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Trichologists and Hair Specialists have been searching therapies for years, to help their patients effectively. Though plagued with side effects, prescription medications have been the main choice in treating hair loss patients with doubtful clinical support and evidence of raised hormones. Most patients have do not have raised androgens or dihydrotestosterone (DHT) levels [1]. Even the Thyroid levels, Ferritin and Vit. D levels are not always found deviating from the normal range, though clinically the patient is suffering hair loss. Our initial understanding of hair loss merits it to be labelled as Androgenetic Alopecia. However gradually correlating with clinical evidence we realized that the hair loss can occur with normal androgen levels (1). It can occur without family history [2], it can skip siblings and skip generations. It can also occur without any family history. Therefore it is not necessarily genetic or androgenic. Due to which we changed the nomenclature to more appropriate terms, calling it male pattern hair loss (MPHL) and female pattern hair loss (FPHL). After further review of clinical reports and records, research workers found that this hair loss does not always follow a pattern, so they have defined a new entity of diffuse unpatterned hair loss or DUPA. The traditional or conventional teaching makes us approach hair loss as a sickness or disease. Hence, we are trying to search for a cause and treat the cause as we do for all medical problems. We would like to suggest, that hair loss is not a sickness or a disease but a slowing down of the biological cycles due to unfavourable conditions of the internal cellular environment [4]. Can we improve the internal environment and strengthen the weak, sensitive hair follicles to achieve better hair growth instead of merely fighting hair loss with enzyme blockers.
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Journal of Clinical Trials & Research
JCTR, 1(2): 24-26
www.scitcentral.com
Original Short Communication: Open Access
SciTech Central Inc.
J Clin Trials Res (JCTR) 24
A New Approach to Hair Loss Management without DHT Blockers
Rajendra Singh Rajput*
*ISHRS, IAT, & AHRS, India
Received April 3, 2018; Accepted April 28, 2018; Published August 10, 2018
Trichologists and Hair Specialists have been searching
therapies for years, to help their patients effectively. Though
plagued with side effects, prescription medications have
been the main choice in treating hair loss patients with
doubtful clinical support and evidence of raised hormones.
Most patients have do not have raised androgens or
dihydrotestosterone (DHT) levels [1]. Even the Thyroid
levels, Ferritin and Vit. D levels are not always found
deviating from the normal range, though clinically the
patient is suffering hair loss. Our initial understanding of
hair loss merits it to be labelled as Androgenetic Alopecia.
However gradually correlating with clinical evidence we
realized that the hair loss can occur with normal androgen
levels (1). It can occur without family history [2], it can skip
siblings and skip generations. It can also occur without any
family history. Therefore it is not necessarily genetic or
androgenic. Due to which we changed the nomenclature to
more appropriate terms, calling it male pattern hair loss
(MPHL) and female pattern hair loss (FPHL). After further
review of clinical reports and records, research workers
found that this hair loss does not always follow a pattern, so
they have defined a new entity of diffuse unpatterned hair
loss or DUPA.
Overall with all our efforts in a hair loss patient, we cannot
assure and determine a specific cause. Androgens may not
be raised. If we say hair loss is due to bad water in a town,
you sure have many people with good hair living in the same
town. If we say stress, there are many people doing the same
jobs, meeting the same deadlines and not losing their hair. It
we blame DHT, there are persons with normal DHT levels
losing hair.
Researchers now agree that it is not the raised levels of DHT
but increased sensitivity of the follicle or weakness of the
follicle that results in damage and hair loss [3], despite
normal DHT levels. The metabolism of DHT in the hair
follicle tissue at the cellular level is at fault. Altered
metabolism can be caused by an imbalance of the internal
environment which as we know has been the common
predisposing cause and origin of multiple illnesses like, heart
disease, hypertension, diabetes and cancer. Derangement of
the internal cellular environment is primarily caused by the
accumulation of free radicals, the reactive oxygen species
(ROS) along with poor repair and restoration of the damaged
cells due to essential nutrient deficiencies.
With this background in mind, should we have a new
approach towards hair loss management instead of fighting
DHT, expecting side effects and not supporting cell repair or
cell growth with a balanced internal environment. The
traditional or conventional teaching makes us approach hair
loss as a sickness or disease. Hence, we are trying to search
for a cause and treat the cause as we do for all medical
problems. We would like to suggest, that hair loss is not a
sickness or a disease but a slowing down of the biological
cycles due to unfavourable conditions of the internal cellular
environment [4]. Can we improve the internal environment
and strengthen the weak, sensitive hair follicles to achieve
better hair growth instead of merely fighting hair loss with
enzyme blockers.
