If you’re new to Quora, the question and answer website that rapidly seems to have trumped Yahoo Answers, you’ll be thrilled to hear it’s all brilliantly simple. People post a question that they’d like an answer to, and anyone – from random people with an opinion to world-famous experts – can post a reply, with the best answers quickly “up-voted”. While there are plenty of queries about Beyoncé, NASA and conspiracy theories, there are also some interesting entries about hair loss, too.
One of the best threads is based around the question “What are the genetics of Male Pattern Baldness?” While it might only have garnered just two replies to date, one of these has attracted more than 4,000 views. And the fact that the answer comes from Adriana Heguy, who says she has “worked in genetics and genomics for the past two decades” probably helps.
The first thing that Ms Heguy does is caution how complex the science behind all this is. She also admits that “the genetics of Androgenetic Alopecia (genetic baldness) is not really well understood.” Acknowledging that genetic baldness is a ‘highly heritable’ condition, so is most likely to be passed on through families, she does go on to explain that there is further evidence that non-genetic factors also play a part. Although she does not elaborate on these, this is likely a reference to issues which can exacerbate or trigger hair loss, such as stress, illness or dietary imbalances.
Of the specific genes thought to play a part in Male Pattern Baldness, Ms Heguy first mentions the androgen receptor (AR) gene. She points out that because this receptor is on the X chromosome – which is inherited from your mother – the myth persists that men need only look at the maternal line of their family tree to see if they’re likely to go bald or not.
“But it (AR) is not the only gene involved,” Ms Heguy explains, “or even the main gene. There are genes in basically all chromosomes that have been implicated in Androgenetic Alopecia, and this is what makes it so difficult to unravel.”
This fits researchers’ findings that it is, in fact, more likely any actively expressed genetic traits are likely to come from our father’s side of the family – including hair loss. People are able to carry the genes for androgenetic alopecia without displaying any of the signs if these genes lie dormant and are not active, which can explain why sometimes hair loss appears to ‘skip’ a generation.
DHT inhibits hair growth
Androgen receptors are also known as NR3C4 – which stands for Nuclear Receptor subfamily 3, group C, member 4 – and they control cell behaviour. When testosterone reacts with the enzyme 5-alpha-reductase in a cell, it is converted into the androgen dihydrotestone (DHT) and, as those with an inherited predisposition to male pattern baldness have an innate sensitivity to DHT, the hair miniaturisation process starts.
Male Pattern Baldness begins when the DHT gradually impedes hair growth by binding to the androgen receptors in the hair follicle and causing increasingly thinning hair, then eventually stops them from producing hair altogether. For this reason, successful treatment of Male Pattern Baldness often involves the use of a clinically-proven drug, finasteride 1mg, which inhibits the production of DHT.
A second product, and one that Belgravia hair loss specialists often recommend, particularly for stubborn areas such as a receding hairline, is the topical daily treatment high strength minoxidil. When applied directly to the affected areas of the scalp as advised, this can encourage accelerated hair growth. This is most often used by Belgravia’s male clients as part of a comprehensive treatment course alongside finasteride and hair growth boosters to maximise the chances of seeing an improvement to both their hair loss and the condition of their hair.
While Ms Heguy admits that we are still far from a definitive “cure” for Androgenetic Alopecia – by which she presumably means a single-dose, one-off medication that will completely stop MPB before it has even started – she does offer some hope to men who have already lost their hair to the condition: “If there is any consolation for men distressed about hair loss, if it was a phenotype that was repulsive to females, the gene variants would have been weeded out a long time ago, by sexual selection. Many of us find bald heads very manly and attractive.”
The Belgravia Centre
The Belgravia Centre is the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.