Losing hair is a common concern for many men. While a little thinning here and there might be easy to shrug off, significant hair loss can be distressing. It’s about more than just aesthetics. For men and women, hair loss can affect confidence, style and even identity. Whilst its easy to dismiss hair loss in men as part and parcel of ageing, the underlying causes can be more intricate. This is why preventing and treating hair loss in men can be complex. In this article we take a deep dive into what causes hair loss in men. We also explore evidence-based measures to prevent and non surgical treatments to stop hair loss in men.
What Causes Hair Loss in Men?
Hair loss in men, also known as male pattern baldness or androgenetic alopecia, is caused by a number of factors. The most common causes of adrogenetic alopecia is thought to be a combination of genetic, hormonal and environmental factors. Below are the primary causes of hair loss in men.
Male pattern baldness is largely hereditary. A family history of baldness can significantly predispose men to hair thinning. If men in your family, especially on the maternal side, have experienced hair loss, there’s a higher chance you might too.
Dihydrotestosterone (DHT) plays a central role in hair loss for men. Testosterone, the male sex hormone, is converted to DHT with the help of the enzyme 5-alpha reductase. Some men have hair follicles that are more sensitive to DHT. Over time, DHT causes the hair follicles to shrink. This leads to thinner hair and eventually hair loss.
Certain medical conditions can cause hair loss in men. Alopecia areata is an autoimmune disorder that results in sudden hair loss when the immune system mistakenly targets and attacks hair follicles. There are also certain skin disorders, such as lichen planus that can result in scars. This can cause permanent hair loss at the site of the scarring.
Thyroid disorders, both hyperthyroidism and hypothyroidism, can disrupt the hair growth cycle. If untreated this can lead to hair thinning and loss. Similarly, systemic chronic diseases like lupus and diabetes can also contribute to hair loss. Moreover, scalp infections, such as ringworm, can infiltrate the skin and hair of the scalp. This can cause patchy hair loss.
Several medications can cause hair loss as a side effect. In men, this hair loss can manifest as thinning, patchiness, or total baldness, depending on the medication and your individual response. Here are some of the common medications that can cause hair loss as a side effect:
- Chemotherapy Drugs: these are used to treat cancer. They target rapidly dividing cells, which includes hair follicles. This can lead to hair loss all over the body.
- Antihypertensives: some blood pressure medications such as beta-blockers and ACE inhibitors can cause hair thinning.
- Anticoagulants: blood thinners like warfarin and heparin can lead to hair shedding.
- Mood Stabilizers and Antidepressants: some of the drugs used to treat depression, anxiety and bipolar disorder can trigger hair loss.
- Anticonvulsants: medications like valproic acid, used to treat epilepsy and other seizure disorders, can cause hair thinning.
- Retinoids: these are used to treat skin conditions like acne. Oral isotretinoin can lead to hair loss in some individuals.
- Anti-androgens: these are used to treat prostate conditions and certain types of cancer.
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): prolonged use of some NSAIDs can result in hair loss.
- Antifungals: certain antifungal medications can cause hair shedding.
- Immune-suppressing Drugs: medicines like methotrexate are used to treat rheumatoid arthritis and some types of cancer. They can cause hair loss.
- Hormone Replacement Therapy: testosterone replacement can sometimes lead to hair shedding.
- Antiretroviral Drugs: some medications used for treating HIV can result in hair loss.
In most cases, if hair loss is caused by medications it can be reversed once the medication is stopped or the dosage is adjusted. If you suspect that a medication is causing your hair loss, immediately consult with your doctor. Do not stop any medication abruptly without guidance.
There are three primary types of hair loss that stress can cause. The first is Telogen effluvium which is temporary hair loss due to excess shedding. Normally, your hair goes through a life cycle that includes a growth phase (anagen), a resting phase (telogen) and a shedding phase. With telogen effluvium, a big stressful event can shock a large number of follicles. This causes them to enter the resting phase prematurely and a few months later, hair may shed in larger amounts. Secondly, stress can cause Trichotillomania. This is a compulsive behaviour where individuals feel an urge to pull out their hair. It’s often a way to deal with negative emotions. Thirdly, there’s alopecia areata. Severe stress can sometimes trigger your immune system and cause it to attack your hair follicles. This leads to hair falling out in round patches on the scalp and even other areas of the body.
The good news is that stress-related hair loss is usually temporary. If you manage and reduce your stress, your hair typically starts to grow back. However, regrowth can be slow. In some cases, especially with trichotillomania or chronic stress, you may require medical intervention. This could include stress management techniques, therapy, or medical treatments. If you have significant hair loss and think it might be due to stress its a good idea to first speak with a doctor.
An absence of vital nutrients, like proteins, iron, and vitamins, can contribute to hair thinning. For instance, iron deficiency can reduce blood supply to the scalp. This can lead to hair thinning and shedding. Similarly, inadequate protein can cause weaker hair strands. This is because hair is predominantly made up of protein. Zinc, a mineral that promotes hair tissue growth and repair, when in short supply, can also lead to hair loss. Essential fatty acids, particularly omega-3s, nourish hair follicles. Their absence can result in a dry, flaky scalp and hair loss. Additionally, B-vitamins, especially biotin, are pivotal for healthy hair. Deficiency in them can lead to brittleness and increased hair fall.