Researchers agree that hair loss is multifactorial-genetic,
androgenic, inflammatory, immune mediated, nutritional or
from an imbalance causing a dysregulation of the hair
growth cycles [5-7]. The factors affecting hair loss can be
divide into two types. The predisposing factors and the
sensitizing factors. Predisposing factors can be Genetic
and/or Hormonal. Sensitizing factors are often
inflammatory, immunity and nutrition driven, which can
alter the internal cellular environment making it
unfavourable for hair growth (Table 1). Sensitizing factors
weaken the hair follicles making them sensitive even to
normal hormone levels. Thus we find hair loss with normal
DHT and normal androgens. Sensitizing factors cause
dysregulation of the hair growth cycles through micro
inflammation, altered immunity and nutritional deficiencies
leading to slowing down of hair growth, gradual hair loss
*Corresponding Author: Dr. Rajendra Singh Rajput, Hair Restore, 401,
Saffire, 65B Linking Road, Santacruz west, Mumbai 400054, Tel: +91-
9821308411, +91-22-26041785, +91-8097786688; Email:
drrajeshrajput@gmail.com
Citation: Rajput RS. (2018) A New Approach to Hair Loss Management
without DHT Blockers. J Clin Trials Res, 1(2): 24-26.
Copyright: ©2018 Rajput RS. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited.
ISSN: 2637-7373
SciTech Central Inc.
J Clin Trials Res (JCTR) 25
J Clin Trials Res, 1(2): 24-26 Rajput R S
Table 1. Some of the factors causing hair loss due to dysregulation of hair cycle or unfavourable conditions for hair growth
without any role of DHT
Internal Factors External Factors
Iron, calcium deficiency Smoking, Hookah, Passive smoking,
Vit. A, C, E, D deficiency Tobacco, Pan, Beetle nut, Tea
Overuse of Vit. & Supplements Alcohol
Thyroid hypo or hyper Hard water areas,
Side effect of medications Stress, Lifestyle,
Metabolic disease, diabetes, gout Lack of sleep,
Siborrhoeic scalp Exposure to excess heat or cold
Prolonged illness Dryness of the Scalp
Crash Dieting Exposure to Dust, Pollution,
Poor fluid intake Continuous Air Conditioning
Fat free Diet, Exposure to chemical fumes
High Protein Diet Mining areas, Construction work
Derangement of liver function Pressurised Airline Cabins
Derangement of Kidney function Over use of Hair Products
Post Pregnancy Hair loss Blow drying
and baldness. This type of hair loss we should recognize as
'Non Hormonal Hair Loss'. The non-hormonal causes are
interlinked, affecting individually and then, one cause
leading to the other. We have seen that use of antioxidants
to prevent accumulation of ROS, providing nutritional
support for recovery and growth of damaged cells has
clinically resulted into new hair growth in men and women
without blocking the normal levels of androgens or DHT. It
is not wise to judge the hair growth without correcting the
factors that make the cellular environment unfavourable for
hair to grow. A controlled clinical trial for hair loss
management, using antioxidants, iron, calcium, aminoacids,
B-complex, biotin, in men and women without the use of
anti-androgens or DHT blocker Finasteride showed an
average improvement in density of 18% at 2 months and
30% and at 4 months (Figures 1a and 1b). The average
improvement in calibre in 2 months was 9% and at 4 months
Figure 1a. Hereditary hair loss in a male patient.
SciTech Central Inc.
J Clin Trials Res (JCTR)
26
J Clin Trials Res, 1(2): 24-26 Rajput R S
was 21%. Hair loss was controlled within 4-6 weeks [8].
The approach has also helped in hair loss due to smoking
[9], hair loss due to pollution [10], poor hair structure from
hair shaft disorders like monilethrix [11] and hair loss from
exposure to cell phone radiation [12], apart from routine hair
loss seen in routine clinical practice. Figures 1a and 1b
show improvement in hair density and calibre achieved in
four months with use of nutritional supplements and without
the use of DHT blocker, finasteride.
Figure 1b. Improvement in hair quality, density and caliber
after 4 months of nutritional therapy.
CONCLUSION
In conclusion, hair loss is not always androgenic or genetic.
Non hormonal factors can lead to hair loss which clinically
displays all characteristics of hormonal hair loss. Correction
of nutrition can restore the balance of the internal
environment of the body leading to promotion of strong and
healthy hair growth. Once the hair follicles are strong they
can stand against any cause, just like many others exposed to
the same causes and living in the same circumstances, who
have similar tissue DHT levels as our patients and do not
have any hair loss. The new approach will help in long term
hair loss management without side effects.
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1. Cranwell W, Sinclair R (2000) Male androgenetic
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3. Sawaya ME, Price VH (1997) Different levels of
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