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The Genetics of Hair Loss

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  • MJR
    Citizen of Tanelorn
    • Jan 2004
    • 281

    The Genetics of Hair Loss

    April 4, 2004

    So exactly where is hair loss inherited from? Mother's father like they tell us? An unpredictable unorganized appearance throughout family members? Dr. Richard Lee of addresses the genetics of hair loss, and gives the solid scientific answer to this age old question...

    Dr. Ken Washenik, medical director of the Aderans Research Institute, has an amusing and straightforward retort to alopecia androgenetic patients who tell him that there is no history of MPB in their family. He simply says, “Now there is�.

    Unquestionably, the two most important factors in the etiology of the common patterned loss of scalp hair known as male pattern baldness (MPB) are the genetic predisposition and the dependence on androgens. Without both components, MPB does not occur. Whereas the hormones involved in MPB (primarily testosterone and dihydrotestosterone) have been identified, the inheritance of MPB remains only partially solved.

    Is it Mom's Fault?

    It’s an enduring and common misconception among patients that MPB is �inherited from the mother’s side’. Well, that statement is neither right nor wrong. Pattern baldness can be inherited from the mother’s side. But it can also be inherited from the father’s side. Despite the universal interest in the genetics of MPB, there is a surprisingly small number of scientific studies in regards to the genetics of MPB and there is only one known extensive family study on MPB. This study of hair growth patterns in 22 families concluded that common pattern baldness was an autosomal dominant phenotype in men and an autosomal recessive phenotype in women. However, the validity of these results are controversial because of a lack of details regarding examination methods and sampling errors of this study, which was published in 1916.

    Despite the fact that the entire human genome, comprising approximately 30,000 genes in the human DNA, was completely mapped out as of April 2003, the gene or, more likely, genes responsible for MPB, have not been identified. Studies of the genes (on chromosome Xq11.2^q12) encoding the two 5alpha-reductase isoenzymes show that they are not the genes associated with male pattern baldness.

    What is known is that the age of onset, the rate of progression, and the pattern of follicular miniaturization are all influenced by heredity. Generally, the earlier the onset of balding, the more extensive the degree of hair loss will eventually be.

    There are often times when an accelerated rate of progression of MPB will coincide with some other event, such as a change in medication, or the onset of another medical disorder, or a change in habits, etc. Although these events may cause hair loss, they do not precipitate or aggravate MPB.

    Maybe we can blame Dad?

    A study examining 410 men with premature baldness found evidence of a genetic influence from the father’s side in only 236 cases. Hair loss similarities between father and son have also been observed in another study in regards to the frequency of MPB in brothers of men having prematurely bald fathers (66%) compared with brothers of men with unaffected fathers (46%). The relatively strong association of MPB between fathers and sons in this study was not consistent with a simple Mendelian autosomal or sex-linked dominant inheritance and suggested that several genes (a polygenic etiology) may be responsible for MPB. As further evidence against a single and/or X-linked gene being responsible for MPB is the observation that only 33% of the fathers of 18 women suffering from severe pattern baldness also had MPB. These findings suggest that other autosomal genes play an important role in the expression of MPB.

    Dr. Richard Lee

    Dr. Lee obtained his degree in medicine from the University of Pittsburgh, and has founded and operated one of the few private medical practices devoted entirely to the research and treatment of hair loss.. "Regrowth" was incorporated in 1987. Dr. Lee provides consultation services to hair loss sufferers, and has a line of custom minoxidil and topical spironolactone solutions which are widely used by our members here at Dr. Lee is a respected member of the HairlossTalk Community, and one of the few physicians truly educated on the causes and treatments of hair loss. You can see his website and products at


    Considering the high proportion of men affected by MPB, its distribution in the general population, the increased risk of MPB as the number of affected close relatives increases, and the high risk of inheritance from either or both affected parents, one can support a strong argument in favor of a polygenic inheritance.

    It seems ironic that with all the knowledge that has been accumulated in regards to MPB in the past several decades, we still do not know the exact genetic inheritance of MPB. What is known is that the genes are autosomal (not on the X or Y chromosomes), dominant (as opposed to recessive), and have variable penetrance (so it may not affect siblings of the same parents to the same degree).

