Alopecia areata is a common skin disease that can be classified into male pattern baldness (also known as androgenetic alopecia, androgenic baldness, commonly known as early baldness, alopecia areata or Mediterranean, etc.), seborrheic alopecia (also known as lipoatrophy), and baldness, among a dozen others. Most of the common types of hair loss are male pattern baldness (over 50% of hair loss patients) and seborrheic alopecia (over 45%), while other types of hair loss account for a total of only 5% of all hair loss patients (with baldness accounting for 3% and the rest accounting for only about 2%). Many people, including many doctors, confuse seborrheic alopecia with male pattern baldness, but this is a confusing fallacy because seborrheic alopecia has its own unique causes and characteristics, in addition to the same causes of abnormal androgen levels as male pattern baldness. Seborrheic alopecia is a type of hair loss that occurs on the basis of excessive seborrhea. Its symptoms are excessive fat overflow from the patient’s scalp, often accompanied by increased dandruff, oily scalp and pronounced itching. It mostly occurs in young adults with strong sebaceous secretion. Patients usually have fine hair and some have seborrheic dermatitis of the scalp. The hair loss starts gradually from the top of the head, spreads to the forehead, and then spreads to the whole top of the head. The scalp is oily and bright red, with yellow oily scabs. Seborrheic alopecia is a kind of permanent hair loss. Some men start to lose their hair after development, and then the hair is greasy and shiny, dandruff slowly increases, often itchy, sometimes the hair is dry and lusterless, as long as you scratch it with your hands, the hair will fall out, especially the two sides of the frontal corners will also occur chronic diffuse hair loss.
I. Clinical manifestations of seborrheic alopecia.
Seborrheic alopecia is more common in men, and there are more mental workers than physical workers. It is clinically proven that seborrheic alopecia may be related to human endocrine function (mainly androgens), mental state, genetics and certain drugs.
It is clinically proven that seborrheic alopecia may be related to endocrine function (mainly androgens), mental status, genetics and certain medications.
Seborrheic alopecia occurs mainly in young men, but in recent years there has been an increase in the number of female patients. The clinical manifestation of seborrheic alopecia is that the patient’s scalp is overflowing with fat, resulting in a greasy and moist scalp, which is mixed with dust and dander. Hair loss usually starts from the two forehead corners, forehead and the middle of the top of the head, and then spreads over the entire top of the head, but the hair around the head does not fall out much. In severe cases, the hair loss area becomes oily and shiny, and the remaining hair becomes fine and yellow. Patients usually experience persistent hair loss starting in their twenties, and in severe cases into their thirties, and generally lose basically all their hair by their forties, seriously affecting their beauty. The development process of hair loss is more and more serious, at the beginning of the day, many hair can be seen on the pillow towel and hair comb, and later as long as a gentle plucking can be pulled off a large, wash your hair when the basin is full of hair loss, the bathroom spout is covered with a thick layer of hair loss, called a lot of heartache, but also not overwhelmed with fear.
Second, the classification of seborrheic alopecia.
There are two types of seborrheic alopecia: acute seborrheic alopecia and chronic seborrheic alopecia.
(1) Acute seborrheic alopecia
Symptoms are: increased scalp oil, itchy, dandruff or pimples, hair in a short period of time into handfuls or even all off, the scalp can have small papules, mostly in adolescence, more common in men, easy to recur after cure.
(2) Chronic seborrheic alopecia
The symptoms are: greasy and shiny scalp, oil coated, with a large amount of grayish white bran-like dandruff, dry hair, lack of luster, itching is heavy, male hair from both sides of the forehead and the top of the head slowly fall off, a few years or a dozen years after the formation of baldness, but not easy to form a total baldness, the disease occurs in young and strong men and women, more common in men, while women are manifested as thin and dry hair, hair is also slowly, scattered shedding, revealing scalp, but there is rarely the possibility of forming baldness.
Third, the causes of seborrheic alopecia.
