Hair Care, Hair Loss, and Hair Regrowth

Hair fashions change rapidly and without a rational pattern. Hair styles that are out-of-favor with current fashions often evoke unexpectedly strong emotions and attempts to outlaw them are common. Ancient Persian men considered a shaved face as absurd. But their contemporaries, the Hittites, shaved their beard, mustache, eyebrows, and patches of hair near the temples. The Celts often shaved their beards but not their mustaches. Ancient Greeks wore beards and long hair but in the 4th century B.C., Alexander the Great ordered his soldiers to shave beards and keep head hair short.

Roman law once required prostitutes to wear blonde wigs, but the Emperor Claudius' wife, Messalina, wore a yellow wig on her nightly outings. The regulation was repealed and blonde wigs became the fashion of the day. The Romans generally shaved for about 500 years, but around the year 200, beards reappeared. This lasted until Charlemagne in 800 ordered his subjects, most of Western Europe, to shave. Beards started to return but the Bishop of Rouen warned in 1096 that men with beards were in danger of damnation. However, women in the Middle Ages often wore their hair long with great looping braids over their ears. Women revived the blonde hair fashion and dyed their hair blonde or wore blonde wigs.

In the 1500's men's head hair was cut short but beards flourished. Women generally braided their hair and many married women revived the Orthodox Jewish custom of only showing their hair only to their husband. In 1770, the British parliament passed a law that a marriage was voided if a man was tricked into marriage by a women using false hair, cosmetics, or high heels. This law has never been repealed.

In the United States during the first half of the nineteenth century, beards were generally shunned, but made a strong comeback during the Civil War. The World Wars of the twentieth century and military regulations caused men again to shave and shorten their hair. Women wore their hair short and curly, as curling iron and permanents began to arrive. The actress, Veronica Lake, brought back long, wavy, seductive blonde hair after her 1941 movie, "I Wanted Wings". But by the 1950's, both men and women were back to short hair, only to return to long hair by 1970 despite attempts by employers and schools to outlaw long hair. As the year 2000 approaches, head hair has shortened but short beards and goatees are becoming popular among young men.

I never gave a lock of hair away,
To a man, Dearest, except this to thee,
Which now upon my fingers thoughtfully,
I ring out to the full brown length and say' Take it.'
Elizabeth Barrett Browning "Sonnets from the Portuguese"
Painting - Detail from Rubens' "Venus and Adonis"

The hair roots or follicles contain pigment cells that, depending on your genetic background, creates a black pigment called melanin or eumelanin and a reddish pigment, produced by a separate gene, called heomelanin (or sometimes called phaeomelanin). The greater the amount of pigment sent to the hair, the darker the hair becomes. if the amount of pigment is reduced, the hair color turns brown and then reddish or blond. Color changes with age. Most "towheaded children" who have blonde-whitish hair turn into brunet adults.

The shades of hair color are influenced by how light bounces off the hair proteins, but basically depends upon pigment contained within the hair shaft center or cortex. Eumelanin is the pigment found in brown or black hair and to lesser degrees in blonde hair. Heomelanin, produces red hair while and mix of eumelanin and heomelanin produces a blonde-red mixture or "strawberry blonde". When pigment is significantly diminished, the hair appears gray and when it is absent, the hair is white.

Under severe stress hair or malnutrition, hair can lose its color. In the trench warfare of World War I, there were cases of young men whose hair turned gray within two months after prolonged episodes of severe fighting and artillery bombardments. Copper is the key nutrient in pigment (melanin) production in the skin and hair. A lack of sufficient dietary copper can cause hair to lose its color.

Hair grows at a faster rate in the spring and summer than in autumn and winter - a fact that often is used to "prove" that certain hair growth remedies stimulate hair growth. The growth rate is however very much related to the individual person, his age, diet etc. The lifetime of the anagen phase is responsible for the maximum of hair length you can have. Waist length hair takes about 5 years to grow out from a short hair cut, periodic trims included. If your hair has a lifecyle of 2 years, you will never achieve a nice waist length mane. In rare families, long hair cycles are combined with rapid hair growth - producing floor length hair in women. At right is the person with the longest well documented record for hair length who is Diane Witt, a mother of two who lives in Worcester, MA. Her hair measured over 12 ft. 8 in. in March 1993. Witt has not measured (or cut) her hair since then. She has a website at www.alh.tj/diane-witt/index.html.

Hairs: Average length (cm) Growth rate per day (mm)

On the head                70                                             0.35
Eyebrows                   1.0                                           0.15
Mustaches                28                                             0.4
(beards or whiskers)
Armpit hairs                 5                                              0.3
Pubic hairs                   4                                             0.2

Mature hairs are biologic filaments composed primarily of proteins (88%) of a hard, tough, insoluble, fibrous type known as keratin. Proteins are built up from individual amino acids to form long chains where each amino acid is a link in the chain. Two amino acids are joined together by a "peptide bond", and the correct number of amino acids placed in their correct order will form a specific protein; i.e. keratin, collagen, elastin, and so on. The keratin found in human hair is also a major protein in fingernails. Three layers of keratin form every hair. The outer sheath of cuticle forms overlapping scales.

Hair proteins have a high sulfur content from the amino acid cysteine which can easily form cross-links to other cystines in the hair molecule. These bonds are responsible for the hair's toughness and abrasion resistance and the cross-links hold the hair fibers together. As long as this organization is not disrupted, the fiber is strong and appears "healthy". The breaking and re-linking of cysteines in the hair protein is used to "perm" the hair to change its shape and add curl to the hair.

