jeudi 1 janvier 2015
Hair Loss:HAIR LOSS PREVENTION
problem in males and females regardless
of their age. Whilst a common problem
not usually associated with physical
illness, it can cause significant
psychological effects such as diminished
self-esteem, emotional distress,
embarrassment and social inadequacy
(1). Hair loss can be due to genetic
factors, aging, stress, mechanical damage
to scalp and hair, skin infections, diseases
that affect the body generally – e.g.
thyroid disease – and use of certain
medications such as anti-cancer drugs.
Many attempts at classifying hair loss
have resulted in complex and rather
impractical classifications. Currently the
widely accepted one is as follow:
– Androgenetic alopecia – also known
as androgenic alopecia or male and
female pattern baldness;
– Alopecia areata – also known as spot
baldness;
–Telogen effluvium – shedding or
thinning of hair.
Androgenetic alopecia is the most
common cause of hair loss, affecting
about 50% of men and women older
than 40 years of age (2). Androgenetic
alopecia is hereditary thinning of the hair
induced by androgens (male hormones)
in susceptible men and women.
It usually
begins between the age of 12 and
40 years old and is generally caused by
three interdependent factors: male
hormone dihydrotestosterone (DHT),
genetic disposition and advancing age (2).
DHT, a potent metabolite of the androgen
testosterone, causes gradual and
progressive shrinkage in hair follicles that
leads to production of smaller and finer
hairs. DHT also shortens the anagen
g rowth phase of the hair follicle so the
hair is shorter when it stops growing.
The treatment of hair loss ranges
from the common sense to the esoteric
which included almost religious like
rituals. However, the commonly accepted
ones include reassurance, hair
prostheses, surgery and topical/oral
medications (3,4). The most common
pharmacological management of
androgenetic alopecia is topical minoxidil
and oral finasteride. Clinical trials have
shown that 2% minoxidil applied topically
to the scalp could stimulate hair growth
in some men and women while higher
percentage of 5% showed increased
therapeutic efficacy (5). However, the
main problem with topical minoxidil
therapy is patient compliance as
continued use is required to maintain
hair growth (6,7). On the other hand,
oral finasteride is associated with
significant adverse effects such as decreased sexual drive, impotence and
ejaculation disorders (8). Moreover,
finasteride is not encouraged to use in
female patients of childbearing age as it
may cause abnormalities in male fetuses.
Other drugs that have been used include
exogenous estrogen, spironolactone and
topical tretinoin.
Deficiency in oxygen supply as a
cause of male pattern baldness was
investigated by G OLDMANet al (9). The
results showed that penetration of
oxygen was lower in bald frontal scalp
than in hair bearing temporal scalp area
and hence indicated that good blood
supply to the scalp was essential to
maintain normal cycle of hair growth..........
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