Updated: Dec 11, 2020
There is a common misconception by many people that when you start to lose your hair, and eventually go bald, your hair simply falls out and doesn’t grow back. This couldn’t be further from the truth, your hair doesn’t just all of the sudden die, it is a long drawn out process.
What happens is a process called miniaturization.
What is miniaturization?
When you begin to lose your hair (due to pattern hair loss) it is because you have a genetic sensitivity to dihydrotestosterone (DHT).
DHT binds to your hair follicles and kick starts the process of miniaturization. But, to fully understand how miniaturization works, you need, at bare minimum, a surface level knowledge of the hair cycle.
The hair cycle consists of four phases: anagen (growth), catagen (transitionary), telogen (resting), and exogen (shedding), and every single hair on your head completes several cycles in that exact order, at different times of course (cycles last anywhere from 4-7 years).
The anagen phase of the hair cycle is the most important because it is when growth occurs. In a healthy hair follicle, the anagen phase would last, on average, anywhere from 3-5 years and grow a total of between 18-30 inches. Miniaturization, as you may have guessed, negatively impacts the anagen phase.
When DHT binds to your hair follicle, and miniaturization begins, the anagen phase starts to shorten. With each cycle that your hair follicles complete the anagen phase will get shorter and shorter, while the telogen phase gets longer. And as the window of growth shortens, the hair follicles will be unable to grow as long or thick, which eventually leads to the anagen phase being so short that the hair does not grow anymore (i.e. bald).
But, there is a critical window between after miniaturization starts, and before you are completely bald, where you can re-lengthen the anagen phase and revitalize your dying hair. The window is when your healthy hair has turned into vellushair.
What is vellus hair?
Vellus hair is essentially peach fuzz (also called baby hair). They are the short, thin, unpigmented hairs that are barely noticeable. While most people would probably prefer vellus hair vs. dark/thick hair on their body, nobody wants vellus hair taking the place of healthy hair on their head.
Vellus hairs have no pigmentation, and are extremely thin, which is why you may appear “bald” when in reality you just have a lot of vellus hair growth. They are the result of the anagen phase shortening, because as growth time shortens, the hair turns from healthy terminal hair into not-so-healthy vellus hair.
But, vellus hair can be turned back into terminal hair, in fact that is what most hair loss treatments try to achieve. It is only when the vellus hair does not come out of the scalp anymore that the hair follicle is considered “dead” and hair will not grow there anymore.
In short, if you have vellus hair anywhere on your head, there is hope that you can turn it back into thick, long, pigmented terminal hair.
How to turn vellus hair into terminal hair
Now that you know what causes vellus hair and what it is, how do you turn it back into healthy terminal hair?
There is one thing you need to do: re-lengthen the anagen phase, and there is two main ways to accomplish this: block DHT and increase blood flow.
First: blocking DHT.
This is of upmost importance when it comes to overcoming hair loss and re-growing your vellus hair. DHT is what causes miniaturization in the first place, and it is what will continue to worsen your hairs condition unless it is taken care of. Treatments like finasteride or dutasteride are going to be your most effective option for blocking DHT.
Second: increasing blood flow.
Scientists are still unsure whether blood flow contributes to, or is a result of miniaturization, but regardless, low blood flow and hair loss are inherently related. This is because blood is responsible for delivering vital oxygen and nutrients to your hair follicles that they use to grow. Blood flow can also help re-lengthen the anagen phase.
If you can effectively control DHT and optimize blood flow your vellus hairs will be well on their way to becoming terminal again.
Why you need to be patient
The process of regrowth doesn’t occur overnight, in a week, or even in a month. It can take anywhere from 6 months to a year before you begin to see results. But why is this? Why does it take so long?
Like stated earlier, hair growth takes a long time because the hair must go through all four phases before beginning a new cycle. As your treatments begin to re-lengthen the anagen phase, your vellus hairs will begin to turn terminal, but not without undergoing several sheds.
When treating vellus hair, the growth phase (which is the longest phase of the hair cycle) is still very short (because it has been miniaturized), meaning that your hair needs to go through the exogen (shedding) phase multiple times before your growth phase lengthens back to a healthy level. This can take, again, up to a year. But, if you are patient and remain determined throughout the sheds, you will reap the benefits of having a longer anagen phase and subsequently longer, thicker, and healthier hair.
Hopefully after reading this article you have a better understanding of what miniaturization is, how it creates vellus hair, and what vellus hair is/how to turn it back into terminal hair.
Yes, hair loss can be a little bit confusing, but don’t fall into the trap that so many others have fallen into: not educating yourself about how hair loss works. The more you understand it, the easier it will be to overcome it.