Chemicals applied to hair and mechanical flexing of hair can sometimes damage the structure of these biologic filaments and cause the hair to have an undesirable appearance, be less manageable, or be more vulnerable to breakage.

Chemical and mechanical injuries to the hair or scalp can produce a number of different effects. Tight hairstyles, hot combs, hot oil treatments, and harsh use of hair blowers can all produce damage to the hair fiber. One should be aware of potential consequences when manipulating hair and to exercise caution.

The typical chemicals used to alter hair include bleaches, dyes, relaxers, and agents used for permanents. Any of these chemicals can cause some degree of hair damage but, with care, most cosmetic products produce minimal unwanted side-effects. It is more difficult to repair damaged hair than to use gentler techniques that result in less damage to your hair. Some cosmetic products are partially beneficial in repairing damaged hair but normal quality of hair will return only after the production of new hair to replace the damaged fibers.

Factors that damage hair include the normal "weathering" that occurs to the ends of long hairs that have been exposed to the environment for many years or exposure to chlorine from swimming pools. The apparent lightening of hair color noted to occur with individuals who have prolonged sun exposure during the summertime is an example of photochemical damage. As with other forms of damage, full reversal is often not possible.

Excessive shampooing is the main cause of damage to the hair shafts. The best shampoos for hair should be at about pH 5.5. This is at the high end of the pH range of the scalp (4.5 to 5.5) or slightly acid. This natural acid environment of the hair and scalp helps keep the hair proteins hard and prevents the growth of foreign bacteria. The natural hair and skin oils also help maintain scalp health.

Shampoos of higher pH (more alkaline) work better to clean the hair and scalp but more alkaline shampoos strip away too many natural scalp oils and extract the "glues" that help hold the hair shafts together. Experts say that these high pH alkaline shampoos make your hair look great for a few weeks but then cause the hair to become dry and brittle which and increases breakage of your hair. Also, avoid baby shampoos which are formulated for gentleness if they get in to the eyes but dry out the hair.

Be careful of "clarifying shampoos". They are rather harsh and intended to remove materials that build up on hair such as mousses and sprays but they also can remove color and perms. Some hair experts recommend avoiding such shampoos and instead just mix, in your hand, plain baking soda from your kitchen with your normal shampoo and apply this to your hair to remove build up.

The foaming of shampoos is often enhanced by "flash-foamers" but foaming means that too much shampoo was used and/or the shampoo is filled with foaming chemicals. Likewise, fragrances have no positive effect on shampoos. The test of a shampoo is what your hair looks like after using the shampoo for a week or two. Examine your hair's condition after this time. Does is seem healthy and easy to comb or is it hard to comb and limp looking? Also check to see if the hair becomes dry and if your scalp become itchy. If a shampoo doesn't work for you, try another brand. The cost of a shampoo is not generally related to quality but to advertising.

Dry hair lacks enough natural oils. To shampoo, use a minimum amount of a mild and slightly acid shampoo. Do not over shampoo and do not repeat the shampoo application regardless of instructions. Cosmetic companies try to increase your use of their product. If your hair is very dry, only shampoo every two to three days. Our ancestors went months between hair washing and had healthy hair.

Oily hair is more difficult to manage and shampoo. Oily hair looks moist, dull and is often difficult to comb. The fatty substance that covers oily hair called sebum is over produced by the sebaceous glands of the hair follicle. Sebum is rapidly is restored after washing the hair. More frequent washing with stronger, more soapy shampoos helps remove oil but damages the hair. Retinoic acid may be used to reduce oil production. Retinoic acid also stimulates hair growth and increases follicle health. But do not overuse the retinoic acid since this can result in scalp irritation.

When finished, the shampoo should be completely rinsed from the hair to help bring the pH back down to its natural level. Also, the detergents in shampoos are very irritating to the scalp and must be completely removed. Most experts recommend using a shower for the most complete removal of the shampoo.

Some shampoo manufacturers recommend that you comb through your wet hair to distribute the shampoo evenly into the hair. But wet hair is more easily broken way and you will only end up with worse hair.

The outer layer of hair forms cuticles somewhat like fish scales and is shown in the picture to the left. A healthy strand of hair has an outer layer of scales that are laying close above each other. If scales are laying flat, the hair will look shiny, and a comb or brush will glide smoothly. The cuticles are glued down by mixtures of polypeptides - similar to the yellow liquid collagen glues used by schoolchildren such as LePage's Glue. Shampoos and soaps remove the glue-polypeptides and loosen the cuticle. High quality conditioners add small peptides back into the cuticle to glue it into place again. A small amount of pantothenic acid (vitamin B-5) is also used which helps with the glue process. If the cuticle stays open it can start a tear (see second photo at the left) in the hair shaft that ultimately leads to breakage of the hair shaft (see third photo at the left). High quality conditioners also help glue together split hair ends. The longer you leave the conditioner on the hair, the better it smoothes out the hair cuticle. Some manufacturers say only to condition for a few seconds, but longer is better.

Many conditioners today contain botanicals and herbal extracts such as extracts of juniper berries and buckhorn leaves and so forth. These herbal extracts interfere with the glue process and reduce the protective effects of the hair conditioners. Combs with unpolished teeth, sharp hair clamps and tight elastic bands can also disrupt the hair scales and produce damage. With such a damage, the strand will rip more easily, the opened scales do not allow other strands to glide over as smooth as before, which can result in tangles.

Conditioners should be at a low pH of about 4.0 to 4.7. The hair proteins remain very strong at a low pH. Shampoos - with their higher pH - should be completely rinsed out of hair. Higher pH's start unraveling the protein strands and loosen and break the hair. Conditioners add a small amount of fat to give the hair a better shine.

