Alopecia Areata - Baldness - Hair regrowth Treatment Arganlife

How is hair loss classified?

There are numerous ways to classify hair loss. One useful way has been to classify hair loss by whether the loss is localized (small area) and patchy or whether it affects large areas or the whole scalp (diffuse). Other medical classifications for hair loss include scarring versus non-scarring hair loss and are beyond the scope of this article

Patchy hair loss

Some conditions produce small areas of hair loss, while others affect large areas of the scalp. Common causes of patchy hair loss are

• alopecia areata (small circular or coin size patches of scalp baldness that usually grow back within months),
• traction alopecia (thinning from tight braids or ponytails),
• trichotillomania (the habit of twisting or pulling hair out),
• and tinea capitis (fungal infection).

What is alopecia areata?

A common condition, alopecia areata usually starts as a single quarter-sized circle of perfectly smooth baldness. Alopecia patches usually regrow in three to six months without treatment. Sometimes, hair grows back in white. In another variant, alopecia can produce two or three bald patches. When these grow back, they may be replaced by others. The most extensive form is called alopecia totalis, in which the entire scalp goes bald. It's important to emphasize that patients who have localized hair loss generally don't go on to lose hair all over the scalp. Alopecia can affect hair on other parts of the body, too -- for example, the beard or eyebrow.

Alopecia areata is generally considered an autoimmune condition, in which the body attacks itself (in this case its own hair follicles). Most alopecia patients, however, do not have systemic problems and need no medical tests. While alopecia areata has frequently been blamed on "stress," in fact, it may be the other way around; that is, having alopecia may cause stress.

Treatments for alopecia areata include injecting small amounts of steroids like triamcinolone into affected patches to stimulate hair growth. Although localized injections may not be practical for large areas, often this is a very effective treatment in helping the hairs return sooner. Other treatments such as oral steroids, immunosuppressives, or ultraviolet light therapy are available for more widespread or severe cases but may be impractical for some because of potential side effects or risks. In most mild cases, patients can easily cover up or comb over the affected areas. In more severe and chronic cases, some patients wear hairpieces; nowadays, some men shave their whole scalp now that this look has become fashionable

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What vitamins are good for hair loss?

A good daily multivitamin containing zinc, vitamin B, folate, iron, and calcium is a very reasonable choice. Newer studies suggest that vitamin D may be somewhat helpful and worth considering. Specific vitamin and mineral deficiencies like iron or vitamin B12 may be diagnosed by blood tests and treated.

Multiple vitamins including biotin have been promoted for hair growth, but solid scientific studies for many of these claims are lacking. While taking biotin and other supplements marketed for hair, skin, and nails probably won't worsen anything, it may also not necessarily help the situation. Therefore, advertised hair-regrowth supplements should be approached with mild caution.

Can itchy scalp cause hair loss?

Itchy scalp may cause mild, reversible hair loss. Causes may include seborrheic dermatitis (dandruff). Treatments may include medicated shampoos likeketoconazole (Nizoral) and topical cortisone creams and lotions to help decrease itching.

How do I prevent hair loss?

Hair loss prevention involves several factors depending on the underlying cause. Good hair hygiene with regular shampooing is a basic step. Good nutrition, especially adequate levels of iron and vitamin B, is helpful. Treatment of underlying medical conditions like thyroid disease, anemia, and hormonal imbalances may useful in prevention.

What other options do I have for hair loss?

There are many options and alternative cosmetic treatments for hair loss. Some of these are listed here and include hair fiber powders, hairpieces, synthetic wigs, human hair wigs, hair extensions, hair weaves, laser, and surgery

• Hair fiber powders

•  Colored, powdery fiber sprinkles are commercially available and may work really well to cover up thinning hair areas. These colored sprinkles have special properties that help them attach to hair and give a fuller appearance. Toppik is one manufacturer of these products and can be found online. These cosmetic products are available without a prescription, are fairly inexpensive ($20-$40 range), and quite safe with minimal risk. Often these may be used in addition to medical treatments like Rogaine, Propecia, and hair transplants, and they are a great temporary measure to tie you over for special occasions.

• Hairpieces: Among the time-honored ways to add hair temporarily are hairpieces or hair weaving, in which a mesh is attached to your remaining hair and artificial or human hair of similar color and texture is woven with existing hair. Quality varies considerably with price; also, hairpieces and weaves may stretch, oxidize, and loosen.

