At some point in time, men and women will notice their hair strands becoming shorter. The texture of their hair will also be noticeably more brittle and weaker. Over time, the hair becomes remarkably thinner, their scalp almost showing. Eventually, the hair follicles will stop growing hair entirely. This progression is called hair miniaturisation.
The hair follicle growth cycle consists of three phases: a growth phase (“anagen”), a transitional phase (“catagen”), and a resting phase (“telogen”). In genetically-susceptible hair follicles, a hormone called dihydrotestosterone (DHT) can cause the growth phase of the hair cycle to become progressively shorter. The individual hairs produced by these follicles are unable to grow to full size due to this shorter growth window and so they decrease in size (diameter and length) over time until they eventually disappear. This process of “miniaturisation” is the main mechanism in androgenetic alopecia (genetic balding).
Hair Miniaturisation Causes
The most common cause of hair miniaturisation is Androgenic Alopecia. Androgenic Alopecia is known to be genetically inherited. It affects an estimated 10 million men and 3.4 million women in the United Kingdon. Miniaturisation due to Androgenic Alopecia can start as early as when a person is a teenager. As a person ages, he or she also becomes more at risk. More than 50 percent of men over 50 experience hair loss. In women, hair loss most likely happens after menopause. In normal hair growth cycle, follicles under the skin produce strands between 2 to 6 years. The process will go into a resting phase for several months, and then hair falls out until follicles start growing hair again. This cycle continues until there is increased of androgens in hair follicles. When this happens, there will be a shorter cycle of hair growth and hair becomes shorter and thinner. There will also be a delay in the replacement of lost strands that are being shed. Consequently, hair miniaturisation takes place. Hair miniaturisation is identified with hair thinning from either temporal side of the head, creating the “M” shape. Miniaturisation can also start at the top of the head.
Dihydrotestosterone or DHT
Dihydrotestosterone (DHT) is an androgen hormone, a type of male sex hormone found in both men and women. Androgens are responsible for biological male characteristics like body hair, increased muscle mass, and a deeper voice. It’s thought that DHT attaches to androgen receptors on the hair follicles. The DHT then causes hair follicles to shrink. As a result, the anagen, or growing, phase of the hair growth cycle decreases in length while the telogen, or resting, phase of the hair cycle is extended. The anagen phase becomes shorter over time, until eventually no hair grow past the scalp line. Additionally, the hair shaft becomes thinner as the hair follicle shrinks, so hair begins to thin and is more prone to breakage.
It is normal to shed approximately 30-150 hairs from our scalp daily as part of our hair cycle, but this can vary depending on washing and brushing routines. Hair regrows automatically so that the total number of hairs on our head remains constant. Telogen effluvium occurs when there is a marked increase in hairs shed each day. An increased proportion of hairs shift from the growing phase (anagen) to the shedding phase (telogen). Normally only 10% of the scalp hair is in the telogen phase, but in telogen effluvium this increases to 30% or more. This usually happens suddenly and can occur approximately 3
months after a trigger. If the hair prematurely enters into this phase, the head will have less hair over time and hair miniaturisation sets in.
Increased hair shedding in telogen effluvium occurs due to a disturbance of the normal hair cycle. Common triggers of telogen effluvium include childbirth, severe trauma or illness, a stressful or major life event (such as losing a loved one), marked weight loss and extreme dieting, a severe skin problem affecting the scalp, a new medication or withdrawal of a hormone treatment. No cause is found in around a third of people diagnosed with telogen effluvium.
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