Hot oil treatment conditioners are the latest marketing ploy from the cosmetic companies. The idea dates back to the 1950's when hot oil treatments were first marketed by Alberto Culver. The basic idea is that the application of heat drives the conditioners - oils, peptides, etc. - deeper into the hair shaft and the hair looks better for a short time. However, the high heat - about 250 degree F. from a hot air dryer - will ultimately damage the hair follicles - which cannot take heat much about 120 degrees F. - and the follicles will produce less hair and thinner hair.

Where to get good shampoos and conditioners? The best products are sold in successful hair salons. The salons need happy, repeat customers and usually do not advertise their products.

Brushing is an essential part of healthy hair. Brushing helps keep the scalp healthy and improves the blood circulation which feeds the hair roots (follicles). It also helps distributes the natural protective fats along the length of the hair shafts. These fats serve as lubricants that allow smoother combing without breaking the hair shafts.

Morning brushing is best with a natural hair bristle brush which is similar to your hair structure and less likely to produce tangles on long hair. The brush should have a wooden base that reduces static electricity. If combing, start with a wide tooth tortoise shell comb. Never use a metal or rubber comb.

For brushing, stand with feet a little apart and bend down from your waist until the hair falls in a curtain before your face. Then brush your hair gently, starting from the hair roots at the nape of your neck and moving toward the end of the hair. Follow each brush stroke with a stoke from the open palm of your other hand to help counteract the build up of static electricity. Slowly build up you brushing to 50 strokes a day.

Some hair stylists recommend parting your hair on the right side. Most people use a left part or a center part. These experts say that hair follicles have a natural tendency to to grow from the left to the right. A right side part tends to push the hair against this angle and adds more natural "push-up" height to your hair. They say not to use a middle part which puts additional stress on the weakest hairs on the top of the head.

A center part starts a line that goes down the middle of the face and this accentuates the nose and any irregularities that exist between the left and the right sides of your face. The movie and television industries found this out many years ago. Few people have faces are regular enough to look good in a center part. Studies on the biological basis (genetically ingrained) for viewing others as beautiful have found that humans highly value, albeit unconsciously, symmetrical facial features. Yet very few people have truly symmetrical faces. By parting the hair on the side, you distract the mind of other people from focusing on any possible facial irregularities.

The famous hair stylist George Michael (now 82 and living in Florida) of New York City developed successful methods to grow out very long lengths of hair in women and eventually owned 2,000 salons dedicated to long hair. Women are often told that after they reach thirty that hair should be no longer than shoulder length. Michael felt long hair was majestic on a mature woman, did much to downplay wrinkles, made them look younger immediately.

Dr. Michael has found that it is important for growing the longest, healthiest hair possible is to have hair that's all one length - without bangs or fringes. He says that the body will try to equalize uneven hair by excessively shedding hair. He says that "The longer the hair, the stronger the root," and this results in healthier hair.

Longer Hair Reduces Shedding - Studies by Dr. George Michael
Hair Length - Inches	Average Number Hairs Lost Per Day
4	87
12	26
Waist Length	16
Floor Length	2

One of his secrets was the use of acid conditioners and acid pre-treatment products use before swimming in chlorinated pools or salt water or exposing the hair to sunlight. This kept the hair proteins very tightly bound together. He used hair dryers set only about 10 degrees F. higher than body temperature. Common blow dryers reach temperatures of up to 260 degrees. Water boils at 212 degrees. This high heat can damage hair follicles. Large rollers of soft mesh or plastic were used for drying the hair. Velcro rollers were not used because they can tear the hair. Special care was taken to protect the ends of the hair when rolling or setting.

Hair cutting was done as one-length style using a straight blunt cut Michael felt that when hair was cut in layers, the body automatically tried to even out the hair which created extra fallout. Shampoos were kept to a minimum. Vitamin and mineral supplements were recommended. He recommended covering hair at all times when exposed to direct sunlight.

We thank Jennifer Bahney of Long Hair Lovers for the above photographs of Dr. Michael. A very interesting interview with Dr. Michael is at http://www.bbahneycomm.com/longhairlovers/

Hair experts have a number of suggestions. But remember, people who only want to cut your hair off usually know little about hair.

1. Hair is best cut when dry. The detangling comb is designed to be used on damp hair. Start at the ends and work up.

2. Detangle dry hair before washing. De-tangle ends first, then work your way up. Do not try to remove from top to bottom since this may pull out hair. Before entering a shower, use your your comb or brush to give your hair a few strokes. This aligns the strands, and help prevent tangles.

3. For washing, bring your hair to the front before you wet it and leave it there hanging down and keep it there during shampooing. During the washing, try not to move your hair. This keeps the hair strands in position so they won't move upwards and wrap themselves around other strands, resulting in tangles. Use water of room temperature for your hair. The lowest temperature that you can use is best for hair. Warm water open the hair scales, making the hair shaft more vulnerable to damage.

4. Use a minimum of a shampoo with a pH 5.0 to 6.0. Foaming the shampoo is overkill. Pour some shampoo into your palm, then rub your hands together and run the palms of your hands over your head but not yet down the string of hair. If the shampoo begins to foam, you used too much.

5. The shampoo is used to remove dirt from the top layers of your hair. Don't try to wash your hair inside out - just let the shampoo suds penetrate these under layers briefly as it flows over the lower part of your hair. Use your fingers to help release the soap from your head and works the shampoo down the hair. Running your fingers down the string of hair helps detangling.

Make sure that you wash out all of the shampoo. When you think all shampoo is gone, allow another half minute of constant water flow to ensure that residues are gone. Then bend over, and
give a final rinse of the lower hair part with cold water.

