Dr. Sharon Keene of AZ, an elite member of the Coalition of Independent Hair Restoration Physicians has been working with HairDX on the testing and prediction of androgenic alopecia (genetic hair loss) in men. Below, Bill Seemiller , Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center and Dr. Keene collaborate in writing about the benefits and limitations of this genetic hair loss test.
Hair loss is an unpredictable and progressive condition that affects men and women worldwide. Treatment options such as Propecia (finasteride) for men only and Rogaine (minoxidil) have been around for some time, but typically, balding men or women only start to use a hair loss treatment after visible signs of baldness has already started. According to Dr. Sharon Keene, “hair loss is typically not visible to the human eye until about 50% of the hair has already fallen out”. Because of this, to treat baldness successfully becomes more difficult because by the time its recognized by balding men and women examining their hair in a mirror, they have already lost a lot of hair and hair regrowth may or may not be possible.
But what if there was a way to predict whether or not you were going to suffer from androgenetic alopecia (hereditary hair loss) before it even starts? Though there is currently no hair loss cure, starting proper treatments early could help you preserve your hair.
There is now a test by HairDX that can provide you with a genetic analysis of your risk for developing male pattern baldness. The HairDX hair loss test (for men only) examines tiny variances found in 95% of all bald men in genes responsible for receptor recognizing androgen hormones in the body. These variances called SNPs have been found to be associated with the development of the early onset of male pattern hair loss.
The test is a simple procedure where participant swabs the inside of their cheek for a few seconds and returns the swab to the HairDX testing center. HairDX then performs an anonymous and confidential genotype analysis of the DNA in the genetic sample to determine an individual’s genetic makeup. The lab results are then entered into their unique (patent pending) genetic information system that determines whether or not they are at risk for early onset of male pattern baldness. These results are then delivered to the participant, safely and confidentially through a secure website. The test participant can expect to receive information such as specific genetic variances, a simple explanation of their risk of developing early male pattern baldness, and information on managing and ways to treat baldness.
Dr. Sharon Keene has been actively participating in the development of this hereditary hair loss test and shares her professional and medical insight on the subject:
“First, it is important to let patients know, once they have seen a hair loss pattern develop and they know they have androgenic alopecia (AGA), they do not need this test. Secondly, this test is a “screening” test for risk, not a diagnostic test. Because androgenic alopecia is polygenic (caused by more than one gene) we know the androgen receptor gene does not, by itself, cause androgenetic alopecia. However, it is the first gene identified, in 4 separate, published, scientific studies to have a close association with the occurrence of androgenic alopecia.
How does a screening test work? Proteins, molecular substances or genes which are found to exist in association with a particular medical condition are used as a marker to identify the risk for development of the condition prior to onset of symptoms or in an earlier stage. Screening tests are used today for several types of cancers and other conditions. They aren’t diagnostic themselves, but raise the flag of awareness that a particular condition may be present or developing so that steps can be taken to prevent or treat the condition earlier. In the case of androgenic alopecia we have identified variations in the androgen receptor gene that have been associated with hair loss. Patients with the “high risk” variant have a 60% increased risk of male pattern baldness, and those with the low risk variant have an 85% likelihood they will not lose their hair.
The advantage of knowing about risk is that patients don’t have to wait until they are in the midst of massive hair shedding, when they are more likely to feel anxious and willing to try anything to stop hair loss. Precious time can be lost when patients try useless products to stop hair loss because there is always lag time between the onset of therapy and the effect of therapy to treat baldness. It is critically important to be sure the best and most effective therapies are being used as early as possible because there is no hair loss treatment to date that will repopulate lost hair follicles. However, in most cases, today’s medications are quite effective at stabilizing hair loss, and turning pseudo vellus (baby fine, miniature) hairs into long, strong terminal hairs. By learning about their risk before the hair loss begins, patients can also learn about the proven methods to treat them.
The idea of treating hair loss early may make some hair loss doctors concerned that no one will need their surgical skills in the future, but alas I doubt that will happen. As with heart disease, diabetes and cancer we know too many patients will not take proactive measures to reduce their risk, even when their lives are at stake! In the case of androgenic alopecia, it is likely that many will postpone their concern before hair loss is occurring and will lose substantial hair before they make an appointment to see their doctor and learn what could have been done to prevent it.
There is evidence that for many, hair loss is not a slow gradual process, but occurs in a massive fall out cycle with great speed. For those patients who wish to be proactive there is now a paradigm to take action. By combining the results of a genetic screen, with confirmatory tests to establish hair miniaturization at the earliest signs of hair shedding (either a “pull test” or one of the newer methods of calculating the anagen to telogen ratio) a diagnosis of androgenic alopecia can be made and treatment initiated during the earliest stages of hair loss. I have seen many patients who did make it in to their doctor with complaints of increased hair shedding – with a visibly full head of hair, and were quickly ushered out without even an exam. They were told they did not have a problem because thinning was not perceptible. Now patients will have a tool to help them get medical help before they can see their scalp.
Like other screening tests available, there will be some false positives and some false negatives. But risk assessment is one more tool to help patients get medical treatment when it is most cost effective for them before they have had substantial hair loss. Andy Goren, the CEO of HairDX, is committed to updating the test as genetic science advances even further. We know that androgenic alopecia is caused by several genes, but the Androgen receptor gene is part of the puzzle that patients can now learn about now, in the privacy and convenience of their home.”
Some patients however, have expressed concern and some level of skepticism. How accurate is this genetic test? What is its purpose? Could this test be potentially encouraging young people to start risky medication well before they need it? Is it really a good idea to start taking Propecia (finasteride) when you are not losing hair?
If this genetic hair loss test proves accurate however, with proper information, the balding patient can make an educated decision as to whether or not to start and which treatment options to use. For more information, the HairDX website can be found at www.hairdx.com.
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