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The formation of Androgenic Alopecia, called male pattern baldness, is associated with the structure of human genetics and hormones. It is an organ loss that occurs entirely with the effect of our hormones, where there is no intervention. Because each of the hair follicles is called an organ that functions on its own.
Generally, in males, there is hairlessness or apparent hair sparseness due to loss of hair on the top and forehead, however, hair loss does not occur on the nape of neck and between two ears and there is a hairy tissue structure with dense hair. This is also called KAISER'S CROWN among the public. This happens due to fact that there are two types of hair follicles in human genetics.
Type 1 hair follicles have a shedding characteristic and are located above the forehead. Hair follicles of these types start to shed with the increase of testosterone (male hormone) in the blood that exists in males, and hair will never come out again. Because it destroys the hair follicles. It is a futile effort to wait for hair to regrow since this causes a loss of hair follicles. Therefore, all drug and lotion type applications prepared with the aim of re-growing hair do not make any sense. Each hair strand is at the same time a hair follicle. Hair growth is not possible in the absence of follicle. Since it is entirely associated with hormone and genetic formations, intervention has other risks. Medical field does not propose any medicine prepared in this regard because of the risk of disturbing the hormone balance. This applies to type 1 hair follicles.
The hair follicle, which has type 2 genetic structure, is not affected by the increase of the testosterone hormone and therefore does not have a shedding characteristic. There is no shedding after hair follicle transplantation due to this positive structure. The success of hair transplantation is as a result of this genetic structure. Hair transplantation involves the transplantation of hair follicles that have genetically no shedding characteristic to the areas where hair loss (baldness) has occurred; this is the basis of the operation.
Causes of Hair Loss
1- Androgenic alopecia (male-pattern hair loss) due to increase of male hormone
2- Malnutrition (Lack of Zinc and Iron)
3- Medicines (Especially Antidepressants)
4 - Traumas (in Accidents such as Traffic Accidents and Occupational Accidents, and Scars)
5 - Burns (Regional burns)
6- Stress (Having a Stressful Life Style)
Both men and women have "male hormones" called androgenic hormones. Some of them are testosterone, androstenedione and dihydrotestosterone (DHT). These hormones are secreted by the testes and adrenal glands in males, and in smaller amounts by the ovaries and adrenal glands in females. As a result of prolonged exposure of some hair follicles to DHT first results in hair thinning and attenuation, followed by shedding..
How does DHT affect these follicles?
Some hair follicles with genetic predisposition are rich in an enzyme called 5 alpha-reductase, and this enzyme is responsible for the conversion of testosterone to DHT. DHT binds to the receptor and affects cell metabolism, causing the natural cycle of the hair to stop. In the early stages of hair shedding, the hair becomes thin (miniaturization) and loses its pigment and decolorizes. Rogain (minoxidil) and Propecia (finasteride), which are recommended for use in this period, inhibit 5 alpha-reductase and prevent DHT from increasing in the follicles. Nape hair and over-the-ear hair (donor area) do not shed since they do not contain 5 alpha-reductase activity. In hair transplantation, the hair does not fall despite the presence of testosterone in the after-transplantation environment since it is taken from the nape region, which is insensitive to DHT. When the hair shedding begins and stops and the degree of shedding is unpredictable. The important point here is genetic predisposition. It has been programmed already in the mother's womb whether the hair will fall in the future or not with the genes passed from the mother and father.
A direct relationship has not been found between age and hair loss. Hair loss can start even in 20 years of age when there is a genetic predisposition, that is to say, in those with significant hair loss in their family. Hair loss is most intense between 25 and 35 years of age. We also encounter hair loss that starts at the 40's and progresses rapidly although cutting speed over the age of 45's.
Other Causes of Hair Loss
Alopeci Areata (AA)
It is a recurrent disease that arises with hair losses in oval or circular areas in any part of the scalp. Although it is usually seen on the scalp and brows, it may also occur in other parts of the body. Although the exact cause is unknown, it can be said that it is an autoimmune disease. Stress may lead to exacerbation of the present situation and start of shedding. Sometimes the loss of all body hair can be seen (Alopecia Totalis). Mostly the hair comes back in 6 months to 1 year. Topical or injectable steroids are used in the therapy. Surgical therapy i.e. hair transplantation is not recommended.
It is a type of permanent hair loss that arises as a result of longtime stretching and rupture of hair. Very stretched gathering of hair, tight braids and tightly applied turban-like head scarves may cause hair shedding especially on the forehead hairline and on the sides. By men, traction alopecia occurs in the areas where glues and clips are applied after a long term hair prosthesis. At the same time, this type of permanent hair loss can also occur in "trichotillomania", a psychological disorder (such as eating nail) that is more common in women. In addition to psychotherapy, hair transplantation is quite successful in such hair losses.
Scars and burns resulting from facelift and head-area surgeries constitute the causes of such hair shedding. In this type of hair shedding, a preliminary examination is absolutely required for examining whether hair transplantation can be beneficial. During the examination, the thickness of the scar and the blood circulation of the skin should be evaluated. Often it is possible to obtain successful results in hair transplantation on scar tissue. In the case of very wide scars, a plastic surgeon may need to perform a scalp expansion surgery.