Good afternoon. In this article I have decided to fully consider a hair loss problem, to give maximum information for those who is really disturbed by this problem, as the intelligible and accessible information on this point isn't simply present. At once, I want to warn that some moments can seem to you difficult for perception, but it's impossible to manage without it, differently the picture will be not full. Be patient, try to catch sense. We should shortly disassemble the reasons and the mechanism of development of the given illness, so you could understand and estimate methods of treatment.
What is hereditary hair loss? What in fact person inherits from parents? Person inherits the second kind of hair follicles, which are sensitive to man's sexual hormones, also called 'androgen-dependent' follicles. People who don’t suffer from АGА have only one kind of hair follicles. As well as any other hereditary disease, Androgenetic alopecia (AGA) has the age of implication. So to say, the beginning of hair loss is genetically programmed. It means that the person can grow bald at any age from the moment of offensive of a sexual maturity. There are more man's hormones in men, therefore it is obvious that they are more subject to hair loss.
It is noticed that with age augmentation, the quantity of growing bald people is enlarged. So, at the age from 20 to 30 years percent of men with hair loss equals approximately 20 %, on the fourth ten of life – 30 %, on the fifth 40 % and so on. It is also a degree of sensitivity of hair follicles to man's sexual hormones is transferred by right of succession. Three degrees of sensitivity are allocated: high, average and low. At high degree person become absolutely bald within 4-5 years. At low degree hair leaves head gradually during the whole life. Average degree is intermediate.
Androgen-dependent follicles are placed in a parietofrontal zone only. Nobody actually knows why. This zone is called androgen-dependent. There are no such follicles in occipital and temporal areas; these are called androgen-nondependent zones. This phenomenon is taken as a principle of hair transplantations in case of AGA, but we'll talk about it later. There is a classification of a hereditary hair loss.
Before examining the mechanism of AGA progressing, it is necessary to talk about physiology of hair, i.e. about norm. Head hair grows cyclically, in average 5 – 7 years. Each cycle consists of three phases. Anagen – active growth of hair phase, it occupies almost all time of a cycle. Then comes short catagen phase, it lasts only 3 – 4 weeks during which follicles are disconnecting from vessels and nerves and "dump" their covers. The following phase is telogen (rest phase), it lasts for about 3 - 4 months. In this phase hair isn’t sensitive any more and isn't supplied with blood, it doesn't grow, as a matter of fact, it is dead. It is gradually pushed out to a surface of a skin by a new hair and drops out. Now the cycle comes to an end. The quantitative parity of hair growth in different phases is: anagen-85 %, catagen-1 % and telogen-14 %. Hair growth rate on the average is 0,35-0,5мм a day or about one centimeter a month. It is the highest rate of a mitosis (cell fission) among tissues of all organism.
Here now let's survey the mechanism of a hereditary hair loss. As soon as term (age) at which androgen-dependent follicles start to show sensitivity to man's sexual hormones (androgens) approaches, pathological process is started.
All in all the mechanism of androgenetic alopecia's educing (pathogenesis) looks like: in a follicle, under the influence of 5-alpha reductase enzyme, man's sexual hormone Testosteron-Depotum will be transformed into more active hormone - dihydrotestosterone which influences hair follicles.
Intrafollicular dihydrotestosterone is a source of all troubles. It causes a strong, long vasospasm which breaks synthesis of proteins that causes a dystrophia. During hair degradation its growth phase is shortened.
So, during the first dystrophia degree (there are only three degrees of a dystrophia), anagen duration is reduced into two years, during the second - one year, and during the third degree into six - four months. Hair's follicle suffered from dystrophia decreases in sizes, starts to produce thinner hair, growth rate is considerably reduced, chromogenic function of a follicle is oppressed, i.e. hair is gradually decolorizing.
