Diffuse Hair Loss and How to Treat It

Unlike male pattern baldness (MPB) and female pattern hair loss (FPHL), which tends to follow one of the hair loss patterns defined by the NorwoodScale and the LudwigScale, Diffuse Patterned Alopecia (DPA) is characterized by diffuse thinning throughout the front, crown and vertex(crown) with no distinct pattern evident. However, like male and female pattern balding,Diffuse Patterned Alopecia patients typically preserve the stable "permanent zone" on the sides and back of the scalp and may sometimes retain a well-defined hairline. DPA is also a type of hereditary balding condition like and rogenetic alopecia (genetic hair loss).

Diffuse Patterned Alopecia (DPA) can be difficult to diagnose and, particularly in its early stages, may be confused with a similar condition known as Diffused Unpatterned Alopecia (DUPA). While both conditions are characterized by diffuse thinning, DUPA sufferers lack the stable permanent zone necessary for surgical hair restoration.

Treatment for Diffuse Patterned Alopecia

DPA often responds well to medical hair loss treatments like Propecia (finasteride) and Rogaine(minoxidil) and, due to the preservation of the permanent donor region, many DPA sufferers are candidates for hairrestoration surgery.

Conclusion

It’s essential that hair loss suffering men and women seeking medical and/or surgical treatment for diffuse thinning consult with a skilled and experienced hair restoration physician. Differentiating between DPA and DUPA is critical because Diffuse Patterned Alopecia patients frequently make good hair transplant candidates, whereas DUPA patients rarely do.

Hair loss is a universal condition, affecting all ages, races, genders and nationalities. It’s estimated that “androgenetic alopecia,” or male and female pattern baldness affects 35 million men and 21 million women in the United States alone. This section examines how race, age and gender affect hair loss.

Race and Hair Loss

In physiological terms, human beings are all composed of the same bones, muscles, and everything else down to the cellular level. But there are specific differences.

Hair, in all of its variations, is one area in which human beings display their differences. Hair follicles can widely vary in terms of color, length, shape, thickness, strength and various other factors.

There are many ethnic groups to consider. But we will focus on the special considerations of Asians, Blacks (of African descent) and Caucasians.

Asian Hair Loss Considerations

Asian people typically have very straight hair. Their scalps contain fewer hairs per square centimeter, they actually have a lower hair density than that of Caucasian hair follicles. But because the individual hair follicles of East Asians are thicker, this gives the look and impression of greater hair density.

For these reasons, hair restoration techniques for East Asians, much like other races, must be sensitive to a variety of anatomic and cultural differences. For instance, East Asian females often have an increased likelihood of developing “diffuse alopecia,” or hair that thins evenly over the entire head than Caucasian females.

Even though it’s not a definite requirement, it’s very helpful for Asian patients to seek out doctors with experience in Asian hair.

Another consideration for East Asians considering hair restoration surgery is the increased chance of developing keloid scars. A keloid is a thick, irregularly shaped and elevated scar with uncontrolled growth that results from excess fibrous skin tissue. East Asians typically have a greater likelihood of keloid development than Caucasians, but less than that of people of African descent. Therefore, before undergoing surgery, East Asians may want to consider being medically evaluated for keloids.

African Hair Loss Considerations

People of African descent usually possess naturally curly hair. This curly hair gives the visual impression of increased hair density for a given amount of hair, which is beneficial in hair restoration surgery.

The hair follicles beneath the skin of people of African decent also typically curve more than Caucasians. This can make harvesting the donor hairs, without severing or transecting the hair follicles beneath the scalp, more difficult. A hair restoration physician needs to be very aware of this difference and adjust to its requirements.

As in the case of East Asians, people of African descent possess some unique hair and skin characteristics. Some of these medical conditions are more common in black skin than in white skin. This may increase the risk for post-surgical complications.

Those of African descent have a higher chance of developing keloid scarring when injured. This in turn leads to a greater chance of noticeable donor scars. Keloids aren’t a widespread problem. But those with a history of them are carefully evaluated in regard to their existing scars. The evaluation usually involves a small "test procedure" to determine if there’s a normal healing rate.

Another issue is that of postoperative skin discoloration. With darker skin, there’s often a greater risk of both increased and decreased skin color after injury or surgery. These risks can be determined by the patient’s medical and family history.

Ingrown hairs are also a more common problem in darker skin. If a patient has a history of ingrown hairs or other minor skin infections, this may signal a higher risk for ingrown hairs post-hair restoration surgery. Again, this risk can be determined by a small test procedure.

Caucasian Hair Considerations

Caucasians (white people) may have a wide range of hair and skin types. However, if someone has dense and or coarse hair, as well as skin color similar to their hair color, they will generally achieve the best results for a given amount of restored hair.

Learn more about aging and gender hair loss

What is Traction Alopecia?

Traction alopecia is a form of hair loss resulting from the repeated yet unintentional pulling, twisting or rubbing of the hair. Traction alopecia can affect both men and women, though it's more commonly seen in women. Though it can be temporary, balding from traction alopecia may become permanent if these traumatic forces are applied to the hair and scalp repeatedly and for prolonged periods, resulting in scarring.

What Causes Traction Alopecia?

