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causes of hair lossAndrogenetic alopecia, also known as “male pattern shedding” or “widespread shedding”, is the main cause of hair loss in males. It happens due to the effect of DHT hormone which men have to the genetically sensitive skin. This type of loss is more common on the anterior, upper, and upper nape and temple area. (Norman, 2005)

You often hear the phrase “Hair loss comes from the mother’s side”. The fact is that genetic shedding can be inherited from both sides. However, recent research has revealed that the causes of male hair loss are even more complicated than we thought it was. Factors in the X chromosome have shown that the genes taken by the mother’s side are more effective than those taken from the father’s side regarding hair loss.

Androgenetic Hair Loss and it is affected by three independent factors;


Widespread baldness does not occur outside of a specific hereditary of genetic entity. These genes may have passed from either parent. Genes are found in the chromosome and they form the building blocks of the DNA. Chromosomes are in pairs. There are 23 pairs of chromosomes in humans, and each individual takes one set of chromosomes from each parent to form its own DNA. The reason for hair loss in men is more than a single gene. This condition that is under the effects of more than one gene is called polygenic.

The genes found on the X or Y chromosomes are termed as the genetic inheritance genes. The genes found in the other 22 pairs of chromosomes are autosomic genes. Genes that cause baldness are autosomic. So; it is possible for these genes to be passed down from both mother and father’s side.


Hormones are biochemical substances produced in various secretory glands in the body. These glands secrete the secretions they produce directly into the bloodstream, so the produced chemical travels within the body. These chemicals are quite powerful so that even a tiny piece of them has a great effect on the body.

The most effective male hormone is testosterone. Testosterone and other hormones with masculine effects are first produced in the testicles, so these hormones do not reach significant levels until puberty. These hormones are the main reason for the basic changes such as the growth of the phallus and testis bag, the increase of the sperm production, the thickening of the voice, hairing on the pubes and armpits, the increase of bone and muscle weight.

It has been discovered over the past century that there is a connection between reduced hair and testosterone and hormones. There is a record of a case of maternal twins, stating while one of the twins whose mental health is normal had hair loss, while the other whose mental status is inadequate never had hair loss. To see the effect of the testosterone, the physician injected testosterone to the sibling who still has his hair and soon saw that he was beginning to lose his hair. He followed the process by stopping the testosterone injections, but his hair continued to fall off even after it was stopped, and the patient never gained his healthy hair back. This work shows that, even in the case of reduced testosterone, it is clear that dead hair roots cannot be restored.

The hormone that is directly effective in the androgenetic alopecia is DHT rather than the testosterone. DHT is formed by the activation of enzyme A5. DHT is activated as a result of communication between custom recipient zones and cells.

DHT decreases the size of the anagen (growth), increases the telogen (standby) time so that the hair shaft gradually decreases with each cycle. In addition, DHT causes the hairline to reshape.

Interestingly, while the public and underarm hair is affected by the testosterone; DHT affects beard, moustache, sideburns and hair. While hair stem growth is not androgen-dependent, casting is caused by androgen.


The presence of the necessary genes and hormones is not the only reason for hair loss. Even after a person enters puberty, the hair on the delicate skin must be constantly exposed to a hormone for a long period of time for the hair loss to occur. Age varies from one person to person depending on the level of testosterone in the bloodstream and the personal genetic composition.

A point that is overlooked is that the male type shedding does not happen in an instant or within a stable course. Hair loss is a cyclic occurrence. It varies from dense to sparse and stagnant from time to time. The cause of a sudden increase or decrease in hair loss is unknown. However, it is known that; as the age increases, the volume of the hair decreases.


Scattered Hair Loss

Hair loss in women is most often seen as a disorganized state. Scattered hair loss is usually hereditary, but it can also be caused by a medical condition, a treatment, and other reasons.
The widespread or “hereditary” hair loss, also called feminine type alopecia in females, is genetic and can be passed down by both parents. It is caused by the interaction of the aromatase which is predominantly found in females and of 5-A reductase found in both males and females.

Compared to males, the 5-A reductase that females have is about 50% less. However, there is a high amount of aromatase, especially in the front hairline area. Aromatase is responsible for the formation of hormones such as estrone and estrostol. This hormone reveals why female type hair loss is so different from male types.
Women’s hair is more sensitive to medical interventions. Even though the systematic problems cause scattered hair loss, people sometimes think of it as a genetic hair loss.

Medical conditions that cause diffuse hair loss;

Obstetric and gynecological conditions such as postnatal, postmenopausal or overcystic conditions.

  • Anemia – iron deficiency
  • Thyroid disease
  • Tissue problems such as lupus
  • Sudden diets, blumia, protein deficiency, fatty acid and zinc deficiency, impaired absorption, excess vitamin A
  • Stress – surgical procedures, general anesthesia, emotional problems

Numerous medications cause “telogenism”, which means discontinued hair growth. However this situation ends when drug treatment is over, but it can be mistaken as a genetic female hair loss can be confused if the cause of the reaction is not treated properly.

Drugs that cause hair loss;

  • Blood diluents such as warfarin and heparin
  • Paralysis and crisis medications such as dilantine
  • Gut, saffron, alopurinol drugs such as Xyloprim
  • Blood pressure stabilizers
  • Anti inflammatory agents such as prednisone
  • Treatments that lower cholesterol and other lipids
  • Mood altering drugs such as elavil, prozac and lithium
  • Chemotherapy
  • Thyroid therapy
  • Contraceptive pills containing progesterone
  • Diet pills, high-dose vitamin A and cocaine
Localized Hair Loss

Although there are many dermatologic conditions that cause hair loss, female genetic, diffuse hair loss is separated from the localized hair loss by the diagnosis of dermatologists.
Localized hair loss has two types; scarred and scarless. Alopecia Areata is known as a genetic and scarless auto-immune disease. It can be treated by local steroid injection.

Scarred Alopecia is caused by many medical or dermatological reasons such as dermatophyte, lichen. Hair loss caused by injury or local medical problems can respond to hair transplants. Radiotherapy may cause scarred and scarless localized hair loss and if the region is not very large hair transplantation can be done.

Paternal Type Hair Loss

This type of hair loss has a similarity to the male hair loss. In other words, there is loss on the anterior, upper, and upper nape and temple area. For this reason, this type of hair loss generally shows a more characteristic course. Patients with paternal hair loss is the most ideal candidate for the hair transplant.


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