Bald Head Explained

What You Need to Know About Your Bald Head: Causes, Characteristics, and Care

Male baldness is usually a form of androgenetic alopecia, which literally means male pattern baldness. Among 30% of men, baldness begins before the age of 30, 50% experience baldness before the age of 50, and about 70% are balding at 80. Women can also develop this form of hair loss, but they usually do not become completely bald; their hair becomes thin. They mainly experience symptoms after menopause, with about 40% of women at the age of 65 being affected.

Caucasian men are more affected than other ethnic groups. Androgenetic alopecia is hereditary. Dihydrotestosterone (DHT), a form of male hormone, is more present in the hair follicles of men with this type of baldness. There are more receptors for this male hormone in male baldness, resulting in the hair follicles shrinking (becoming miniature), causing the hair to thin and eventually disappear. The sensitivity to DHT is not evenly distributed across the scalp hair. These differences determine the pattern of hair loss.

Hair Growth Cycle and the Impact of DHT

Hair normally grows in certain phases:

1. Anagen phase: This is the growth phase of the hair, with 66-96% of the hairs in this phase.
2. Catagen phase: Growth has stopped. The hair is still attached to the scalp, with 0-6% of the hairs in this phase.
3. Telogen phase: The hair falls out, but at the same time, a new hair begins a new growth cycle in the same follicle. Between 2-18% of all hairs are in this phase.

DHT has the following effects:

• Shortening of the anagen growth phase: This makes the hair implant appear thinner.
• Relative increase in the number of hairs in the telogen phase with hair loss.
• Ultimately, the shrinking of the hair roots. Once the hair roots have shrunk, new hair growth is no longer possible.

pH Value and Skin Care

The pH value is another term for acidity. pH values range from 0 to 14, with 0 being extremely acidic and 14 extremely basic. The pH is neutral around 7. Solutions are considered acidic if the pH is below 7. The skin also has a certain pH value, which ranges between 4.5 and 5.5 and is therefore quite acidic. The natural protective layer of the skin consists of sweat, sebum, and dead skin cells, known as the acid mantle of the skin. This is the best environment for good skin bacteria, but not for harmful bacteria. It is therefore very important to keep the skin slightly acidic.

Many cleaning products such as soaps and shampoos have a high pH value to effectively remove grease. As a result, they dry out the skin and damage the acid mantle and thus the skin barrier. It is better to avoid products with a high pH value (above 7) and choose a product for care with a pH value around the skin's pH value, which is around 4,5-5.5. If you use a product with a neutral (7) or higher pH, you make the skin less acidic. The skin then needs 4-6 hours and sometimes longer to restore the natural protective layer. If you use products with a too low pH value, this stimulates sebum production. This makes your skin too oily, which can cause problems such as blackheads and pimples.

Sebum Production and Skin Protection

Sebum (Latin: sebum) or skin grease is a fatty substance produced by sebaceous glands. The sebaceous glands are usually located near hair roots, and the sebum is transported to the surface of the skin via the hair follicles. Sebum has a protective effect against drying out of the skin and against infection by bacteria and fungi. Sebum is odourless, but bacteria can give it a characteristic smell. Sebum production depends on hormone balance and age. The most important hormone that stimulates sebum production is Dihydrotestosterone (DHT). As mentioned earlier, this is more present in the hair follicles of men with androgenetic alopecia. Research on the skin of men with baldness showed that the sebaceous glands were also partly enlarged. Sebum production is therefore slightly higher in male baldness and only decreases when DHT production decreases with age.

Protection of the Bald Scalp

Hair keeps your head warm and protects the scalp and partly the ears from external influences such as sunlight. UV rays in sunlight cause skin dryness, pigment changes, and in the long term, skin cancer and its precursors. It is a cumulative effect. We are generally older than before, spend more time outside for work, vacation, or hobbies, so sun exposure increases. Protection and care of the bald scalp are therefore essential, especially if you became bald at a young age. Caring creams, sunscreens, and protection with a hat or cap are crucial. Additionally, many men regularly shave the remaining hair, making follicle inflammation more likely. To reduce this effect, good cleaning with, for example, a shampoo is necessary, even if there is no hair left.

Barbara E.W.L. van Huystee, Retired Dermatologist