Stress, Neurogenic Inflammation and Hair Loss
Inflammation, known in pattern balding as perifollicular inflammation, plays a significant, perhaps the most significant role in hair loss. Stress is known to exacerbate hair loss in those genetically pre-disposed, It has been assumed this was due to temporary elevations in cortisol . This article identifies a type of hair follicle inflammation that is specifically caused by stress, and identifies “Capsures” (a Resveratrol/Curcumin combo) as a way to remedy this inflammation. The systemic use of Resveratrol/Curcumin has already been shown to be effective in treating pattern hair loss in a patent filed by an Italian firm.
Andrea Marliani, Paolo Gigli e Daniele Campo
For many years, perhaps for even several decades, stress has been indicated as a possible cause of hair loss though, to tell the truth, there is no real proof of this.Some patients under stress show widespread hair loss, which is more noticeable in the central area just in front of the crown, while hair growth continues along the front hairline. Marino Salin calls this "incidenza nervosa."
This fact is well known to all those who are actively involved in hair care. But how it happens is not clear to anyone.
Biological response to stress usually takes place by way of the hypothalamus-hypophysis-surrenal gland axis. There is however another mode, involving a large number of interrelated peripheral neurotransmitters and hormones which are released by the non-myelinic nerve fibres of the skin and have a direct effect on the way an organism reacts to stress.
Psychological or physical stress sets off a chain of molecular reactions. It does this by way of the Nerve Growth Factor, the Substance P and Catecholamins. These are all key players which limit hair growth.
Each hair follicle has a rich nervous plexus. It's important and interesting to know that this follicular nervous plexus is directly connected with the cerebral cortex. The follicular nervous plexus is partly composed of motor fibres but it is mainly composed of sensory fibres and also of sympathetic non-myelinic noradrenergic free ended fibres.
Stimulated by Nerve Growth Factor, which increases under stress, the sensory fibres are able to liberate Substance P. Substance P is considered the main pain signal transmitter from the periphery to the nerve centres. Substance P attracts inflammation mediators. Substance P causes macrophage and mast cell degranulation with production of inflammatory cytokines from lymphocytes leading to induction and inhibition of the keratinocyte proliferation in the follicle and in the hair matrix and a videomicroscope will show a clear depressed erythematous ring around the infundibula. We are talking about neurogenic inflammation. Daniele Campo calls it "Psychogenetic Alopecia". For patients, who have no family history of Androgenetic Alopecia and show widespread hair loss which is more noticeable in the central area, just in the front of the crown, while hair growth continues along the front hairline, we need to consider a diagnosis of "Psychogenetic Alopecia".
Let us now consider the perifollicular sympathetic plexus. The sympathetic plexus is able to release noradrenaline into the intercellular perifollicular spaces and noradrenaline is a powerful vasoconstrictor and inhibitor of the adenil cyclase enzyme. If the adenil cyclase enzyme is inhibited or completely blocked the entire kinase system chain is slowed down and glycolysis, the pentose phosphate shunt and the Krebs cycle are also slowed down, if not completely blocked. If glycolysis stops, the hair's energetic metabolism is blocked and so are the mitoses of the hair matrix. The interruption of glucose metabolism turns off the supply of energy and ends the anagen phase. As we saw earlier, the sympathetic plexus is able to release noradrenaline into the intercellular and perifollicular spaces, The visible, and well-known, effect is horripilation.
But if there is excess adrenergic tone in the metabolic system, then there is also vasoconstriction, ischemia and hypoxia and if there is hypoxia, glycolysis leads to lactic acid.
Other compounds that are reportedly effective in treating perifollicular inflammation are topically : Emu Oil, Ketoconazole (Nizoral Shampoo) and systemically, Green Tea Extract, Fish Oil, Viviscal (Marine Protein Extract), and Pomegranate Extract. Ashwaghanda ( specifically Sensoril extract) and Rhodiola are low cost adaptogenic herbs that enhance cognitive functioning and keep stress hormones (cortisol) at bay. A recent published study in fruit flys showed that Rhodiola significantly extended mean lifepan.
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