Recent research indicates that the DHT that harms hair follicles comes from the the skin's sebocytes and sweat glands (sebaceous glands). (Chen et al 1996) 5 alpha-Reductase, the enzyme system that converts testosterone into DHT occurs into two enzyme forms. Type 1 represents the 'cutaneous type'; it is located primarily in the skin's sebocytes but also in epidermal and follicular keratinocytes, dermal papilla cells and sweat glands as well as in fibroblasts. Type 2 is located mainly in the seminal vesicles, prostate and in the inner root sheath of the hair follicle.
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With the therapy, sometimes, it is possible to assist to the inversion of the follicle miniaturization, then the progressive enlargement and the formation of hair bigger, more pigmented, up to hair type terminal.
It is important that therapy is mixed, striking the problem from the varied anglings, in particular way if baldness is advanced.
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. 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 estrogens level may decrease and the protective effect may be overridden by the DHT message. Then hair can begin to thin rapidly. Some women are genetically pre-disposed to have pattern hair loss.
This type of hair loss or Androgenetic Alopecia or pattern baldness affects over 70% of men but also 15% of women. Women usually do not develop bald spots, but rather have overall thinning hair. Over 50% of the hair can be lost before the results are readily apparent.
Estrogens help to 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. Hormone replacement therapy has been a controversial treatment for menopause but newer methods are finding reductions in the risk of some cancers and in the risk of heart diseases.
The best known DHT (dihydrotestosterone) blocker is Propecia®, a drug from Merck, but Merck does not recommend Propecia for women: a one year study of hair growth in 136 post-menopausal women found no significant effect of Propecia on hair growth.
