Hair Loss

Male pattern baldness is a type of hair loss. It is thought that 95% of male hair loss is caused by male pattern baldness (MPB), with over half of men over the age of 50 suffering from the condition.

At a certain age, those with an inherited sensitivity to the hormone dihydrotestosterone (DHT) begin to lose their hair. DHT causes follicles to shrink, and with each growth cycle, the shaft of the hair also shrinks.

Alopecia can occur in different ways and can often be classified into different types, each with varying levels of occurrence. Some of these include:

• Male pattern hair loss (androgenic alopecia) comprises over 90% of male hair loss cases. Often the hair often begins to thin out already in the mid-twenties, which is often characterised by a receding hairline. This is also the most common case for female hair loss, called female pattern hair loss.

  

• This type of hair loss is also referred to as hormonal-hereditary hair loss as it is caused by genetic hypersensitivity of the hair root cells to androgens, in particular the male hormone testosterone. When the enzyme 5-alpha reductase converts testosterone to at a higher than normal level, the DHT then attacks the hair follicles at the root, preventing any further healthy hair growth.

• The second most common type of hair loss is spot or patch baldness (alopecia areata). This is thought to be caused by an autoimmune disease, where the immune system attacks localized areas of hair growth on the body (usually the scalp) believing there to be a threat. This resulting attack leads to inflammation, which causes the hair to fall out, leaving bald spots.

  

• The patchy hair loss appears different sizes or shapes but are often round or oval. Alopecia areata (AA) can occur over a small period of time or on a longer term basis with a certain side of the scalp being affected compared to the other. Approximately 1-2% of all men are affected by alopecia areata.
• Another form of hair loss is total hair loss (alopecia totalis). It causes a complete loss of hair on the scalp and is also caused by an autoimmune disease similar to alopecia areata. It is often seen as being in between alopecia areata and alopecia universalis (total loss of hair across the whole body).

  

• It is often difficult to assess the main cause or trigger for this type of hair loss, but it is said to affect mainly young people, those under the age of 40 and those who have just completed chemotherapy. There is a small chance that hair regrowth can occur if the condition is treated, but this is not often.
• Traction hair loss (traction alopecia) is mainly prevalent in women and is linked to certain hairstyles and styling procedures. Excessive pulling, heating, bleaching, dyeing, braiding and binding can put too much strain on the scalp and hair follicles. This strain can cause inflammation and result in increased loss of hair in that area. When identified early, traction alopecia can be reversed by using safer hair products and styling practices.



• Sometimes, periods of high stress or psychological issues can cause you to shed or lose more hair than normal for a short while. This is known as temporary hair loss (alopecia effluvium). The loss of hair is usually more prominent at the top of the head and sometimes around the temple. This condition is more evident in women who have just given birth or those who have nutrient deficiencies. Managing stress can see the hair return back to its previous level.

  

Causes range from genetics and medical conditions to lifestyle factors. However, the most common is “androgenic alopecia,” more typically referred to as “male pattern baldness”. MPB is a hereditary condition where the body becomes particularly sensitive to the hormone dihydrotestosterone (DHT), which leads to thinning hair.

Diet, stress and illness are less common causes. If you believe one of these is the reason for your hair loss, you should seek medical advice immediately.

The significance of DHT and male hair loss

Hair loss is associated with too much of the testosterone-related male hormone DHT (dihydrotestosterone), which attacks hair follicles and causes them to shrink. Some of the best hair loss treatments work by targeting this hormone's production.

Hair loss and age

Hair loss is an expected part of the aging process, with 2 out of 3 men experiencing a significant level of hair loss by the time they reach the age of 60. Only a small proportion of men, approximately 1 in 5, experience very little hair loss by the time they are in their 80's.

While there are some contributing lifestyle factors, such as diet and stress, hair loss is largely genetic and an inevitable part of the male aging process.

There are ways to slow and even reverse the process of hair loss.

Minoxidil (Rogaine) and Finasteride (Propecia or Proscar) are two clinically tested treatments for treating hair loss. Minoxidil is available over-the-counter and can be applied as a foam, directly to the scalp. Finasteride and Propecia require a prescription and is available in 1mg tablet form, to be taken daily. They are considered the best medical treatments for hair loss.

Herbal hair loss treatments

Many people turn to alternative hair loss treatments, such as coconut oil, saw palmetto, and onion juice to improve hair growth. Despite their popularity, there is limited data supporting the use of herbal products in treating hair loss.

Over-the-counter treatments

There are many over-the-counter treatments that claim to help restore your hair. These range from creams to hair loss shampoos. However, while many can strengthen your existing hair, they are not usually good at helping regrowth or preventing loss.

The most effective treatments contain the active ingredient minoxidil, which is sold as Rogaine. This is a topical treatment available as both a foam and a cream, which helps combat male pattern balding when applied correctly. Some men find that Rogaine can be useful for both slowing hair loss and promoting regrowth.

Regrowth normally takes a few months, with results showing around the crown of the scalp.

Hair transplant surgery

There are three main hair restoration treatments, which include hair transplantation, scalp reduction, and flap surgery.

A hair transplant involves taking hair from the back of your head and moving it to the front of the scalp. Scalp reduction shortens a mild bald patch by removing a piece of your scalp and stretching the area where hair is thicker over it. Flap surgery involves putting a healthy portion of your scalp over a small area of hair loss.

These treatments often work well, but can be expensive and invasive. If you're unsure about whether this kind of treatment is suitable for you, speak to a medical professional.

Laser therapy

Low dose laser therapy treatments are sometimes used to encourage hair growth. Some people have experienced positive results, but overall the evidence for this treatment is inconsistent.

Prescription treatments

Finasteride, available under the brand names Propecia and Proscar, is an FDA-approved hair loss treatment. It is used for male pattern hair loss on the vertex (top of head) and anterior mid-scalp area (middle front of the head). The active ingredient finasteride inhibits the activity of DHT, the primary cause of male pattern hair loss. Clinical trials have found that 90% of men who took finasteride either maintained scalp coverage or showed visible improvement over 5 years.

If you are concerned about hair loss, speak to your doctor or a dermatologist. Dermatologists are skin experts who treat hair loss issues.

Preventing hair loss can be difficult, and will largely depend on your type of hair loss. Male pattern baldness (androgenic alopecia) is usually caused by hereditary factors, which makes it difficult to prevent.

The following lifestyle tips may not be guaranteed to prevent hair loss, but can improve the quality of your hair follicles and hair itself:

Follow a balanced diet - Hair follicles are made up of proteins and because of this, it is important that you incorporate plenty of protein into your diet. In addition to meat and fish, beans are a major source of protein, as are eggs, soy, dairy, cheese and nuts.

Avoid certain shampoos - Some hair care products may contain chemicals that can be harmful to your hair. Research your product well to make sure you are not sensitive to its ingredients.

Increase the calcium in your diet - Calcium has also been hailed as a valuable vitamin for hair loss, and has also been shown to be beneficial for hair strength, thickness, and overall health.