6. Use an acidifying conditioner with peptides that re-glue the hair cuticles. Such conditioners help detangle hair, add body and increase the hair's natural shine. Put extra conditioner on the hair ends to prevent split ends. Give the conditioner at least a minute to glue into the hair. For a final rinse use cool or cold water.

7. Air dry your hair whenever possible and use a special highly absorbent towel for your hair. Do not dry your hair with your general bath towel.

8. When you must blow dry your hair, first wrap in a towel for a time to remove most of the water. Blow dry the hair for a time, then let it air dry for a time.

15. Many hairdressers only cut hair. Tell them to keep trimming to an absolute minimum. Avoid hostile or hyper-critical hairdressers.

17. Think of your hair as a silk garment and treat it accordingly. Both silk and hair are protein fibers. You would not wash a silk garment with a cheap detergent in a washing machine at a high temperature with a high agitation cycle and then dry it in a dryer at a high temperature. Think of what a silk garment would look like after such a treatment.

18. Take time for your hair. There is no product that can create wonderful hair within a few hours. Hair improvements take a few weeks.

19. If someone criticizes your hair, ignore them. Hair arouses may emotions and jealousies so arrange your hair in the fashion that pleases yourself.

The hair's appearance can be altered by changing its color, through dying, or its shape, by permanent waving or straightening. These procedures all cause some damage to the scalp and hair follicle with should be promptly repaired with a scalp repair cream such as Folligen. If damage becomes excessive, serious hair loss may occur after a few years. Folligen can be found at www.folligen.com.

Dyes - Hair dyes lighten, darken and cover gray hair. Temporary hair dyes wash out after one shampoo. Gradual hair dyes produce a color change over a two- to three-week period. These dyes generally don't cause problems.

Semipermanent hair dyes that wash out after four to six shampoos, and permanent hair dyes that don't wash out can cause allergic reactions. These products should be tested on a small area of skin behind the ear or inside the elbow for 24 hours before using. Semi-Permanents have lower amounts of ammonia and peroxide, or none at all. Semi's have a wide variety of colors but the results with your specific hair type may be somewhat unpredictable as the the final tint or shade.

Permanent hair dyes are the only product that can make hair lighter or darker and should be applied by professional salons. Ammonium persulfate, sometimes used to lighten hair, can cause both irritant and allergic contact dermatitis in some individuals. It can also cause an immediate allergic reaction of hives and wheezing. Semipermanent hair dyes that wash out after four to six shampoos, and permanent hair dyes that don't wash out can cause allergic reactions. These products should be tested on a small area of skin behind the ear or inside the elbow for 24 hours before using.

Bleaching is used to lighten hair. To get to a platinum blond from dark hair is difficult but possible but professional help is recommended. Several short bleachings spread out over a number of days produce better results. Remember, bleaches can burn the scalp and can damage your eyes. Commercial bleaches such as Clorox bleach should not be used. Beauty supply store sell powder bleaches such as Clairol Ultra Blue or L'Oreal Blanc ($4)) and a bottles of developer ($3) that come in different strengths such as 20, 30, and 40 with 40 being the strongest and harshest.

The powder bleach and developer are mixed in a glass or plastic bowl and spoon to form a slurry which is applied to the hair. Sometimes the hair is covered with a plastic bag to speed the reaction but your head may become very hot. Finally, the head is thoroughly rinsed with cold water with special care taken not to get the bleaching mixture into your eyes.

Semi-permanent dyes that you can apply yourself include some interesting and good products.

    Punky Color
                This is made from a vegetable dye and works best in bright blonde hair.
                Most colors are fairly mild except for Violet, Plum and Midnight Blue which
                can be bright and beautiful. The reds wash out in 1-2 weeks. Strong Reds are
                Pillar Box, Fire and Flame. Blues fade in 2-4 weeks. The lighter blues may turn
                out somewhat greenish. Purple and Violet stay the longest.
          The Official Wicked Hair Dyeing Page from students at Stanford University.

    Clairol Natural Instincts
                Clairol colors on hair are about what is displayed on their boxes. Clairol has
                fragrances that cover some of the obnoxious chemical smells. Their dyes wash
                out after about 25 shampoos.

    L'Oreal Accenting Highlighting Duo
                L'Oreal tries to gives two different color highlights for areas of your hair in one
                box. Experience is needed to get good results but the color highlights can be
                dramatic.

    Kool Aid/Jello
                This is a tricky but low cost way to dye hair. It gives some great bright blue
                hair. It washes out fairly quickly. For use just thicken the Kool Aid or Jello
                with water and saturate hair with it.

    Egg Whites & Food Coloring
                This is a messy but cheap way of hair dyeing. Mix egg whites with food
                coloring, massage into your hair, spike the hair, and blow dry. Good theme
                idea for college parties.

O blue black hair, pennon with sheen, and shadow fraught. You give me back the vast blue skies of dawn and dusk. As on the downy edges of your tresses, caught in your soft curls, I grow drunken and hot. Charles Baudelaire, Of Her Hair (Evidence that punky colors are not new)

Permanent Waving - "Permanents" make straight hair curly. A perm solution temporality breaks the disulfide bonds to allow the hair to be wrapped around a roller or into a tight curl and formed into a new texture. Then the disulfide bonds are chemically reset and the new texture is locked in-place. Hair should not be permed more often than every three months. If the perming solution is left on too long, is too strong or is applied to hair already damaged by dyes, bleaches or recent permanents, it can produce damage to your hair strand and shorten its useful life. Scalp irritation may also occur. Rub Folligen Lotion into your scalp at nighttime for the next 3 - 4 days to restore scalp health. Folligen is described below (click here) and can be purchased at www.folligen.com.