As soon as the dystrophia reaches the third degree, the anagen phase (hair growth phase) is blocked, i.e. the follicle ceases to produce hair (augmentation of hair quantity in telogen), during three-two cycles. If anagen block lasts about 10-12 years the follicle perishes (it is very average term). The connective tissue cicatrix is formed on its place.
Hair loss treatment for men.
The short of a hereditary hair loss treatment is reduced into three principles:
- Protection of hair follicles from destructive action of dihydrotestosterone.
- Unblocking nonfunctioning follicles.
- Creation of necessary conditions for hair growth and reconstruction.
Attention! Efficiency of AGA treatment is inversely proportional to age of the patient, time which has passed from the beginning of hair loss and degree of follicles' sensitivity to dihydrotestosterone.
Let's talk about the treatment sequentially.
1. Follicles' protection from dihydrotestosterone action.
We remember that dihydrotestosterone is formed from Testosteron-Depotum under the influence of a reductase 5-alpha enzyme. Nowadays trichologists all over the world use only one reception. It is a blocking of a reductase 5-alpha enzyme.
As a chain: Testosteron-Depotum - 5-alpha reductase - dihydrotestosterone, an average link is beaten out. Neither 5-alpha reductase, nor dihydrotestosterone. All medical agents referred to blocking 5-alpha reductase have received the corresponding name -5-alpha reductase blockers.
Blockers are divided into two types, external which are put immediately on a head skin and internal, for intake (per os).
Not to overload you with stories about all existing blockers, take my word: there are lots of blockers, but it is not necessary to be sprayed on experiments. All experiments are already made.
From my private experience I will tell that, perhaps, the only worthy 5-alpha reductase blocker is finasteride. All other blockers, internal and external considerably concede it in efficiency. Finasteride is issued under different trade marks, I will result the most known: Propecia, Finpecia, Proscar, Finast, etc.
Not so long ago the five of the most effective preparations used for androgenetic alopecia treatment has been published on web-site Regrowth.com. According to experts, the indisputable leader of this cohort is Propecia. Buy Propecia and Finpecia here.
I will not tell you the story about finasteride occurrence, I will only tell that it is entered into medical practice in 1980 for treatment of a prostate adenoma among elderly men. The matter is that there are two types of 5-alpha reductase in a man's organism. First type is placed in prostate, second – in skin and its appendages. First type starts to react with finasteride in doses from 5 milligram and above, i.e. less 5mg of a first type 5-alpha reductase practically doesn't react to a dose. Second type of 5-alpha reductase reacts with finasteride in a dose from 0,5mg, i.e. ten times smaller.
When it has been understood, after carrying out clinical tests in 1998, the commission on foodstuff and medical products - FDA (Food and Drug Administration) has resolved application of finasteride in 1mg dose for heredity hair loss treatment.
The safety aspect of using finasteride for hair loss treatment was important. By-effects of finasteride reception meet extremely seldom. Finasteride safety dose was estimated on 3200 men (1 mg a day). 0,5 % of examinees suffered from by-effects in different forms, such as libido depression, erectile dysfunction, reduction of quantity of an ejaculate which have completely disappeared after preparation cancellation. As a matter of fact, I will tell that described by-effects don't appear if selection of a dose is correct. Today finasteride is officially used for AGA treatment practically all over the world.
2. Unblocking nonfunctioning follicles.
To deal with this problem so-called hair growth stimulator of hair is used. The ancestor of this group of preparations is minoxidil. It is possible to say that the minoxidil appearance was a break in hereditary hair loss treatment.
Honor of minoxidil foundation belongs to the American doctor Alfred Kligman. He discovered its stimulating influence on hair growth in 1982. And only in 1996 in the USA, the aforementioned commission on foodstuff and medical products - FDA (Food and Drug Administration) has resolved application of minoxidil for AGA treatment.
In Europe minoxidil extends under Regaine trade mark, in the USA and in some other countries - under Rogaine trade mark. Rogaine is on sale in 2 % and 5 % execution. Actually minoxidil acts as the activator of potassium channels. The potassium channel is protein which is responsible for delivering ions K + through a cell membrane. Potassium ions' stream influences a membrane potential (charge). It leads to change of streams of other ions, in particular, calcium.
