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Biological processes: hair loss, balding & hair growth

I observe much confusion amongst my patients and amongst people having problems with hair loss or those wishing for more hair growth in areas where hair has fallen.
To bring some clarity into these matters I explain in this document what are the major differences between these biological processes.
By Mark Williams, specialist trichologist HairClinics Netherlands
Mark writes for

Many times men and women read on the internet that a particular shampoo is developed against hair loss. They buy it, use it and after months they see pretty much no difference in their hair coverage factor. This factor is depicted in the Norwood O’tar schemes and is gradually classified from scale I to scale VI, depending on the level of the balding.

What they do not understand properly is the fact that hair loss, hair growth and baldness are quite different issues. Here are the concepts:
Hair Loss is the biological process through which old hair is replaced by new one.
Balding means the progressive process of follicular transformation that leads eventually to the so called permanent hair loss.
Hair Growth is the process through which the follicle generates a new hair matrix will develop into adult hair.

A product that is designed to work against hair loss, is not in particular developed to stimulate hair growth. In other words:

Hair loss is a natural biological process. We shed our hair, just like our skin. It is normal and required. Otherwise we would not get new hair or new skin.
In cases where people become bald, hair loss is involved. But this is not just the normal, natural process mentioned above. There is more to it that meets the eye. To put is simply, men are worried that they will end-up bald and they start searching for answers related to hair loss.
This is not the whole picture. In these cases we talk about a certain kind of hair loss called androgenetic (or androgen) hair loss.
This type of problem is not due to the fact that hair sheds in order to get let new hair grow but because of a form of androgen hormone, called dyhydrotestosterone (or shortly DHT).
DHT stimulates the hair follicle to enter in a reverse cycle which, in time, will produce regressed, reduced forms of strands of hair which are smaller, smaller and colourless. This process begins actually around the age of 18 and ever since it will take place every second of our lives, in an accelerated pace as we grow older. This form of baldness is called alopecia androgenetica.

I want to mention briefly why does this happen. The whole process becomes reality due to an enzyme that is found in the human body, mostly concentrated in the scalp skin and prostate tissue, called 5-alpha reductase, or shortly 5ARD.
This enzyme acts like a catalyst upon the testosterone molecule and transfers a hydrogen atom to it, hence the name dyhydrotestosterone. Literally translated ‘dy’ means two, ‘hydro’ comes from hydrogen and testosterone is obviously the hormone testosterone.

Curiously enough, only the follicles that are located on the head, on the so called “crown area”, are sensitive to DHT. This is the reason why a hair transplant fixes the problem permanently.
Geneticists suspect that a certain chromosome is responsible for this DHT sensibility but up to now they have not come up yet with the definitive results. When we will know we will be able to say exactly what are the genetic differences in these follicles located on the body and those located on the top of the head.

This is the process that leads to baldness. To control it we need to control the DHT levels in the blood.
There are several so called DHT inhibitors on the market and I want to stress that this formulation is not entirely correct. We can not inhibit DHT since DHT by itself does not exist. DHT becomes.
More precisely, testosterone becomes DHT with the help of the 5ARD enzyme.
Obviously we can not remove the testosterone from the equation, since it plays an important role in the functioning of the body. But if you turn it around, no enzyme, no DHT.
Personally, I prefer the term 5-alpha reductase inhibitor instead of DHT inhibitor.

Hair loss does not necessarily mean baldness. Men want to avoid becoming bald. To keep baldness under control the 5ARD needs to be kept under control.
By doing this the DHT levels at the hair follicle are lower or very low and the susceptible follicles are less stimulated to enter the reverse cycle.
When people buy a shampoo against hair loss, they should expect it to approach against hair loss and not hair growth. The Kératene® line is one of the many options available for men that want to tackle the beginnings of alopecia. For more details look on Article Manager module by by George! Software.