Hair straighteners - A technique used to make curly hair straight is called hair straightening. It is a difficult procedure using dangerous chemicals and should be performed only by hair salon professionals. The disulfide bonds that keep hair curly are broken by an alkaline reducing agent.

Hair straighteners are mostly creams or cream lotions containing about 2-4% of strong bases such as sodium hydroxide, potassium hydroxide, lithium hydroxide or 5% calcium hydroxide plus a solution of up to about 30% guanidine carbonate. The pH is around 12. Some straighteners contain about 4% ammonium thioglycolate as the active ingredient. These caustic bases make the cream dangerous for the skin and eyes, and it has to be handled carefully by skilled personnel. The cream is applied to the hair, with a brush or by using protective gloves, strand by strand after dividing the hair into different areas. After a time, the straightener relaxes the hair and the curly hair is combed and becomes straight. Finally, the hair is washed thoroughly with pH neutralizing shampoo.

Alternatively, intense heat can also reset hair bonds, allowing curly hair to be straightened by ironing with a regular electric iron and an ironing board or flat surface covered with a smooth towel. This technique was very popular in the "long-hair" times of the 1960's and 70's. It is best to have someone else iron your hair straight to avoid the danger of burns.

Conair makes a product that helps straighten hair without the dangers of burns to the skin or hair damage. It is called Straight Styles, #SS6 that produces steam which straightens the hair as you comb through the hair. It is sold in Sears and Service Merchandise stores or can be ordered directly from Conair $33.99 plus shipping and handling by calling Conair's number at 1-800-326-6247, Monday - Friday, 8:30 am - 4:30 pm EST.

Hair is produced from a skin structure called the hair follicle. The root of the hair is located within the base of the bulb-like follicle. The follicle is very metabolically active producing hair shafts and is supplied with rich nutrients and growth factors through small blood vessels. The hair follicle is closely associated with clusters of fat cells which seem to support the health of the follicle.

Baby hair begins to grow around the third month after conception within the womb of the mother. Hair follicles develop as the fetus grows, producing downy hairs (vellus hair) several centimeters long when the baby is born. After birth, vellus hair in the head is converted into the thicker, longer shafts of 'terminal hair" or what we consider normal of the head. During wound healing, the new skin cells appear to arise from the hair follicle.

Follicles can naturally switch back and forth from vellus hair to terminal hair. This raises the possibility that the vellus hair of baldness could be reconverted back into terminal hair with the proper biochemical signals. Few new hair follicles are made after birth but the skin contains undifferentiated stem cells that might also be transformed into new follicles with proper biochemical signals.

Your hair follicle adheres to a genetically programmed schedule that includes growth, resting and hair shedding, then the regrowth of new hair. During its lifetime, a human hair goes through three stages:

Stage 1 - Anagen
Scalp hair follicles enter the hair growth phase and synthesize hair for a period of 2 - 5 years at a rate of about 6 inches (15 cm) per year. Thus a hair 2 feet (60 cm) in length would be about four years old at the end, and only a month or so old near the scalp. In general, 85% of the scalp hair is in the anagen phase. Eyelash follicles, and the follicles for hair on your arms and legs, have a growth stage lasting only a few months, the resultant hairs that they produce are short.

Stage 2 - Catagen
This is a short transitional stage, The follicle becomes physically smaller as the lower portions of the follicle are absorbed by the body, and ceases to make hair.

Stage 3 - Telogen
A resting stage lasting two to four months, after which it sheds the hair shaft. Only 15% of your hair is resting at any one time. The hair follicle relaxes its hold on the hair shaft bulb, and the bulb of the hair shaft moves closer to the surface of the skin. Over time the hair shaft loosens and eventually the hair is shed. At the end of the resting stage, the old hair falls out, the follicle enlarges, and a new growth cycle starts and a new hair shaft begins to grow.

Hair follicles have specialized cells that have receptors for certain types of hormone messages, when the hormone binds to the cell, the cells respond to according to their innate genetic instructions. However, some hair follicle cells are programmed differently than others in other parts of the body. In men there are three basic types of hair follicles. A hair follicle on the chin of a young man will begin to grow thick terminal hair as male sexual hormones increase at puberty. A second type of follicle located on the man's scalp at the hairline is pre-programmed, when it receives the increase of male hormones at puberty, to start spending more time resting and less time growing thick new hairs. This second type of follicle will contribute to a receding hair line, the stage of male pattern hair loss. A third type of follicle, located on the back and the sides of same man's scalp, has a genetic program that is unaffected by the male hormone message after puberty. This type of hair follicle continues its normal cycle of growth, rest, shedding the old hair, and then starting another cycle of growth. It will continue this cycle for many decades.

The innate genetic programming of hair follicle is the reason that hair restoration surgery works. Hair restoration surgeons select hair follicles from scalp areas that have a genetic predisposition to continue growing new hairs, such as the hairs on the side and back of the head. They move these third type of hair follicles to areas on the scalp where the hair follicles have been programmed to cease hair growth when exposed to male hormones. The location on the scalp does not affect the genetic programming of the relocated follicles, since the genetic program is dominant over other factors and they continue to grow hairs in the new location.

In a 1998 report, scientists at the University of Chicago's Howard Hughes Medical Center explained how they were able to transform normal skin cells of mice into hair follicles. Many researchers in wound healing have observed such changes in the past, but never have found the precise signal factor for this transformation. The University of Chicago researchers found that a protein called beta catenin is able to convert normal skin cells into hair follicles. The message for this protein was successfully introduced into the skin cells of mice and this converted the cells into hair follicle cells and produced very hairy mice.

