Hair Loss in Men

Causes of Hair Loss in Men

Hair loss (alopecia)  is one of the most common problems worldwide, considering up to 40 per cent of men in their thirties struggle with inherited hair loss, and that number reaches 50 per cent by the age of 50. It is a natural phenomenon, and everyone loses 100 hair stands each day. The biggest role belongs to genes, but hormones, diet, mineral deficiency, medications, stress and hygiene problems are also common causes of hair loss in men.

Hair loss can occur in any part of the body, but most commonly affects the scalp. Although it is often regarded as a relatively minor condition, hair loss has a significant influence on self-image and is a severe cause of anxiety and depression in some men, considering the societal and cultural importance of aesthetics.

Symptoms of Hair Loss

The most common cause of hair loss, androgenetic alopecia is characterized by gradual hair thinning that mostly disrupts the hair growth on the crown and frontal areas of the scalp. In many cases, hair regression around the temples is considered the main symptom of male pattern baldness. As the hair thinning moves back to the mid-scalp, the mildly receded hairline you previously had evolves into a distinctive M-shaped hairline. The length and thickness of the hair which is being affected by hair loss is quite ambiguous, so it is not possible to make accurate predictions about the severity of the loss. The occurrence of irregular lengths and texture is also regarded as a prominent sign of male pattern balding.

There are other types of hair loss too, apart from the male pattern balding, such as diffuse hair thinning. This condition results in baldness which starts from the back or top of the head, affecting the entire scalp or specific areas such as the crown.

However, it is important to know that a few hair strands in the bathtub do not mean that you are losing all your hair. On average, people shed around 100 hairs in a day, so you should not be concerned about baldness unless you start to lose an excessive amount of hair throughout the day. Before becoming alarmed, you should be certain about the characteristics of your hair loss, whether it is a temporary process or there are signs of permanent hair loss.

Diagnosis of Hair Loss

Before learning about the diagnostic approaches, it will be effective to know more about the types of hair loss affecting a large proportion of men worldwide. Hair loss is commonly categorized into scarring and nonscarring alopecia. Firstly, it is worth to note that scarring alopecia is quite rare, and most patients with hair loss seeking medical advice are usually diagnosed with non-scarring hair loss. The crucial step of the diagnosis process is the distinction between the further categories: focal hair loss or diffuse hair loss on the scalp.

Firstly, focal hair loss could be an indicator of an underlying problem resulting in nonscarring or scarring alopecia. Causes of focal nonscarring alopecia include tinea capitis or alopecia areata, and in some cases, traction alopecia or trichotillomania. As for the scarring alopecia, although it is quite rare, there could be several triggering conditions such as lupus erythematosus.

On the other side, diffuse hair loss is considered as the most commonly seen type of hair loss, and it includes two main categories: namely telogen effluvium and male or female pattern hair loss.

If you are concerned about hair loss and seeking medical expertise, you should consult with a dermatologist. Before making a diagnosis, your doctor will ask about your medical history including information such as medications or supplement you take, your daily diet, family members with hair loss, stressors in your life, and whether you have a persistent habit of pulling your hair out or not. And after the physical examination, your doctor may also ask for certain tests, including:

• Pull and tug test: Your doctor will gently pull several hair strands in order to determine the condition of your hair loss.
• Blood test: These tests may be performed for revealing the underlying medical conditions in relation to hair loss or identifying vitamin or mineral deficiencies.
• Examination under a microscope: Problems with the hair shaft can be revealed with a microscopic examination.
• Scalp biopsy: Tissue samples from the skin or from hair strands are analyzed, providing insight into risks of infections.

