Male-Pattern Hair Loss – A Supraorbital Nerve Entrapment Syndrome?

Abstract

The cause of male-pattern hair loss remains obscure. It is noted to occur in the geographic distribution of the supraorbital and sometimes the great occipital nerves. It is suggested that these nerves are susceptible to entrapment and subsequent neuropathy since signs of the latter precede and accompany hair loss. Male-pattern alopecia is uncommon in women, yet neuropathy and deprivation of the trophic factor can lead to hair loss in any part of the body in both men and women. It seems therefore that scalp hair loss, more common in the male, occurs because higher levels of testosterone create a situation in which scalp nerves become vulnerable to neuropathy. Testosterone greatly increases muscle and skeletal bulk, thickens skin and reduces subcutaneous fat, most especially in the head. These factors may well cause increased tension to scalp nerves. Recent animal experiments have demonstrated that early neuropathy may be amenable to electrical stimulation and the author has personally found that hair loss may thus be temporarily retarded. Further study by those working in this field is recommended. Perhaps surgical release of the entrapped nerves (as in a carpal tunnel syndrome) may be the final answer.