In the future, it may be possible to genetically introduce the genes for beta catenin into your scalp where hair is not growing well. Genes can be carried into cells with harmless viruses and such effects are usually well localized. This breakthrough should reach clinical use within 10 to 15 years.

A Hair Loss Test
To determine if you are losing hair at an excessive rate, count your shed hairs. Each morning hairs from your pillow, bed linens, your shower drain, and from your hair brush or comb. Also, collect hair from your clothing.

Count the hairs and put them into an envelope, marking the day and the number of hairs on the envelope. Use a new envelope every day. Do this for a two weeks. A dermatologist can evaluate the quantity of lost hairs, and can determine whether the hairs are being shed, pulled out, or are breaking along the hair shaft.

When a hair regrowth plan is started, you then have a reference base to determine the plan's success.

Androgenetic alopecia or pattern baldness is the most common cause of hair loss is pattern loss, which eventually affects over 70% of men and 15% of women. In classic pattern, hair thins in a horseshoe pattern, although more diffuse loss can also occur. Painting - Self Portrait by Cezanne.

At least two sequential processes contribute to pattern loss, which begins as an abnormal sensitivity of the hair follicles to androgens of male sex hormones. In most people, this is followed by a local immune reaction to the affected hair follicle, which further damages it and is probably responsible for its eventual death. Both men and women experience androgenetic alopecia, or pattern hair loss, although men generally experience a much greater degree of loss. In men, the pattern of loss starts with the hairline or back of the head, advances to thin the top of the head, and often leaves just a fringe of hair extending from ear to ear across the back of the head and affects the thinner, shorter, and less pigmented hairs of the frontal and parietal portions of the scalp.

In women, pattern loss tends to be more diffuse, and occurs over a broader area. Women usually do not have bald spots, but rather have overall thinning hair. In diffuse hair loss in men or women, over 50% of the hair can be lost before the results are readily apparent.

The combination of various hormones, diseases, or injuries, and immune effects progressively "miniaturizes" the involved hair follicle. The smaller follicle produces a smaller, thinner hair and has a progressively shorter growth cycle. The hair becomes shorter and finer with each hair cycle until it finally becomes "peach-fuzz". Thus, pattern loss is actually more a problem of replacement than of loss.

A major cause of this miniaturization appears to due to the development of striking changes in capillaries surrounding the hair follicles. Comprehensive surveys of the male scalp from birth to senescence find that very significant changes in the structure of the blood vessels of the scalp. The number of the blood capillary loops supplying the hair follicle is greatly diminished. The inadequate subepidermal circulation that can develop as males age does not provide a rich nutrition for the follicle. Strong hair growth requires a large flow of nutrients such as such as vitamins, minerals and amino acids so that the follicle can actively synthesize new hair.

Blood flow impairments to the follicle, and their reversal, may explain why the administration of copper peptides (such as Folligen and Tricomin) to the scalp increase hair growth and increase the size of hair shafts. It has long been known that certain copper-peptide complexes strongly stimulate angiogenesis or new blood vessel formation. In laboratory hair-growth models using mice, the copper-peptides in Folligen or tricomin increase hair follicle volume by 5 to 8-fold. It is likely that these copper-peptides also increase the volume of human hair follicles, although an increase is likely to be smaller than the change in mice. The increase in hair follicle size and the rate of hair growth caused by the administration of copper-peptides may be due to their causing blood flow changes that provide adequate nutrients to the follicle for strong hair growth. Folligen can be found at
www.folligen.com and Tricomin at www.tricomin.com/.

Testosterone and DHT, a metabolic product of testosterone, are required in males for normal development in the womb and for development in adolescence of libido or sex drive. They are important in the development of secondary sexual characteristics such as pubic and facial hair, and the maturation of male muscle mass and skeletal integrity.

Testosterone is the male sex hormone associated with sexual drive, fertility, muscle growth, and male psychosocial attitudes. DHT, is more essential for the fetal development of the male reproductive system and the male genitalia. If in males, the enzyme which converts testosterone into DHT is lacking during fetal development, then the female-appearing genitalia system will be formed although these men will be genetically males. These males appear physically as rather thin-hipped and small-breasted but highly attractive females. Normally, personality difficulties emerge since these men possess many male attitudes. At this point, genetic testing often reveals their basic male identity and hormonal therapy is often used to switch their body into a more male growth pattern.

However, later in life, a higher than normal blood DHT level appears to cause premature aging of the male reproductive system, male pattern baldness, and the prostate condition known as benign prostate hyperplasia which is a non-cancerous enlargement of the prostate gland. An enlargement of the prostate gland makes urination increasingly difficult in men as they age. The production of DHT in older men is not well controlled by biochemical feedback mechanisms and compounds such a saw palmetto oil or the Merck drug Proscar (finasteride) are used to reduce the body's level of DHT.

The most current idea on androgenic scalp hair loss is that it is a two step process: (1) DHT acts on sensitive hair follicles to inhibit their growth and shrink their size. This is followed by (2) a decay in the health and vitality of the follicle and the surrounding skin. This causes immune system cells to damage the hair follicle and ultimately stop its hair growth. Blocking both of these steps is the best method to stop hair loss and regrow hair.

DHT is produced from the male sex hormone, testosterone, by an enzyme called 5-alpha reductase. Not all hair follicles are inhibited by DHT, for example, body hair in men may increase while scalp hair is lost.

Studies on DHT and hair loss are conflicting but the general conclusion is that DHT is a key player in hair loss but other factors influence the final outcome. It does appear that hair follicles in balding individuals are more sensitive to inhibition by DHT.

