Help I’m Balding! Men’s Hair Loss Treatments and Solutions

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 and 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 perspectives.  

• 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 sulfate-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 that are not offered on the NHS. This has led to people going abroad for transplants and seeking hair loss treatments from aesthetic clinics often being 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.

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

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^{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 0}