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Androgenic alopecia, commonly called male pattern baldness, advances in a predictable sequence of events. It also afflicts women, but in a different pattern. Basic processes include the genetic programming of hair follicles and the circulatory strength of male hormones. Baldness, while not exactly a physical disease, does cause emotional distress to the men and women who suffer from it. Revita is a richly medicated shampoo that works through multiple pathways to help prevent and reverse hair loss. It includes natural cleansers, plus anti-inflammatory, antifungal, antioxidant, and anti-DHT agents, as well as humectants, nutrition, stimulants, and proteins. The synergy of these cutting-edge ingredients means Revita can help you avoid hair loss and regrow hair, so men and women at all stages of thinning can look and feel their best. DEMOGRAPHICS. White men suffer most from baldness. Ninety-six percent will lose a significant volume of hair eventually, which testifies to the role of genetics. But few women or eunuchs ever go bald, which testifies to the role of hormones. By age 30, 30 percent of white males will show signs of androgenic alopecia. By 50, 50 percent will. They are four times more likely to go bald than black males. Revita is safe and effective for both men and women. PATHOLOGY. The standard pattern of male balding begins with bitemporal recession of the hairline (W shape). At roughly the same time, the vertex (swirl at the crown) begins to thin. The two bare patches merge, leaving an island of hair at the center-top. This holdout is the last to go. While the exact order of events may vary, the back and sides of the head remain largely intact. Hair loss can start as early as puberty, when androgens first appear in high concentration. Male pattern baldness is classified from 1 to 8 on the Hamilton-Norwood scale (above). In women, however, androgenetic alopecia appears in a different pattern: diffuse hair loss occurring over a wide area of the scalp. Female pattern baldness is classified from 1 to 3 on the Ludwig scale (below). For some men, it takes only five years to go completely bald, although 15 to 25 years is more typical. While average hair loss is five percent per year, the process often goes in spurts — three to six months of accelerated loss, followed by six to 18 months of relative quiescence. MINIATURIZATION. Hair follicles do not just shut down suddenly. They produce strands progressively thinner and shorter, a process called miniaturization, during each follicular cycle. Three phases of growth make one cycle: anagen, catagen, and telogen. In the anagen phase, which normally lasts a few years, cells at the base of a follicle grow and divide. They build a hair root from the structural protein keratin, also used to build nails and skin. The root is fed by a dermal papilla, which pulls nutrients from the bloodstream. As the root grows, a hair strand pushes up and out of the scalp and continues to lengthen during the anagen phase. In the catagen phase, a transition of just a week or two, the strand is nourished and remains attached, but the follicle shrinks and the hair stops growing. In the telogen phase, normally several weeks, the follicle rests and stops nourishing the hair, which can fall, be pulled, or get pushed out at any time. When the follicle cycles back into anagen phase, it produces a new hair that pushes out any remaining old hair. The ratio of anagen to telogen follicles is normally 12:1. With androgenic alopecia, that ratio gets progressively thinner, maybe 5:1. Anagen phases get shorter and telogen phases get longer. So, when starting a new treatment, patients need patience. Follicular miniaturization affects the papilla (a vascular process), the matrix (an environment in which the hair forms), and the shaft. Roots often become rigid and compress the blood vessels that nourish them, a process called the rigidification of collagen. As follicles miniaturize, the diameters of their hairs get smaller as well, perhaps from .08 mm down to .06 mm. Pigment production also decreases. PATHOGENISIS. Counterintuitively, the same hormones that cause hairs to lose pigment and fall out of the scalp after puberty also cause them to gain pigment and grow thick on the face, chest, armpits, and pubis. Studies of androgen insensitivity and 5-alpha-reductase deficiency have attempted to explain this paradox. Why do certain follicles react to hormonal activity by shutting down? Major theories include: higher higher higher higher numbers of androgen receptors, local production of dihydrotestosterone (DHT), level of systemic testosterone, and or production of DHT by the prostate. The enzyme 5-alpha-reductase catalyzes testosterone into DHT, which binds to the same receptors and more avidly. While the prostate does produce more DHT than the scalp, the role of each site in androgenic alopecia is not fully understood. Changes in scalp hair does not mean changes in body hair or sex drive. The effects of androgens on a follicle depend entirely on its location. When occipital hair follicles get transplanted to a bald vertex, they continue to resist alopecic attack. Conversely, follicles from a bald vertex do not start growing hair when transplanted amid other growing hairs. In men, scientists believe this genetic programming comes from dominant autosomal genes that control testosterone and its conversion to DHT, but they do not rule out polygenesis. Female pattern baldness, however, is believed to result from a decrease in estrogen, a hormone that normally counters the effect of testosterone. Other forms of baldness include traction alopecia, which happens to people with tight ponytails or cornrows. Telogen effluvium results from chemotherapy, childbirth, surgery, poisoning, or severe stress. Alopecia areata, an auto-immune disease that strikes as a one-inch round patch, affects one percent of men, women, and children. Cicatricial alopecia causes either local or diffuse hair loss. Cancer, tumors, and other growths can induce localized loss. Mycotic infections can cause generalized hair loss, so Revita incorporates ketoconazole, a powerful antifungal agent. TREATMENTS. Premature hair loss generally distorts and diminishes a man's self image in proportion to his degree of baldness, making him feel older and less attractive than his peers, especially when still young and unattached. Optimal treatment would include measures to enhance self esteem. Three forms of physical treatment are effective for men: surgical reconfiguration of the scalp, drugs taken orally, and lotions applied topically. Transplantation generally gives good results, since follicles retain their genetic programming to grow hair even after they are moved. Current procedures using smaller grafts give a more natural appearance than the larger plugs used a few years ago. The excision of bald scalp and the stretching of hirsute scalp is another surgical technique, sometimes used in conjunction with transplantation. But there is pain, inconvenience, and cost. One oral drug, finasteride, was approved a few years ago for men only. The 5-alpha-reductase inhibitor arrests hair loss by reducing DHT produced in the prostate. Half of drug users regrow some lost hair. As a side effect, some men lose libido, but it returns when the drug is discontinued. Many topical lotions have been touted, then disproven, over the years, including ascorbic acid, benzoic acid, jojoba oil, lanolin, sulphanilamide, tetracaine hydrochloride, and urea. Only three topical compounds are proven effective through clinical trials published in peer-reviewed medical journals. They are minoxidil, Aminexil, and procyanidin B-2. Two products, Spectral.DNC® and Spectral.DNC-L®, contain all three of these cutting-edge ingredients, plus a battery of auxiliary agents known to enhance their effectiveness. Revita is a shampoo formulated to complement these products. It works through multiple methods of action: Procyanidins promote hair growth at the hairline as effectively as minoxidil does on the vertex. Copper peptides counter many of the degenerative diseases of aging skin and hair. Spin traps detoxify free radicals that damage cells through age, pollution, and ultraviolet radiation. Ketoconazole reduces irritation and excess sebum to inhibit DHT production. Rooibos contributes antioxidant and anti-inflammatory properties. Methylsulfonylmethane (MSM) contains sulfur and serves as an antioxidant, disrupting lipid peroxidation. Caffeine stimulates follicles. Carnitine tartrate helps the body generate adenosine triphosphate, the currency of biological energy. Amino acids form keratin, the hard fibrous protein that makes up hair. Emu oil contributes fatty acids to feed and hydrate the skin. Biotin improves the metabolism of scalp oils and expands the hair shaft directly.