How Hair Transplantation Works
MALE
Physicians divide hair loss, or balding, into scarring or non-scarring alopecia. Scarring alopecia includes a variety of diseases that cause patchy hair loss due to internal disease or trauma, or certain straightening agents. Stress can also cause hair thinning in a generalized way all over the head. Only one type of hair loss will give a distinctive pattern of hair loss in men and women. This is called male and female pattern baldness. It is caused by the effects of DHT on the hair follicle in both men and women. Men and women have a certain amount of male hormones in their bodies, which are converted by the enzyme 5 alpha-reductase to DHT. Women probably have other factors at work as well, such as low serum iron, various medications, low thyroid and low growth hormone, all of which cause diffuse thinning.
In the case of males, distinct and progressive pattern baldness usually starts in the 20's, 30's and 40's and continues briskly for eight to fifteen years. After that, it slows down, but continues at a slow, progressive course for life. The result of the interaction of DHT with the hair follicle is the major cause.
NORWOOD MALE HAIR LOSS PATTERNS
FEMALE
In females, the effect of DHT on the hair follicles gradually, over many years, results in slow thinning of the hair on the top of the head. This gives us the Ludwig Patterns 1, 2, and 3 or Christmas Tree Pattern. Loss of estrogen after menopause adds to this effect. In some cases, women may have diffuse thinning all over the head, rather than the pattern baldness. Diffuse thinning is not treatable by hair restoration surgery, but frequently is improved by thyroid extract (to increase free T3) or growth hormone after blood tests to determine an individual's requirements.
LUDWIG FEMALE HAIR LOSS PATTERNS
In both male and female pattern baldness, the effects of DHT on the hair follicles cause a gradual miniaturization of the hairs produced by the follicles until they eventually stop growing and fall out. This is why a person's hair will feel finer for several years before actual baldness occurs.