Why the transplanted hair grow permanently?

The Pattern loss is genetic hair loss where the hairs at the top central and horse shoe shaped are is where the hairs gradually miniaturize and die because these hairs are  Genetically Hormone (5DHT) sensitive. This is the reason this hair loss is also called Andro Gentic Alopecia (AGA).The hairs at the back and side of the head are permanent and are resistant to this effect of 5 DHT hormone.

When the head is developed from embryo the frontal and parietal bone area of the head has migrated Neural crest tissue but the occipital and temporal bone area ( back and side of the head ) does not have this tissue of origin. It is believed that certain genes responsible for AGA affect only these hairs which are having Neural crest origin and the area at the back and sides escape the effect of these genes. As a result even if this hairs transplanted in the front they keep growing because they remain unaffected by 5 DHT.

The analogy is it is not the problem of the land but the seeds are bad in the front and when the good seeds from the back of the head are planted in the front they grow normally because the land is fertile.

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Prolactin and Hair loss

High Prolactin level and Hair Loss:

It has been shown recently that some hair loss is related to higher Serum Prolactin level.

An abnormally high level of prolactin (hyperprolactinemia) is a condition characterized by elevated serum levels of the hormone prolactin in non-pregnant individuals. Hyperprolactinemia may cause progressive pattern hair loss due to an indirect effect on increasing free testosterone level. Prolactin also enhances LH (Luteinizing Hormone) receptors in Leydig Cells, resulting in testosterone secretion, which leads to spermatogenesis.

Prolactin delays hair regrowth in mice. It has been shown in research that Treatment of organ-cultured human scalp HFs with high-dose PRL (400 ng/ml) results in a significant inhibition of hair shaft elongation and premature catagen development, along with reduced proliferation and increased apoptosis of hair bulb keratinocytes. Human scalp hair follicles are both a target and a source of prolactin, which serves as an autocrine and/or paracrine promoter of apoptosis-driven hair follicle regression.

Conditions associated with elevated prolactin secretion

 

Hyperprolactinaemia is the term given to having too-high levels of prolactin in the blood, which can result from:

• Prolactinoma
• Excess thyrotropin-releasing hormone (TRH), usually in primary hypothyroidism stimulates prolactin secretion
• Many antipsychotic  Anti depressant medications
• Increased Emotional stress
• Pregnancy and lactation- Oxytocin sectreion by nipple stimulation releases Prolactin. Estrogens provide a well-studied positive control over prolactin synthesis and secretion, and increasing blood concentrations of estrogen during late pregnancy appear responsible for the elevated levels of prolactin that are necessary to prepare the mammary gland for lactation at the end of gestation.
• Some sexual disorders
• PCOS ( POLY CYSTIC OVARIAN SYNDROME)
• It has also been shown that prolactin levels after sex are 4x higher than prolactin levels after masturbation but these hormonal changes are very short term and does not affect hair loss
• daylight exposure significantly alters prolactin levels. This temporary increase in the number of telogen hair follicles
•  

Dopamine released by Hypothelamus in turn inhibits Prolactin.

Treatment:

In one of the studies at Argentina Prolactin Inhibitor like Bromocriptine (dopamine receptor agonists), Quinagolide, Pergolide, Cabergolide have been shown to help those with Hyperprolactinemia and have not been benefited otherwise.

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