The first link of hair loss to testosterone metabolism was the very ancient observation that men who were castrated at a young age did not develop pattern baldness. Modern research has confirmed this but such men can develop baldness if they receive supplemental testosterone.

Individuals born with a deficiency of 5-alpha reductase suffer neither scalp hair loss nor prostate hyperplasia. The deficiency reduces levels of DHT and spares sensitive hair follicles. (Imperato-McGinley J et al Science 1974; 186:1213-5) reported that adult males with congenital 5 alpha-reductase deficiency had decreased levels of dehydrotestosterone (DHT). These individuals had a small prostate gland throughout life and did not develop BPH. They also did not develop male pattern baldness or acne.

On the other hand, the genes controlling 5-alpha reductase activity and DHT production are not the only factor involved in balding. In a study of 828 healthy families comprising 3000 individuals, both young, bald individuals as well as older, non-bald individuals were compared for the genes controlling DHT production. It was found that the genes controlling DHT production in men are not the cause of male pattern baldness. This study shows that there is no overproduction of DHT, or if there is it is not caused by the genes that control DHT production (5-alpha reductase activity).

Another interesting finding of this study was that baldness did not follow a simple genetic inheritance pattern which suggests that multiple genes and or environmental factors control hair loss (Genetic analysis of male pattern baldness and the 5-alpha-reductase genes, Ellis JA; Stebbing M; Harrap SB, J Invest Dermatol, 110(6):849-53 1998).

Estrogens, the feminizing hormones, can inhibit or counteract the follicle-shrinking effect of the androgens. Women have more estrogens circulating in their blood than men. As a result of this higher level of estrogens, even women having a genetic predisposition for pattern hair loss are protected from losing their hair because of the high level of estrogens in their blood. When these women reach menopause however, their estrogen level may decrease sufficiently, and the protective effect of the estrogen may be overridden by the DHT message. Then hair can begin to thin, sometimes rapidly. Some women are genetically pre-disposed to have pattern hair loss.

Estrogen supplementation can raise are estrogen levels, and help restore the emotional and physical condition of the patient to the pre-menopause states. It may also slow or stop hair loss triggered by menopause. However, hormone replacement therapy is a controversial treatment for menopause, with possible links to both increasing the risk of some cancers, and possibly reducing the risk of certain heart diseases.

Anabolic steroids are similar to testosterone and are used to increase muscle mass. They also can produce hair loss along with other side effects. However, because of the dangers associated with their use, fewer persons are using them.

Even without anabolic steroids, rigorous exercise tends to raise testosterone and, in women, reduce estrogens. Estrogen levels are lowered in women undergoing severe physical training. This can lead to a stopping of the menstrual cycle. Thus, severe exercise in both men and women can increase the rate of hair loss.

Alopecia areata, the second major cause of hair loss, generally appears as patchy loss but may also occur as alopecia totalis, which involves the entire scalp, or as alopecia universalis, which involves the entire body. It occurs most frequently in young and middle-aged adults of both sexes. Although mild erythema may occur initially, affected areas of scalp or skin appear normal. This may be anywhere on the scalp or even the rest of the body.

Alopecia areata is also an autoimmune disease but without the normal hormonal component in pattern loss. In simple terms, white blood cells attack the hair roots resulting in loss of hair. About 30% of individuals with this problem are aware of a relative with this disorder; thus, there seems also to be a genetic component. At times, scarring (cicatricial) alopecia follows scar tissue formation resulting from inflammation and tissue destruction.

A variety of approaches are currently used for treatment; all are aimed at interrupting the "attack" of white blood cells upon the hair roots. The major therapies include topical and locally injected corticosteroids ; topical minoxidil along with anthralin; various topical irritants or sensitizers; special light treatments (called PUVA); and a number of experimental drugs which alter the immune system.

It cannot be accurately predicted when the condition may become occur. An episode might be precipitated during a illness or a physiologic stress. This type of hair loss may recur at any time. New patches of hair loss can develop while older patches are being effectively treated. Sometimes hair will regrow spontaneously over a period of months to years - this is less likely with more extensive hair loss. The areas of hair loss often have spontaneous hair regrowth. The new hair may initially be non-pigmented, with pigment production resuming at a later. Intralesional corticosteroid injections are beneficial for small patches and may produce regrowth in 4 to 6 weeks.

This condition is not transmitted by contact with a person who has it - it is not contagious

Nutritional deficiencies must be severe to cause hair loss. In situations where hair loss is the result of a nutritional deficiency, other more serious symptoms are usually evident. Nutritional treatments for hair loss are only effective in the rare situations where a nutritional deficiency actually exists. A deficiency of iron can results in anemia or a reduced amount of red blood cells, and this can contribute to hair loss. Anemic people generally appear pale and weak.

Trauma to hair follicles can result in permanent hair loss. Thermal and chemical burns for example, can kill hair follicles and result in hair loss. Hair straighteners can cause follicle damage and produce serious hair loss.

Thyroid gland irregularities cause hair loss. There is no way to predict which patients will experience hair loss, which will not, and who will be severely affected and who will have only minimal hair loss.

Excessive thyroid hormone production is a condition called hyperthyroidism which results in thin soft hairs that are easily extracted, along with other symptoms. An under-active thyroid gland causes thyroid hormone deficiency, called hypothyroidism which results in coarse lifeless hairs, that are also easily extracted, along with other symptoms.