Change of concentration of intracellular calcium serves in vessels as a signal for synthesis of a nitrogen oxide (NO) - endogenous vasodilator that causes a vasodilatation. Already through three, four months from the beginning of application of a preparation there is a notable result. But it has very essential disadvantage - a withdrawal. It means that after two, three months after minoxidil cancellation appeared hair completely drops out again.
For this reason minoxidil application in the pure state is very limited for AGA treatment. Including minoxidil in the AGA treatment scheme isn't worthy today. Combinations of minoxidil with retinoids, amino acids, copper containing polypeptides, external blockers 5-alpha reductase, zinc, estrogens etc. are much more effective.
The most allocated representatives of this group are "Proxifen" and "Remox" (Re-mox). The scourge of all minoxidil containing preparations is a withdrawal.
Recently the great popularity is got by the preparations framed on the basis of vegetative extracts. As a rule, they possess very weak withdrawal and are effective enough. Many of them are made in China.
3. Creation of necessary conditions for hair growth and reconstruction.
It is very important component of a hereditary hair loss treatment! Follicles are very sensitive to bad blood supply, deficiency (disbalance) of certain trace substances.
It is necessary to begin AGA treatment from correction of a trace substances disbalance. Why? The follicle is like a factory which produces hair. Rate of a mitosis (cell fission) there is very high, the highest in the whole organism. Trace substances, figuratively, are the basic raw materials for hair manufacture. If it wasn’t made, before applying stimulators at once, there will be follicle attrition very soon. Hair will leave during telogen phase. Stimulator application effect will reduce to zero, retrogress will be outlined.
To correct disbalance of trace substances it is necessary to address corresponding experts.
In case of AGA not only follicles suffer, but also all appendages of skin, including capillaries and precapillaries, and not only vascular, but lymphatic too. The bad lymph drainage leads to puffiness of tissues, to accumulation of toxins etc. Inadequate blood supply leads to oxygen starvation, which causes tissues’ souring, anaerobic type of breath. It is possible to improve blood supply of scalp skin through applying trichologic massage, the infra-red laser, Darsonval currents.
Trentalum is very effective dosing under the certain scheme. It is necessary to improve rheologic of blood property (fluidity) and its transport function. Thereupon it is necessary to saturate organism with iron, vitamin В12, and cobalt. It is very important to use antioxidatic therapy, a bistimulation, enterosorption during the treatment course. The patient should receive up to 40 mg of zinc aspartate (5мг pure zinc) a day during all period of treatment.
Let's talk about a withdrawal.
It is necessary to spend treatment not less than year and a half to lower a withdrawal as much as possible.
The thing is that androgen-dependent follicles' resistibility to dihydrotestosterone action is appreciable, but insufficient. In case of first degree dystrophia resistibility sharply falls, at the second and third it is absent in general.
During AGA a problem zone follicles have a dystrophia of different degree. Duration of a growth phase at a first degree dystrophia lasts from ten months to one year and at dystrophia of third degree only three, six months. Hence, in the course of treatment at least two changes of hair passes through and it deteriorate result and cause some hair rareness.
It is a normal process. It is necessary to know about it before initiating treatment not to be depressed, having faced with the given effect. So to say, treatment needs to be spent until hair don't become terminal (mature). Only after that it is possible to start selecting supporting scheme. It should be made softly within two, three months.
In the conclusion I want to say that androgenetic alopecia's treatment is especially individual. Here, as anywhere, one of main principles of medicine should be observed: «it is necessary to treat not illness, but the patient». If all is made correctly, results of hereditary hair loss treatment is excellent. Don't self-medicate, address experts. They will carry out the necessary analyses and will prescribe effective course of treatment for you.
I will be very glad, if this information helps you.
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