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Can
adult pattern baldness be observed in a baby ?
Yes, sometimes. Dr James Hamilton made significant contributuions
to our understanding of male pattern baldness. Several of the
discoveries
and comments he made back in the 1950s have been overlooked by
current dermatologists. Dr Hamilton noted that the areas of hair
loss seen
in men and women with pattern baldness were the exact same areas
of the scalp where hairloss can temporarily develop in babies.
There can be
a significant lack of hair growth in an androgenetic alopecia
pattern in both male and female babies. The frontal areas of
scalp skin
may have very thin hair in babies, especially those born prematurely.
Babies may look like they have a widow's peak as is often seen
in
men and observed (with a less distinct pattern) in women.
Whether this temporary hair loss in babies can be used to predict
future adult susceptibility to androgenetic alopecia is unknown.
Can
adult pattern baldness be observed in a baby reference summary
- Hamilton JB. Patterned loss of hair in man:
types and incidence. Ana N Y Acad Dermatol 1951: 53; 708-728
Summary. Types or categories of scalp hairiness are described
for use as standards in classification and grading of the extent
of common baldness. At least 99 per cent of scalp can be classified
with reference to these types. The accuracy with which such classifications
can be repeated in subsequent independent examinations was 99.5
per cent in surveys by the writer, 98 per cent in surveys by personnel
who had no scientific training.
Hairs on the surface of the scalp were absent in three of four
fetuses 141mm and 144mm in length from crown to rump, but were
present in all except one of 58 fetuses 158mm or more in length.
These early hairs were very fine in texture and extended without
interruption to cover the forehead. In progressively older fetuses,
the hairs were more coarse on the scalp but not necessarily so
on the forehead. The hairs were grossly uniform in character over
the entire scalp until near the end of prenatal life. In six of
eight specimens considered to have reached term, the frontoparietal
and frontal areas, but not the tonsure, were covered by hairs
that were less coarse than that elsewhere on the scalp.
Soon after birth, many babies were observed to develop a marked
alopecia in the same areas that become bald in adult men, that
is, the frontoparietal and frontal regions and, in some babies,
the tonsure. Baldness of these areas continued for weeks or months
and occurred in both sexes. While hair was still being lost, new
hairs appeared on the surface of the scalp until, by the end of
the first or second year, most children had a completely hairy
scalp of type I.
Thereafter, a type I, or completely hairy scalp, was observed
to be characteristic of most children until puberty, when hair
was lost in members of both sexes.
With advancing age, baldness (Types IV to VIII) occurred with
increasing frequency in males until a peak was reached in the
seventh decade of life. In females, the incidence did not increase
after the fifth decade. Advanced stages of baldness, Types V to
VIII, were not found in any women, although they present in 58
per cent of the 112 men age 50 to 92 years of age.
No case of alopecia other than common baldness was observed in
any of the 526 subjects between 20 and 92 years of age. This,
in the general population, the common forms of baldness account
for almost all instances of alopecia
Type I scalps, i.e., those which lack recessions of the anterior
regions, and are characteristic of children until adolescence,
were retained in 95 per cent of 20 men who failed to mature sexually.
This type of scalp was eliminated after androgenic treatment in
all of 11 sexually immature men and was present in only 2 of 24
virilized women
After normal sexual maturation, Type I scalps were retained in
only four per cent of men but in 21 per cent of women. A study
of pedigrees in normal men with type I scalps showed that a tendency
in this type of scalp was inherited in certain families among
Caucasians and was a racial trait in Chinese.
Baldness was less common and, when present, occurred at a later
age in Chinese men than in Caucasian men. The genetic, endocrine,
and aging factors, which are responsible for baldness are interdependent.
Although androgens induce common baldness, the degree of denudation
does not parallel the degree of stimulation by steroids, as tested
by assays of urinary titers of ketosteroids, or by quantitative
measurements of the growth of a secondary sex character, axillary
hair, which reflects the extent of stimulation afforded by steroids.
Men with bald scalps had a slightly higher incidence at an early
age of baldness in another site, namely on the lateral aspects
of the legs, than did men without bald scalps. The difference
between the two groups of men, however, was not statistically
significant.
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