Causes of Hair Loss in Men

Making a healthy diagnosis or considering the treatment options is greatly depends on a comprehensive understanding of causes leading to hair loss. The most common causes of hair loss can be briefly listed as follows:

• Hereditary causes: The most common type of hair loss in men stems from genetic conditions. This means that if you have close relatives struggling with hair loss, it is highly possible that you will as well. These inherited genes cause the hair follicles to shrink and eventually die. Male pattern baldness, the most common hereditary cause of hair loss, usually occurs gradually with ageing, resulting in receding hairline and bald spots on the scalp.
• Medical conditions and hormones: A vast variety of conditions such as thyroid problems, scalp infections, alopecia areata, trichotillomania, heart disease, high blood pressure, diabetes and obesity has also been associated with male pattern baldness.
• Medications: Hair loss can occur as a side effect of certain drugs, such as those used for treating cancer, depression, arthritis, heart problems and gout.
• Incidents triggering stress: Whether caused by emotional or physical stress, extreme stressors are considered as a possible cause for hair loss. However, this type of hair thinning is usually temporary and passes off with the disappearance of the core cause.
• Scalp problems: Scalp conditions such as ringworm and folliculitis can cause hair loss in men. Ringworm is a fungal infection, whereas folliculitis is the inflammation of hair follicles usually resulting from a bacterial infection.
• Certain hairstyles and treatments: Hairstyles that pull the hair tightly can damage the hair over time, and as a result of this, a hair loss condition, called traction alopecia, can occur. Also, hair treatments including extreme heat can cause inflammation leading to hair loss.

The Main Suspect: Male Pattern Baldness (Androgenetic alopecia)

Considered the most prevalent cause of hair loss in men, it will be extremely useful for patients to understand the nature of this condition, as preparing a plan of action requires a rational approach to the condition.

Being the most common type of hair loss in men, male-pattern hair loss is a condition that affects the majority of them during adulthood, and it is also known as androgenetic alopecia, caused by a combination of genetic and hormonal factors. It is not life-threatening, but continual monitoring is needed as male appearance is increasingly becoming an important indicator of prestige in today’s world. The psychosocial effects of the condition increase the significance of immediate treatment and observation of high quality so as to prevent damage on self-image and even disorders such as anxiety and depression.

Male pattern hair loss is a genetic condition, associated with inherently determined sensitivity to a hormone called dihydrotestosterone (DHT), which is regulated by an enzyme called 5-alpha reductase and causes a change in the hair follicle cycle on the scalp. In brief, male pattern baldness leads to an undesired change in the natural hair cycle, miniaturization of hair follicles, and ultimately inflammation. To be more precise, the aforementioned hormone DHT shortens the anagen phase of the hair cycle, from a natural duration of 3–6 years to mere weeks or months. Ultimately, the anagen phase becomes so short that hairs created by the affected follicles become gradually smaller in diameter and shorter in length until the follicles shrink completely, leaving behind an empty hair follicle.

The genes which are the source of the hair loss susceptibility are inherited from both mother and father. Several genes are involved which determine various characteristics of the condition such as progression, pattern and severity of the hair loss. And unfortunately, the genetic tests used for measuring the possibility of hair loss are not considered reliable sources.

While the skin on the scalp looks usually typical on examination, the diagnosis is often executed on the basis of information such as the history of scalp hair loss or a receding hairline, the pattern of hair loss and the family history of similar hair loss. In some cases, the attending physician could ask for additional blood tests.

Psychological effects of hair loss in men

Whether men or women, hair is a significant part of the self-image and strongly associated with socialization. Since the effects of male pattern baldness are related to psychological consequences, it is not unusual that some men experience severe internal, or even external treatment regarded as degrading. Various studies have shown that hair loss in men is associated with low self-esteem and low self-worth, anxiety, depression and introversion. Furthermore, there are a number of available data on how men with hair loss are treated differently as opposed to men with healthy hair; they are seen as less attractive and less successful. Also, the negative effects of male pattern baldness are often ignored by others, further damaging the social standing of affected men.

Considering these possible effects, doctors also should be on guard regarding the mental condition of their patients. They need to put emphasis on patients’ comprehension of the issue and help them to understand the psychological problems they are experiencing. It is also worth noting that advising a treatment with a low chance of success can end up with more negative effects on one’s mental health.

