A Review of male pattern baldness Research.

[FutureSaitama]

For what it's worth if you believe that it plays an important role in male pattern baldness you can actually perform a "galeatomie" in Belgium.

Costs around 1000 euro and they claim it stops your hair loss completely.

Consists of making a cut of approx 3 cm above your ear on both sides to loosen up your galea.

A clinic that does it; http://www.hoffkliniek.nl/haren-en-huid/haarverlies-galeatomie

Any statements from people who had this kind of surgery ? I would actually cut my ears of if it would stop my hair loss.

 

[Captain Rex]

I still cannot believe that its 2017 and we still have the same solutions from 1990 for hair loss today. This is the biggest cosmetic issue in the world affecting millions of people why are companies not giving two shits about it ? Even a topical anti androgen that doesnt go systemic is yet to be developed by a reputable company for f*** sake I'm completely dissapointed by the lack of progress.

yeah man it's really upsetting that we may have all the data and reasons behind male pattern baldness but we still have no cure yet.
addressing the causes may not prove a cure for male pattern baldness otherwise it wud have been cured now, i personally think the cure lies in the embryonic stages. WE HAVE TO START FROM THE BEGINNING (formation of follicles or the cells which helps in hair growth like DP)
i hope these stem cell therapies work out.

 

[Morning Norwood]

I believe mechanical stress associated with the galea sheath may play an important role in male pattern balding. There is some research that shows that hair follicle androgen sensitivity is regulated by Hic-5, an androgen receptor co-activator which may be activated by the mechanical stimulation. ncbi.nlm.nih.gov/pmc/articles/PMC4639964/

Interesting! Natural follow up question, is Hic-5 observed as elevated in balding vs nonbaldding scalp.

I do know that when I massage the muscles around and behind my ears (which feel super tense btw), my scalp feels looser and less itchy in male pattern baldness areas.

 

[Galeaoman]

For what it's worth if you believe that it plays an important role in male pattern baldness you can actually perform a "galeatomie" in Belgium.

Thank you for the reference Swoop. I am thinking that it is possibly a complex problem and something like a galeatomie might do more harm than good. From observing my own scalp over the years, I notice that the skin of the top of the head changes and becomes thinner in a pattern that leaves a small island of hair in the front.
I have recently noticed that exercising the occipitofrontalis muscles in various ways can either cause flushing, heat, and increase blood flow to the top of the scalp but other ways of flexing those muscles can cause restriction of circulation and coldness to the top of the scalp. Is there a correlation with higher blood pressure and male pattern baldness? Post menopausal women also experience an increase in blood pressure along with increased tendency for pattern baldness.

 

[anonimoes]

i've read your document and this thread. I dont understand it 100% of course but i does sound like it makes allot of sense.
But it sounds so easy to fix.
Do the clinics/docters even want to fix this problem? instead of getting money for r&d or transplanting...

 

[Galeaoman]

Miniaturized Hairs Maintain Contact with the Arrector Pili Muscle in Alopecia Areata but not in Androgenetic Alopecia: A Model for Reversible Miniaturization and Potential for Hair Regrowth - ncbi.nlm.nih.gov/pmc/articles/PMC3500053/

Alopecia areata has the potential for regrowth but not androgenetic balding and miniaturization, interesting. The hypothesis is that the arrector pili muscle (APM) attachment to the hair follicle bulge. The bulge is a recognized repository of stem cells and it may be necessary for reversal of hair follicle miniaturization.

Perhaps changes in the skin of the upper scalp cause changes and eventual separation of vellus hairs from the arrector pilli muscles. I am wondering if restoration of the tissues of the upper scalp can re-establish connection of the arrector pilli muscles with the vellus hairs?

 

[Gone]

I read on some other website today that body hair transplanted to the scalp takes on the characteristics of scalp hair. Is this true?

 

[nameless]

I read on some other website today that body hair transplanted to the scalp takes on the characteristics of scalp hair. Is this true?

I've never heard anything like that. Body hair is shorter and finer than scalp hair and I would imagine that if you transplant body hair to the scalp it will grow out shorter and finer just like it did in other parts of the body.

 

[Galeaoman]

I have also read that body hair transplanted to the scalp can take on some of the characteristics of natural scalp hair. That could be some evidence that the physical region on the body also has a mechanical influence on hair growth. I recall that someone called Dr. Umar does body hair to scalp transplants.

