Androgenic Alopecia is also called “Female Pattern Baldness or Female Pattern Hair Loss.” It is the most common cause of hair loss in females and affects up to 50% of women in their lifetime. Androgenic Alopecia advances with age and menopause.
AGA is a non -scarring diffuse condition that is caused by genetic and hormonal conditions. The hallmark of AGA in women is the transformation of normal hair into vellus hair, commonly called “Peach Fuzz”
In Men ,hair loss usually begins above the temples whereas in women, the hair loss is usually at the “part line” along the temple followed by increasing diffuse hair loss from the top of the head. A women’s hair line rarely recedes, and women rarely become bald.
Mechanism of Hair Loss in Women
Thought to be caused by genetic and/or environmental factors, the 5 alpha reductase converts testosterone to dihydrotestosterone. This binds to the androgen receptors and then transform healthy hair into villus type hairs in the hormone dependent areas of the scalp. These areas are the parietal, frontal and central regions.
Four stages of Hair Growth
- Anagen Phase or Active Growth Phase is when your hair cells are rapidly dividing, and new hair is being formed.
During the Anagen Phase hair growth is approximately half an inch a month.
The Anagen Phase lasts on the average about 3-5 years, 7 years in people of Asian descent
- Catagen Phase is when the hair pulls away from the blood supply and active hair growth is stopped.
This phase lasts approximately 10 days.
3% of all hair is in the Catagen Phase at any given time.
- Telogen Phase is when the hair remains in the follicle but are not actively growing.
10-15% of all hair is in the Telogen Phase at any given time.
The Telogen Phase last approximately 3 months.
- Exogen Phase is when individual hairs are released from the follicles and the hair falls out.
Each follicle is independent and goes through the growth phases at different times.
Healthy scalp shed about 80-100 hairs a day.
Hair loss from androgenic alopecia occurs because of a genetically determined shortening of the anagen phase of hair growth. Also, there is a lengthening of the time between the shedding of hair and the start of new growth. The hair follicle change, shrinking and produces a shorter thinner hair shaft. This process is called follicular miniaturization. This result in a smaller shorter non-pigmented miniature hairs called vellus or Peach Fuzz.
Current Treatment Options for Women
Hair loss in women causes a considerable psychological and emotional distress leading to decreased quality of life.
Current treatment options.
- Minoxidil
- Finasteride
- Spironolactone
- Nutritional Supplementation
- Low Level Laser Therapy
- Hair Transplantation
- Platelet Rich Plasma
Minoxidil was initially introduced as a treatment for high blood pressure, but patients noted hair growth as a side effect. This side effects were confirmed by studies and minoxidil applied directly to the scalp stimulated hair growth.
Minoxidil does several things to help with hair loss. Minoxidil shortens the telogen phase of the hair growth cycle. Therefore, less resting phase and more time in the growing phase. Minoxidil stimulates the dilation of the blood vessels in the scalp, providing more blood flow to the hair follicles. This gives more nutrients to the follicle. Minoxidil may inhibit the adverse effects of androgens by blocking the conversion of testosterone to dihydrotestosterone. However, this effect is minimal.
While it can produce some new growth of fine hair in women, it cannot produce the full density of lost hair. The minimum use to start to see improvement is two months and the effect peaks about 4-6 months. The production of hair growth stops when the medication is discontinued, therefore minoxidil is a life -long commitment.
Side effects of Minoxidil include new hair formation in different colors and texture from normal hair. Also, excessive hair growth in different areas called hypertrichosis.
Finasteride (Propecia) prevents testosterone from turning into dihydrotestosterone. DHT is a hormone that is linked to hair loss. DHT halts the growth of hair. Initially used to help with the symptoms of an enlarged prostate in men. This medication has side effects far more serious than the disease it treats. Some side effects may be irreversible such as erectile dysfunction, depression, suicidal tendencies, loss of libido, anxiety and other neurological conditions. Currently, finasteride is not approved to treat hair loss of thinning hair in women.
Spironolactone is an anti-androgen which blunts the action of testosterone in women. This is especially true in women with polycystic ovarian syndrome because they make increased amounts of androgens. Possible side effects include weight gain, loss of libido, depression and fatigue.
Nutritional support has been used for years in the hair loss industry. Vitamins play a key role in all tissues of the body especially in hair growth and scalp support. Vitamin A, Vitamin C, Vitamin B12, Biotin , Riboflavin and Folate are the major supplements in this regard.
Vitamin A increases the production of sebum by the glands in the follicle. Sebum is important for hair growth and moisturization.
Vitamin C benefits hair by promoting collagen synthesis. This reduces hair loss and improves hair growth
Vitamin B12 is a key ingredient in the process of red blood cell production. Increasing red blood cells will promote more blood and oxygen carried to the scalp and hair follicles resulting in hair growth.
