Latest research

Research is also looking into connections between hair loss and other health issues. While there has been speculation about a connection between early-onset androgenetic alopecia and heart disease, a review of articles from 1954 to 1999 found no conclusive connection between baldness and coronary artery disease. The dermatologists who conducted the review suggested further study was needed. ^[19]

Environmental factors are also under review. A 2007 study indicated that smoking may be a factor associated with age-related hair loss among Asian men. The study controlled for age and family history, and found statistically significant positive associations between moderate or severe androgenetic alopecia and smoking status. ^[20]

In February 2008 researchers at the University of Bonn announced they have found the genetic basis of two distinct forms of inherited hair loss, opening a broad path to treatments for baldness. They found that a gene, P2RY5, causes a rare, inherited form of hair loss called Hypotrichosis simplex. It is the first receptor in humans known to play a role in hair growth. The fact that any receptor plays a specific role in hair growth was previously unknown to scientists and with this new knowledge a focus on finding more of these genes may be able to lead to therapies for very different types of hair loss.[12][13]

Etymology

The term alopecia (pronounced /ˌæloʊˈpiːʃə/) is formed from the Greek alópix (αλώπηξ), meaning fox. The origin of this usage is because this animal sheds its coat twice a year.

The term bald likely derives from the English word balde, which means "white, pale", or Celtic ball, which means "white patch or blaze", such as on a horse's head.^[18]

Baldness folklore

There are many myths regarding the possible causes of baldness and its relationship with one's virility, intelligence, ethnicity, job, social class, wealth etc. While skepticism is warranted due to lack of scientific validation, some of these myths may have a degree of underlying truth.

• "You inherit baldness from your mother's father."

  Previously, early baldness of the androgenic type was thought to be sex linked dominant in males and to be sex linked recessive in females.

  Research suggests that the gene for the androgen receptor, which is significant in determining probability for hair loss, is located on the X chromosome and so is always inherited from the mother's side.^[10]There is a 50% chance that a person shares the same X chromosome as their maternal grandfather. Because women have two X chromosomes, they will have two copies of the androgen receptor gene while men only have one. However, research has also shown that a person with a balding father also has a significantly greater chance of experiencing hair loss.^[11][12]

• "Intellectual activity or psychological problems can cause baldness."

  This notion may be because cholesterol is involved in the process of neurogenesis and also the base material from which the body ultimately manufactures DHT. While the notion that bald men are more intelligent may lack credibility in the modern world, in the ancient world if a person was bald it was likely that he had an adequate amount of fat in his diet. Thus, his mental development was probably not stunted by malnutrition during his crucial formative years, he was more likely to be wealthy, and also have had access to a formal education. However, a sedentary lifestyle is less likely to correlate with intelligence in the modern world, and dietary fat content is not linked to economic class in modern developed countries. Of course, aside from all these scientific reasons, baldness could be linked to intellect or wisdom simply due to the fact that people go bald as they age and become more experienced.

• This is sometimes used as a stereotype in films, where the more intellectual or rather frustrated characters are most usually portrayed as bald and generally unattractive, as opposed to the main characters which are usually portrayed as attractive, fit, mentally stable and generally with no apparent hair problems.

  There is evidence, confirmed by cross cultural studies, for an association between androgen levels and intellectual ability. These findings are controversial due to their implications regarding psychology and gender.

  Total testosterone exhibits a positive relation to tactual-spatial abilities and to the degree of lateralization. Total testosterone is negatively correlated with verbal fluency. Testosterone in the saliva is also significantly positively correlated to tactual-spatial test scores and, in addition, to field independence. DHT and the ratio DHT/total testosterone are positively related to verbal fluency and negatively to the degree of lateralization of tactual-spatial performance.^[13]

• "One's ethnicity can increase the chances of going bald."

  This idea has been seen as somewhat discriminative and sensitive in nature, however studies have shown that men of Greek or Macedonian heritage have the highest percentage of bald or balding men. (age group 16-28, typical, non married, non-drug using, males) Studies done between 6 countries in Western Europe, incl. Britain, France, Italy, Germany, Spain and Ireland and 4 countries in Eastern Europe including Greece, Macedonia, Bulgaria and Romania show that Greek men of the same age group and study period had the highest percentage of full crown baldness or Alopeciae totalis (front, top and back)^{[citation needed]} Another typical study during the same period showed that Greek men, 1700 out of 2457 total studied males also suffered the highest amount of random alopecia areata among men (aged 16-28, typical, non-drug using males)^{[citation needed]}

• "Baldness can be caused by emotional stress, sexual frustration etc."

