Men’s Hair Loss: Not a Losing Battle

What causes men to lose their hair? Is it genetics? What treatments are available? Find out the common reasons for hair loss — also known as alopecia — and what really works to treat it.

How hair grows

Here’s a simple way to understand the hair growth cycle: Hair doesn’t grow like grass. If it did, you would expect every hair to be growing at the same rate on your scalp. After a period of time, all the hairs would end their life span together and fall out simultaneously. This would leave you totally bald until a new crop began to grow.

Instead, the hair growth cycle prevents this all-or-nothing scenario, because every hair grows at a different rate on your scalp. At any one time, about 90 percent of the hairs are in a growing phase, a process that can take from two to six years, according to the American Academy of Dermatology (AAD).

As such, 10 percent of the hair rests for several months until it’s ready to shed, writes AAD. Once a hair falls out, the body immediately gets busy growing a new hair to replace it. Per day, you can lose up to 100 hairs, according to AAD.

What affects the hair cycle

Many circumstances can impact the hair cycle, increasing the amount of hair that falls out. These include chemical hair treatments, heredity, age, hormones, fever, infection and medications. After you’ve recovered, however, hair can resume its normal growth rate.

Noticing a pattern

Hair loss doesn’t happen overnight; it typically starts in your 20s or 30s. By age 50, up to half of men experience hair loss, according to the University of British Columbia Hair Research & Treatment Center.

Common male pattern baldness can result from androgen levels and genetics.

• Hormones. A man’s higher levels of testosterone — an androgen — are largely responsible for male pattern baldness. An enzyme turns testosterone into dihydrotestosterone or DHT. Then, a reaction occurs between DHT and hormones in hair follicles. The result is less growth of new hair or no new hair growth at all, according to About.
• Genetics. Some researchers believe that the X chromosome — passed on by your mother — is related to hair loss. In fact, a German study found that “the resemblance should be greater between affected males and their maternal grandfathers than between affected males and their fathers,” writes Miranda Hitti for WebMD. So, if your mother’s father was bald, there’s a chance you might be as well.

For most men, hair loss follows a specific pattern. The so-called “pattern” of male baldness starts at the front of the hair near your forehead, where your hairline recedes. In addition, “hair at the crown also begins to thin,” notes MedHelp. As this happens, more and more scalp on the top of your head will become visible.

Treatments to try

In the past few years, dermatologists have seen a rise in hair loss consultations — probably due to a variety of reasons. For one, today’s increasing emphasis on cosmetic appearance makes people more aware of the issue than in previous generations. Also, education on hair loss and new treatments are bringing more patients with alopecia to dermatologists.

• Topical treatments such as minoxidil (Rogaine) slow hair loss as well as promote hair regrowth. In fact, according to the University of British Columbia Hair Research & Treatment Center, 10 percent of men who use Rogaine have “cosmetically acceptable regrowth.” How? The mechanism isn’t completely understood, but minoxidil can encourage new growth from hair follicles.

  Be patient — it can take up to six months before you notice any changes, according to the American Family Physician. This treatment option may work best for younger men with small bald areas who are just starting to lose their hair.

  Unfortunately, if you stop using Rogaine, hair loss will return. Also, some men can experience scalp itching or redness from Rogaine.

• Oral therapy with finasteride (Propecia) halts hair loss and promotes hair regrowth by lowering testosterone production. Remember, when testosterone becomes DHT, it affects your follicles and prevents regrowth. Propecia “reversed hair loss in 66 percent of men,” reports the University of British Columbia Hair Research & Treatment Center.

  As with Rogaine, however, hair loss will return if you discontinue Propecia. Side effects like diminished sex drive might result, since the medicine affects testosterone.

• Transplantation surgery or grafting is a more dramatic option. In this procedure, hair is taken from a donor area of your head — where your hair is thicker — and transplanted into thinner balding areas. Follicles through which hair grows are also transplanted along with the hair.

  Although the process is often successful and most people are happy with the results, you might need multiple transplants to get the desired look of thickness. Expect some discoloration, pain and swelling along transplant areas. You might even experience temporary numbness, which can last up to three months, according to The American Society for Aesthetic Plastic Surgery. Scarring and infection are also possible, warns MedHelp. If you opt for transplant surgery, be sure to do your homework; choose a licensed, qualified surgeon and ask to see before and after photos of patients who’ve had the same procedure.

  In addition, keep costs in mind. Some men will need more hair transplanted than others, based on the amount of hair they’ve lost. The price of the surgery is based on the number of grafts required and the number of sessions needed to get the look you want. Anesthesia or other medical costs might be involved, too. The total cost of a hair transplant ranges between $4,000 and $15,000, according to Hair Transplant Costs.