Everything you need to know about follicle miniaturisation

Jan, 02 2020 | By Dr. Sangay Bhutia (Hair Transplant Specialist in Delhi)

Baldness doesn’t happen in a day, a week, a month, or even a year, it is a process that can start off as early as in the twenties and happen over years. It starts with hair fall, which is more than the 50-100 strands that a normal person loses everyday. In most men, the reasons behind hair fall and eventual baldness are usually genetic. More than a quarter of the male population experiences a condition called male pattern baldness or androgenetic alopecia, but as much as 85% face some kind of hair fall in their lifetime.

The reason behind male pattern baldness is follicle miniaturisation, a process due to which hair shrinks over time in size and eventually falls off. To understand follicle miniaturisation, it is important that we understand the hair growth cycle. Hair grows in three phases: the first is the Anagen or the growth phase, which can last between three to five years. The second phase is Catagen or the transition phase, which is about one to two weeks long. This is the phase between the growth and resting phases. The third phase is Telogen or the resting phase, which lasts about three to four months. This is when shedding of hair happens. The hair which sheds is replaced by new hair and the hair growth cycle continues.

In follicle miniaturisation, the main culprit is DHT or dihydrotestosterone, a hormone which gives men their male characteristics. However, it also causes the hair cycle to become much shorter than it is supposed to be. It affects hair follicles and renders them incapable of growing to full size. The hair sprouting out of follicles affected by DHT has a smaller window of growth which makes them incapable of growing in both length and diameter. And they eventually fall off and are not replaced by new hair. This process over a period of time leads to balding.

Each normal follicular unit contains one to four hairs, however follicular units affected by DHT are in different stages of miniaturisation, and hence they will be thinner. Thinner hair also occupies less area, and as the miniaturisation reaches advances stages the space occupied by each follicle will grow progressively smaller. This gives an appearance of thinning hair and eventually leads to baldness.

The good news, however, is that there are medicines which taken in early stages of hair fall, especially, can help. Take Finasteride, for instance. The medicine blocks the enzyme 5-alpha reductase Type II from converting testosterone into DHT. This means that the DHT will not not be able to affect the hair follicles and disrupt the hair growth cycle, and hence not lead to hair fall.

There is also a topical medication called Minoxidil, which works by lengthening the hair growth cycle, countering the effect of DHT on the hair follicle.

These medicines, however, work in the early stages of hair fall, and they can keep the patient from losing more hair than they already have. However, these are not effective in bringing back the hair that is already lost. Since male pattern baldness causes permanent hair loss, these medicines won’t bring back lost hair.

For such patents, hair transplants are the answer. Hair transplants involve taking healthy hair follicles from the donor area of the scalp, which are the back and sides of the head, which are DHT-resistant zones, and implanting them onto the bald and thinning spots. The back and sides of the head are not prone to hair miniaturisation as they can are not affected by DHT. Therefore, the follicles taken from these zones and implanted on to the bald spots will also be permanent.

Follicle miniaturisation and in effect male pattern baldness impacts a lot of people worldwide, causing a huge amount of mental stress and anxiety to people. While the hair fall caused by miniaturisation may not be reversible, hair transplants present an excellent and the only permanent solution to the problem. The good news is, the procedure is accessible, affordable, natural, and an almost pain free way to get your hair back.