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Hair loss in men

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 4 minutes read

Hair loss can cause distress and a sense of premature ageing in men, as it often appears in your 30s or 40s, at a time when you feel healthy and young, and are striving in your career, relationships and family life. It's very common, with half of all men in their 50s having visible hair loss.

It's usually part of the natural ageing process and mediated by hormones. Everyone wants to know what they can do to halt the process, or even to regain their locks.

Let’s talk you through the options, and the less common causes of an underlying medical condition.

Hair loss as we age

Balding in men is referred to as male pattern hair loss, or androgenetic alopecia. Genetic and hormonal factors both play a role – a hormone called dihydrotestosterone changes the hair follicles on the scalp, where new hairs gradually become thinner, shorter and lighter in colour. Over time, these follicles stop producing hair altogether.

Male pattern hair loss is characterised by hair loss initially from the temples, then later the forehead, in what we call a receding hairline. Additionally, men may get a bald spot on the top of the head at the back.

This differs from female pattern hair loss, where loss is all over, especially the crown, without a distinctive receding hairline,

It can occur at any time after puberty, but often follows genetics, so you may lose your hair around the same age as your father did, or as the men in your mother’s line.

Hair is an important part of our appearance and, in turn, our sense of identity and self-esteem. If your condition is causing you significant emotional trauma or making you feel quite down and depressed, this may be reason to seek help from your doctor.

Can medical conditions cause hair loss?

Medical conditions can cause hair loss. Autoimmune conditions such as lupus, Hashimoto’s hypothyroidism (underactive thyroid gland), Grave’s hyperthyroidism (overactive thyroid gland) and rheumatoid arthritis can all cause hair loss.

Alopecia areata (patchy loss of hair) or alopecia universalis (total loss of hair) are autoimmune conditions where the body attacks its own hair follicles.

Iron deficiency can cause hair loss, with or without anaemia. To rule it out as a cause, dermatologists recommend that your iron levels are really robust, not just “within the normal range”. Zinc deficiency may also contribute to hair loss, but it’s rare if you’re eating a healthy balanced diets and/or taking multivitamins – you only need a very small amount for the body to put to good use.

In reality, the above medical conditions are much more common in women than men. For men, the most common type is related to ageing. Book an appointment with your doctor if you have reason to suspect the above conditions, or if you are suddenly losing hair, you have bald patches or hair is falling away in clumps, or if your scalp is itchy or burning.

What can I do about hair loss?

Unfortunately there’s no cure for age-related hair loss – it progresses gradually over months or years. Without hair to cover your scalp, it’s important to protect it from sun damage, and you should wear a hat and sunscreen when outdoors.

It’s difficult to reverse hair loss, and any treatments to reduce the progression take time to see results and there are no guarantees of effectiveness. Unfortunately little is available on the NHS, so most treatment options are self-funded.

Wigs and hair pieces such as toupées are medication-free, however, some people find them hot and itchy, or expensive, especially if you opt for the more natural-looking human hair over synthetic hair. The NHS will fund these in certain circumstances.

Camouflage products aim to build the appearance of a full crop with products that temporarily add fibres to existing hairs, and these are available to buy from some pharmacies and specialist outlets.

Hair transplantation is a surgical option in certain circumstances, but again, not suitable for everyone, and not within everyone’s budget range.

What are the medicated options?

Minoxidil liquid or foam is a medication available to buy from pharmacies to help slow the progress of hair loss. It works by keeping hairs in the anagen (growth phase) of the hair cycle longer, thereby reducing the amount of hair follicles in the telogen (or shedding phase). The net result is that more hair is growing than being shed.

Minoxidil products have clinical evidence to show they work in most people, but they only work for as long as you keep using them – once you stop treatment, hair loss resumes. Manufacturers advise it can take 3 to 6 months to see any visible improvement. Users should bear in mind the expense of maintaining treatment.

Regaine comes as a foam applied directly to the scalp, and there are products aimed at men and women in different concentrations.

Finasteride tablets are a treatment only for men, and are available to buy privately. They reduce levels of dihydrotestosterone, with the aim of slowing down hair loss and boosting hair growth. Again, the manufacturers advise a 3 to 6 months continuation until you may see results, and continuing medication is essential to any continued results. Some men may experience reduced sex drive and erectile problems with this treatment.

There are many vitamins or supplements that claim to promote hair growth. Whilst good nutrition and circulation to the hair roots are important factors, the hormonal factor in androgenic hair loss is the most important. Key nutrients such as biotin, protein intake to build hair, iron and other trace minerals may help in some cases.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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