Hair loss in men

How common is hair loss in men?

The average person sheds more than a hundred hairs per day. This is no real cause for concern, as long as your body is replenishing these losses. When hair loss begins to exceed these thresholds, then it is time to worry.  

Alopecia is a chronic inflammatory condition affecting hair follicles, resulting in discrete areas of hair loss. The separate areas may coalesce to form larger areas. The most commonly affected site is the scalp, but in rare cases the whole body, including pubic hair, may be affected. This is called alopecia universalis.

Alopecia occurs in approximately one per 1000 persons, affecting men and women equally. Most patients are below the age of 30 at the outset. The majority of cases resolve spontaneously, though recurrence is common.

Male pattern baldness, the most common form of alopecia, has been the source of emotional distress for men over the centuries.

Man's obsession with hair dates back to 3500 BC. From ancient biblical times to the Roman period, the specter of male pattern baldness has reared its ugly head. Julius Caesar was preoccupied with his hair loss and grew his hair long in the back and combed it all forward. He also wore laurel wreaths to camouflage his baldness.

Hippocrates, the father of Medicine made a potion for hair loss consisting of opium, horseradish, pigeon droppings, beetroot; spices and many other exotic ingredients (it didn’t work).

He observed that eunuchs (sexually immature men) never became bald. 2400 years later, researchers at Duke's University showed the association between the male hormone testosterone and male pattern baldness.

Baldness affects the scalp in a "horse shoe" pattern on the top of the head. In the majority of cases, the sides of the head is never lost. In approximately 1-2% of cases, the condition is spread to the entire scalp (called alopecia totalis). 

What causes baldness?

There is no single definite-known cause for alopecia, but the most accepted explanation is that it is an auto-immune condition. Antibodies to hair follicles are frequently present in affected persons: these attack and temporarily damage the follicles, preventing further hair growth.

There is an association with other auto-immune diseases, such as thryoiditis, vitiligo and pernicious anaemia.

Up to 20% of patients have a family history of alopecia, which suggests a genetic predisposition. You may even have this tendency despite the fact that your parents have full heads of hair - this is due to a process known as spontaneous mutation, whereby the genetic information changes at conception.

Regardless of the genetic or auto-immune status, it is possible that a triggering event is required to initiate the episode of alopecia.

Trigger factors which have been proposed include: 

• drugs
• vaccination
• infections
• burns
• radiation therapy
• surgery    

Read more: 

Sources:

Dr Craig Ress and Dr Larry Gershowitz at Medical Hair Restoration (021) 425 7755, South African Hair Foundation.