have lower levels of male hormones in comparison with men, need more predisposing genes than men, so that the baldness appear. Therefore, a woman with androgenetic alopecia has necessarily many predisposing genes and can transmit more easily the problem to herchildren.
Baldness is usually most premature and serious if many family members are already suffering from it. Not all hair equally respond to the action of androgens and for this reason the androgenic alopecia affects only certain areas of the scalp: they are called androgen-dependent areas, and concern fronto-temporal regions and the vertex, the top of the head. In these areas, the hair undergo a progressive thinning caused by androgen hormones.
The thinning of the hair is a consequence of the follicle’s shrinking process (miniaturization). Their growth phase becomes increasingly shorter and the produced hair are shorter and thinner.
The thinning and shrinking of the hair diameter that characterizes baldness is a slow and gradual process that happens gradually. In areas suffering from baldness, hair often are present, but you cannot see them because they have become light, thin and short down.
Baldness does not concern all the hair in the same way: nearby follicles do not respond to androgens in the same way, indeed each follicle reacts autonomously for this reason in the area affected by baldness, not all hairs are miniaturized, but it is usual to see hair with different thickness and length.
The most important hormone for the development of baldness is dihydrotestosterone (DHT), which is the most important androgen hormone. DHT is produced locally in the hair follicle, from testosterone that reaches the follicle through the blood vessels, and it is regulated by the enzyme 5-alpha reductase. The follicles predisposed to androgenetic alopecia produce increased amounts of DHT compared to the follicles that are not affected by baldness.
For men, baldness does not depend on an excess of male hormones. Bald men are not more virile or more fertile than their peers with more hair; men suffering from baldness have normal levels of male hormones in their blood, but they produce a higher amount of DHT in the follicular level.
However, in women hair loss may be due to an excess of male hormones.
Classically, the alopecia is divided into temporary (transient functional inhibition of the papilla of the hair) and definitive (disappearance of the follicle and the germinating papilla). These must be differentiated from the pseudo-alopecia, in which hair has been ripped off or are broken (tricoclasìa) after traumatic events, chemical or infectious factors or for congenital abnormalities of the shaft: with the exception of the first possibility, the alopecia shows up without complete loss of hair.
The alopecia are divided into: scarring alopecia (cicatricial alopecia), non-scarting alopecia (non-cicatricial alopecia) and pseudo-alopecia.
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