Surgery or hair transplants: 

Surgical hair restoration approaches include various versions of hair transplantation (taking hair from the back and putting it near the front) or scalp reduction (cutting away bald areas and stitching the rest together). Transplant procedures have improved greatly in recent years. They can produce much more attractive and natural-looking results than older methods that sometimes leave a "checkerboard" or hair plug look. Many transplant patients now take Propecia to maintain or keep what they've transplanted. When considering a hair transplant, check the surgeon's credentials and experience carefully. Micrografts are some of the newest techniques whereby single one to two hair follicles are transplanted. Hair transplants may be very expensive and time-consuming procedures ranging widely anywhere from $1000-$20,000, depending on the number of hair grafts transplanted. Typically 500 or more hairs may be transplanted in a session

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Solutions For Hair Loss
If you are one of the unlucky fellows who is becoming "follicly challenged" over time, you don't have to sit back and helplessly watch your hair fall out. There are treatments available that will stop your follicles from failing you. Losing your hair can take its toll on your self-esteem and sex appeal, but there are ways to remedy or reverse the damage.

what causes hair loss?

A normal person will lose between 50 to 100 hairs daily, because 90% of hair is in growth phase and 10% is in shedding phase at any given time. However, any significant change that alters the normal growth cycle of hair, or permanently damages the roots of the hair (the follicles), can result in excessive hair loss of over 100 hairs a day, which may be temporary or permanent.

Genetics: About 95% of hair loss from the scalp comes from heredity. If your grandma, grandpa, mom, or dad has lost their hair, you may inherit the genetic tendency to lose yours as well. Balding can skip generations, and its incidence is random in terms of siblings. For instance, one brother could go bald in his 30s and another may keep a full head of hair his entire life.

Stress: Surgery, illness and a variety of mental stressors can cause excessive hair loss. Those with the rare anxiety disorder trichotillomania, often pull their hair out in clumps to the point of baldness.

Age: The aging process causes the breakdown in many of the skin's functions, including hair follicles. Many people over 50 have thinning hair because their hair follicles are less effective and therefore hair grows more slowly. Also, mature hair changes in texture and tends to break more easily.

Trauma to the hair: Although this may not apply to the majority of men, botched bleach jobs, abuse of permanents and over-the-counter hair dyes or straightening products, forceful brushing, styling or combing, and tight hairstyles like corn rows, can break and damage hair, and cause hair loss. On rare occasions, due to friction or hair breakage, wearing a ponytail that is too tight can literally pluck or exfoliate the hairs off your head. However, in this instance, the hair loss will not be as widespread as male pattern baldness and will resolve itself after cessation of ponytail wearing.

Certain drugs or diseases: Lupus, certain autoimmune diseases, and radiation therapy or chemotherapy, all contribute to temporary or permanent hair loss.

Men who notice their hair shedding in large quantities should consult a doctor or a dermatologist. Sometimes hair loss indicates an underlying medical condition for which treatment is necessary. If hair loss is sudden and in concert with other worrisome symptoms, see your doctor immediately.

male pattern baldness

The most common hair loss problem that plagues men of all races from their mid-20s onwards is genetically-triggered male pattern hair loss, medically termed as "androgenetic alopecia." Genes affect the age at which a man begins to lose his hair and the extent, rate, shape, and pattern of hair loss. In most men, male pattern hair loss typically begins at the temples and the crown.

Here's why you're losing it, and what you can do to get it back...

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What is acne and who gets it?

Acne is the common cause of spots. Most people with acne are aged between 12 and 25, but some older and younger people are affected. Boys are more commonly affected than girls. Acne usually affects the face but may also affect the back, neck, and chest. The severity can range from mild to severe. About 9 in 10 teenagers develop some degree of acne. Often it is mild. However, it is estimated that about 3 in 10 teenagers have acne bad enough to need treatment to prevent scarring. Untreated acne usually lasts about 4-5 years before settling. However, it can last for many years in some cases.

What causes acne?

Understanding normal skin

Small sebaceous glands lie just under the skin surface. These glands make the oil (sebum) that keeps the skin supple and smooth. Tiny pores (holes) on the skin allow the sebum to come on to the skin surface. Hairs also grow through these pores. During the teenage years, you make much more sebum than when you were a child. This is due to the hormonal changes of puberty which stimulate the sebaceous glands. As a rule, the more sebum that you make, the more greasy your skin feels, and the worse acne is likely to be. Some people make more sebum than others.

Mild-to-moderate acne - blackheads, whiteheads, and small pimples

Some pores become blocked (plugged). This is due to the skin at the top of the pores becoming thicker, combined with dead skin cells that are shed into the pores. You can see the plugs that block the top of the pores as tiny spots known as comedones (blackheads and whiteheads). Note: the black of the blackheads is due to skin pigment, and is not dirt as some people think. In many cases, acne does not progress beyond this mild stage.

Some sebum may collect under blocked pores. You can see this as small spots called pimples or papules. In some cases, acne does not progress beyond this mild-to-moderate stage when you can see a number of small pimples, blackheads, and whiteheads.

What makes acne worse?

• The progestogen-only contraceptive pill may make acne worse.
• In women, the hormonal changes around the monthly period may cause a flare-up of spots.
• Thick or greasy make-up may, possibly, make acne worse. However, most make-up does not affect acne. You can use make-up to cover some mild spots. Non-comedogenic or oil-free products are most helpful for acne-prone skin types.
• Picking and squeezing the spots may cause further inflammation and scarring.
• Sweating heavily or humid conditions may make acne worse. For example, doing regular hot work in kitchens. The extra sweat possibly contributes to blocking pores.
• Spots may develop under tight clothes. For example, under headbands, tight bra straps, tight collars, etc. This may be due to increased sweating and friction under tight clothing.
• Some medicines can make acne worse. For example, phenytoin which some people take for epilepsy, and steroid creams and ointments that are used for eczema. Do not stop a prescribed medicine if you suspect it is making your acne worse, but tell your doctor. An alternative may be an option.
• Anabolic steroids (which some bodybuilders take illegally) can make acne worse.
• Research suggests that diets high in sugar and milk products may make acne worse.

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What are causes of hair loss?

There are many causes of scalp hair loss, and they do differ in men and women. This article will cover the common ones. Studies show that losing up to 100-150 hairs per day is normal. Human hair naturally grows in three phases: anagen, catagen, and telogen. Anagen is the active or growing phase. Catagen is a fairly short phase of the natural hair cycle during which hairs begin to break down. Telogen is the resting phase. The hairs that are shed daily are often in the resting or late phase in the hair cycle. Normally, about 10% of the scalp hairs are in the resting or telogen phase at any time. These hairs are not growing and are getting prepared for cyclic shedding.

In general, most hair loss is not associated with systemic or internal disease, nor is poor diet a frequent factor. Frequently, hair may simply thin as a result of predetermined genetic factors, family history, and the overall aging process. Many men and women may notice a mild and often normal physiologic thinning of hair starting in their thirties and forties. Other times, normal life variations including temporary severe stress, nutritional changes, and hormonal changes like those in pregnancy, puberty, andmenopause may cause a reversible hair loss.

Notably, several health conditions, including thyroid disease and iron deficiency anemia, can cause hair loss. While thyroid blood tests and other lab tests, including a complete blood count (CBC), on people who have ordinary hair loss are usually normal, it is important to exclude underlying causes in sudden or severe hair loss. If you are concerned about some other underlying health issues, you may start by seeing your family physician, internist, or gynecologist for basic health screening. Dermatologists are doctors who specialize in problems of skin, hair, and nails and may provide more advanced diagnosis and treatment of hair thinning and loss. Sometimes a scalp biopsy may be taken to help in diagnosis of severe or unexplained hair loss.

Although many medications list "hair loss" among their potential side effects, drugs are also not overall common causes of thinning or lost hair. On the other hand, with cancer treatments and immune suppression medications including chemotherapy, hair loss is a very common side effect. Complete hair loss often occurs after a course of major chemotherapy for cancer. Usually, hair regrows after six to 12 months.

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How To STOP Hair Loss and REGROW Thinning Hair-Baldness is not your DESTINY

Baldness is the partial or complete lack of hair growth, and part of the wider topic of "hair thinning". The degree and pattern of baldness varies, but its most common cause is androgenic alopecia, alopecia androgenetica, or alopecia seborrheica, with the last term primarily used in Europe.

Pattern balding is distinct from alopecia areata, which commonly involves patchy hair loss. Extreme forms of alopecia areata are alopecia totalis, which involves the loss of all head hair, and the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body.

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Hair Loss Treatment - Best way & products to cure your Hair Loss

Eat plenty of fruits, vegetables, meats, and fish. Diet may seem unrelated to your hair, but it makes a huge difference. Diet also has the added benefit of improving your body at the same time.

• Since hair is made of protein, make sure you're getting plenty of protein in your diet. People who suffer from anorexia nervosa or those who undergo extreme weight-loss programs will experience stunted hair growth.
• Some proteins to consider incorporating into your diets: lean meats such as chicken and turkey, fish, eggs, soy products, beans, and nuts. These foods will help promote healthy keratin production, which are the building blocks of hair.
• Eat the right kinds of fat. Certain fats are essential to both a healthy lifestyle and healthy hair production. Fats in moderation help maintain healthy hair and skin production.
• Fats will help you process the vitamins and minerals in your diet that are necessary for healthy hair production, including Vitamins A, D, E, and K.
• Eat the right kinds of fats. Saturated fats, trans fatty acids, and hydrogenated fats are examples of fats that you should avoid. Omega 3 fats, found in marine and plant oils, are good for healthy hair.
• For this reason, B-complex tablets containing fish oils are helpful in speeding up the growth of hair follicles.
  
  
  
  Make sure you're getting enough iron and zinc. Iron and zinc, along with other vitamins, are essential in creating great, healthy hair.[2]
• Iron is responsible for delivering oxygen to your cells, from the blood in your toes all the way up to your hair follicles. (That's why blood smells like iron.) Lean animal meats are great ways to get iron, but if you're vegetarian, consider eating beans, lentils, and soy products such as edamame or tofu.
  
• Zinc assists in the repair of your tissues, making sure that the oil glands around your follicles are working in the proper way. Get your zinc by eating oysters, low-fat roast beef, toasted wheat germ, roasted pumpkin and squash seeds, dark chocolate, and cocoa powder.
  

Get enough vitamin C. Vitamin C deficiencies cause can hair that is weak, lusterless, and prone to breakage.Your body uses vitamin C to build collagen, which is crucial in developing hair growth. Vitamin C also assists in breaking down iron, another building block of hair, so maintaining good levels of vitamin C is necessary to absorb iron.

• The body cannot make vitamin C on its own. It's therefore crucial that you eat and drink foods that have high concentrations of vitamin C. Cantaloupe, citrus fruits, broccoli, bell peppers, and spinach are all fantastic and great-tasting foods that are packed with vitamin C.
• The government recommends 45 mg/day of vitamin C for children ages 9-13; around 70 mg/day for teens aged 14-18; and in between 75 and 90 mg/day for adults.

Try not to repeatedly perm, crimp, chemically or mechanically straighten, curl, bleach or color hair. These processes can cause serious damage to your hair, altering the natural makeup of each strand. Excessive heat, in either blow-drier or flat-iron form, can singe the hair, so try to manually dry your hair whenever possible.

Brush and comb sparingly. There used to be a myth out there than brushing your hair 100 times a day would promote hair growth.[5] Not only is this false, brushing your hair to excess can actually pull hairs out of the scalp.

Comb your hair when it's dry, not wet. Your hair is especially vulnerable when it's wet, so it's best to wait until it's on the drier side before you take a wide-toothed comb to go through your lovely locks.

• Try not to detangle or pull at your hair without the aid of a leave-in conditioner or detangling spray.
• Don't use rubber bands to style or pin the hair back. If you need to pull your hair back and pin it up, use a hair tie. The hair tie won't cause the hair to get stuck on its surface as much and lodge it from its roots.
  
• Clean your hair carefully. Use the right products when cleaning your hair. Depending on how oily your hair is, shampoo and condition your hair only about 3-4 times per week. You don't need to shampoo and condition every day, as this will suck out the natural oils present in your hair.
  

• Those with curly, coarse, or dry hair may want to wash their hair only 2-3 times weekly, as natural oils are key for strong and healthy hair. People who have oily skin probably want to wash their hair more than the 3-4 per week average, as a buildup of oil can be harmful to growth.
• Choose products that contain ingredients that are healthy for hair. Ingredients like arganoil and olive are all beneficial when used in moderation. They help retain moisture and oils while minimizing split ends and other hair damage.

Promote hair growth with natural home remedies. Be careful, however, when applying home remedies, as they may damage your hair instead of stimulating growth.

How To STOP Hair Loss and REGROW Thinning Hair-Baldness is not your DESTINY

Baldness is the partial or complete lack of hair growth, and part of the wider topic of "hair thinning". The degree and pattern of baldness varies, but its most common cause is androgenic alopecia, alopecia androgenetica, or alopecia seborrheica, with the last term primarily used in Europe.

Pattern balding is distinct from alopecia areata, which commonly involves patchy hair loss. Extreme forms of alopecia areata are alopecia totalis, which involves the loss of all head hair, and the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body.

More than 95% of hair thinning in men is male pattern baldness,^[1] or androgenic alopecia.^[2] Male pattern baldness is characterized by hair receding from the lateral sides of the forehead (known as a "receding hairline") and/or a thinning crown (balding to the area known as the ‘vertex’).^[3] Both become more pronounced until they eventually meet, leaving a horseshoe-shaped ring of hair around the back of the head.

The incidence of pattern baldness varies from population to population and is based on genetic background. Environmental factors do not seem to affect this type of baldness greatly. One large scale study in Maryborough, Victoria, Australia showed the prevalence of mid-frontal baldness increases with age and affects 73.5 percent of men and 57 percent of women aged 80 and over. A rough rule of thumb is that the incidence of baldness in males corresponds to chronological age. For example, according to Medem Medical Library's website, male pattern baldness (MPB) affects roughly 40 million men in the United States. Approximately 25 percent of men begin balding by age 30; two-thirds begin balding by age 60.

There is a 4 in 7 chance of receiving the baldness gene.^[4] Onset of hair loss sometimes begins as early as the end of puberty, and is mostlygenetically determined. It was previously believed that baldness was inherited from the maternal grandfather. While there is some basis for this belief, both parents contribute to their offspring's likelihood of hair loss. Most likely, inheritance is technically "autosomal dominant with mixedpenetrance"^{[citation needed]}.

The trigger for this type of baldness is DHT, a powerful^{[clarification needed]} sex hormone, body- and facial-hair growth promoter that can adversely affect the prostate as well as the hair located on the head.^[5] The mechanism by which DHT accomplishes this is not yet fully understood. In genetically prone scalps (i.e., those experiencing male or female pattern baldness), DHT initiates a process of follicular miniaturization, in which the hair follicle begins to deteriorate. As a consequence, the hair’s growth phase (anagen) is shortened, and young, unpigmented vellus hair is prevented from growing and maturing into the deeply rooted and pigmented terminal hair that makes up 90 percent of the hair on the head.^[6] In time, hair becomes thinner, and its overall volume is reduced so that it resembles fragile vellus hair or "peach fuzz" until, finally, the follicle goes dormant and ceases producing hair completely.

Other causes[edit source | editbeta]

Besides the most common cause, male pattern baldness, there are several other causes of hair thinning or loss:

Traction alopecia is most commonly found in people with ponytails or cornrows who pull on their hair with excessive force. In addition, rigorous brushing and heat styling, rough scalp massage can damage the cuticle, the hard outer casing of the hair. This causes individual strands to become weak and break off, reducing overall hair volume.

• Trichotillomania is the loss of hair caused by compulsive pulling and bending of the hairs. Onset of this disorder tends to begin around the onset of puberty and usually continues through adulthood. Due to the constant extraction of the hair roots, permanent hair loss can occur.
• Traumas such as childbirth, major surgery, poisoning, and severe stress may cause a hair loss condition known as telogen effluvium,^[7] in which a large number of hairs enter the resting phase at the same time, causing shedding and subsequent thinning. The condition also presents as a side effect of chemotherapy – while targeting dividing cancer cells, this treatment also affects hair’s growth phase with the result that almost 90% of hairs fall out soon after chemotherapy starts.^[8]
• Radiation to the scalp, as when radiotherapy is applied to the head for the treatment of certain cancers there, can cause baldness of the irradiated areas.
• Temporary or permanent hair loss can be caused by several medications, including those for blood pressure problems, diabetes, heart disease and cholesterol.^[9] Any that affect the body’s hormone balance can have a pronounced effect: these include the contraceptive pill, hormone replacement therapy, steroids and acne medications.^[10]
• Worrisome hair loss often follows childbirth without causing actual baldness. In this situation, the hair is actually thicker during pregnancy due to increased circulating oestrogens. After the baby is born, the oestrogen levels fall back to normal prepregnancy levels, and the additional hair foliage drops out. A similar situation occurs in women taking the fertility-stimulating drugclomiphene.
• Studies have shown that poor nutrition, limited food intake, and deficiencies in certain nutrients can cause thinning. These include deficiencies of biotin, protein, zinc and poor human iron metabolism, although complete baldness is not usually seen. A diet high in animal fats (often found in fast food) and vitamin A is also thought to have an effect on hair loss.
• Stress has been shown to restrict the blood supply to capillaries, inhibiting oxygen and nutrient uptake of hair follicles and inhibiting hair growth, in an effect similar to that from having poor circulation.
• Air and water pollutants as well as minerals in water and the phototoxic effects of sunlight can cause thinning by aging the scalp skin and damaging hair.
• Some treatments used to cure mycotic infections can cause massive hair loss.^[11]
• Alopecia areata is an autoimmune disorder also known as "spot baldness" that can result in hair loss ranging from just one location (Alopecia areata monolocularis) to every hair on the entire body (Alopecia areata universalis). Although thought to be caused by hair follicles becoming dormant, what triggers alopecia areata is not known. In most cases the condition corrects itself, but it can also spread to the entire scalp (alopecia totalis) or to the entire body (alopecia universalis).
• Localized or diffuse hair loss may also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, postmenopausal frontal fibrosing alopecia, etc.). Tumours and skin outgrowths also induce localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
• Hypothyroidism (an under-active thyroid) and the side effects of its related medications can cause hair loss, typically frontal, which is particularly associated with thinning of the outer third of the eyebrows (also seen with syphilis). Hyperthyroidism (an over-active thyroid) can also cause hair loss, which is parietal rather than frontal.
• Temporary loss of hair can occur in areas where sebaceous cysts are present for considerable duration (normally one to several weeks).
• Congenital triangular alopecia – It is a triangular, or oval in some cases, shaped patch of hair loss in the temple area of the scalp that occurs mostly in young children. The affected area mainly contains vellus hair follicles or no hair follicles at all, but it does not expand. Its causes are unknown, and although it is a permanent condition, it does not have any other effect on the affected individuals.^[12]
• Gradual thinning of hair with age is a natural condition known as involutional alopecia. This is caused by an increasing number of hair follicles switching from the growth, or anagen, phase into a resting phase, or telogen phase, so that remaining hairs become shorter and fewer in number.
• An unhealthy scalp environment can play a significant role in hair thinning by contributing to miniaturization or causing damage. Air and water pollutants, environmental toxins, conventional styling products and excessive amounts of sebum have the potential to build up on the scalp. This debris can block hair follicles and cause their deterioration and consequent miniaturization of hair. It can also physically restrict hair growth or damage the hair cuticle, leading to hair that is weakened and easily broken off before its natural lifecycle has ended.
• Demodex folliculorum, a microscopic mite that feeds on the sebum produced by the sebaceous glands, denies hair essential nutrients and can cause thinning. Demodex folliculorum is not present on every scalp and is more likely to live in an excessively oily scalp environment. Baldness is not only a human trait. Some other primates, such as chimpanzees, stump-tailed macaques, and South American uakari show progressive thinning of the hair on the scalp after adolescence^{[citation needed]}. Adult stump-tailed macaques, in fact, are commonly used in laboratories for the testing of hair-regrowth treatments.^{[citation needed]}
  One interesting case study is the maneless male Tsavo lion. The Tsavo lions prides are unique in that they frequently have only a single male lion with an average of 7 to 8 adult females, as opposed to 4 females in other lion species prides. It is theorized that Tsavo males may have heightened levels of testosterone, which could explain both their reputation for aggression and dominance, indicating that manelessness may at one time have had an alpha correlation.^[14]