Balding and thinning hair are normally determined by our genetic heritage.trapianto capelli

Genetically determined hair loss is the most common form of alopecia (baldness) not caused by scarring.

LIn men, common baldness (alopecia androgenetica) is characterised by hair loss initially from the top of the head and later from all parts of the upper scalp. The areas at the sides and back of the head are generally not affected, leaving just the crown without hair. Alopecia androgenetica is often, though not always accompanied by seborrhoea and dandruff.
In its most aggressive form, baldness can strike even at 18 years of age.

Baldness begins with massive hair loss and the replacement of healthy hairs with others that are thinner and paler. This is caused by the increasing atrophisation of the follicles, and eventually leads to a condition in which strong, healthy hair simply cannot be regenerated.

The term “baldness” is generally used to refer to the condition of “alopecia androgenetica”, the most common form of genetic baldness in men.

“Alopecia areata” is another form of baldness and is characterised by the appearance of round hairless patches, even in the beard. On rare occasions the skin also shows visible signs of the condition (in the form of atrophy or red patches).
The hairs at the margins of these patches are typically thin, weak, and almost transparent. The cause of alopecia areata can typically be traced to a state of anxiety, depression or stress, and in most cases the condition can be reversed.

Another form of baldness in men is “frontoparietal alopecia”. This is characterised by an ‘M’ shaped hairline with broad hairless zones at the sides of the forehead and temples. Frontoparietal alopecia is considered clinically distinct from alopecia androgenetica because it not always develops to the same extent.

Women can sometimes suffer from “postpartum alopecia”, a form of hair loss that sets in a few months after childbirth. Luckily, this condition normally resolves itself. It is caused by the increase in galactin and the rapid reduction in oestrogens typical of the post-natal period.

“Traction alopecia” is another form of thinning more common in women than in men. It is caused by mechanical stress from frequent perms and unusual hair styles. In most cases hairs are simply broken off by constant combing or brushing and the simple solution lies in suspending the usual hair style.

In more serious cases, erythema and peeling can occur, leading to permanent damage. Traction alopecia is the reason why some women notice thinning around the parting: constant combing in this area causes aggressive and repeated pulling on the hair.

“Traumatic alopecia” is the appearance of bald patches following a trauma that blocks blood circulation locally for an extended period and “suffocates” the hair bulbs. Hair transplants are the ideal cure for this condition as they restore a population of natural looking healthy follicles.

Other forms of baldness and thinning can be caused by poor diet (often identified by fragile nails), the administration of certain drugs (iatrogenic alopecia), and radiotherapy, and can also appear as side effects of other diseases.
Iatrogenic hair loss is easily cured by suspending administration the drug that caused it.

Androgenetic alopecia or significant thinning is an even worse aesthetic and psychological problem in women than in men.

Yet about 35% of women of childbearing age and around 50% of menopausal women suffer from thinning. Unfortunately, the vast majority of these women prefer to suffer in silence and take no action to resolve the situation.

In women, baldness generally starts later and proceeds more slowly than in men, so that the thinning is usually less evident though it may be more widespread on the scalp.

Increased production of male hormones is the cause of 40% of female androgenetic alopecia. In the remaining cases, even though the body may not produce an increased amount of male hormones, the hair follicles become more sensitive to the level of male hormones already present. Typical consequences are atrophisation of the hair, reduced growth, and an increase in seborrhoea.

Hair loss may be the result of a variety of causes, including the menopause, cysts on the ovaries, hereditary factors and sudden hormonal changes (like those induced by the contraceptive pill).

Baldness and thinning in women is measured on the Ludwig scale, which concentrates on the top and front of the head.

Female hair loss cannot always be treated by hormone therapy, because it is often impossible to determine what form of baldness is involved.