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January 11, 2011

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Home » Feature » Health and Environment

The bald facts about losing your hair

EVERYONE wants a full head of thick, glossy hair and thinning hair and baldness are distressing.

A little daily hair loss is natural, it grows back, but significant loss is a problem and often a sign of inherited factors.

It can also signify underlying problems and issues, some treatable and reversible.

Various factors contribute to major hair loss and balding, including heredity, immune-endocrine system problems, external injury, medication side effects (from some antidepressants, anti-inflammatory drugs, beta blockers, birth-control pills, blood thinners, cholesterol reducers and thyroid inhibitors) and chemotherapy.

But the major cause of balding for both men and women is genetic balding (androgenetic alopecia); it accounts for 95 percent of male hair loss.

Excessive secretion of androgens (male sex hormones present in both men and women) damage hair follicles. The specific culprit is dihydrotestosterone or DHT.

The hormones also cause increased production of sebum that can block hair follicles, but blockage isn't the problem, DHT is.

The future of one's hair is determined before birth, but unhealthy lifestyle (fatigue, poor diet, stress), environmental pollution and radiation accelerate the process, says Dr Li Guihai. He is chief of the Hair Transplant Department of the Meihe Plastic Surgery and Laser Center attached to 455th Hospital of the PLA (People's Liberation Army).

It's common to see hair loss in middle-aged men, but Li says many young men today have premature hair loss, a sign that modern living is taking its toll.

Male pattern hair loss (MPHL) is the most common type of hair loss leading to baldness and generally is hereditary, caused by excessive androgens containing DHT.

Usually, the hair on the forehead or the top of the head goes first and the bald area enlarges gradually. But this doesn't affect hair growth at the back of the head, which is influenced by melatonin, rather than androgens.

Women with endocrine disorders may have similar hair loss, but it's usually less severe than in men.

Heredity, male gender and age are the key factors, according to Dr Li. It happens mostly to men with a family history of baldness.

"Major genetic-factor hair loss can occur in men as young as 18 or 19," says Dr Li. "But an unhealthy lifestyle, stress and environmental pollution usually accelerate it and there are many young men who are quite bald."

"We certainly cannot change the tendency to lose hair, as it's written in the genes, but changing habits can at least help slow the process."

According to traditional Chinese medicine, lack of nourishment by the blood and weak qi (energy) is the major reason for unhealthy hair and hair loss. (Western medicine says it's DHT).

Getting eight hours of sleep, eating a balanced diet and exercising regularly help ensure sufficient blood and energy flowing to the organs and the scalp, according to Dr Ma Shaoyao, of the Special Care Department of Longhua Hospital attached to Shanghai University of TCM.

Foods that reinforce energy and produce blood, like jujubes and sesame, are recommended.

Dr Li recommends foods high in protein and vitamins, especially A and B. These include milk, tofu, egg whites, carrots and radish. He suggests cooking the radish together with meat to ensure better absorption of vitamin A. Spicy foods should be avoided as they increase sebum production, he says.

One of the myths about hair loss is that washing increases loss, says Dr Li, adding that washing helps clean away accumulated sebum and prevent blockage of hair follicles.

Washing every day or two is ideal, especially for men, but women with long hair may not wash as frequently.

Reducing exposure to radiation from computers is important, so is maintaining a positive, balanced mood, says Dr Li.

Medication may be used in severe cases; some oral medication can reduce hormones, hence DHT, but there can be fertility side effects.

External medication is more widely used. Ginger is a widely used folk remedy; rubbing raw cut ginger on the scalp or applying a ginger lotion is said to help, but if hair follicles are already damaged or dead it's ineffective.

Hair transplant may be the only choice for those with dead follicles. The surgery removes healthy follicles at the back of the head and transplants them in the bald area. FUT (Follicular Unit Transplant) is widely used because of its high success rate and the natural look after surgery.

People considering transplant surgery should seek a qualified hospital and consult their doctor beforehand about conditions like diabetes or cardiovascular problems that could rule out the procedure.


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