The results of gravity might clarify the apparently paradoxical results of testosterone in male sample baldness, or androgenic alopecia (AGA), in line with a particular subject paper in Plastic and Reconstructive Surgical procedure — International Open®, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).
The “power of downward pull attributable to the gravity on the scalp pores and skin” is the important thing contributor to the occasions resulting in progressive hair loss in male sample baldness, writes Dr. Emin Tuncay Ustuner, a plastic surgeon in Ankara, Turkey. He provides, “The brand new idea’s unparalleled capability to elucidate even the main points of the hair loss course of and the formation of the sample in AGA is obvious.”
“Gravity Concept” Helps Clarify DHT’s Position in Androgenic Alopecia Dr. Ustuner’s idea seeks to reconcile some puzzling observations associated to the event and development of AGA. Balding areas of the scalp present will increase in a potent type of testosterone known as dihydrotestosterone (DHT), whereas medication that block conversion of testosterone to DHT can sluggish hair loss.
Within the scalp, DHT appears to trigger hair follicles to turn out to be thinner. However in different areas of the physique, such because the underarms and genital space, DHT and different male intercourse hormones promote thickening of hair follicles. Why ought to DHT have an effect on scalp hair a technique however hair in different areas otherwise? And why does balding — and the related improve in DHT ranges — happen solely on the highest of the top?
The reply, Dr. Ustuner believes, is the load of the scalp on the hair follicles. In youth, the scalp has ample fats tissue beneath the pores and skin, and it’s “able to protecting itself well-hydrated,” buffering the strain on hair follicles. However with growing older, the pores and skin and underlying (subcutaneous) fats turn out to be thinner, and the strain on the hair follicles will increase. Testosterone contributes to thinning of the subcutaneous fats. In ladies, estrogen prevents thinning of those cushioning tissues, not less than till menopause.
Growing old and Testosterone-Associated Modifications Create ‘Vicious Circle’ Resulting in Hair Loss Because the cushion decreases, the hair follicle should try towards greater strain, requiring extra testosterone to attain regular development. This “native demand” results in a buildup of DHT ranges within the scalp, however not within the bloodstream. Rising DHT ranges trigger additional erosion of the subcutaneous fats — making a “vicious circle,” in line with Dr. Ustuner.
The hair development cycle accelerates in response to DHT, but it surely’s not sufficient to beat the elevated strain. Over time, the hair follicle turns into smaller and smaller, leading to progressively rising hair loss.
If the strain created by the load of the scalp is the reason for balding, then hair loss ought to happen on the prime of the top — “That is precisely what occurs in AGA,” Dr. Ustuner factors out. He believes that particular person hair loss patterns are affected by variations within the form of the top, reflecting variations in scalp strain. The load of the facial tender tissues provides to the strain on the entrance of the scalp, contributing to hair loss there. In distinction, the ears assist resist the consequences of gravity on the scalp, lessening hair loss on the perimeters of the top.
“There’s not one other idea that fairly and satisfactorily explains hair loss in AGA with out ascribing a operate to DHT that’s reverse to its identified operate,” Dr. Ustuner writes. He notes that, whereas a number of elements recommend that genetic elements contribute to male sample baldness, the rise in scalp DHT ranges “just isn’t an prevalence immediately decided by genes.”
Dr. Ustuner acknowledges that his “gravity idea” of AGA has met with “notable skepticism and resistance.” However he provides, “Simplifying a really difficult drawback might be the one drawback of the idea.”