Washington: Gravity may help explain the apparently paradoxical effects of testosterone in male pattern baldness, or androgenic alopecia (AGA), a new research has revealed.
Dr. Emin Tuncay Ustuner, a plastic surgeon in Ankara, Turkey said that the "force of downward pull caused by the gravity on the scalp skin" is the key contributor to the events leading to progressive hair loss in male pattern baldness.
He said that the new theory's unparalleled ability to explain even the details of the hair loss process and the formation of the pattern in AGA is apparent.
Dr. Ustuner's theory seeks to reconcile some puzzling observations related to the development and progression of AGA. Balding areas of the scalp show increases in a potent form of testosterone called dihydrotestosterone (DHT), while drugs that block conversion of testosterone to DHT can slow hair loss.
Ustuner believes that in youth, the scalp has sufficient fat tissue under the skin, and it is "capable of keeping itself well-hydrated," buffering the pressure on hair follicles.
He said that but with aging, the skin and underlying (subcutaneous) fat become thinner, and the pressure on the hair follicles increases. Testosterone contributes to thinning of the subcutaneous fat. In women, estrogen prevents thinning of these cushioning tissues, at least until menopause.
According to Dr. Ustuner, as the cushion decreases, the hair follicle must strive against higher pressure, requiring more testosterone to achieve normal growth. This "local demand" leads to a buildup of DHT levels in the scalp, but not in the bloodstream. Rising DHT levels cause further erosion of the subcutaneous fat-creating a "vicious circle."
The hair growth cycle accelerates in response to DHT, but it's not enough to overcome the increased pressure. Over time, the hair follicle becomes smaller and smaller, resulting in progressively increasing hair loss.
The study has been published in Plastic and Reconstructive Surgery-Global Open (PRS GO).