Each human has on average more than 100,000 hairs on his or her head. We lose approximately 70 to 100 hairs per day. In healthy people hair is regenerating continuously and old hairs are replaced by new ones. We only speak of pathological hair loss if apparent areas of hairlessness are present. Pathological hair loss can have a various reasons and is subdivided into different types.
The best-known type of hair loss is probably the androgenic alopecia. Androgenic means due to hormonal causes. These hormones are released with advancing age, mostly in men. One of the first signs is the receding hairline, which can already appear in the adolescence and under certain circumstances later on broaden until going bald. Women can also be concerned; particularly in the menopause several women suffer from mostly limited hair loss.
If coin-sized round spots remain bald this condition is named alopecia areata. The exact cause of this type of hair loss is unknown, but it is assumed that the reason may be a disorder of the patientʼs own immune system, which is about to destroy hair roots at a certain area of the scalp. In Germany there are about one million people affected by this type of hair loss.
The term diffuse hair loss includes all possible reasons for hair loss. The most important additional causes are thyroid diseases, supply shortages due to diets, and various diseases of the skin such as syphilis or certain fungi.
Therapy of Alopecia
The free market offers a lot of remedies against hair loss. However, the patient should first get an expert opinion on whether he is in fact affected by pathological hair loss and on what’s the reason for losing hair.
In androgenic alopecia the standard treatment includes the medication Minoxidil. Minoxidil, actually a remedy against hypertension, is locally applied to the scalp where it is supposedly carrying out its stimulating effect on the circulation. The result can be seen relatively quickly. However, the patient has to apply the medicine very strictly frequently, as otherwise regrown hair is going to fall out again.
Alopecia areata is treated in a different way and is limited to individual areas. In more extreme cases the bald spots are rubbed with cortisone to suppress an exceeding immune reaction in the treated areas.
Treatment with Bioidentical Hormones and Dietary Supplements
Hair loss, especially in women, may be an indication for hormonal imbalances of the body and can be treated accordingly. First of all a detailed analysis of the patient’s hormone status is made. Some of the imbalances can be corrected with the intake of dietary supplements or by changing lifestyle habits. If this is not sufficient, bioidentical hormones, which means hormones that are similar to the body’s own hormones regarding chemical structure, are administered to the body.
Stem Cell Therapy of Hair Loss
Mesenchymal Stem Cells (MSC) or Stromal Vascular Fraction (SVF) obtained from autologous fat can be used in both types of hair loss. Stem cells are said to be precursor cells of all completed body cells. In the meanwhile we know that mesenchymal stem cells primarily act via modulating the immune system and stimulating regeneration of tissue and blood vessels by cytokines. Alopecia areata especially has an inflammatory component, wherefore stem cell therapy suggests itself.
In diffuse alopecia the degenerative component is predominating, so even there the usage of stem cells could make sense as well. In case of androgenic alopecia hair roots can obviously only regenerate in areas that still possess vital hair follicles. Researchers from the University of Yale in the U.S. have proven that stem cells in men who suffer from androgenic alopecia doubtlessly exist in the scalp, but they have lost their central function and therefore are not able to regenerate anymore. How far injections of autologous stem cells into the scalp can have an effect on “sleeping” stem cells cannot be said yet. In completely bald heads it is necessary to perform hair transplantation according to current scientific knowledge.
Unfortunately significant studies are still missing. But many researchers and physicians hope for a drastic improvement and see a great opportunity in the treatment with stem cells for the future type of treatment of almost all forms of alopecia.
Therapy with Hair Transplant
In case of complete baldness a hair transplant is currently required. In the course of this treatment individual follicles or groups of follicles are taken from the areas of the scalp on which hair is still growing, which are subsequently transplanted to the bald areas. There are a number of methods of hair transplantation. The method yielding the aesthetically most satisfactory results involves extracting parts of single hair follicles and transplantation thereof after preparation in a stem cell suspension.