Does the Arrector Pili Muscle Have a Role in Hair Loss?

pubmedcentralcanada.ca/pmcc/articles/PMC4158628/

 

[Gone]

Another thing (the body hair is still very important and we should seek an answer), but, if I'm correct, this theory could be proven right or wrong by doing the following:

Harvesting a miniaturizing hair, and transplanting it in the same area of scalp using the same incision and transplant techniques of a standard hair transplant. This would ensure that the "fibrotic cage" is formed and allows regrowth.

This would be incredibly simple to test with the right equipment. If the hair regrows then this theory has some weight to it. If the hair continues to shrink then it has to be something else.

Is the "miniaturizing hair to arm transplant" thing a study? If so, can I see it?

 

[Galeaoman]

Is the "miniaturizing hair to arm transplant" thing a study? If so, can I see it?

I have read other discussion forums and I believe this experiment was performed and a balding scalp follicle transplanted to the arm continued to shrink. I do not have the reference to the study though. S Foote mentioned earlier in this thread about miniaturized human follicles transplanted to the backs of immunodeficient mice became terminal hairs again.

 

[Gone]

Right, and the scalp to arm hair transplant is also very important and similar to the experiment I proposed. I wish I knew how to find it though

 

[Galeaoman]

Perhaps the ability to move the scalp via the occipitofrontalis muscles improves lymphatic draining from the top of the head and gives better scalp tissue health?

 

[Armando Jose]

Right, and the scalp to arm hair transplant is also very important and similar to the experiment I proposed. I wish I knew how to find it though

Trans-Gender Induction of Hair Follicles
Jahoda CA, Reynolds AJ. Trans-Gender Induction of Hair Follicles. Nature 1999; Vol. 402.

 

[Galeaoman]

Possibly related to S Foote's edema hypothesis of pattern balding is this idea that gravity contributes to pattern balding...

https://www.sciencedaily.com/releases/2013/10/131030092856.htm

In the scalp, DHT seems to cause hair follicles to become thinner. But in other areas of the body, such as the underarms and genital area, DHT and other male sex hormones promote thickening of hair follicles. Why should DHT affect scalp hair one way but hair in other areas in a different way? And why does balding -- and the associated increase in DHT levels -- occur only on the top of the head?

The answer, Dr. Ustuner believes, is the weight of the scalp on the hair follicles. In youth, the scalp has sufficient fat tissue under the skin, and it is "capable of keeping itself well-hydrated," buffering the pressure on hair follicles. But with aging, the skin and underlying (subcutaneous) fat become thinner, and the pressure on the hair follicles increases. Testosterone contributes to thinning of the subcutaneous fat. In women, estrogen prevents thinning of these cushioning tissues, at least until menopause.

Aging and Testosterone-Related Changes Create 'Vicious Circle' Leading to Hair Loss As the cushion decreases, the hair follicle must strive against higher pressure, requiring more testosterone to achieve normal growth. This "local demand" leads to a buildup of DHT levels in the scalp, but not in the bloodstream. Rising DHT levels cause further erosion of the subcutaneous fat -- creating a "vicious circle," according to Dr. Ustuner.

The hair growth cycle accelerates in response to DHT, but it's not enough to overcome the increased pressure. Over time, the hair follicle becomes smaller and smaller, resulting in progressively increasing hair loss.

If the pressure created by the weight of the scalp is the cause of balding, then hair loss should occur at the top of the head -- "This is exactly what happens in Androgenetic Alopecia," Dr. Ustuner points out. He believes that individual hair loss patterns are affected by differences in the shape of the head, reflecting variations in scalp pressure. The weight of the facial soft tissues adds to the pressure at the front of the scalp, contributing to hair loss there. In contrast, the ears help resist the effects of gravity on the scalp, lessening hair loss on the sides of the head.

"There is not another theory that reasonably and satisfactorily explains hair loss in Androgenetic Alopecia without ascribing a function to DHT that is opposite to its known function," Dr. Ustuner writes. He notes that, while several factors suggest that genetic factors contribute to male pattern baldness, the increase in scalp DHT levels "is not an occurrence directly determined by genes."

It does seem to be a paradox. DHT causes body hair to increase and hair on the top of the scalp to decrease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174066/

Why does DHT (or 5-alpha reductase enzyme activity) increase in balding scalp?

How does DHT cause hair loss while exactly the opposite effect is expected?

Why does balding (or increase in DHT levels) occur only at the top of the head?


...

