The average human head has about 100,000
hair follicles. Each follicle can
grow about 20 individual hairs in
a person's lifetime. Average hair
loss is about 100 strands a day.
Incidence of pattern baldness varies
from population to population based
on genetic background. Environmental
factors do not seem to affect this
type of baldness greatly. One large
scale study in Maryborough, in central
Victoria (Australia) showed the
prevalence of mid-frontal hair loss
increases with age and affects 57%
of women and 73.5% of men aged 80
and over.
Male pattern baldness is characterized
by hair receding from the lateral
sides of the forehead, known as
"receding hairline".
An additional bald patch may develop
on top (vertex). The trigger for
this type of baldness (called androgenetic
alopecia) is DHT, a powerful sex
hormone and hair growth promoter
that can adversely affect the hair
and prostate.
The mechanism by which DHT accomplishes
this is not yet understood. In genetically-prone
scalps, DHT initiates a process
of follicular miniaturization. Through
the process of follicular miniaturization,
hair shaft width is progressively
decreased until scalp hair resembles
fragile vellus hair or "peach
fuzz" or else becomes non-existent.
Onset of hair loss sometimes begins
as early as end of puberty, and
is mostly genetically determined.
It was previously believed that
baldness was inherited. While there
is some basis for this belief, both
parents contribute to their offspring's
likelihood of hair loss. Most likely,
inheritance is technically "autosomal
dominant with mixed penetrance"
(see 'baldness folklore' below)
There are several other kinds of
baldness:
Traction alopecia is most commonly
found in people with ponytails or
cornrows who pull on their hair
with excessive force. Wearing a
hat shouldn't generally cause this,
though it is a good idea to let
your scalp breathe for 7 hours a
day.
Traumas such as chemotherapy,
childbirth, major surgery, poisoning,
and severe stress may cause a hair
loss condition known as telogen
effluvium.
Some mycotic infections can cause
massive hair loss.
Alopecia areata is an autoimmune
disorder also known as "spot
baldness" that can result in
hair loss ranging from just one
location (Alopecia areata monolocularis)
to every hair on the entire body
(Alopecia areata universalis).
Localized or diffuse hair loss
may also occur in cicatricial alopecia
(lupus erythematosus, lichen plano
pilaris, folliculitis decalvans,
central centrifugal cicatricial
alopecia, postmenopausal frontal
fibrosing alopecia, etc.). Tumours
and skin outgrowths also induce
localized baldness (sebaceous nevus,
basal cell carcinoma, squamous cell
carcinoma).
Hypothyroidism can cause hair
loss, especially thinning of the
outer third of the eyebrows
Temporary loss of hair can occur
in areas where sebaceous cysts are
present for considerable duration;
normally one to several weeks in
length.
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