Why is the thinning area in male pattern baldness exactly the galea area ?

[cyberprimate]

I think it's important with any hypothesis on male pattern baldness that involves the galea, to consider the 1979 Norstrom study and suggest an explanation about why hair transplanted far from the galea keeps on thinning.

 

[freakout]

In this experiment, immune-deficient male and female mice were grafted with tissue that contained vellus-looking hairs from affected human male and female donors. In 15 to 20 weeks after the transplant, the vellus-looking hair grew into even longer terminal (normal) hair.

Transplants from balding and hairy androgenetic alopecia scalp regrow hair comparably well on immunodeficient mice. Rozlyn A. Krajcik, PhD, Joseph H. Vogelman, DEE, Virginia L. Malloy, MS, and Norman Orentreich, MD Cold Spring-on-Hudson, New York

It's odd when compared with the Norstrom study. But then again, they're mice - not men.

One possibility is adaptation. Hair follicles are complate organs. Much like its individual cells, it has a 'mind' and 'life' of its own separate from the host organism.

It could be that it has 'decided' to shrink itself (to adapt) to cope up with the reduced blood supply.

So actually, I don't totally subscribe to the Norstrom study because given enough time, that transplanted follicles might actually regain its ability to regrow thick hairs shafts which could take a year or more depending on how long it has been losing on the galea area. And this might not be the same with every individual.

 

[cyberprimate]

Freakout, what happens with a "tissue that contains vellus-looking hairs from affected human male and female donors" when it's grafted to mice that are NOT immune-deficient? Did they try that? Because the result of the experiment you mention could suggest either an immune cause to male pattern baldness or a hormonal cause (as mice don't produce the same amount of dht i guess). The same results with mice that have NO immune deficiency would suggest the cause of male pattern baldness is primarily hormonal. No?

(btw the Norstrom study lasted 21 months so you would have to wait more than 21 months if the thinning process diminished in the long term on transplanted hairs)

 

[cyberprimate]

And?

 

[Bryan]

By the way, the correct spelling of the name of the Finnish doctor who did the experiment of transplanting balding frontal hair follicles onto the arm of the young man is exactly the way I spelled it in the other thread: Nordstrom, with a "d". Rolf E. A. Nordstrom. N-O-R-D-S-T-R-O-M.

There's also a little accent mark consisting of two dots over the "o" in Nordstrom, but I don't know how to make that on my computer!

 

[cyberprimate]

Alright " Nordström ".

 

[freakout]

Freakout, what happens with a "tissue that contains vellus-looking hairs from affected human male and female donors" when it's grafted to mice that are NOT immune-deficient?

They used immuno-deficient mice because the transplanted follicles are contained in skin tissue.

THey transplanted male and female donors to male AND female mice and they had good results.

Hair follicles themselves are immune-privileged which mean they can be transplanted to practically anyone if the skin tissue is totally removed.

Transgender induction of hair follicles. Nature. 1999 Nov 4;402(6757):33-4). (Reynolds AJ, Lawrence C, Cserhalmi-Friedman PB, Christiano AM, Jahoda CA.

(I'm actually cheating. I have this book where I get the gibberish i'm throwing in here)

Where can I read the Nordström study? thanks.

 

[Bryan]

Where can I read the Nordström study? thanks.

I have the full medical reference for it in that thread on the "New Treatments, Studies, and Discoveries" forum. I also quote quite a bit of it verbatim in that same thread.

 

[cyberprimate]

They transplanted male and female donors to male AND female mice and they had good results.

Yes, and i remember reading that the substantial decrease of androgen production during treatment against prostate problems didn't help more than Finasteride, and doesn't give these good results anyway. So one can think that immunity is the main evil in a sequence of events that involves androgens.

