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Baldness, also known as alopecia, is hair loss, propecia baldness, or absence of hair is a trait which involves the state of lacking hair where it often grows, especially on the head. The most common form of baldness is a progressive hair thinning condition called androgenic alopecia or 'male pattern baldness' that occurs in adult human males and some primate species. The severity and nature of baldness can vary greatly; it ranges from male and female pattern alopecia (androgenetic alopecia, also called androgenic alopecia or alopecia androgenetica), alopecia areata, which involves the loss of some of the hair from the head, and alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body. Treatment for alopecia has limited success. The more hair lost, the less successful the treatment will be.

Baldness is usually most noticeable on the scalp, but can occur anywhere on the body where hair grows. The condition is more common in men than in women.

Causes of baldness

Hair loss is believed to be primarily caused by a combination of the following:

  • Aging
  • Change in hormones
  • Illness
  • Family history of baldness
  • Burns
  • Trauma

Hair loss is not caused by the following:

  • Poor circulation to the scalp
  • Vitamin deficiencies
  • Dandruff
  • Excessive hat-wearing
  • A gene passed on from an individual's maternal grandfather

Generally, the earlier hair loss begins, the more severe the baldness will become.

Types of baldness

Baldness can be classified into various types, depending on the cause. Several of the many different types of baldness include the following:

  • Female-pattern baldness

Although less common, female-pattern baldness differs from that of male-pattern baldness in that the hair generally thins all over the head, but the frontal hairline is maintained. Female-pattern baldness rarely results in total hair loss.

  • Male-pattern baldness

Male-pattern baldness usually is a hereditary condition. The condition may begin at any age. Hair loss often begins on the front, sides, and/or on the crown of the head. Some men may develop a bald spot or just a receding hair line, while others may lose all of their hair.

  • Alopecia areata

This hair loss disorder is characterized by sudden loss of hair in one particular area, which grows back after several months. However, if all body hair is suddenly lost, regrowth may not occur. The cause of this type of hair loss is unknown.

  • Toxic alopecia

Toxic alopecia may occur following a high fever or severe illness. Certain medications, especially thallium, high doses of vitamin A, and retinoids, may cause toxic alopecia. Medical conditions, such as thyroid disease, and after giving birth may also trigger toxic alopecia. The condition is characterized by temporary hair loss. Also, some cancer medications can cause hair loss.

  • Scarring alopecia

Scarred areas may prevent the hair from growing back. Scarring may occur from burns, injury, or x-ray therapy. However, other types of scarring that may cause hair loss can be caused by diseases such as lupus, bacterial or fungal skin infections, lichen planus, sarcoidosis, tuberculosis, or skin cancer.

  • Hair pulling (Trichotillomania)

Hair pulling, a habit most common among children, may cause hair loss. How is the type of baldness diagnosed? In addition to a medical history and physical examination, a biopsy of the skin area may help to identify the type of baldness and/or its cause.

Treatment for baldness:

Specific treatment for baldness will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Your tolerance for specific medications, procedures, and therapies
  • Expectation for the course of the disease
  • Your opinion or preference

Most forms of baldness have no cure. Some types of baldness will disappear on their own. Treatment may include:

  • Certain medications to promote hair growth (such as minoxidil and finasteride)
  • Corticosteroid injections (when treating alopecia areata)
  • Treating any underlying condition or disease
  • Hair transplants
  • Scalp reduction
  • Skin lifts and grafts

However, there three effective ways to deal with baldness currently available, which the evidence shows work to at least some extent.'

  • Minoxidil

Minoxidil is sold over the counter as a topical solution, to be applied twice a day. About two-thirds of the men who use it have some improvement in their hair growth, ranging from minimal regrowth to moderate to dense regrowth after four months of use. It depends on how bad the hair loss has been and how long it has been happening. It is not possible to forecast how effective minoxidil will be or who it will help. There is no evidence that it works better for younger men because of their age. They may get better results because their hair loss is not that severe and has only recently started but this would apply to a man in middle age too.

  • Finasteride

Finasteride is an oral treatment for male pattern baldness now available on private prescription in the UK. It works by inhibiting the action of an enzyme in the body called type II 5-alpha reductase. This enzyme is responsible for converting the male hormone testosterone into dihydrotestosterone (DHT). DHT is a hormone that can damage hair follicles and lead to hair loss in men who are genetically sensitive to it.

  • Hair replacement grafts

Another approach to combating baldness is to transplant the hair from the back of the scalp where it usually grows abundantly in bald men, especially younger men. It is transplanted to the bald patch where it grows in the same manner as if it were still on the donor site. The minor operation is under local anesthetic and can be done in several stages or in one mega session where thousands of hairs are involved.