What are the causes of seborrheic alopecia? The essential cause of seborrheic alopecia is still not clearly determined in medical science. At present, Western medicine tends to believe that fat baldness is related to high levels of human androgens, while Chinese medicine believes that it is related to the deficiency of human kidney blood. Experiments have been done to prove that when the concentration of androgens such as serum testosterone reaches more than 30 micrograms/liter, it will inhibit the growth of hair follicle cells, and the higher the concentration, the stronger the inhibitory effect. On the other hand, many studies have shown that serum androgen concentrations do not increase significantly in seborrheic alopecia compared to normal subjects. Long-term studies and observations suggest that the most direct key cause of seborrheic alopecia is excessive sebum secretion, and that some ingredients in the skin, such as oleic acid, linoleic acid and squalene, have toxic effects on hair follicles when in excess, leading to toxicity, wilting and shedding of the hair coat. Experiments show that the oil containing these ingredients applied to the animal fur will cause a large number of hair loss. One of the evidence that seborrheic hair loss is directly related to excessive sebum secretion is that human sebum secretion is related to the temperature, the higher the temperature the more sebum secretion. Therefore, seborrheic alopecia is particularly serious in summer and autumn, and the symptoms are lighter in winter and spring, which is generally experienced by patients.
Therefore, it is not possible to confirm that excessive androgens are the root cause of lipoatrophy. In addition, traditional Chinese medicine believes that hair loss is caused by kidney and blood deficiency, liver depression and qi stagnation, and yin deficiency and internal heat. However, this view lacks a clear classification and detailed pathological analysis of the different types of hair loss. It should be seen that the etiology of different types of hair loss is different, and it is difficult to attribute all of them to kidney deficiency, especially seborrheic alopecia.
Today’s medical community generally believes that seborrheic alopecia is related to the following three factors.
(1) androgens
Modern medicine confirmed that seborrheic alopecia, androgens are mostly more, which is mainly the testicular secretion of androgens into the blood circulation, reaching the scalp through the transformation of the formation of toxic substances to stimulate the hair follicle, hair follicle energy metabolism and protein metabolism disorders, resulting in hair loss.
(2) Genetic factors
The hereditary gene of seborrheic alopecia is dominant in men, and the causative factor can be directly inherited from the previous generation to the next generation, so it is common for men with seborrheic baldness.
In men, as long as there is a gene for hair loss, it will cause hair loss, while in women, because the gene for hair loss is recessive, there is no appearance of hair loss unless there are two genes for hair loss at the same time. Even if there are two alopecia genes, for women in general, they will only become thinning hair, and will not become a big hair loss or only leave the edge of the hair and the middle bald situation.
How is seborrheic hair loss formed?
People who are engaged in intense and complex mental work, mental stress and great energy consumption of the brain, stimulate the body’s autonomic and hormonal adaptations to make adjustments to maintain the normal body temperature, metabolism and immune function of the physiological balance, secrete more androgens, so that people’s analytical power, judgment, resourcefulness and wisdom, while making people’s temperament become more anxious, sebaceous glands secrete a lot. The sebaceous glands on the scalp are the most developed compared to other parts of the body, so they secrete more in this case, thus providing conditions for the proliferation of lipophilic fungi and head mites on the scalp. The lipophilic fungi on the scalp proliferate under the premise that the sebaceous glands secrete a large amount of sebaceous fungi, and the disaster of lipophilic fungi obtain nutrients from the hair follicles and discharge the metabolites there, stimulating the hair follicles and scalp to develop chronic inflammation – seborrheic dermatitis.
If seborrheic dermatitis is not treated in time, the bacteria at the root of the hair grow and multiply to produce a lysing enzyme that dissolves the hair roots into stumps, loosens the hair roots, gradually shrinks the hair follicles, gradually decreases the function of hair growth, and gradually reduces the hair until baldness.
Hair mites are tiny parasites that are invisible to the naked eye. Hair experts have discovered that the head mite, a lipophilic microscopic animal, is as much a culprit of hair loss as genetics or hormonal imbalance. It lives in human hair follicles and feeds on sebum. After eating, it secretes a lipolytic enzyme (lipase) to aid digestion, which further breaks down and erodes the sebaceous glands in the scalp, blocking the hair follicles, causing them to lack nutrients and shrink, resulting in hair loss or baldness.
V. Treatment of baldness
Three types of drugs that are currently the most effective in the treatment of hair loss worldwide.