How to Prevent Hair Loss in Men
The best way to figure out to prevent hair loss in men is to start by identifying whether there is an underlying cause. If your hair loss is due to a medical condition then treating or better managing this will prevent hair loss. Similarly, if its caused by a certain medication, then your doctor may adjust your dose or switch you to a different medicine. This will prevent further hair loss and eventually regrow it.
To prevent further hair loss due to genetics, hormones or stress start by improving your overall health and lifestyle. Ensure that you east a diet rich in essential vitamins, minerals and proteins as this can bolster hair health. Regular exercise, meditation and relaxation techniques can improve your overall health and help manage stress. This will may in turn reduce hair loss. Lastly, avoid or limit harsh chemical treatments as these can weaken the hair and make it more likely to break.
Effective Treatments For Stopping Hair Loss in Men
If you are experiencing unusual or sudden hair loss, its important to consult with a doctor first. This will help find out if there is an underlying medical condition that might be the cause and treat that accordingly. For common types of hair loss in men like male pattern baldness or stress, there are a number of effective treatments. Often, the best way to stop and reverse hair loss in men may involve combining several treatments. Below are the best known treatments for hair loss in men.
Minoxidil was initially developed as an antihypertensive medication but later it was found to help with hair regrowth. In the UK, minoxidil is available both over-the-counter (as Rogaine) and through prescription for concentrations higher than 5%. When applied topically to the scalp, minoxidil can prolong the anagen phase of hair follicles. Minoxidil is thought to enhance blood circulation to hair follicles. This increases the delivery of essential nutrients and oxygen. This seems to wake up dormant follicles which increases the number and density of hair strands. Additionally, there is evidence to suggest that minoxidil increases the diameter of hair follicles which makes hair thicker. However, whilst minoxidil is an excellent treatment for hair loss, results can vary between person to person. Furthermore, you will need to use it for at least 3-4 months to start seeing results. You’ll also need to continue using it otherwise your hair loss will return.
This is a prescription only medicine that is primarily used to treat male pattern hair loss (androgenetic alopecia). Finasteride acts as an inhibitor of the enzyme 5-alpha reductase. This enzyme converts testosterone into a more potent derivative called dihydrotestosterone (DHT). Elevated levels of DHT in the scalp can cause the miniaturisation of hair follicles. This is a hallmark of androgenetic alopecia. As these follicles shrink, the hair can become progressively fine until eventually they cease to produce hair altogether. By reducing DHT levels, Finasteride reduces the impact of this hormone on hair follicles. This leads to a slowing or reversal of hair thinning. With prolonged use, finasteride can even lead to hair regrowth. It is usually prescribed as tablets and often used alongside minoxidil. Again, the effect of finasteride can vary among individuals.
This non-invasive treatment uses red or near-infrared light to stimulate hair follicles. The main way it works is to increase blood flow to the scalp and hair follicles. This provides them with more nutrients and oxygen. Hence it can extend the growth phase of the hair cycle. This is usually and at home treatment and there are a number of devices on the market ranging from laser combs to helmets and caps. Whilst clinical studies are promising, this is still a relatively new technology. As such more research is needed to backup the claims. As with all hair loss treatments, results can vary from person to person. It’s important to follow instructions carefully, be consistent and patient as well as set realistic expectations. Given that this is an expensive and new treatment, consult with a dermatologist first to make sure its right for you.
Microneedling has emerged as a potential treatment for hair loss, particularly androgenic alopecia in men. The procedure involves using a device equipped with fine needles to create thousands of tiny injuries to the scalp’s dermis. This controlled damage stimulates your natural wound healing process. This increases blood flow and growth factors which are both vital for hair growth. When combined with other treatments, such as topical minoxidil, microneedling has shown to augment their efficacy, allowing for better absorption and amplified results. Preliminary studies have indicated positive outcomes with microneedling, with many patients experiencing a noticeable increase in hair density and thickness. Nevertheless, as with any therapeutic intervention, the success of microneedling can be variable, and it’s essential for individuals considering this treatment to consult with a dermatologist or specialist healthcare practitioner to discuss its potential benefits, risks and how to use it.
Platelet-rich Plasma (PRP)
PRP has gained a lot of attention as a promising treatment for androgenic alopecia. This procedure uses the body’s own regenerative abilities. A sample of your blood is drawn and then spun down in a centrifuge. This isolates and concentrates platelets and growth factors. This is then injected into affected areas of the scalp. The growth factors within PRP are believed to stimulate dormant hair follicles and rejuvenate shrinking ones. So far, clinical data is positive but limited. Studies show that some patients have reported a noticeable improvement in hair thickness but this varies. More data and higher level clinical trials are still needed to validate it. PRP is a medical procedure and should be done in a clinical setting. If you are considering PRP, speak with a dermatologist or other qualified medical practitioner to ensure it is suitable for you. They will perform the procedure properly and minimise risks.
If you’re struggling with hair loss, remember you’re not alone. This is a very common problem for both men and women. Stopping hair loss can be difficult but not impossible. There are a number of good treatments and the best one will depend on the cause of your hair loss and individual response. Be aware that there usually isn’t a one-off solution and you may require more than one approach. Results regardless of treatment will take time and consistency. To set yourself up for success, adopt an holistic approach that takes into account your overall health and wellbeing. These are closely tied to hair health. Also be aware that whilst some treatments might work wonders for some, this is variable. So be patient with yourself and set realistic expectations. If your hair loss is sudden or unexplained, start by seeing a doctor to check whether there is an underlying cause.
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