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I'm Balding! Men's Hair Loss: Treatments and Solutions

This article was written by Dr Ingrid Wilson, a portfolio GP in Cheshire and a Trichologist. She is the Director of Crewe Hair and Skin Clinic

Men’s hair loss is a very common issue (affecting around 50% of men over the age of 50), but regardless of how common it is, it can be rather distressing to see your hair thin or fall out

The first thing to work out is whether you are losing more hair that is deemed typical. You may have noticed a little more hair than usual on the pillow, on your clothes, in the plughole after washing. However, it is usual to use between 50-100 hairs per day and there is usually more hair shedding in the autumn, but it fluctuates through the year.

Men’s hair loss can be temporary or permanent. For someone experiencing hair loss it can be difficult to work out which type of hair loss they are experiencing. 

The temporary forms of hair loss are more responsive to treatment, particularly in the early stages. The permanent forms of hair loss need to be identified early so that further hair loss can be prevented and treated by a dermatologist.

The most important thing is to take action early when you notice it, and to seek help from a hair loss specialist such as myself who spends time identifying up to date information about the treatment of hair loss from the medical, cosmetic and aesthetic perspective.  

Men’s Hair Loss: Causes

There are dozens of causes of men’s hair loss, and often more than one factor can be contributing.  which include:

  • Hormonal changes (male pattern baldness)
  • Medical conditions, scalp conditions and disorders (such as thyroid disease, alopecia areata, scalp infections like ringworm, and indirectly, dry scalp, dandruff, eczema and dermatitis).
  • Medication: side effects from meds that treat things like cancer, high blood pressure, arthritis, depression, heart problems, anabolic steroid use (1) etc
  • Stress (Trichotillomania – when someone can’t resist the urge to pull out their hair and feel “growing tension” until they do. This may be done in response to a stressful situation, and Telogen effluvium – hair loss due to stress, a shock or a traumatic event).
  • Diet – not getting the nutrients your body and hair needs for healthy growth.
  • Traction Alopecia (repeated tension, excessive styling and processing).
  • Smoking is associated with early onset male pattern baldness (2)
  • Low levels of vitamin D are linked to male pattern baldness as well as a range of other hair loss conditions. A case control study published last year found that more advanced male pattern baldness was associated with lower vitamin D levels (3). In this country there are national recommendations around vitamin D supplementation is taken all year round for bone health for those with darker skins (4) and between October and April for those with lighter skins
  • Obesity is thought to accelerate male pattern baldness (5)
  • Increased air pollution levels are associated with male pattern baldness

Male Pattern Baldness 

So what is Male pattern baldness? Male pattern hair loss (MPHL) is the most common type of hair loss in men. It is also known as androgenetic alopecia. It affects about 50% of men over the age of 50. 

MPHL is caused by a combination of genetic and hormonal factors. A hormone called dihydrotestosterone (DHT) causes a change in the hair follicles on the scalp. The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in colour until eventually the follicles shrink completely and stop producing hair. 

The usual pattern of hair loss is a receding frontal hairline and loss of hair from the top of the head. Hairs in the affected areas are initially smaller in diameter, and shorter compared to hairs in unaffected areas, before they become absent.

Balding? Thinning? Men’s Hair Loss Tips, Prevention & Treatment

The most important action is to take action early when you notice it, and to seek help from a hair loss specialist such as myself who spends time identifying up to date information about the treatment of hair loss from the medical, cosmetic and aesthetic perspective.   

There are treatments that can thicken existing hair, but it is really important to know that there are no instant results. Results take time. There is ‘no cure’ for hair loss – just treatments. 

But what things can you do to help reduce hair loss? A healthy lifestyle is very important, so to help we’ve listing out some key things for you to consider, below: 

  • If you can get someone to look at your scalp, get them to see whether there are areas of thin hair or no hair. If you are not able to do this, take pictures of the top view, side view and back view of your head with your hair parted in different places.
  • Ask yourself whether there have been any significant changes to your usual habits, such as nutrition, medication, stress or hair care practices.
  • Have a look at photos taken within the last year or so to see whether there is a significant difference in the thickness of your hair.
  • Check whether you have had other symptoms such as scaling or crust on the scalp, loss of hair on the eyebrow, armpit, body or any unusual skin problems.
  • Consider whether there have been other changes in your health
  • Overall a well balanced diet will help to reduce the chances of hair loss
  • Think about giving up smoking or at least reducing
  • Take your Vitamin D
  • Avoid chemical hair treatments 
  • Consider consulting a medical professional about diagnosis, options and treatment such as medication
  • Try massaging your scalp. Afrocenchix's scalp oil Soothe contains lemongrass and olive oil and was created by Afrocenchix's founders to treat their own traction alopecia caused by years of relaxers, tight braids and weaves. They massaged Soothe into the scalp twice a day, morning and night, to help stimulate blood flow to the scalp. This can help to encourage new hair growth, provided the follicles are still intact. This method can be helpful in cases where the hair loss/alopecia you are diagnosed with is reversible, meaning that the hair follicles are still intact and well-connected to your hair bulb.
  • Don’t be afraid of washing your hair. Many people are afraid to wash their hair when they see hair loss because they are afraid that they will lose more hair by washing it. This isn’t the case as the hair is already dead when it is on the scalp. Swish is a sulphate-free shampoo that gives your hair a crisp clean and removes build up without stripping it of moisture. Scientifically formulated but containing 97% natural ingredients means you’re getting the best of both worlds – it works and it does so by using ingredients that are good for your hair like Aloe Vera and fruity essential oils. 
  • Carefully consider medications, such as Minoxidil, which is available over the counter as Regaine. This prolongs the growth phase of the hair. It doesn’t work for everyone, so if someone has been using it consistently for 6 months without a result I would recommend a TrichoTest – DNA Test for personalising hair loss treatment – Crewe Hair and Skin Clinic.  This will advise on which topical medications and supplements are likely to work for MPHL (and Female Pattern Hair Loss, Alopecia Areata and Telogen Effluvium)