But despite the 1979 Norsdström study i still think the galea is also involved in the process. First because of this exact similarity between it and the baldness area. Second because of a personal observation on my own scalp. Several people have noticed (myself included) that my hair loss is, obviously only on the top, but also that it's less pronounced on two incurved areas of my skull. My skull is not round but slightly spiky along the metopic and sagital sutures, and there are 2 incurved areas on my scalp (it's very slightly observable with the eyes but obvious when i touch my skull). My understanding of this is that on these 2 incurved surfaces the influence (whatever it does) of the galea in the process of male pattern baldness is lessened.

 

[Bryan]

In that Nordstrom paper, he spends the first three paragraphs discussing the "galea theory", before he starts discussing his own experiment with the hair follicle transplant to the arm of that young man. The first paragraph is a bit too long to type out here (although I'll do it if the rest of you are really interested in that galea theory), but here are his second and third paragraphs (I'm leaving out his medical references):

In 1941, Kessler started experimental work with frontal galeotomies in order to reduce the supposed increased tension of the galea aponeurotica. In 1961 he reported a success rate of 87% with this treatment of male pattern baldness. At that time this operation was popular in Europe. In 1963, Ponten reported that after frontal galeotomy he could not find any objective improvement in his 56 patients and he still holds this view concerning this operation (personal communication, 1976).

The present author has seen several patients who have undergone frontal galeotomy and later developed an advanced degree of male pattern baldness. The popularity of this operation has waned.

 

[cyberprimate]

Maybe you could post a url link to the whole Nordström study if it's on the web.

As I suggested earlier, the galea could play a role in a long lasting alteration of follicles by androgens. This alteration would remain after transplantation of these altered follicles to the arm, leaving the follicles subject to further decay (inflammatory process,…), despite the absence of galea there. Unless a treatment is done to the transplanted follicles to counter their initial alteration from the galea/androgen "system" (work on stem cells?…), balding goes on. How the galea interacts locally with androgens in the initial alteration of follicles, I have no idea, that's why i don't like to refer to any rigid description of the galea action (poor blood supply, scalp tension…).

As for 1941 Kessler vs 1963 Ponten, one needs to have all details to really conclude anything.

 

[freakout]

cyberprimate said Several people have noticed (myself included) that my hair loss is, obviously only on the top, but also that it's less pronounced on two incurved areas of my skull. My skull is not round but slightly spiky along the metopic and sagital sutures, and there are 2 incurved areas on my scalp (it's very slightly observable with the eyes but obvious when i touch my skull).

Good observation. It's actually the reverse of what some cases are - the M-shaped frontal progression leaves (or delayed) a patch of thick hair at the front center.

Let me guess: you're scalp is not oily and maybe drier than it should be. Mine is not dry nor too oily. But I noticed more hair loss in the depressed areas.

When I massaged the depressed areas vigorously, I noticed my fingers become slightly oily. I've read that this oil (sebum) can become lodged and eventually become viscous.

I did a massage twice a day combined with "physiological therapy" (not to be confused with 'physical therapy') over a few months now. Miniaturized hair is now noticably longer, maybe slightly thicker, but still thin. I'm hoping this will thicken and not fail overtime.

But yours seem different - more hair in the depressed areas. hmmm... makes me think that the Androgenetic Alopecia+blood supply equation is much larger.

The galea is rigid and biochemically 'inert'. Being a few layers apart, its effect on hair follicles is only anatomical but very compelling and I also believe that it affects the dynamics of the entire process of male pattern baldness over the long term but only as a factor, not a cause.

 

[freakout]

If we blame the galea as the factor that 'causes' baldness, it's like blaming water in a drowning incident.

With this, I will dispute. There is still water, and there is torrents, whirlpools, etc. So the fact you can swim safely in one basin, does not mean every basin is equally nonthreatening.

Allow me to be more explicit. You can blame the torrents and whirlpools but you cannot blame the water that entered your lungs.

For me, I wouldn't blame the torrents or whirlpools either. I'd blame the victim for his stupidity for swimming in those waters.

