Involutional alopecia is a natural process of hair thinning, shortening, and follicle loss that comes about as a result of the natural aging process.
Basically, involutional alopecia is your hair aging along with you as you grow older.
Involutional alopecia is the second most common cause of hair loss, just below androgenetic alopecia.
Involutional alopecia comes along with a gradual and diffuse thinning of the hairs on the head. You may notice an overall thinning of your hair, and the hair that is growing may not be able to reach the same lengths as it once used to.
What is happening in the scalp to cause these effects is a natural change to the hair growth cycle.
Your hair normally goes through the hair loss cycle in phases starting with the anagen growth phase (3-6 years), then moving onto the catagen transition phase (1-2 weeks), and finally finishing at the telogen resting-to-shedding phase (5-6 weeks). Normally, these phases then start cycling through again with a newly grown hair.
With involutional alopecia, the growth phase is often significantly shortened, making it difficult for your hair to grow as long as it once did before moving onto the non-growth phases. This leads to proportionally more hairs being in the transition, resting, and shedding phases as compared to when you were younger.
What you may notice is that your hair seems thinner (as some hairs stop growing altogether) and that your hair has trouble growing past a certain length.
Involutional alopecia and androgenetic alopecia (male pattern hair loss and female pattern hair loss) are the two most common forms of hair loss, and they may be different to distinguish between to the untrained eye.
However, there are a few signs that may point to one over the other.
Androgenetic alopecia is known for changes to the hairline and causing bald spots in men, often causing the hairline to recede and balding areas on the crown of the head. In men, this type of hair loss can proceed to large bald areas or full baldness. Androgenetic alopecia in women tends to come along with diffuse thinning all over the scalp as well as a widening or zagged “Christmas tree” look to the part in the hair.
On the other hand, involutional alopecia tends to develop as less dense hair that can’t grow to longer lengths, and is unlikely to change hairlines or develop bald spots.
Involutional alopecia is related to age and the changing of the hair cycle, while androgenetic alopecia is genetically predetermined and hormonally mediated by DHT (dihydrotestosterone). For this reason, androgenetic alopecia tends to respond to medications targeting these androgens like Finasteride or Spironolactone, while involutional alopecia likely will not respond well to these.
Androgens like DHT damage hair follicles by shrinking them and causing the growth of vellus hairs which are fine, short, wispy, and may lack color. Since androgenetic alopecia is caused by damage from these androgens while involutional alopecia is not, doctors may be able to analyze the growing hair and make a diagnosis of androgenetic alopecia over involutional alopecia from seeing a much larger proportion of these vellus hairs over regularly formed hairs.
If you and your doctor have determined that you are likely dealing with involutional alopecia, there may be a few things that you can do to help enhance the health of your hair or disguise the appearance of a thinning mane. These tips can’t reverse involutional alopecia and there is currently no treatment for this type of hair loss, but these tips may help your hair look as healthy as it can to improve the overall appearance.
Try a hair, skin, and nail vitamin: A good hair supplement can’t reverse the natural thinning from involutional alopecia, but it may help your hair be the healthiest it can be.
Utilize a scalp massage: Scalp massages may help your hair reach the best health that it is capable of by increasing scalp circulation and stimulating the hair follicles.
Opt for a shorter hairstyle: If your hair is struggling to reach certain lengths, trying to make it work with styles suited to log hair may just make it look stringy, wispy, or even thinner than it really is. Talk to your hairstylist about shorter cuts that suit your face while helping to boost volume and disguise gradual thinning.
Involutional alopecia may not respond well to hair loss treatment therapies, but male and female pattern hair loss have been found to be improved from medications such as Minoxidil (generic for Rogaine) and androgen blockers like Finasteride or Dutasteride for men, or Spironolactone for women.
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