The following is prepared by Dr. Proctor, a leading
specialist in hair loss treatments who has many patents to his credit.
Emerging Model for Pattern Balding (after Kligman,
others ) - By Dr. Proctor
Hormones do something to hair follicle which causes it to be read as "foreign
body" by your immune system, which then mounts an attack. The main damage in balding
is probably immunologically-mediated. Damage to lining of blood vessels, which produces
hair growth-stimulatory factors, makes this worse.
•Hormonal factors:
Castration, lack of DHT-receptors/enzymes (testicular feminization) , feminine status
block the progression of balding . However,women and castrated males have other sources of
androgens and can still experience pattern loss.
Also, androgen action may be related to generation of active oxygen species, as detailed
here.
•Immunological factors:
Microscopically, balding looks like organ rejection. Cells of your immune system clustor
round the follicle base. Further, immune system cells normally cluster around the hair
follicle.They may have a role in the normal hair cycle.
Organ rejection drugs ( e.g., cyclosporin ) reverse balding better than antiandrogens.
This gives a rough indication of the relative importance of hormonal verses immunological
factors in maintaining the balding state. Conversely, cyclosporin and similar agents may
also have a "phenytoin-like" action on follicles, separate from their
immunosuppressive properties.
Antibodies to hair follicles are also present in blood.
•Blood Vessel Lining evidence
Minoxidil, other agents apparently imitate hair growth factors ( nitric oxide radical,
etc. ) produced by vessel lining. In diseases
involving damage to vessel lining (e.g., atherosclerosis) production of these factors
decreases. Such diseases are associated epidemiologically with severe balding. Also,
decreases in circulation reported in balding scalp may reflect local damage to vessel
linings. Alternately, some deficit in both the blood vessel and the hair follicle produces
coincidental deterioration in both organs. Again, a good candidate is the nitric
oxide/superoxide system.
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