The ancient Egyptians already applied herbal ointments and oils to prevent hair loss and make it grow. In ancient Rome it was animal fat, while in the Middle Ages herbal concoctions and bloodletting were prescribed. In those times it was not well known why men in particular lost their hair. Today we do know, but despite better understanding the causes, a definitive solution has not yet been discovered.
Why does our hair fall out?
The so-called androgenic alopecia is the most common form of hair loss in men, and its causes are genetic and hormonal. It is characterized by the progressive thinning of hair follicles in certain areas of the scalp, especially the hairline and crown. It is estimated that androgenic alopecia affects approximately 30% of men before the age of 30, 50% before the age of 50 and more than 80% at older ages. Alopecia can also affect women, but in a much smaller proportion and with a different hair loss pattern.
The hair loss process due to androgenic alopecia is mediated by the action of a hormone called dihydrotestosterone (DHT), a derivative of testosterone that is produced by the action of the enzyme 5-alpha reductase. In genetically predisposed people, hair follicles are more sensitive to DHT. This hormone shortens the so-called anagen (growth) phase of the hair cycle and, on the contrary, prolongs the rest and loss phases, which leads to the follicles producing increasingly finer and shorter hair, until they finally stop generating hair.
Although hair loss can be a natural part of aging, it can also be associated with factors such as stress, hormonal imbalances, autoimmune diseases, nutritional deficiencies, or even the use of certain medications. In recent years, both topical (lotions) and pharmacological treatments and different techniques have been developed to inhibit the hormonal process that causes hair loss and stimulate the follicles, with different degrees of effectiveness.
Minoxidil
Minoxidil is a topical vasodilator, which is applied directly to the scalp and has been shown to be effective in stimulating hair growth in people with androgenic alopecia. Its mechanism of action is not yet fully understood, but it is believed to improve blood circulation in the scalp and prolong the anagen phase of the hair cycle, the one in which the follicle is active and growing.
The drawback of minoxidil is that its use must be constant. The results usually take between three and six months to become evident, and if the treatment is stopped for any reason, the hair begins to fall out again.
Finasteride and dutasteride
Finasteride and dutasteride are oral medications that work by inhibiting the enzyme 5-alpha reductase, responsible for converting testosterone into dihydrotestosterone (DHT), the hormone that in turn weakens follicles. Studies have shown that both finasteride and dutasteride can significantly slow hair loss and, in some cases, even promote hair growth.
However, as it is a hormonal treatment, its use is associated with certain side effects. Until 15% of men Those who use these drugs may experience sexual dysfunctions such as erectile dysfunction, decreased libido, and reduced ejaculate volume.
Platelet-rich plasma injections
Platelet-rich plasma (PRP) injections have become more common in recent years due to their use to help heal wounds in trauma and joint injuries, but, above all, as a treatment for baldness and to stimulate hair growth. hair transplants.
This technique consists of drawing blood from the patient, centrifuging it to concentrate the platelets, and then injecting this enriched plasma into different points on the scalp. Platelets release growth factors that can stimulate the regeneration of hair follicles and improve the quality of existing hair. Although several studies have proven that there are significant improvements in patients with alopecia, without the side effects of minoxidil or finasteride, not everyone responds the same. The results of PRP treatment are most evident after six months for scalp injections, and are not permanent; Patients may need additional injections.
Low level laser therapy
Another emerging treatment for hair loss is low-level light or laser therapies (LLLT). It consists of using devices that emit low-power laser light at certain wavelengths. These light frequencies penetrate the skin and can stimulate cellular activity in hair follicles. LLLT is believed to work by stimulating the energy-generating mitochondria in cells, and also reduces inflammation and prolongs the hair growth phase.
Although studies on its effectiveness are promising, many have been funded by the manufacturers of these medical devices themselves. A review of studies without conflict of interest concluded that LLLT had a similar efficacy to minoxidil. As with other treatments, it is not a definitive solution, but requires multiple sessions and long-term consistency to experience any improvement.
LED light therapy
As an alternative to laser light, you can find homemade devices that use LED lights at the same frequencies as LLLT to obtain similar results. Some of these devices look like a hat with lights located inside, which can be worn while doing other activities. Studies of its effectiveness are scarce, but, as in the previous case, some have found that this frequency (650nm, red light) LED light can also stimulate follicles. The advantage of these devices is their low price, and the convenience of being able to do the treatment at home.
Taking into account that some of these treatments have side effects, or require a significant outlay or commitment, it is advisable to obtain a diagnosis from a professional trichologist to determine the causes of alopecia. This may include hormonal testing, studies for nutritional deficiencies, or a medical evaluation to rule out possible autoimmune diseases. In some cases, there may be improvements just by treating diet or managing stress, while in others pharmacological or more invasive treatment may be necessary.
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