Menu
Hair loss (alopecia) is a pervasive problem that has significant social implications, so much so that entire industries are dedicated to restoring lost hair. The slow emergence of hair loss beginning in the late teens and early twenties can have a number of emotional ramifications, particularly as hair is seen as a signal of health and attractiveness. Though female type hair loss is reported to occur more frequently and more intensely in male type hair loss, which might explain the historically higher preference and consequently targeted more associotoxic beliefs and subjective notions of oneself in male individuals. There are numerous forms of hair loss, classified as either scarring or non-scarring alopecia, congenital or acquired, focal or diffuse. One of the most common forms of hair loss is androgenetic alopecia (AGA), an example of non-scarring, heritable hair loss that is influenced by a number of genetic, metabolic, and hormonal factors. The prevalence of a narrower balding pattern, which may be one of the multifactorial causes of AGA, along with marital status, happiness, and college education, has been found to have a significant genetic component. However, since hair loss is a slow process that often develops over a number of years, the chronic nature of the problem does not lend itself well to self-report data on specific age of onset or duration.
It is well understood that younger individuals experience more scalp issues and are more likely to seek medical treatment than their older counterparts, utilizing primarily hospital-based studies and cross-sectional prevalence data. However, understanding the average hair loss age of onset and speed of progression to baldness is relevant as the pharmacokinetics of the medication is now known, which allows for an evidence-based approach to prescribing.
Aging leads to many changes, one of which may be the loss of an individual’s hair. The time at which male type hair loss begins can vary greatly from person to person and can be attributed to various factors, including genetic predisposition. Women do tend to experience female type hair loss at an earlier age. In addition, studies regarding male type hair loss instances between fathers and sons suggest that there may, in fact, be a genetic predisposition to hair loss. Study results also show that hair loss does occur more frequently in instances where more people in one’s direct family have experienced such.
Environmental expectations may also play a role in an earlier hair loss age of onset. This holds true for those who live in an urban setting, where pollution is more prevalent. Furthermore, it seems that the evidence indicates that smokers will suffer hair loss at an earlier age than non-smokers. Stress and psychological factors, including trauma, can lead to hair loss, and it has, in part, been suggested to be linked not only to the onset of hair loss but perhaps to a worsening of it as well. Nutritional aspects also play a role in hair loss by possibly enhancing its onset. A lack of essential vitamins, such as A, B, C, and E or a lack of biotin, iron, magnesium, copper, selenium, zinc, lysine, and methionine, may contribute to the development of hair loss.
There are many factors that come into play to affect the onset of hair loss age. Hair loss itself evolves into a self-sustained mechanism of progression upon its beginning, resulting in hair loss in other regions, such as the vertex. New treatments are continuously being researched, and, in due time, they will improve treatment and may, perhaps, prevent hair loss. The average age at which someone begins to lose their hair may vary by sex, with females experiencing an earlier onset of hair than males. In general, hair loss can also be affected by environmental aspects and individual environments. This includes an individual’s choices of diet, nutrition, lifestyle, habits, and various factors that affect the overall wear and tear of the scalp and the body.
Hair loss has been and remains a concern for both men and women. Men and women, however, are not similarly affected. Male type hair loss tends to lose hair in distinct patterns, while in women, female type hair loss tends to spread, and this spread varies significantly. Baldness tends to occur later in women, but its spread in women almost always tends to be far greater than in men. The most common type of male type hair loss and the most common female type hair loss is androgenetic alopecia, affecting a significant portion of the world population. In female-type hair loss, androgenetic alopecia manifests as diffuse hair thinning and a reduced density of hair throughout the scalp. In male-type hair loss, androgenetic alopecia initially presents with a receding hairline and thinning of the hair at the temples, which is gradually followed by the development of a bald patch around the top of the scalp, giving the typical ‘M’ shape with hair left at the sides of the scalp.
