Both men and women lose hair density as they age. The medical term for baldness or loss of hair is alopecia, and the most common type is known as male or female pattern baldness.
Although thinning hair is much more prevalent in men, women also have alopecia. Most of the time this hair loss is not caused by disease, but is inherited and this genetic tendency is derived from either parent. One-fourth of all men begin this pattern by the time they are 30 years old, and about 67 percent have some degree of baldness by age 60. Interestingly, men who do not produce testosterone (because of genetic abnormalities or castration) do not develop this pattern of baldness.
The average scalp contains about 100,000 hairs, with blondes having 140,000, brunettes 105,000, while redheads have only about 90,000 hairs. Hair grows about half an inch a month, while each individual hair lasts four to five years, when the hair falls out and is replaced within six months. Inherited or genetic baldness is caused by the body’s failure to produce new hairs and not by hair loss.
The common causes of excessive hair loss are: heredity and aging, hormonal changes, serious illness, fever, medication such as cancer chemotherapy or excessive vitamin A, emotional or physical stress, and excessive shampooing and blow-drying. As we were growing up, we were taught to brush our hair vigorously, but it turns out that this is not good for the hair. In addition, hairstyles that pull on the hair, like ponytails and braids, should not be tight and should be alternated with looser hairstyles.
Surprisingly, the use of chemical treatments on the hair including dyes, tints, bleaches, straighteners and permanent waves rarely damage hair if they are done correctly. However, if any of these chemicals are used too often or if solutions are left on too long, the hair can become weak and break. According to the American Academy of Dermatology, if hair becomes brittle from chemical treatments, it’s best to stop until the hair has grown out
Treatment for male or female pattern baldness often starts with minoxidil (Rogaine) solution, an external product that was originally used orally
as an agent for hypertension. The solution is rubbed into the thinning spots twice daily, while taking about four months to show evidence of hair growth. There is also a 5 percent solution, as well as a foam, approved for both men and women.
Minoxidil is sold without prescription and is available generically. It will not grow an appreciable amount of new hair, but it does help prevent any more loss. Studies have found topical minoxidil solution to be very safe.
Finasteride (Propecia, Proscar), a drug primarily used to treat urinary problems in men caused by enlargement of the prostate, is an oral treatment to prevent hair loss in men only; it has been associated with birth defects and is not effective in women. A new oral drug has been developed for women with hair loss, but it is not yet available in the United States.
It is important to see a dermatologist, a physician who specializes in conditions of the hair and skin, before beginning any treatment. The dermatologist will examine the scalp to make sure it is healthy, determine the cause of the thinning hair and then prescribe the treatment. Both male and female pattern baldness are best treated if begun early, when the thinning is first noticed.