Hi, I am Dr Deepa Kanchankoti. I have been practising dermatologist, cosmetologist and trichologist in Kandivali, Mumbai since last 17 years. Today I am going to speak about the crowning glory- balding in men.
Whenever a male patient comes to us for reasons of balding, we need to understand or rather classify whether it is localized or it is generalized. The localized balding alopecia is called as alopecia areata and it is much different from the generalized hair loss. Generalized hair loss is again divided into scarring alopecia or non scarring alopecia. Scarring alopecia we have to find out whether it is because of an internal problem in the system or it is a disease on the scalp. Amongst the non scarring alopecia whether it is relive effluvium which is more of stress-related or other problems like diet medicines some local applications etc or it is hormone induced. The hormone induced alopecia in men also known as androgenetic alopecia is the most common problem and here we are going to dispel some of the myths.
What happens is this is the length of the hair and the root is here which is getting its blood supply from the scalp. Within over a period of time this length goes on reducing smaller and smaller and smaller to a very fine non visible hair. So this terminal long thick deep rooted hair converted into a very fine non-visible hair. This process is called as miniaturization and more often what patient calls as hair loss is nothing but hair miniaturization.
Why does this happen?
This happens because at the root of the hair there is an enzyme which causes certain conversion of hormones and this is under the influence of these hormones and more so this is genetically predetermined. Now if one works prevention from this type of miniaturization then there are medicines available which can stop the activity of this enzyme at the root of the hair so long as the medicines are being consumed the enzyme does not act and the miniaturization does not happen but if you stop taking the medicine the miniaturization process stops. There is a myth that people have the understanding if they stop taking the medicine there is more hair loss. There is not more hair loss.
What has been stopped so far it starts happening again. Men usually find that initially they have a v shaped balding which happens during the teenage. This goes on increasing with a deeper V. Over a period of time a bald patch starts appearing in this area and then at the vertex the hair killing happens and the area widens and this area completely balds. So according to the Hamilton grading what starts is great to androgenetic alopecia goes on to increasing and becoming grade 3,4,5,6,7 where in you have a small strip of hair behind and all the hair are lost. So whenever you start the medicine the process of miniatures, medicines stops or gets delayed and if you stop taking the medicines the process starts again. Sometimes patients have this query I don't want to take medicines forever.
Can I go for hair transplant?
That is aan excellent solution where the Velice hair cannot be completely transformed into a terminal hair. Again the hair which is removed from the back of the scalp called as the donor area is transplanted into the front cay area where these hair starts growing here.
Is that a solution for not taking the oral medication?
Probably one needs to look into this. His hair will not grow because the transplant happened and the hair restore is it the glory but this hair is still under the influence of hormones so over a period of time this starts balding again. If one needs to maintain the hair then they must continue taking the medicines inspite of the transplantation because otherwise this hair will remain And this hair will go leading to unnatural balding. So one must always while getting the treatment for hair loss have realistic expectations as to what can be achieved? What can't be achieved? Whether they need to or area they prepared for taking forever or they are happy with natural balding.dermatologist cosmetologist