Men and women react differently to the symptoms of hair thinning, with female-type hair loss typically reporting reduced psychological well-being, depression, and decreased self-esteem, closely connected to external and social status. In addition to significant differences between the sexes that could represent the subject of successful treatment following targeted therapeutic approaches in the future, an understanding of these demographic, ethnic, and gender-related differences, as well as their psychological correlation and differences according to hormonal levels or genetics, can help practitioners identify the optimal treatment options for women and men. Available therapies often need to consider hair loss age, sex, and ethnicity. Normative ranges related to sex and gender need to be developed in clinical studies. Epidemiological data show that more men tend to be affected by androgenetic alopecia than women. Not only are the predisposing genetic patterns different, with the androgen-dependent genetic predisposition that is partially dominant in the female line and very dominant in the male line, but also the relative distribution of androgens and hormonal receptors in each sex differs, explaining the different entry points of androgenetic alopecia dynamics.
Several therapeutic options are available for those who wish to prevent or treat their hair loss. The most common approved topical treatment is minoxidil at 2% or 5% twice a day. Its dermal vasodilator properties reduce hair falling and facilitate hair growth in many patients. Finasteride is given orally to men in a daily 1- to 5-mg dosage to prevent male type hair loss. Although patients begin to see results after approximately 3 months, the drug often causes an increase in hair loss in the patient during the initiation phase. Afterward, the hair loss drug slows natural hair loss modestly and still causes side effects, including loss of interest in sex, impotence, and an increased risk of prostate cancer. There are several other non-medication treatment options for hair loss. These include lifestyle changes, including a healthy diet and yoga. Using alternative therapy through the holistic perspective and natural remedies is another way to address hair loss.
Even though there are treatment options available, the best way to prevent hair loss is through early treatment and intervention. Additionally, surgical methods can be used to treat or restore hair loss. The most common surgical method is a greffe de cheveux, which usually goes unnoticed once the procedure is completed. There have been significant advances in hair transplantation technology in the past few years, and follicular unit transplantation and follicular unit extraction are the most common methods used. Micrografting and slit surgical techniques are used in this type of operation. Platelet-rich plasma is a new treatment for hair loss and shows a statistically significant difference in hair restoration compared to the control group. However, more studies are needed to determine its clinical effectiveness. Since the treatment modalities differed based on the etiology of AGA, an individualized treatment plan was created. The pattern and time of hair loss treatment impact the effectiveness of the therapy.
The results demonstrate that, while large interethnic variation in the difference in hair loss age of onset is seen, white men experienced an earlier hair loss onset than either black or Asian men and women across all hair loss groups. Further research into the underlying biological mechanisms is warranted, as limited understanding of the molecular pathways is a significant gap in our current knowledge of hair loss. This should include large population pharmacogenomics and multi-omics research to identify potential preventative interventions to slow down or stop hair loss before it becomes a problem. Multiple time point and/or cohort studies designed to track the age of onset and progression of hair loss, alongside broader lifestyle factor data, would also be useful for further examining this promising area. An opportunity for tracking and further understanding early onset of hair loss has been missed in the multi-generational study, and we call for global and national funding bodies to support the establishment of such studies to answer these questions. We also call for potential collaboration with high-income countries, where population studies are already established, to understand more about hair loss within a Northern European setting. Future research should also focus on the potential interdisciplinary clinical benefits of a better understanding of the patterning of early onset hair loss, including dermatologists, psychologists, and nutritionists. Specifically, we recommend work to identify potential lifestyle-driven interventions, which also take advantage of further understanding of the molecular pathways, to move the field towards a more effective delay in the onset of hair loss targeting people in their teens and early adulthood. It is an opportunity to open up treatment pathways for the condition and collaborate with established hair loss clinicians and researchers worldwide.
En tant que clinique GOODLOOK, nous opérons dans le domaine esthétique depuis plus de 12 ans avec la devise « Nous nous soucions de vous ».