Practices that may result in traction alopecia include; wearing tight braids, ponytails or cornrows and extended use of hair extensions.  Due to the popularity of these hairstyles, traction alopecia has become one of the leading causes of hair loss among African America women.

Balding from traction alopecia can also occur from repeatedly wearing tight-fitting hats, helmets or other headgear.This is likely where the popular hair loss myth about hats causing hair loss derived, but it is important to note that, under normal circumstances, wearing a properly fitted hat will not negatively impact hair growth.

Treating Traction Alopecia

The first step in treating traction alopeciais to change the habits leading to the condition. This may mean adopting a new hairstyle or altering your wardrobe. Finally, applying a vaso dilator like Rogaine(minoxidil) to the affected area can increase blood flow to the damaged follicles and effectively speed up new hair growth. Assuming the hair follicles have not been permanently damaged, new hair growth will likely occur though it may take several months.

In cases of severe and permanent tractional opecia, the only effective method of restoring hair to the bald areas is surgical hair restoration. State of the art, ultra-refined follicular unit hair transplantation allows quality surgeons to harvest DHT resistant hair from the donor region at the rear and sides of the head. These hairs are then implanted into the balding areas of the scalp, resulting in a natural and undetectable appearance. To see which physicians we recommend and for a free virtual consult, visit the Coalition of Independent Hair Restoration Physicians.

To learn more about how surgical hair restoration can be used to treat traction alopecia hair loss, view the following results from our hair loss forum and social community:

• Dr.Robert Dorin - 1909 Grafts on a Traction Alopecia Patient
• Dr.Victor Hasson / 3560 Grafts / One Session / Traction Alopecia / One Year

Contained in Several Popular Hair Loss Treatments for Men

Nettle root extract can be found in a number of popular hair loss treatments, such as Provillus and Procerin, and at your local health food store as a standalone product. Conjectured to effectively inhibit the production of DHT, below we examine whether or not nettles are as effective as Propecia (finasteride) in blocking DHT and stopping the progression of male or female pattern hair loss.

Description

“Nettles” is the common name for Urtica Dioica, an herbal plant also known as the Stinging Nettle. This perennial herb is often eaten in many parts of the world and is often added to soups, salads or cooked as greens, though less frequently. Nettle leaves are long and pointy, but only the shoots and top of the plant are eaten. Nettle plants have dark green leaves and typically grow about 2 or 3 feet tall and its flowers are covered with tiny stinging hairs that contain an irritant. Allergic reactions are common if they come in contact with human skin.

Use of Nettles

Nettle root extract was found to partially block 2 enzymes by researchers such as R. Hartmann.  The first is 5-alpha-reductase that when combined with testosterone, produces DHT (dihydrotestosterone). DHT is the hormone responsible for androgenic alopecia hair loss. The second enzyme is aromatase, which makes estrogen.  Combining nettle root extract with another herbal agent pygeum has been found to inhibit these two enzymes more effectively than either one alon It was shown that nettle root extract had to be used at high dosages in order to effective whereas lower doses of pygeum worked well.  Prostatonin, the combination product of nettles and pygeum have been used to treat BPH (benign prostatic hypertrophy).

Studies by researchers JJ Lichius and others have shown a reduction in prostate growth in mice when large doses of nettle extract were taken orally. Combining nettle root extracts with saw palmetto berries in BPH patients reduced the amount of testosterone and estrogen. Conversely, it has been conjectured that nettles can block testosterone from binding to the sex hormone globulin, a carrier protein that binds testosterone and limits its bioavailability in the body. As a result, nettles have been called an aphrodisiac since it may help maintain testosterone levels.

Other uses of Nettles include treatment for arthritis, asthma, kidney, urinary tract infections, and last but not least, baldness.

Nettle Root as a Hair Loss Treatment

Like many other herbal supplements with some clinical evidence suggesting efficacy in treating enlarged prostates (BPH), some have claimed that nettle root extract may stop hair loss and maybe even aid hair regrowth.  Because Propecia (finasteride) works to stop the progression of male pattern baldness by inhibiting the production of DHT, it is conjectured that nettle root extract may be of similar benefit.

Nettle root is a popular ingredient taken orally in a couple big name hair loss products such as Provillus and Procerin.  Some have also conjectured that applying nettle root extract topically to the scalp may also facilitate new hair growth. Because many topical irritant type products are used to treat alopecia areata hair loss, some suggest nettle root extract applied topically may be effective in treating it. Those who conjecture its efficacy to treat baldness recommend doses of 500mg or more daily.

Though some have declared that nettle root extract may be an effective hair loss treatment, no clinical controlled studies have been performed proving its efficacy for androgenic alopecia (genetic female hair loss and male pattern baldness) or alopecia areata. 

Possible Side Effects of Nettles

Despite claims made that “all natural” herbal supplements are free from side effects, nettle root has its share of warnings. When topically applied, irritation of the scalp or an allergic reaction can occur. When taken orally, it can cause upset stomach, burning, difficulty with urination, bloating and edema.  Nettle root extract should not be used in patients with heart or kidney problems, due to fluid retention properties.
Those who want to try nettle root extract as a hair loss treatment should proceed with caution and consult their doctor before using it.