 

[cyberprimate]

Another intriguing and unexplained reality of male pattern baldness that makes me inclined to give credit to the influence of an additional factor like the galea in the whole male pattern baldness process, is the geographical evolution of male pattern baldness on the scalp. It's not uniform in time. Some regions of follicles (like often the frontal hairline) shrink faster generally. How can the orthodox theory explain this difference?

As far as i understand it, the orthodox theory suggests that all hair on the scalp of a man with male pattern baldness have a negative follicular response to androgens (release of negative growth factors), but that this response on balding area is MUCH more intense. (Correct me if i'm wrong) Now, the observation of balding in time shows there's also a difference of response WITHIN the follicles of the balding area. So why is there a CONTINUUM of genetic difference between follicles on the galea area and suddenly an ABRUPT difference in this gradual continuum, exactly where the galea becomes absent? Why would human biology organize on the scalp a gradual genetic variation that gets suddenly abrupt where the galea ends? I just can't believe this can be true.

I think the idea of genetic differences between follicles is not enough to explain this regional and non gradual disparity of follicular response to androgens. There needs to be something else and I think it could have to do with the galea and how this galea is organised on the head. The galea is probably not put uniformly (hence the different balding pace between hair regions on it), and its area is limited (hence the non balding area around it). But it could be another reason.

 

[bigentries]

What about "unsual" balding patterns like female baldness, Zinedine Zidane-like patterns, etc

 

[freakout]

I think the genetic component of male pattern baldness lies somewhere else - not the scalp hair follicles judging by your last post.

The differences in negative growth which seems to correlate with the topography of the skull within the balding area suggest that genetics could be insignificant. Case example: diabetis type 2 is thought to have a genetic component but is negligible by eating right. Although I don't think diet has a significant influence in male pattern baldness.

The current Androgenetic Alopecia theory suggest that hair follicles are committing slow suicide while it appears that they are trying to survive by miniaturizing. I think that if Androgenetic Alopecia is all there is, male pattern baldness will have developed to its maximum in a matter of years after puberty - as quick as growing beard. There must be other factors.

Case example: Vladimir Putin of Russia had a full head o hair in his early forties when he became prime minister. A decade later, he's now a NW4+. Is stress the trigger mechanism?

 

[cyberprimate]

What about "unsual" balding patterns like female baldness, Zinedine Zidane-like patterns, etc

Depends on what female baldness you're talking about. The post menopause alopecia seems to have the same final shape as the galea. It's just very uniform on top.

Zidane's hair loss looks like the typical male hair loss i've just described. Limited to the galea area, and not uniform through the years on the galea.

Vladimir Putin of Russia had a full head o hair in his early forties

You can see he had very thin hair and a receding hair line before his forties, that's him during his KGB years. He's always looked like a jerk anyway.

 

[Bryan]

I think that if Androgenetic Alopecia is all there is, male pattern baldness will have developed to its maximum in a matter of years after puberty - as quick as growing beard. There must be other factors.

People have brought that up several times on hairloss sites, and I'll give my usual answer: it can apparently take a lot of TIME (decades) for scalp hair follicles to slowly increase their sensitivity to androgens in some cases, which explains why balding isn't always in full force immediately after puberty. Furthermore, I suspect that the negative effect from androgens can be cumulative, which could further explain a considerable time-lag.

 

[freakout]

thanks for the putin pic. I should verify those posts first.

... it can apparently take a lot of TIME (decades) for scalp hair follicles to slowly increase their sensitivity to androgens in some cases, which explains why balding isn't always in full force immediately after puberty. Furthermore, I suspect that the negative effect from androgens can be cumulative, which could further explain a considerable time-lag.

Yes, but that is based on observation and on the assumption that no other factor is involved. Is that right?

It's much like making a rule based on observation - like the law of gravity - simply because there was no other way to explain it.

 

[Bryan]

Yes, but that is based on observation and on the assumption that no other factor is involved. Is that right?

It's based on simplicity, common sense, and the results of published scientific studies.