    Ellis JA, Stebbing M, Harrap SB: Genetic analysis of male pattern baldness and the 5alpha-reductase genes. J Invest Dermatol. 110(6):849-53, 1998
    Harris H: The inheritance of premature baldness in men. Ann Eugenics 13:172-181, 1946
    Neale MC, Cardon LR: Methodology for Genetic Studies in Twins and Families. NATO ASI Series. Dordrecht: Kluwer Academic Publishers, 1992
    Kuster W, Happle R: The inheritance of common baldness: Two B or not two B?
    J Am Acad Dermatol 11:921-926, 1984 Salamon T: Genetic factors in male pattern alopecia. In Baccaredda-Boy A, Moretti G, Frey JR (eds): Biopathology of Pattern Alopecia. New York, Karger, pp 39-49, 1968

    - Legitimate Proven Treatments for Men: Overview
    - Other Helpful Treatments for Men: Overview
    - Legitimate Proven Treatments for Women: Overview
    - Other Helpful Treatments for Women: Overview
    \"No, I think Space is a dimension of Time. My theory is that Time is a field and that Space exists as an aspect of Time.\" Michael Moorcock

    \"All I know about anything is \"I wasn\'t. I am. I will not be.\" Michael Moorcock
  • PsychicWarVeteran
    Flesh Bag of Mostly Water
    • Mar 2004
    • 2554

    Very interesting, MJR. I can always count on fascinating reading from you! :)

    I was one of those people under the misconception my balding pattern came from my mother's father. I am losing my hair in the exact same pattern as he did, so it stood to reason (my father, on the other hand, was almost fully bald by age 22).

    I have learned to take my balding like a man. Just say no to Rogaine. :lol:
    "Wounds are all I'm made of. Did I hear you say that this is victory?"
    --Michael Moorcock, Veteran of the Psychic Wars


    • MJR
      Citizen of Tanelorn
      • Jan 2004
      • 281

      Much obliged....glad others finds this stuff's some more on the topic:

      A real cure for baldness using stem cell therapy?
      29 Apr 2004

      Baldness is probably the one thing that causes men more anxiety than anything else in their life. Now, scientists believe they may have found a new way to reverse baldness and treat conditions like alopecia.

      Scientists have identified stem cells or master cells in the hair follicles of mice. They found that these cells grow into hair follicles and produce hair when transplanted into skin. George Cotsarelis, Assistant Professor of dermatology from the University of Pennsylvania, said that the study could lead to new ways of treating hair loss in humans through drugs or surgery.

      “This may lead to a new type of tissue engineering for treating baldness – for example, isolating hair follicle stem cells from the scalp and reconstituting hair follicles in bald areas,� Dr Cotsarelis said. “I can’t predict the future but this type of research certainly opens new avenues for developing new treatments for baldness.�

      The study, published in the journal Nature Biotechnology, isolated the stem cells within the bulbous follicle at the base of a hair shaft. Sometimes these follicles go into a permanent resting phase, halting hair regeneration. When the researchers transplanted the stem cells into the skin of other mice, hair follicles began to re-grow within four weeks.

      “Now that we can isolate stem cells involved in hair growth, we can develop targets for manipulating hair growth,� Dr Cotsarelis said.

      Receding hairlines and the arrival of the bald patch are feared by men around the globe. Hair may start to disappear from the temples and the crown of the head at any time. For some men this process starts as early as the later teenage years, for most it happens in the late 20s and early 30s. Initially it may just be a little thinning that’s noticed. Then, the absence of hair allows more of the scalp to become visible.

      Some men are not troubled by this process at all. Others, however, suffer great emotional distress associated with a lack of self-confidence and sometimes depression.

      In male pattern baldness, which is hereditary, the hair is usually lost at the temples and the crown. This happens because an over-sensitivity of the hair follicle to normal levels of testosterone switches the hair loss gene on. Not every hair follicle has this gene which is why some hair falls out whilst other hair doesn't. Other causes of hair-loss that are usually reversible include; iron deficiency anaemia; under-active thyroid; fungal scalp infection; some prescribed medicines; and stress.

      Scientists have long-suspected that hair follicles contained stem cells. However, it has proved difficult to isolate these cells in humans. This latest study raises hopes that they can now track these genes and identify stem cells in human hair follicles. “Ultimately, these findings provide potential targets for the treatment of hair loss and other disorders of skin and hair,� the researchers wrote.

      While the discovery could lead to new treatments for baldness and conditions like alopecia, the researchers believe it may also help burn victims. “One problem with a burn is that the wound is never covered with hair follicles,� said Dr Cotsarelis. “These cells have that capability so if we can isolate them and seed them onto a wound we can constitute skin that is more normal than currently possible.�
      \"No, I think Space is a dimension of Time. My theory is that Time is a field and that Space exists as an aspect of Time.\" Michael Moorcock

      \"All I know about anything is \"I wasn\'t. I am. I will not be.\" Michael Moorcock


      • Bill
        Champion of the Balance
        • Feb 2004
        • 1063

        My Mom's Dad had hair like Yul Brenner when he passed, and my Dad's Dad had hair like Ted Koppek when he passed, so I was worried. But I am 36 going on 37 and I still have most of it, albeit a lot more is grey than it used to be.