In: Root » Health » Men and women
The cause of pattern thinning in men is primarily related to two sex hormones, testosterone and DHT. The body converts testosterone into the hormone DHT by way of an enzyme found in various tissues throughout the body. In men with the genes for ANA, DHT increases the resting (telogen) phase and decreases the growing (anagen) phase of hair. Consequently, as a man ages, less hair grows at any given time, and the hair starts to thin as a normal consequence of aging, especially in men with ANA. Eventually, baldness occurs. In men who haven’t inherited the ANA balding genes, the combination of DHT and testosterone doesn’t cause hair loss and may have a lesser impact on aging hair. Some areas of the scalp are more susceptible than others to the affects of DHT. For example, the hormone doesn’t usually affect hair on the back and side of the head, which is why these areas retain hair. The term “male pattern thinning” is used because hair loss occurs in a pattern — the back and side of the head retain hair but the crown and frontal areas may lose it. The loss may be confined only to the frontal area or the crown area based upon the genetics that are inherited from the family tree. DHT does play a role in the growth of beard hair; body hair; and eyebrow, nose, and ear hair, but doctors don’t clearly understand that role. Sometime after puberty, male hormones trigger a biological clock that makes hair grow in these areas. In men, the enzyme 5AR activity is higher in the balding area. Women have half the amount of 5AR overall as compared to men but have higher levels of the enzyme aromatase, especially in their frontal hairlines. Aromatase decreases the formation of DHT, and its presence in women may help to explain why female hair loss is somewhat different than hair loss in males. The only way to stop DHT is to block it with finasteride or dutasteride, drugs that interfere with DHT production. At present, only finasteride has been approved by the Federal Drug Administration (FDA). Dutasteride is still being evaluated for its safety and effectiveness for hair loss in young men. There are some reports that dutasteride has significant effects on male sperm production; as such, it may not be approved for men experiencing hair loss. Blocking DHT in women with dutasteride hasn’t been shown to prevent or reverse female hair loss or hair thinning. Its safety with regard to breast cancer, particularly in women who carry the breast cancer producing BRCA genes, is not understood.
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