Hair loss can be caused by a wide range of conditions, beginning with inflammatory skin diseases and inflammation in the hair follicles. The exact causes of auto-immune inflammation are not well known; also, it is not known why in most cases only certain areas of the scalp (patches) are affected.
What causes inflammation?
Inflammation is caused by abnormal levels of cytokines (cell-signaling proteins also known as “immunomodulating agents”), which are produced in excess by overactive immune cells. White blood cells and antibodies are part of our immune system and are produced by our body to fight against foreign objects (viruses, bacteria).
Does DHT causes scalp inflammation?
Amazingly there are very few studies that have attempted to answer this question. There is one though that suggests DHT causes vascular inflammation:
In conclusion, activation of the NFκB mediated COX-2/iNOS pathway by the selective androgen receptor agonist, DHT, results in a state of vascular inflammation.
DHT can bind to androgen receptors in the hair follicles, particularly in the scalp. This binding can lead to a process known as “miniaturization” of hair follicles. Miniaturization causes hair follicles to shrink over time, leading to the production of finer and shorter hair strands. As hair follicles miniaturize, they may become inflamed and less capable of producing healthy hair.
As hair follicles miniaturize and produce thinner hair strands, the body’s immune system may perceive these miniaturized follicles as foreign or damaged. This can trigger an inflammatory response in the scalp, characterized by localized inflammation and immune cell activity.
Inflammation caused by DHT-related hair loss can lead to symptoms such as scalp itching, redness, and discomfort. Frequent scratching or rubbing of the scalp can further exacerbate inflammation and potentially lead to hair loss.
Chronic inflammation of the scalp can disrupt the normal hair growth cycle, pushing hair follicles into the resting (telogen) phase prematurely. This can result in increased hair shedding and overall hair thinning.
Why does inflammation cause hair loss?
In autoimmune conditions, your body’s immune system treats your own cells or organs as foreign objects and puts in place a mechanism to destroy them, which leads to inflammation – your body’s response to intruding microorganisms. A high body temperature is the most common sign of inflammation.
When it comes to hair loss, your body mistakenly treats hair follicles as ‘foreign objects’ and destroys them, resulting in alopecia. Moreover, inflammation interferes with the nourishment of your hair roots by damaging the scalp (e.g. burning sensation, itchy/red spots, flaking).
What causes scalp inflammation and how exactly does this happen?
Cicatricial alopecia is one of the rarest conditions causing scalp inflammation. Infectious folliculitis, discoid lupus erythematosus and lichen planopilaris are only a few examples of cicatricial alopecia.
In cicatricial alopecia, the stem cells and sebaceous glands at the upper part of the hair follicle are affected by inflammation, which eventually destroys the follicle and replaces it with scar tissue. Therefore, the damage is considered by many to be irreversible and hair will not grow back after the inflammation has been treated.
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Autoimmune inflammation around the hair follicle, e.g. alopecia areata is also considered to be an autoimmune disease where hair roots are mistaken as foreign bodies. White blood cells gather around them, leading to inflammation. This cuts off nutrient supply, causing follicles to become weak and eventually fall out.
However, unlike in cicatricial alopecia, hair will regrow if the autoimmune reaction is treated; therefore, there is a good chance for your hair to look better than ever if you receive treatment for alopecia areata.
Seborrheic eczema and psoriasis are inflammatory skin conditions that damage the scalp, causing red, dry, flaky patches which affect hair roots and the aspect of the hair shaft. Depending on the stage of the condition, it may be possible for hair to regenerate once the underlying causes have been treated.
How to reduce scalp inflammation (and increase hair growth)
Reducing scalp inflammation has been shown in several cases to cause partial and even total hair regrowth after significant hair loss. So, how can you reduce inflammation in the scalp?
Here are several treatments that can reduce scalp inflammation and have also shown significant improvements in hair growth: