Alopecia historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ogechukwu Hannah Nnabude, MD


The origin of the words uses to describe alopecia are of Greek and Celtic origin. Balding is often associated with enhanced social status and maturity. The term alopecia dates as far back as the time of Hippocrates. Minoxidil was not initially created for the treatment of alopecia and the idea of using finasteride in the treatment of alopecia was conceived by observing patients with a mutation in the 5-alpha-reductase enzyme. Hair transplantation began in the 19th century.

Historical Perspective


  • The term alopecia (al-oh-PEE-she-uh) was used by physicians dating back to Hippocrates alopecia and is formed from the Greek αλώπηξ (alopex), meaning fox. The origin of this usage is because this animal sheds its coat twice a year. [1]
  • The first use of the phrase alopecia areata is attributed to Polish physician John Jonston (1603–1675) in his book “Medicina Practica,” written in 1664. The term alopecia areata. (AA) was introduced by French physician Sauvages de Lacroix (1706–1767) in “Nosologia Methodica,” published in 1763. [1]
  • The term bald probably comes from the word ball, a Celtic word which means "white patch" such as is sometimes seen on a horse's head or the old English word balde, which means "white or pale". [2]

Landmark Events in the Development of Treatment Strategies

  • Minoxidil was initially produced for the management of refractory hypertension in the 1970s. [3] The effect of minoxidil on hair growth was first identified by Guinter Kahn. He observed and report hair growth on patients who were on the minoxidil patch and postulated their possible use for hair growth.
  • Julianne Imperato-McGinley discovered smaller prostates and the absence of male patterned baldness in Caribbean males with a deficiency of 5-alpha-reductase, the enzyme required in the conversion of testosterone to dihydrotestosterone. These discoveries subsequently culminated into the development of finasteride, a 5-alpha-reductase inhibitor. [4] [5] [6]
  • In 1897, Menahem Hodara succeeded in using scalp tissue harvested along with its intact blood supply from an unaffected region of the scalp to treat an area of the scalp scarred by favus. The foundations of the modern methods used in hair transplantation originated in the 1930s, [7] where Japanese surgeons replaced patchy regions of eyebrows or eyelashes using small grafts. However, this was not to treat baldness.
  • Norman Orentreich pioneered the modern age of hair transplantation in the 1950s by successfully transplanting large amounts of hair. He experimented with using free donor grafts in the treatment of patients with male pattern baldness. The initial school of thought at that time was that hair transferred to an area affected by alopecia would do no better than the hair it replaced. However, Orentreich proved that the grafts were "donor dominant," by showing that the transferred hairs thrived just as they would have at their previous location. [8]

Cultural Impact

The world is more accepting to men with baldness than women. In most parts of the world, baldness is considered to be less desirable and acceptable. However, majority of males and females with hair loss feel less desirable as a result of it. [9]

Famous Cases

There are several famous people who are who have shaved heads including former soccer players and current soccer managers Pep Guardiola and Zinedine Zidane, former basketball player Michael Jordan and actors such as Bruce Willis, Vin Diesel, and Jason Statham.


  1. 1.0 1.1 Callander J, Yesudian PD (2018). "Nosological Nightmare and Etiological Enigma: A History of Alopecia Areata". Int J Trichology. 10 (3): 140–141. doi:10.4103/ijt.ijt_23_18. PMC 6028995. PMID 30034197.
  2. Harper, Douglas. "Entry for "bald"". Online Etymology Dictionary. Retrieved 2006-12-07.
  3. Campese VM (1981). "Minoxidil: a review of its pharmacological properties and therapeutic use". Drugs. 22 (4): 257–78. doi:10.2165/00003495-198122040-00001. PMID 7030707.
  4. Zabkowski T, Saracyn M (2018). "Drug adherence and drug-related problems in pharmacotherapy for lower urinary tract symptoms related to benign prostatic hyperplasia". J Physiol Pharmacol. 69 (4). doi:10.26402/jpp.2018.4.14. PMID 30552307.
  5. Andrade C (2018). "Why Odds Ratios Can Be Tricky Statistics: The Case of Finasteride, Dutasteride, and Sexual Dysfunction". J Clin Psychiatry. 79 (6). doi:10.4088/JCP.18f12641. PMID 30549493.
  6. Dai JY, LeBlanc M, Goodman PJ, Lucia MS, Thompson IM, Tangen CM (2019). "Case-only Methods Identified Genetic Loci Predicting a Subgroup of Men with Reduced Risk of High-grade Prostate Cancer by Finasteride". Cancer Prev Res (Phila). 12 (2): 113–120. doi:10.1158/1940-6207.CAPR-18-0284. PMC 6365187. PMID 30538099.
  7. Okuda S (1939). "The study of clinical experiments of hair transplantation". Jpn J Dermatolurol. 46: 135.
  8. ORENTREICH N (1959). "Autografts in alopecias and other selected dermatological conditions". Ann N Y Acad Sci. 83: 463–79. doi:10.1111/j.1749-6632.1960.tb40920.x. PMID 14429008.
  9. Kowalewski J (1972). "[Australia antigen and its clinical significance]". Wiad Lek. 25 (12): 1069–72. PMID 4560543.