  Emotional stress has been shown to accelerate baldness in genetically susceptible individuals.^[14]

• Stress due to sleep deprivation in military recruits lowered testosterone levels, but is not noted to have affected SHBG.^[15]

• Thus, stress due to sleep deprivation in fit males is unlikely to elevate DHT, which causes male pattern baldness. Whether it can cause hair loss by some other mechanism is not clear.

• "Bald men are more 'virile' or sexually active than others."

  Levels of free testosterone are strongly linked to libido and also DHT levels, but unless free testosterone is virtually non-existent levels have not been shown to affect virility. Men with androgenic alopecia are more likely to have a higher baseline of free androgens. However, sexual activity is multifactoral, and androgenic profile is also not the only determining factor in baldness. Additionally, because hair loss is progressive and free testosterone declines with age, a person's hairline may be more indicative of their past than present disposition.^[16][17]

• "Frequent ejaculation causes baldness"

  There are many misconceptions about what can help prevent hairloss, one of these being that frequent ejaculation may have an influence on MPB. Depending on frequency, it can raise or lower plasma testosterone. [11] The claim that frequent ejaculations can cause baldness is often viewed with skepticism.

• "Standing on one's head alleviates baldness"

  The "blood-flow" theory, which led men to stand on their heads in the 1980s, can be found in the advertising for many of the fake hair loss treatments for sale on the internet. While Minoxidil is a vasodilator and is speculated to work, in part, by increasing blood flow to hair follicles, there is no evidence that standing on one's head can alleviate baldness.

• "Tight hats cause baldness."

  While this may be a myth, hats do cause hair breakage and, to a lesser degree, split ends. Since hats are not washed as frequently as other clothing, they can also lead to scalp uncleanliness and possible Pityrosporum ovale contamination in men with naturally oily scalps.

Embracing baldness

See also: Head shaving

Instead of concealing hair loss, one may embrace it. A shaved head will grow stubble in the same manner and at the same rate as a shaved face. The general public has become accepting of the shaved head as well, but female baldness is less socially accepted.

Eyebrows

Though not as common as the loss of hair on the head, chemotherapy, hormone imbalance, forms of alopecia, and other factors can also cause loss of hair in the eyebrows. Artificial eyebrows are available to replace missing eyebrows or to cover patchy eyebrows. Micro tattooing is also available.

Head

One method of hiding hair loss is the "comb over", which involves restyling the remaining hair to cover the balding area. It is usually a temporary solution, useful only while the area of hair loss is small. As the hair loss increases, a comb over becomes less effective. When this reaches a stage of extreme effort with little effect — it can make the person the object of teasing or scorn.

Another method is to wear a hat or a hairpiece — a wig or toupee. The wig is a layer of artificial or natural hair made to resemble a typical hair style. In most cases the hair is artificial. Wigs vary widely in quality and cost. In the United States, the best wigs — those that look like real hair — cost up to tens of thousands of dollars. Organizations also collect individuals' donations of their own natural hair to be made into wigs for young cancer patients who have lost their hair due to chemotherapy or other cancer treatment in addition to any type of hair loss.

Preventing and reversing hair loss

Main article: Baldness treatments

Treatments for the various forms alopecia have limited success. Some hair loss sufferers make use of so-called "clinically proven treatments" such as finasteride and topically applied minoxidil (in solution) in an attempt to prevent further loss and regrow hair. As a general rule, it is easier to maintain remaining hair than it is to regrow; however, the treatments mentioned will help some of the users suffering from Androgenetic alopecia, and there are new technologies in cosmetic transplant surgery and hair replacement systems that can be completely undetectable. The effectiveness of finasteride and minoxidil is not universally accepted.

In the USA, there are only two drug-based treatments that have been approved by the FDA (Food and Drug Administration) and one product that has been cleared by the FDA for the treatment of androgenetic alopecia, otherwise known as male or female pattern hair loss. The two FDA approved treatments are finasteride (marketed for hair loss as Propecia) and minoxidil.