 

[Galeaoman]

Grass cannot grow very well in hard clay packed soil because there is no room for its roots to expand. In male pattern balding there is a tendency for the scalp tissues to become thinner and for the top of the scalp to increase its sweating ability. Hairs becomes small vellus hairs. There is more DHT in the scalp than in other tissues. DHT and subcutaneous fat are antagonistic to each other so with more DHT fat and water required for root expansion becomes reduced.

Belly fat also inactives DHT somewhat. http://joe.endocrinology-journals.org/content/191/3/637.full

Hair follicle regeneration is controlled by an intricate relationship between epidermal stem cells and their microenvironment. http://www.sciencedirect.com/science/article/pii/S1934590912004237

Spatiotemporal coordination of cell growth underlies tissue development and disease. Mechanical feedback between cells has been proposed as a regulatory mechanism for growth control both in vivo and in cultured cells undergoing contact inhibition of proliferation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992650/

It appears to be a feedback loop of thinning or hardening of scalp tissues required for hair follicle expansion and ever shrinking hair follicles with fewer and fewer terminal hairs.

Is it genetic? They found a couple of genetic factors for chromosome 20 that makes a person 7 times more likely to go bald but some men have both factors and still have a full head of hair...
http://www.cnn.com/2008/HEALTH/10/13/healthmag.baldness.genes/index.html?iref=nextin

 

[Grasshüpfer]

Is it genetic? They found a couple of genetic factors for chromosome 20 that makes a person 7 times more likely to go bald but some men have both factors and still have a full head of hair...
http://www.cnn.com/2008/HEALTH/10/13/healthmag.baldness.genes/index.html?iref=nextin

The gene is mostly related to the androgen receptor. Maybe we could block dht somehow?

 

[InBeforeTheCure]

It does seem to be a paradox. DHT causes body hair to increase and hair on the top of the scalp to decrease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174066/

Why does DHT (or 5-alpha reductase enzyme activity) increase in balding scalp?

How does DHT cause hair loss while exactly the opposite effect is expected?

Why does balding (or increase in DHT levels) occur only at the top of the head?


...

There's no paradox. Different cell types have varying combinations of "internal machinery" that allow them to respond differently to the same external signal, in this case androgen. So for example, due to differences in chromatin structure between dermal papilla cells of scalp hair follicles and dermal papilla cells of body hair follicles, activated AR will induce a different combination of gene expression changes in each of the two cell types.

The gene is mostly related to the androgen receptor. Maybe we could block dht somehow?

It's just so crazy that it might work.

 

[Galeaoman]

The gene is mostly related to the androgen receptor. Maybe we could block dht somehow?

Excessive DHT buildup in scalp tissue might cause premature aging of those tissues...
I recall reading about a study where they transplanted hair follicles that were going bald to another part of a person's body and those follicles continued to shrink. But they transplanted follicles that were going bald onto the backs of immune deficient mice and the hair follicles regrew to a larger size again. That seems to be a clue that if the local condition of the scalp skin can be regenerated to a younger age then maybe the hair will also regenerate.

The mouse and human genetics are closely related and mice are our cousins on the evolutionary tree.

https://www.genome.gov/10001345/

Overall, mice and humans share virtually the same set of genes. Almost every gene found in one species so far has been found in a closely related form in the other. Of the approximately 4,000 genes that have been studied, less than 10 are found in one species but not in the other.

...

On average, the protein-coding regions of the mouse and human genomes are 85 percent identical; some genes are 99 percent identical while others are only 60 percent identical. These regions are evolutionarily conserved because they are required for function. In contrast, the non-coding regions are much less similar (only 50 percent or less). Therefore, when one compares the same DNA region from human and mouse, the functional elements clearly stand out because of their greater similarity.

 

[Galeaoman]

There's no paradox. Different cell types have varying combinations of "internal machinery" that allow them to respond differently to the same external signal, in this case androgen. So for example, due to differences in chromatin structure between dermal papilla cells of scalp hair follicles and dermal papilla cells of body hair follicles, activated AR will induce a different combination of gene expression changes in each of the two cell types.

Maybe that is true. Humans display neotenic traits in their evolution. https://en.wikipedia.org/wiki/Neoteny

Body hair is relatively diminished compared to other apes and scalp hair is retained, at least in young adulthood. We are naked apes that became naked in order to be more efficient sweating machines. Humans can walk and run long distances in the hunt for food while other hairy animals must stop, rest and pant because they cannot sweat as efficiently. https://en.wikipedia.org/wiki/Endurance_running_hypothesis

A sweaty scalp would help to cool the large human brain. Maybe genetic tendency + biomechanics = balding