The receding hairline creeps into the hairstyle. Also the light spots on the crown and vertebrae. Five million German women already have what at first glance seems to be a typical problem for men: tension hair loss (alopecia contentionalis) – triggered by stress and muscle tension. So far it has not been so easy to defeat, but a new therapy can be seen with its successes. dr Hans Bucher, specialist in plastic and aesthetic surgery in Nuremberg, explains the method.
Tolfioow: What exactly is tension hair loss ?
DR. HANS BUCHER: This special form occurs as a result of stress and tension on the scalp in the upper part of the skull. The scalp stretches more tightly over the bony skull, the fine blood vessels beneath it are compressed. As a result, the hair roots at the top of the skull, which are supplied by these blood vessels, receive less blood and oxygen. If the oxygen supply falls below a certain threshold, the hormone is stored in the case of hereditary sensitivity-dihydro testosterone, DHT for short, to certain cell receptors. The hair roots become horny and shrink. The growth phases of the hair in this area of the skull become shorter. After a few cycles, the roots can no longer produce healthy hair, they fall out. And exactly in the affected regions.
Does this only happen to people who are stressed?
Stress is the main trigger. But strong mental tension or concentration, for example when working frequently on a screen, also plays a role. The upper scalp muscles are then always tensed. Those affected often also suffer from neck tension, tension headaches or grinding their teeth at night. Some of them have ametropia and are therefore prone to scalp tension.
Do hormonal upheavals, such as menopause, also influence these processes?
Yes, menopause has a serious impact on tension hair loss. With estrogen levels, the concentration of certain proteins that bind the hormone DHT decreases. This is why even women who previously had no problems with it suddenly complain about hair loss so often during menopause.
Do nutritional supplements help?
Do nutrient preparations or circulation-enhancing agents help?
No, neither nor. Circulation-enhancing agents are usually applied as a tonic and are intended to dilate the capillaries of the scalp. However, if this already gets too little blood from the arteries and arterioles running underneath, such a hair tonic unfortunately cannot have a satisfactory effect either.
What can those affected do?
Go to an expert. If the specialist uses electrodes to measure tension in the scalp during electromyography, he will inject the local muscle relaxant botulinum toxin A. This is done with a wafer-thin cannula directly into the tense muscle area under the scalp. The muscle relaxant accumulates in the synapses between nerve and muscle and blocks the permanent stimulus signals. The tense muscles relax within a few days, blood flow and oxygen supply to the hair roots normalize.
Forever?
The initial treatment lasts up to six months. For a longer effect, I recommend two to three further injections at intervals of six months.
How successful – and how expensive – is such a therapy?
The success rate is over 80 percent, and the hair loss stops after about six weeks. In 60 percent of patients, the hair grows back even if it fell out a year or two ago. Sometimes there can be a temporary headache. The patient has to pay about 600 euros out of pocket for a treatment with an effect of up to six months.