Fortunately, hair loss from hyperthyroidism or hypothyroidism is usually reversible with proper treatment of the thyroid condition. Typically hair loss does not immediately stop when the blood work becomes normal. Most people stop losing their hair and begin replacing lost hair a few months after the thyroid hormone levels become normal.

Stress can contribute to hair loss. Thyroid disease can have a direct impact on the psychological well-being of patients, particularly under stress. Often as patients become more concerned about their hair loss, their stress levels increase, making the situation worse.

Because of the often fragile condition of the scalp and hair follicles, one must be cautious when considering chemical treatments for hair such as coloring or permanent waves. Cutting the hair shorter, using moisturizing and conditioning hair products, and avoiding back combing decrease stress on the hair.

Physiologic alopecia is the sudden hair loss in infants, loss of straight hairline in adolescents, and diffuse hair loss after childbirth. It is usually temporary.

Trichotillomania is the compulsive pulling out of one's own hair. It is most common in children. In trichotillomania, patchy, incomplete areas of hair loss with many broken hairs appear primarily on the scalp but may occur on other areas as well, such as the eyebrows. In trichotillomania, an occlusive dressing encourages normal hair growth, simply by calling attention to the problem (and to the possible need for psychiatric counseling).

Predisposing factors of non-scarring alopecia also include radiation, many types of drug therapies and drug reactions, bacterial and fungal infections, psoriasis, seborrhea, and endocrine disorders, such as thyroid, parathyroid, and pituitary dysfunction.

Scarring alopecia causes irreversible hair loss. It may result from physical or chemical trauma, or chronic tension at the hair shaft, such as braiding or rolling the hair. Diseases that produce alopecia include destructive skin tumors, granulomas, lupus erythematosus, scleroderma, follicular lichen planus, and severe bacterial or viral infections, such as folliculitis or herpes simplex

Common Drugs, Chemicals, and Conditions that Cause Hair Loss
(Telogen effluvium or toxic effluvium)

At times, hair is lost due to stresses, poisons or medical conditions. Hair loss was reported in patients during the 1918 flu epidemic. The characteristic feature of this type of hair loss is a latent period of several weeks between the inciting event and clinical hair loss.

There is a greater sensitivity of actively growing (anagen) hairs, in contrast to resting hair, to a variety of toxic chemical or physical agents. Indeed, x-ray epilation to rid the scalp of fungus infections was standard therapy. The accidental exposure to poisons or natural products also may cause hair loss. Some cosmetics have produced hair loss.

Antiarthritics: penicillamine, auranofin (Ridaura), indomethacin (Indocin), naproxen
(Naprosyn), sulindac (Clinoril), and methotrexate (Folex)

Beta blocker drugs for high blood pressure: atenolol (Tenormin), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal) and timolol (Blocadren)

Plants and Foods
Ingestion of the nuts of the monkey pot tree, cocoa de mono (Lecithin Collabra) a deciduous tree widely distributed in Central and South America.

Plants such as Stanley, Astragals pectinatus (locoweed), Lacuna, Mellitus (yellow sweet clover), Colchicum autumnal, Glorious, and Saptaceae (several Brazilian woods of this family).

The amino acid analog, mimosine, from the seeds of the shrubby tree Leucaena glauca. This species is widely established in Hawaii (where it was once planted as fodder for grazing animals) and can be found growing wild in southern Florida.

Chemicals
Salts of lithium, lead, mercury, selenium, bismuth, arsenic, thallium, and borates

Demodex is a narrow, wormlike mite that lives in the hair follicles of the scalp, eyelashes, nose and chin of most adults. No one knows what role it plays in hair follicle health although there have been unproved claims that it may cause hair loss. Certain persons with very reactive immune responses to the mite may suffer hair loss from its presence. However, as with the skin's natural bacteria, it may keep away more harmful parasites.

Dr. William Regelson, of the Medical College of Virginia has recently proposed (February 1998) that Demodex is implicated in hair loss. He speculates that people who eventually lose their hair and those who do not, however, likely depends on whether the scalp produces an inflammatory reaction in an attempt to reject the mite.

A researcher at Nioxin, a hair-care and cosmetics developer based in Lithium Springs, GA has recently claimed the discovery of Demodex. However, Demodex was first described in 1842, has been the subject of many studies. While Demodex is associated with many skin conditions, most researchers have concluded that the mite is not a major factor in hair loss. The patterns of hair loss do not correspond with Demodex populations. However, excessive mites have been associated with loss of eyelashes (Demodex blepharitis).

A 1996 study from the Department of Laboratory Medicine, VA Medical Center in North Carolina, published the results of a found an association between mite populations in the hair follicle and scalp inflammation. Demodex mites were found in over 40% of follicles with inflammation, but in just 10% of the follicles without inflammation. However, the researchers could not conclude whether Demodex caused the inflammation or preferentially colonized inflamed follicles.

A 1995 study by the Academy of Sciences of the Czech Republic concluded that while Demodex tend to colonized in the lumen of hair follicles, they do not cause any noticeable pathological conditions. The most common conditions associated with Demodex is a swelling of the colonized hair follicle. This normally requires up to a dozen mites for swelling to take place but many infested follicles showed no swelling.

Skin conditions associated with Demodex can be easily treated by topical medication. Medications include gentamicin sulfate, an ointment of a 0.5% selenium sulfide cream, 4% pilocarpine gel, an ointment of 10% sulfur and 5% balsam and a gel of 4% pilocarpine gel. Pilocarpine gel is directly toxic to the mites by constricting their bronchioles and suffocating them. Nioxin sells a Semodex line of products formulated Demodex infestation. The Semodex line of products is available in many hair salons in the US or send an e-mail to HairSite@aol.com if you have trouble locating Semodex in your area.