Hair loss or Alopecia is a most common sign of ageing among many people. However, it is not restricted to the old people only. Many young people are also quite distressed due to early age hair loss. This problem is affecting men and women all around the world. Research is being conducted by scientists, but only a little success has been achieved to date. To answer “can hair loss be cured” we first need to understand the reasons for hair loss, and what is currently available.
Androgenic alopecia is the most common type of baldness in male and females and is known as pattern baldness. It affects a huge number of men and women all over the globe.
There is a bit of a difference between the pattern of hair loss between men and women. In men, the hair loss usually results in partial or complete baldness, while in women the hairline does not recede rather than the total thickness of hairs is reduced all over the head.
Alopecia in males occurs due to a hormonal imbalance and is more prevalent in the males above the age of 50.
The exact causes of female alopecia are still unclear. However, hair loss is common among women after menopause so it can be attributed to hormonal change.
A hair is made up of a follicle and a shaft. The hair bulb is located at the base of the follicle where the cells divide and grow to produce the shaft made up of a protein called Keratin.
The bulb is surrounded by papilla which contains small blood vessels which nourish the follicles of hairs and regulate the growth of hair by delivering the hormones.
The hair follicles produce hairs on a cyclic basis. A follicle remains active for a few years and then rest for a few years. Like all other cells hair follicles also work in cycles. A natural cycle involves shedding at least 50 to 100 hairs on daily basis. When the hair follicles are in rest phase then hair loss occurs but the follicles present on scalp shed and produce hairs at different timings. Therefore, the hair fall is usually is not noticeable. The problem arises when the cycle of hair growth and shedding is disturbed and results in heavy hair loss or decreased production.
Scientists are now convinced that baldness occurs due to a phenomenon called miniaturization. Few hair follicles are oversensitive to the effects DHT hormone. It binds to receptors present in the hair follicles, shrinks them and makes them smaller over the time. The follicles start to produce thinner and shorter hairs than normal. Eventually, follicles become unable to produce new hairs resulting in baldness.
What hair loss treatments are available at present?
Only a few hair loss treatments are available at present. These treatments restrict miniaturization. But these hair loss treatment therapies mostly manages the excessive hair loss but are not a permanent hair loss solution. The most commonly used method is hair transplants but it certainly has a few limitations.
Finasteride is used to treat the enlarged prostate gland disorder but also has a beneficial side effect i.e. hair growth.
Mechanism of action of Finasteride:
Finasteride inhibits the enzyme Type II alpha-reductase. This enzyme is responsible for the conversion of testosterone enzyme into androgen Dihydrotestosterone.
The Finasteride reduces the DHT levels by 60%. This reduction prevents the susceptible follicles from getting affected by the DHT hormone thus helping them return to their normal size.
The effects of the drugs remain as long as the drug is continued. Finasteride does not have any kind of effects in the women.
Minoxidil was also not discovered for hair loss treatment. It was found accidentally that it is beneficial for the treatment of hair loss. Basically, Minoxidil was widely used for the treatment of high blood pressure. It later came to know that among its various side effects one is hair growth on the body.
Later on, the Minoxidil lotions were applied on the scalp and it worked in many of the cases. Its mechanism of action is increasing blood flow to the hair follicles causing increased nourishment and therefore fights against hair loss.
According to most hair experts at The American Hair Loss Association, Minoxidil is a relatively effective drug against hair loss.
The Minoxidil treatment has nothing to do with the hormones involved in the hair loss problem. Its effects are temporary and will be decreased if the usage is not continued.
Dutasteride is generally used for the treatment of enlarged prostate gland. Though it is not licensed in the U.K for the treatment of hair loss but sometimes prescribed by physicians to treat male pattern baldness. The mechanism of action of Dutasteride is the same as that of Finasteride.
It inhibits type I as well as type II 5-alpha-reductase enzyme. Therefore, due to blocking both the enzymes the drug reduces the levels of DHT to a low level thus reducing the risk of damage to hair follicles.
All the above drug therapies can slow down or usually reduce further hair loss. They can stimulate the follicles to regrow the hairs, but they only act on follicles of hairs that have been dormant but yet viable. It is more beneficial to use these drugs at an early stage of hair loss because they do not work on follicles that have already been inactive.
Hair transplantation is a growing option among people suffering from alopecia. It is a procedure of harvesting hair follicles from the back side of the head and transplanted on the bald areas on the head. These follicles are resistant to DHT. Hairs grow from these follicles either one hair from one follicle or group of hairs from a single follicle. The total no of hairs remain the same but only distributed all over the head. But the limitations to this procedure are pain, expenses, and risk of infection.
Low-level laser therapy (LLLT):
This therapy is basically a light and heat treatment. LLLT has been quite successful in stimulating the growth of hairs in both genders. The mechanism involved is a process of stimulating the stem cells present in the follicles, thus redirecting the follicles into the growth phase.
It is true that the therapies discussed above for treating hair loss are inadequate and have limited effectiveness. The scientists and researchers are striving for the hair loss cures by trying to have a better understanding of the hair growth cycle. Also, they are aiming to target the root causes of hair loss instead of just finding treatments for hair loss.
Little research has been successfully conducted regarding the hair loss arena and scientists are confident enough to find a better treatment plan for alopecia in the near future. Some of these are discussed below.
KROX20 protein and SCF gene:
New research has identified a protein named KROX20, which is responsible for turning the cells in the skin to grow into hairs. These precursor cells produce a protein called SCF which plays an important part in hair pigmentation. A study on SCF genes in mice has shown that in absence of these genes precursor cells produce grey hairs that turned into white hairs with growing age. On the other hand, when KROX20 producing cells were being removed, the hair growth was ceased resulting in baldness.
According to research at the University of Edinburgh, hair loss can be attributed to the genetic code of a person. Most of the men suffering from pattern baldness inherit the gene from X chromosomes of the mothers. You can determine a person’s likelihood of future hair loss through a study of these genes.
Therefore, researchers are working to find the treatment by new drug development.
A study by researchers of University California-San Francisco has reported that defective immune cells which are mostly associated with inflammation control can be responsible for hair loss. These cells named as Tregs stimulate the stem cells to promote hair growth. Therefore, the stem cells are completely dependent on Tregs for healthy hair growth.
The growth of hairs can be increased by inhibiting JAK enzymes located in the hair follicles.
The experiments performed on the mice have shown that the direct application of JAK enzymes helps in the growth of healthy hairs. Ruxolitinib and Tofacitinib are two JAK inhibitors that are approved by FDA.
Scientists are also striving to use stem cells to grow hairs.
Although efforts are being made to find a permanent cure for hair loss in scientific circles globally. Researchers are ongoing in every part of the globe but are still unable to find a solution for good.
A cure for alopecia would lessen the anxiety among people as well as prove to be a source of huge financial resource for the pharmaceutical companies. A large percentage of men and women suffering from hair loss are waiting for an important medical discovery.
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