NB: Final Note About Men’s Hair Loss

It is important to remember that  NHS dermatologists only have limited time to talk through all the factors  that may be contributing to hair loss including nutrition, lifestyle and hair care practices. Whereas approaches at private clinics will allow more time  so that the contributing factors to hair loss can be identified, and a bespoke plan can be made.

In recent years there has been a massive expansion in the cosmetic sector of treatments for hair loss which are not offered on the NHS.  This has led to  people going abroad for transplants, and seeking hair loss treatments from aesthetic clinics who often are in a position to provide a wider range of treatments than has typically been provided in traditional trichology clinics.

I would also encourage black men to consider alternatives to the hair replacement system, popularly known as the man weave if they are experiencing early hair loss.  Hair replacement systems have their place for advanced hair loss, and it is possible to create a good bespoke system which is attached using glue or tape.   My clinic offers a Cyber Mould which is a permanent mould of the scalp which is used to cover an area of hair loss Men’s Hair replacement system – Crewe Hair and Skin Clinic

Many men who I speak to feel that they can solve their hair loss issue using natural products over the internet.  However these natural products are not without risk.

References

1.   Albaker W; Alkhars A; Elamin Y; Jatoi N; Boumarah D; Al-Hariri M.  Anabolic-Androgenic Steroid Abuse among Gym Users, Eastern Province, Saudi  Arabia.  Medicina (Kaunas, Lithuania). 57(7), 2021 Jul 10. 

2. Salem AS; Ibrahim HS; Abdelaziz HH; Elsaie ML Implications of cigarette smoking on early-onset androgenetic alopecia: A  cross-sectional Study. Journal of Cosmetic Dermatology. 20(4):1318-1324, 2021 Apr. 

3.    Sanke S; Samudrala S; Yadav A; Chander R; Goyal R.Study of serum vitamin D levels in men with premature androgenetic  alopecia.  International Journal of Dermatology. 59(9):1113-1116, 2020 Sep.

4.  Vitamins and minerals - Vitamin D - NHS (www.nhs.uk)

5. Morinaga H; Mohri Y; Grachtchouk M; Asakawa K; Matsumura H; Oshima M;  Takayama N; Kato T; Nishimori Y; Sorimachi Y; Takubo K; Suganami T; Iwama  A; Iwakura Y; Dlugosz AA; Nishimura EK.  Obesity accelerates hair thinning by stem cell-centric converging  mechanisms. Nature. 595(7866):266-271, 2021 07.

6.   Abolhasani R; Araghi F; Tabary M; Aryannejad A; Mashinchi B; Robati RM The impact of air pollution on skin and related disorders: A comprehensive  review.  Dermatologic Therapy. 34(2):e14840, 2021 03.

About Dr Wilson
Dr Ingrid Wilson

Dr Wilson is a portfolio GP in Cheshire and a Trichologist. She is the Director of Crewe Hair and Skin Clinic.  She completed her medical training in Liverpool, qualified as a General Practitioner in 1999, and  qualified as a Consultant in  Public Health Medicine in 2006.  She has a Masters in Public Health and is a Fellow of the Faculty of Public Health. Having had personal experience of hair loss she was struck by how little training GPs received in diagnosing and treating hair loss, and was aware that some hair loss conditions were more commonly experienced in black people. She struggled to find a suitable course for GPs. She decided therefore to study trichology with the Institute of Trichologists between 2010 and 2012. She gained a distinction in both years and won the John Mason Memorial prize. Upon completing the course she realised that there was a need to better connect the  diagnostic, prescribing  and referral resources available for hair loss by GPs and connect it with customers’ cosmetic hair care needs though camouflage and wigs. As a black woman she was aware that there was a need to create an environment that was sympathetic to their specific hair care needs and was able to give people the best chance of slowing down the progression of hair loss at an early stage.  

She took voluntary redundancy from her Public Health consultant post in 2012 and since then has been working towards building her clinic while continuing as a part-time GP. 

She is very aware that there are gaps in the NHS to help people tackle hair loss medically without resorting to surgery – particularly for  black women. Her clinic also caters for people with cosmetic skin care concerns including unwanted hair acne, pigmentation and ageing. The clinic uses home care programmes, electrolysis and skin camouflage. 

She has written articles on hair loss for a number of publications and holds memberships at:

  • British Hair and Nail Society
  • Affiliate Trichologist Member: British Association of Hair Restoration Surgery
  • Member of the International Association of Trichologists
  • Member of the Society of Cosmetic Scientists
  • Medical Member of The Trichological Society

Other articles: 

14 Top Tips For Men’s Afro Hair Care

Barber Shop Terms: How to Really Talk to Your Barber

Alopecia: Everything you need to know

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