Remedies for growth

Hair growth occurs in growth phases. Scientists differentiate between the growth phase (anagen), the transitional phase (catagen) and the resting phase (telogen). The growth phase mostly takes four to six years, sometimes even up to ten years. Then a transitional phase lasting one to two weeks sets in, during which cell division is stopped and the hair follicle is regressed. After a resting phase of two to four months the hair falls out naturally, approximately 50 to 100 hairs per day.

At the base of the now empty hair follicle, hair cells are again propagated and the hair begins to grow. Each hair follicle passes repeatedly phases of growth and rest. Normally the hair on the scalp grows completely independently. About 85 percent of the hair is in the growth phase. Various internal and external influencing factors may lead to a large amount of hair ending the growth phase simultaneously. Two to four months later noticeably more hair may fall out. This process can be triggered for example by hormones, high temperature, growth factors, medication and the seasons.

A temporary major hair loss often occurs in women about a quarter of a year after the birth of a child. Due to the hormonal change shortly after the birth, a lot of hair will pass simultaneously from the growth phase to the resting phase and then falls out after two to four months. Hormonal changes during the menopause or stopping to take hormonal contraceptives can also lead to loss of hair. The hair loss due to the menopause is frequently irreversible. Due to the reduced estrogen level, a noticeable thinning out of the hair remains in many women.

Increased daily loss of hair is called effluvium, the medical term for visible hairlessness is alopecia. In 95 percent of the cases it is a so-called androgenetic alopecia. In the course of their lives, approximately 80 percent of men and 42 percent of women are affected by it to varying degrees. It differs in visual appearance among the genders. In women, the hair is thinning out at the parting. Moreover, women complain about the decreased volume and quality of the hair. The hair thinning does in fact increase over the years but women almost never get bald.

Hair loss in men due to androgens is reflected first in a receding hairline and the loss of hair in the area of the hair whirl (tonsure bald patch). Over time, the entire top of the head becomes bald. People with hair loss have – other than perhaps assumed – no increased androgen level in their blood. The cause of the androgenic alopecia lies in fact in genetically determined variants of the androgen receptor. They sensitize the hair follicles against the circulating androgens.

The first-line standard in the treatment of androgenetic alopecia is the local therapy with Minoxidil (Regaine®). In the case of men, the use of a 5-percent solution or foam twice a day is recommended. Women are recommended to apply a 2-percent solution or foam twice a day, or a 5-percent foam once daily. The effectiveness has been clearly proven, if the application is carried out regularly. The loss of hair can be stopped in 80 to 90 percent of users. In half of these, the appearance of the hair is visibly thicker. However, users need to be patient as this effect only becomes visible after two to four months of daily application. At the beginning of the treatment, the hair loss can even be temporarily enhanced. PTA and pharmacists should point this out to customers from the start. There is no need to worry about this effect called »shedding«, on the contrary, it is a sign of its efficacy. Further possible side effects are reddening, scaling of the scalp as well as in rare cases a contact dermatitis. When the Minoxidil therapy has been ended, the newly acquired hair will as a rule fall out again over time.

Alternatively, men can daily take 1 mg finasteride as a tablet (Propecia®). The substance is a 5α-reductase-type-II-inhibitor and prevents the conversion of testosterone into its active form 5α-dihydrotestosterone. The prescription drug finasteride can thus prevent the dying of dihydrotestosterone-sensitive hair follicles at the early stage of hair loss. The effect is similarly strong as the one of Minoxidil. As a side effect, loss of libido and erectile dysfunctions can occur, in rare cases the mammary glands will be enlarged. It is essential to point these possible side effects out to men as they can severely impair the quality of life of those concerned. Finasteride is not approved for women.