I had a friend in med school named Jorge. He was a twenty-three year old overachiever, like most med students. The funny thing about Jorge was how OCD he was. He had to have his notes a certain way or else it just wouldn’t process right. He also had this preoccupation about his hair. He would wake up early and get into his morning routine around 6:30 AM just to get his hair perfect. He was of Middle Eastern descent and had very dark hair. When we started med school, Jorge had a full head of hair. By the end of the first year, he was obsessed about how far it had receded. Of course, I really didn’t notice by how much, but Jorge noticed it all the same. He always paid me compliments about my hair, how full it was. He actually started calling me “locks” as my hair was longer back then.
Jorge was worried because his father had hair problems of his own. By thirty, his dad was full on bald and Jorge didn’t want to meet the same fate. Male pattern baldness or androgenetic alopecia (AA) actually affects both sexes, not just men. I would argue that it actually has a greater impact on women as it is more socially acceptable for men to be bald. For women, it can potentially affect their quality of life, their self esteem, and even their outlook on life.
As the name implies, androgenetic alopecia is caused by a combination of androgen hormones and genetics. There is a distinct pattern in the way that the alopecia occurs. For men, the pattern is usually a slow regression of the hairline. For women, the typical pattern is more of a thinning around the crown of the head along with a usual widening of the part line. Androgens are sex hormones that function in the development of secondary sex characteristics like muscle tone, libido, facial and body hair. For women, these hormones can affect their menstrual cycles. A doctor may want to check androgen levels should a female patient present with AA at a young age.
Other medical conditions, like hypothyroidism, autoimmune disease, polycystic ovarian syndrome and iron deficiency may also affect hair growth. It’s important to distinguish androgenetic alopecia from other forms of baldness like alopecia areata where clumps of hair are lost instead of the typical pattern discussed.
There are treatments and medications these days to try to slow down the process of alopecia, but it can take time for these things to work. Plus, the medications that currently on market may not result in the hair growth that patients may be looking for. The hair may grow in places that patients may not want and the hair may not grow in the same way that it grew in their youth. With hair transplantation, a hair follicle is essentially removed from part of the scalp and redistributed in the area needing the transplant. It is a procedure that is usually never covered by insurance and is not without possible complication, like infection.
There are certain things that patients can do to try to avoid alopecia. One of the easiest things to do is to go natural. Avoid using hair products and doing chemical treatments that can affect the hair follicle. Avoid overstyling and over manipulating the hair by brushing or combing excessively. The simple act of washing the hair can also damage the hair root if done too frequently. Reducing stress may also factor into overall hair growth. Finally, eating right may have some benefit in hair growth. Avoid greasy, fatty foods and try to maintain a healthy body weight to keep the hormones in balance. Sometimes, embracing the condition may be the right solution. These days, it’s fashionable for men to be bald. It can be a sign of wisdom in some cultures. For women, the answer isn’t as simple and it’s important to consult a physician.
I have lost touch with Jorge, but I remember him being a good student. I also remember him being great with patients. I know he’s probably out there practicing good medicine because he had a good head on his shoulders, with or without hair.
By: Dr. Juan Borja
Original post: https://yourdoctordad.com/a-bad-hair-year/