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What Causes Baldness?

This is one of the largest problems facing society from a cosmetic standpoint, and that includes women as well as men. It seems as though more and more people are going bald lately. Is it genetics or is it something we are doing that is bringing this on? Statistics say that at age 30, you have a 30% chance of going bald. Every decade, this number moves up by 10%. At age 60, you have a 60% chance of going bald. They always say genetics are the main culprit. The old saying was “look at your grandfather on your mothers side.” This comes from the fact that the major hair loss gene is on the X chromosone(from Mom). There are other genes involved in hair loss and some of them come from your fathers side as well as mom so that tosses that theory out the window. Baldness can be the result of other non-genetic factors like stress. The number one reason for pattern baldness is androgenetic alopecia (AGA), accounting for 90% of all baldness in males and females.


So What Causes Your Baldness?

The leading causes is related to androgenic hormones. So what does this mean and how does it affect you? To understand this we first need to understand how hair grows. There are 3 distinct phases of hair growth. Anagen- The active growth phase, 80-85% of all hair is in this phase. Catagen- is the “transitional phase”, where hair growth slows down. Telogen- this is where hair completely stops growing and “falls out.”Your hair is in Telogen 10-15% of the time. After hair goes into Telogen, it starts back over in Anagen and hair starts to grow. This continues throughout our lifetimes. As we age, our follicles begin to shrink. This causes lighter, finer, and shorter hairs to grow. The hair is also in Anagen (growth) for less time. Eventually, the hair will fall out and never return. There are two factors that play a part in this; hormonal and genetics.

At the root of all hair follicles is a part called the papilla. The papilla is in direct contact with the blood and allows certain hormones to bind receptors; they are called androgen receptors. Humans have Dihydrotestosterone (DHT) which is a byproduct of testosterone being converted 5-alpha reductase. When DHT binds the papilla, it causes the follicle to shrink and eventually leads to AGA. The genetic side is related to Prostaglandin D2 (PGD2). It is found in high amounts in bald scalps. Researchers thought, if we just block PGD2, we will fix baldness! Well, as it stands, DHT and PGD2 work in synergy. The current thinking is that DHT has upstream control of PGD2. It may take another 2-5 years to have an effective PGD2 blocker.


So What Can You Do Until The PGD2 Blocker Is Developed?

The best option right now is using Minoxidil (Rogaine). Rogaine keeps hair in Anagen longer and also makes follicles larger so the hair grows thicker. The caveat is thta once you stop taking it, the hair falls out. Finesteride (Propecia) also works by inhibiting 5 alpha-reductase. This interferes with the conversion of testosterone to DHT, thus it cannot bind the papilla. The side effects can be problematic such as reduced sexual feeling and delayed ejaculation. Some men have a hard time getting an erection as well. Some guys consider it off limits for this reason alone. Short of a hair transplant, the best thing I have used myself is dermal rollers with minoxidil. Dermal rolling triggers the bodies wound healing response and this in turn can cause progenitor cells (think stem cells) to cause some follices to turn back on or new ones to grow.