If you are having difficulty in coping with the psychological effects of balding, you should consider consulting with a professional, and discussing treatment methods of hair loss as well as the challenges you are encountering at the moment. If your doctor regards it as necessary, you may be directed to a therapist or a psychologist in order for you to learn effective coping techniques.

Is there anything one can do to decelerate the progression of hair loss?

As it is a natural phenomenon, it is not possible to completely prevent your hair from falling out as you age, but there are several precautions that might slow down the process, and strengthen the existing hair. Before seeking medical help, you may want to try out the following methods:

• Follow a balanced diet: Making lifestyle changes and acquiring healthy eating habits is the primary condition of having voluminous hair in the long term. Lean protein found in fish, lean meats, and soy help healthy hair growth, and nuts and seeds rich in vitamin E and healthy fats are ideal for the essential oil needs of the hair.
• Take your vitamins: The deficiency of necessary nutrients such as vitamins can contribute to hair loss in men. While vitamin A is required for regulating the formation of retinoic acid in hair follicles, Vitamin B plays a part in decreasing stress levels, and the vital nutrients needed for hair health are protected with vitamins E, D and C.
• Stay hydrated: Considering the fact that hair strands comprised of water in the ratio of 1:3, no wonder that when you dehydrated, your growing follicles become weak and flimsy. Therefore, drinking at least four to eight cups of water in a day is essential for the growth of healthy hair.
• Do not use tight hairstyles such as man bun: If you like to prefer using tight hairstyles in your daily life, and recently notice a fair amount of hair shedding, then this means that it is time for you to loosen up your hair. Tight hairstyles such as man buns pull or tug hair follicles, and can result in a condition called traction alopecia in where the hair is pulled out of the scalp.
• Get a professional opinion: Various health conditions cause alterations in hormonal balances which can trigger hair loss. Therefore, you should regularly consult your doctor for underlying conditions.
• Regulate your stress level: A wide range of scientific researches have shown that hair loss is strongly associated with stress. High levels of stress can result in several medical conditions such as telogen effluvium, trichotillomania and alopecia areata. As it is crucial to challenge this stress against hair loss, it is logical to try alternative stress managing therapies including meditation and yoga.
• Consider hair loss medications: There are a number of certified hair loss medications that are usually effective in slowing the process. For example, Minoxidil is directly applied to the scalp and known as a helpful method in terms of hair loss prevention. While operating with similar principles, the other most well-known medication, Propecia, is consumed orally each day.
• Reducing alcohol and cigarette consuming: If you are experiencing hair loss, your smoking and drinking habits may be to blame. While smoking has a negative impact on blood flow to the hair follicles, extreme alcohol-consuming results in conditions such as dehydration and nutritional deficiencies.
• Exercising is a big help: Considering the fact that exercise provides stress alleviation, it is not surprising that it can work wonders with hair loss, to say nothing of the effects which promotes blood circulation.
• Reduce the amount of shampoo: Since the habit of shampooing fundamentally does not belong to human nature, these chemical products weaken the hair follicles over time. Shampoos cause the essential oils which are required for healthy hair to fade away, and the action of rubbing can make the hair strand falling out of its follicle. Therefore, you should bear in mind that 3 to 4 times a week of shampooing is fairly enough in terms of hygiene, and for the sake of hair health. And if possible, you should opt for organic, natural shampoos which allow the hair maintaining its essential oils.
• Avoid drying your hair with a towel: When hair is wet, it becomes seriously sensitive and inclined to breaking, so vigorously rubbing wet hair with a towel can result in excessive hair breakage and hair loss. You should always remember that the best way to dry the wet is air drying.
• Disregard grey hairs: Permanent hair colour products can cause irreversible damage to the hair follicles. Frequently exposing the follicles to harsh chemicals can irritate the hair and result in long-lasting harm. If you notice that there is an increase in the amount of hair you lose, then you should consider not colouring your hair.
• Avoid hot showers: Constantly showering with hot water can prevent your hair from growing healthily as the essential oils required for hair growth run off with hot water. For healthier hair, lower the temperature of your showers, even if you don’t like it.