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Some people are just born with luscious, shiny, and silky manes. Others, like myself, struggle to keep a full head of hair, even with the most expensive of products. If you've tried everything under the sun, including hair growth lotions, supplements, and treatments, and nothing seems to work, you may be dealing with an internal issue.
While in some cases hair loss occurs due to a specific medical treatment, condition, or trauma, in other patients the exact cause is almost impossible to pinpoint. How big of a role do genetic factors play in hair health, and can genetic hair loss be reversed? In this detailed guide, we'll take a deep dive into the complexity of hair loss and the importance of genetic factors in this situation.
Hair loss, also known as alopecia, is a relatively common issue in both men and women. To treat hair loss with confidence, it’s necessary to both examine hair loss pathogenesis and determine the core issue.
While a treatment plan without understanding the root cause can be successful in some cases, it’s far more beneficial to focus on the mechanisms of hair follicle development.[1]
Hair health is influenced by much more than your hair care routine and the use of heat tools. It’s dependent on many other factors, including[1][2]:
Hair growth is a complex process involving multiple molecular signals and pathways. The hair growth cycle consists of three phases[3]:
In the anagen phase, the hair follicles produce hair fiber that later proliferates and develops into new hair. This particular stage of hair growth can last for years.[3]
The catagen phase follows, during which the hair follicles go through a regression, losing some of their volume. Regression analyses can provide valuable information about hair thinning, especially the pace of hair loss.[3]
The telogen, or the resting phase of the hair growth cycle, is a stagnant phase that entails no hair growth. Approximately, up to 15% of body hair remains in this stage for a few weeks (e.g. eyelashes) up to almost a year (e.g. scalp hair).[3]
Hair follicle miniaturization is the histological hallmark of androgenetic alopecia. It is characterized by a gradual decrease in the size of hair follicles, and it remains one of the main causes of male pattern baldness, female pattern hair loss, and alopecia areata - including traction alopecia.[4]
Hair follicle miniaturization is characterized by thin, fragile hairs that eventually fall out. While the follicle may have produced healthy, pigmented, thick hairs in the past, due to hair follicle changes, this condition can cause bald spots, a receding hairline, or hair thinning at the crown.[4]
Androgens, male hormones, play a key role in hair follicle miniaturization. DHT (dihydrotestosterone) binds to the androgen receptor gene, leading to hair follicle miniaturization, which shortens the hair growth cycle. DHT is essentially a hormone that affects male sexual development, and it is a result of testosterone conversion – around 10% of testosterone transforms into DHT daily.[5]
Elevated levels of DHT can lead to numerous health issues, including benign prostatic hyperplasia, prostate cancer, male pattern hair loss, as well as PCOS (polycystic ovarian syndrome) in women.
Androgenetic alopecia is the result of the shortening of the hair growth phase (anagen), while the period between hair shedding and the start of a new anagen phase is prolonged.
Though excess DHT is one of the precursors for androgenic alopecia, other factors play a significant role in the hair thinning process, including genetics.[5]
While underlying causes of hair loss tend to repeat with different types of this condition, not every instance of hair loss is identical. Different types of hair loss can manifest differently in terms of severity and treatment options will vary.
Male pattern baldness is the most common form of hair loss in men. It is characterized by a receding hairline and thinning at the crown of the head. Since it is progressive, androgenic alopecia can worsen over time, gradually leading to complete baldness.
While other factors can affect the condition, studies show that male pattern baldness is genetically determined.[6]
Female pattern baldness is characterized by thinning throughout the scalp, with the hairline remaining intact. Androgenetic alopecia in women is very common, and around one-third will experience it at a certain point in their lives.
It mostly develops in menopause and worsens with age. However, hair loss in women can occur due to androgen overproduction, or other endocrine conditions of the pituitary, ovary, or adrenal glands.[7]
How much of the hair loss predisposition can be blamed on genetic factors? Is hereditary hair loss something that can be changed? Genes seem to be a major determinant in hair quality and hair disorders, so let's take a look at the position of genetics in the hair loss scheme.
Hair loss can be inherited in a polygenic pattern, meaning multiple genes cause it. Androgenetic alopecia is an example of hereditary hair loss inherited in a polygenic pattern. In the case of androgenetic alopecia, the reaction to androgens is rather abrupt and causes progressive hair loss after puberty.[8]
On the other hand, alopecia areata follows a different inheritance pattern known as the autosomal dominant pattern, also known as the Mendelian pattern.
A mutation of a single gene triggers this kind of pattern of hair loss, and the gene affects immune system functions. This is precisely why, in this type of hair loss, the immune system attacks and destroys healthy follicles.
Genetic variants of the Androgen Receptor (AR) gene, located on the X chromosome, represent one of the main prerequisites of hair loss, especially male pattern baldness and female pattern hair loss. These genetic changes influence the hair follicles directly, making them more sensitive to dihydrotestosterone (DHT), leading to follicle miniaturization.
In most cases of hair loss, such as hereditary-patterned baldness, the genetic basis represents a significant risk factor. It is, however, not the decision maker, as nutrition, aging, and hormonal changes have an undeniable impact on hair health.[9]
Stress can contribute to hair loss by increasing the production of stress hormones (corticosterone). Consequently, stress hormones can disrupt the normal hair growth cycle. Corticosterone has been found to extend the telogen (resting) phase, limit the growth phase, and compromise the activation of stem cells in hair follicles.[10]
Moreover, a diet lacking essential nutrients can contribute to hair loss. Micronutrients (vitamins and minerals) are vital in cellular turnover and the follicle cycle. For instance, a vitamin D deficiency has been associated with inflammation and poor immune regulation, leading to poor hair quality and conditions such as scalp psoriasis. In addition, low levels of vitamin E, iron, selenium, and zinc strongly correlate with hair loss.[11]
Nowadays, DNA tests can provide answers to a wide range of questions that reach beyond ancestral matters. A wellness report can give you insights into many genetically influenced conditions, including the predisposition for hair loss.
While genetics cannot be influenced, knowing what you’re dealing with, especially in the early onset of hair loss, can be a game changer in your strategy. What’s more, a detailed report based on genetic testing can provide tailored vitamin and supplement recommendations.
Hair loss is a complex condition caused by a combination of genetic and environmental factors. Understanding the genetics of hair loss can help develop more effective treatments and a focused approach. Therefore, an at-home DNA test can provide the information you need to kickstart your hair health journey and act timely.
When it comes to hair loss, detecting the issue early is your best chance at managing the condition effectively. Preventing nutrient deficiencies and ensuring your intake of essential vitamins and minerals is another vital part of the strategy, so make sure to check out our wide range of all-natural supplements.
