Remember the guy in high school with the thick mane of curly hair? At the 10-year reunion, he was almost totally bald on top — a completely different image.

Everyone knows about male pattern baldness, a condition that sooner or later catches up to two-thirds or more of American men. Despite having to suffer a continuing barrage of bad jokes, most men learn to deal with their vanishing head of hair.

You’ve recently noticed quite a few of your own hairs clogging up the drain of the shower and coming out in your comb. What’s going on? Is it cause for concern?

The loss of some hairs, about 100 a day, is normal, part of the natural process of growth and replacement. At any given time, about 10 percent of hairs on the scalp are in a resting (telogen) phase in preparation for being shed. A new hair then begins to grow in the same hair follicle. When hair is shed faster than it is replaced, the result is thinning of the hair or balding.

Excessive hair loss, partial or total, is known as alopecia. And it comes in many forms — some or which are temporary and nearly all of which are treatable.

The male-type baldness that is most common typically occurs in certain patterns — a receding M-shaped hairline, a bald patch at the crown or a completely bald top with a horseshoe ring around the sides. This type of hair loss is primarily determined by genetics and the male hormone dihydrotestosterone.

Women too suffer from androgenetic alopecia, although with a different pattern — generally without a receding hair loss or completely bald areas. A woman may notice general thinning on top with a more exaggerated part line, which can be masked through hair styling.

Hair loss can be a result of telogen effuvium, a condition in which the normal growth cycle of hairs becomes abnormally shortened, causing a predominance of hairs in the telogen or resting phase preparing to be shed. Telegen effluvium is a temporary condition, usually caused by stress, or abnormalities of the thyroid, parathyroid or pituitary glands. It can be reversed by identifying and treating the underlying cause.

Most types of hair loss can be reversed to some extent with minoxidil (Rogaine), available over-the-counter in a topical solutions to apply to the scalp.

Minoxidil revitalizes and increases the size of hair follicles that are dwindling in size, creating increased density in a certain percentage of persons. It will not work on areas that are totally bald, and you have to keep using the drug to maintain the effect. If you stop using minoxidil after 10 years, you will revert to what you would have looked like had you never taken it.

Minoxodil should not be used on areas of the scalp that are inflamed, infected or irritated. Patients with known cardiac disease should avoid the product, and women should use the two percent rather than the five percent solution.

The other treatment for baldness, finasteride, slows hare loss and increases hair growth by inhibiting the conversion of testosterone to dihydrotestosterone. An oral prescription medication, it is not approved for females.

It’s too easy to dismiss thinning, receding or patchy hair as a cosmetic problem. Even though only about five percent of cases are caused by illness, hair loss can have a damaging effect on image and self-confidence in social relationships.



Rupp is information and assistance case manager with the Northern Oklahoma Development Authority Area Agency on Aging.