1, minoxidil hair growth water
-The main ingredient is minoxidil
At present, the treatment of hair loss minoxidil solution is divided into two types: 1 is the minoxidil hair growth solution containing propylene glycol, 2 is the minoxidil series of solutions without propylene glycol
(1) Minoxidil hair growth solution containing propylene glycol: The main ingredients contain alcohol, propylene glycol (30%), purified water, and 5% minoxidil (for men) or 2% minoxidil (for women), and the cheapest one is the “kirkland hair growth solution” provided by kirkland signature produced by costco in the United States.
Minoxidil hair growth lotion containing propylene glycol is the first generation of minoxidil solution developed in the late 1990s in the United States.
(2) During the overall use, more than 20% of patients are allergic to propylene glycol, resulting in increased dandruff, itchy skin, increased greasiness, and in severe cases, rapidly increasing hair loss. Statistically, Asian patients are more likely to be allergic to propylene glycol during use than patients in Western countries.
In order to cope with such side effects, the “Propylene Glycol Free Minoxidil” series of hair regrowth lotion developed by Regrowth in the United States, which uses glycerin as the solvent, completely avoids such side effects and is the only series of Minoxidil solution that does not contain propylene glycol, which has become a major highlight in the hair regrowth industry since 2003. It has become the most cutting-edge hair growth product because of its side effect-free feature. This series of minoxidil is divided into 5% propylene glycol-free minoxidil and 15% propylene glycol-free minoxidil hair growth lotion. This series of hair regrowth lotion will achieve the best hair regrowth effect when combined with the “Anti Hair Loss Lotion” produced by the same organization, which is the mainstream treatment for androgenic alopecia (i.e. seborrheic alopecia) in Western countries. At present, the “Propylene Glycol Free” series of Minoxidil Hair Regrowth Lotion is not yet produced in China, but is introduced by “Mangos Hair Regrowth Organization” from the United States with original and genuine products.
2.Bolfacil
-The main component is finasteride
Mechanism of action】Finasteride is a synthetic steroid compound, which is a specific inhibitor of intracellular enzyme type II 5α-reductase in the process of metabolizing androgen testosterone into dihydrotestosterone. Finasteride has no affinity for androgen receptors and has no androgen-like, anti-androgen-like, estrogen-like, anti-estrogen-like or progestogenic effects. Inhibition of the enzyme impedes the conversion of testosterone to the androgen dihydrotestosterone in peripheral tissues, resulting in a significant decrease in serum and tissue dihydrotestosterone concentrations. Compared to placebo, it increases circulating testosterone levels by approximately 10-15%, but remains within the physiological range. Finasteride causes a rapid decrease in serum dihydrotestosterone concentrations, resulting in a significant reduction within 24 hours of administration.
Indications】Bolfax is indicated for the treatment of male pattern baldness (androgenic baldness), which can promote hair growth and prevent continued hair loss.
Side effects]: Possible side effects include: male feminization features such as breast enlargement, sexual dysfunction, scrotal pain, female exposure can cause abnormal genital development in newborn babies, etc.
3.Antiseptic lotion
-The main ingredient is Ativan
Topical anti-hair loss lotion from Regrowth LLC is a new drug that has been widely used in dermatology in recent years to treat androgenetic alopecia, and is commonly used as an alternative to Propecia (finasteride).
Since it is made into a lotion form for topical use in dermatology, it does not have any side effects. It was introduced in China by the “MANGO Hair Growth Organization”.
Androstenolone is used to stop or even reverse the onset of androgenic baldness. Androstenolone is ideal for suppressing androgenic hormones with the following properties:
(1) It can effectively suppress the activity of androgenic hormones;
(2) It selectively prevents or successfully counteracts DHT without altering testosterone levels in the body
(3) is locally effective, it can be easily used with minoxidil
(4) It is readily absorbed by the skin, but does not have systemic effects on areas not used.
Physicians have been prescribing this drug to patients against androgenic baldness for more than 15 years without any systemic side effects being reported. In studies, the use of 5% ambrisentin with 5% minoxidil was also more effective than the use of 5% minoxidil with prohexadione (with the advantage of zero side effects). Among other androgen suppressants, Ativan is a potent and competitive blocker of DHT attachment to the receptive end of the hair follicle. Therefore, Ativan is effective in preventing DHT from attaching to the receptive end of the hair follicle.