Regular Member Jingo Posted May 27, 2009 Regular Member Share Posted May 27, 2009 We all know we lose hair because of the damm mpb, but how does it start? I would like to know how atacks, what i usually see its that beggins by loosing hair in the temples, then attacks the the little (puff) you still have in the front, then all your back, except some cases where you loose temples and crown at the same time. Is this more or less correct? Link to comment Share on other sites More sharing options...
Regular Member Jingo Posted May 27, 2009 Author Regular Member Share Posted May 27, 2009 We all know we lose hair because of the damm mpb, but how does it start? I would like to know how atacks, what i usually see its that beggins by loosing hair in the temples, then attacks the the little (puff) you still have in the front, then all your back, except some cases where you loose temples and crown at the same time. Is this more or less correct? Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted May 27, 2009 Share Posted May 27, 2009 Jingo, Male pattern baldness (androgenic alopecia) is genetic and occurs when a signal is sent to the hair follicle to kill itself. DHT, a hormone produced when 5-alpha reductase enzymes combine with testosterone binds to hair follicle receptors and attacks the follicle, slowly killing it. What physically happens is this: once the signal is sent to the hair follicle to die, the natural hair growth cycle shortens, lessening the time of the growth (anagen) phase and increasing the time of the shedding (telogen) and resting (catagen) phases. As the hair follicle shrinks, it produces a thinner, finer, shorter hair, until it eventually produces nothing. Which hairs are genetically programmed to self-destruct isn't determinable prior to looking for signs of miniaturization either under magnification or what's visible to the naked eye. However, usually by the time we actually notice we're losing our hair, we've already lost 50% of it in the targeted area. What we do know is that male pattern baldness typically follows a particular pattern, though diffuse genetic hair loss can occur. The norwood scale of hair loss can be used as a measuring tool and guide as to how male pattern baldness typically progresses. Those not suffering from male pattern baldness (at least yet) can consider taking the HairDX genetic hair loss test to help determine their risk. They can also consult a dermatologist who can perform a miniaturization test under magnification and other tests to check for signs of pattern baldness. I'm not sure if this is the information you were looking for, but I hope it helps. Best wishes, Bill Link to comment Share on other sites More sharing options...
Senior Member Dr. Michael Beehner Posted May 27, 2009 Senior Member Share Posted May 27, 2009 In addition to the typical "Norwood" classification progression of hair loss which Bill described, namely gradually deepening recession in front combined with an enlarging crown/vertex until the two meet in the middle to produce total u-shaped baldness, though the commonest progression pattern is not the only one. Three other patterns which are seen fairly often in our practices are the following: a) The "diffuse thinner" who has no one area that is stronger or denser than another. All the hair in the horseshoe shaped area on top just thins at exactly the same rate and disappears together also. b) The "forelock" pattern, in which a roughly oval shaped area of hair in the front-central is denser than the alleys to each side and the large area behind it. Gradually, a forelock much later in time does become thinner and often disappears and becomes total baldness on top. c) The "intact hairline" pattern, in which the early baldness is in the rear crown/vertex and gradually expands until it comes right up to behind the hairline. Al Gore is an example of this pattern of hair loss. Mike Beehner, M.D. Dr. Mike Beehner is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member hdude46 Posted May 28, 2009 Senior Member Share Posted May 28, 2009 so how come not everybody progresses to nw6-7's? Link to comment Share on other sites More sharing options...
Senior Member Dr. Michael Beehner Posted May 28, 2009 Senior Member Share Posted May 28, 2009 HDude46, That's a very good question! Maybe if they all lived to be 100 they actually would. As a general rule, if you see a man in his 30's, 40's, or 50's with some residual "strong" hair on top amidst obvious hair loss behind, around, or in front of it, it is a very safe bet to assume that over the next decade or two that "strong" hair will gradually thin and possibly even disappear. However, like you I also over my 20 year hair surgery career have seen men who defied this theory of "progressive hair loss" and seemed to stay still at a particular stage, whether it was an intact hairline with baldness behind, a large oval forelock with baldness all around it, or a Norwood "Variant" class person who has hair loss off the front only going backwards with strong hair throughout the crown/vertex region. One fellow at my church has a shiny 2 1/2 - 3 inch crown with thick hair all around and it hasn't changed in 15 years. We should all be so lucky! Mike Beehner, M.D. Dr. Mike Beehner is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
Senior Member hdude46 Posted May 28, 2009 Senior Member Share Posted May 28, 2009 so should we assume that if we exsperience mpb that we all will go to a nw6-7? I just dont see how this is possible. While hairloss does follow a pattern to some extent, that pattern is different in its own way in everyone. My family for example has no nw6 or 7's. My grandpa is a 5, my dad is a 1, his brother is a 3-4, other uncle is a 1. you get the idea. According to dr. rassman: ???The general rule is that for those who have hair loss in their 20s, most of it will slow down by the mid 30s and by the time the person reaches 40-45, it should slow down even further.??? He also says that people in their twenties just experience an early progression of the gene. I hear a lot of people say that their hair loss stabalizes as they get older, is that true? There has to be something to explain why we all dont go to 6-7's, otherwise how the heck are ht's docs in business? Link to comment Share on other sites More sharing options...
Bill - Seemiller Posted May 28, 2009 Share Posted May 28, 2009 Though I'm not a medical professional, I tend to believe that even if we lived to be 100, not everyone with genetic pattern baldness will progress to a norwood 7. I believe only certain hair follicles are genetically programmed to self destruct while others aren't. There are plenty of old men at varying levels of hair loss to suggest this. However, on the flip side, I suppose if they lived to 200, we'd have a better indication of just how far and long hair loss progresses. That said, we do know that hair loss progresses at varying rates. Best wishes, Bill Link to comment Share on other sites More sharing options...
Senior Member Dr. Michael Beehner Posted June 5, 2009 Senior Member Share Posted June 5, 2009 I just noticed Bill's reply concerning my comment regarding what might happen if all men with male pattern baldness lived to be 100, and I agree with him. I didn't mean to imply in my earlier statement that all would progress to Class VII as an end stage, but was referring to the collective group of Class VI's and Class VII's. My strong hunch is that, even at 100, a fairly large group of men might still hang on to residual native hair in some regions on top. Mike Beehner, M.D. Dr. Mike Beehner is a highly esteemed member of the Coalition of Independent Hair Restoration Physicians Link to comment Share on other sites More sharing options...
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