Biotin or Vitamin B7 has been known as a major contributor to hair production and support. Studies have proven patient with Biotin deficiency have significant hair loss.
Folate or folic acid helps hair growth as an anti-inflammatory. This benefit is advantageous for hair loss caused by a significant amount of inflammation. When folate is deficient in the body, the structure of the red blood cells is affected, and this structural change renders them unable to adequately transport oxygen and nutrients to the tissues. When oxygen levels fall, the cells require another source of energy to produce ATP which then causes the production of testosterone. In this production ,testosterone is converted to dihydrotestosterone then causing hair loss.
Riboflavin and hair loss is due to its involvement in the absorption of iron and the production of red blood cells and thus the transport of oxygen to the scalp tissue.
Low Level Laser Therapy appears to stimulate anagen re-entry of telogen hair follicles, prolong the duration of the anagen phase of hair growth and increase the rate of proliferation in anagen follicles. The modulation of hair cycle revels an increase of hair density and diameter as well as a decrease of hair shedding resulting in the clinical improvement of alopecia.
Hair Transplantation, a procedure that was instituted in the United States in the 1950’s involved removing a strip of scalp from the back of the head and using it to fill the area of baldness. 90% of all transplant surgeons use a procedure called follicular unit transplantation. This technique began in the 1990” s. The operation involves removing a strip of scalp and then dividing it into hundreds of tiny hair grafts. Each graft is then planted into a slit made in the scalp. The result is hair growing naturally in small clusters called follicular units. The results are significantly improved over larger plug procedures.
Hair transplant procedures cost between $ 4-15 thousand dollars a session and often multiple sessions are needed to obtain the desired results.
Platelet Rich Plasma is a concentrate from whole blood rich in growth factors, cytokines and bio-active proteins known to stimulate tissue regeneration in all parts of the body. Many studies have demonstrated that platelets not only affect the hemostatic system but also affect inflammatory cascades, angiogenesis, stem cell induction and cell proliferation.
Activated platelets in PRP release numerous growth factors and cytokines from the alpha granules contained on the platelet. These growth factors include glial cell-line derived neurotrophic factor (GDNF) which play a major role in stimulating hair growth through cell proliferation, differentiation and angiogenesis. GDNF can stimulate cell proliferation and protect the hair follicle from premature catagen transition. Vascular endothelial growth factor (VEGF) plays a major role as a potent hair growth stimulator as a angiogenesis stimulator. PRP can also induce the proliferation of the dermal papilla cells. PRP can increase the survival of the hair follicle cells and stimulate hair growth by extending the anagen phase. These actions were supported by microscopic examination which demonstrated an increase in the follicular cells, hair follicles, epidermal thickening, vascularization and an increase in basal keratinocytes in PRP treated scalp tissue compared with placebo.
PRP is an autologous preparation of a concentration of platelets. It is safe with relatively few if any side effects. Side effects reported have been pain at the injection site, mild headache, itching, transient erythema and edema at the treated area. These side effects were all transient and rare. No major side effects were reported such as scarring, infections, hematoma, or allergic reaction of any type or degree.
PRP is considered a safe, effective treatment for alopecia that can be used as monotherapy or in conjunction with other therapies.
Studies
Int J Womens Dermatol 2019 Feb;5(1): 46-51 PMID 30809579
Drug Des Devel Ther 2022; 16: 635-645 PMID 35300222
J Cosmet Dermatol 2018 Feb;17(1): 47-53 PMID 28503741
Juventix Regenerative Medical is an industry leader in the regenerative medical field. Our Platelet Rich Plasma Kits are FDA approved and designed for safety and effectiveness. They are cost effective and easy to use.
Juventix Regenerative Medical offers a Biotin PRP Kit for the rejuvenation of the scalp and the promotion of hair growth. The Kit can be used in men and women. The Biotin intradermally will augment the treatment of alopecia.
Juventix Regenerative Medical offers a patent pending LED Activator to activate the platelets and begin the regenerative process. The activation, a critical step in the release of cytokines and growth factors, is accomplished with light and not with the addition of other chemicals such as calcium chloride or thrombin.
Juventix Regenerative Medical is pleased to announce the newest addition to our regenerative family, the LLLT. The Low-Level Laser Therapy is an excellent treatment for many disease states where tissue needs regeneration or rejuvenation. LLLT is a proven therapeutic treatment modality in hair restoration and can be used solely or in conjunction with the Juventix Biotin PRP Kit.
RESTORE, REVIVE, REGENERATE- JUVENTIX REGENERATIVE MEDICAL
