Why do men lose hair?
The hair on your head looks awesome and protects your scalp from hot and cold temperatures alike, but it’s not essential for your body’s health or your longevity. So, once you reach your forties and nature no longer deems you prime mating material (in fact, male fertility begins declining after age 0), the hair starts to fall out. Not for all men, but ~80% of Caucasians and around 50% of other races will begin losing hair in their forties. It’s a very gradual process and you won’t notice it right away, in fact perhaps not even for many years.
There are special cases of stress and autoimmune-related hair loss, but around 95% of all baldness in men is gradual hair loss. It’s called male pattern hair loss (androgenic alopecia) and owes to a chemical process where testosterone is converted into dihydrotestosterone (DHT) at an excessive rate. Too much DHT in the scalp’s hair follicles damages the follicles, causing the hair in it to fall out and never regrow again.
Androgenic alopecia is inherited, but not every male with bald ancestors will also bald himself. Science so far hasn’t offered a conclusive picture of when and why the balding process is triggered in men who have the underlying genetic potential. But it appears that oxidative stress and the chronic inflammation it causes in the body may be primary reasons. Smoking, obesity, environmental factors such as exposure to radiation and certain chemical substances may also act as triggers.
The one fact known for sure is that once male pattern baldness has started, it won’t stop on its own but continue until after several decades not a single strain of hair is left on your scalp. The hair loss usually starts at the hairline above the forehead and at the temples. From there it slowly advances backward across your head. It’s a painless, itch-free process, which is why you don’t notice at first. And we normally don’t count all the hair we lose. If you worry about androgenic alopecia and want to watch out for early signs, it’ll help taking photos in regular intervals and compare your current hairline against these photos.
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What can I do to prevent hair loss from continuing?
As mentioned above, androgenic alopecia doesn’t just stop on its own, and short of using medications (more on that later), there’s no cure that will make it stop. Since male baldness is such a widespread phenomenon there’s a long list of folk remedies and herbal cures. We could list them here, but it’d be a waste of time. In short, scientific research to this day hasn’t yet found an effective natural cure for male pattern baldness.
That said, there are some things you can do to slow down the condition’s progress. Most importantly, try to avoid stress whenever you can. Severe stress can increase cortisol levels in the body, which is damaging to hair follicles and can exacerbate the effects of androgenic alopecia. Also try to avoid oxidative stress (avoid sugar, greasy food, alcohol, and smoking) and consume enough antioxidants through your diet (vitamins C and E or melatonin, for example). And make sure to get at least 7-8 hours of sleep every day. Talk to a nutritionist or doctor to learn more about how your diet and lifestyle can impact your hair health.
Proper scalp hygiene also is vital, which means 3-4 times of washing per week with either just water or a mild shampoo, as well as regular exposure to fresh air and sunlight.
Medication is the only effective way to stop hair loss
There are several treatment options you can choose from. However, some sobering clarifications upfront: these meds are quite effective, but only for as long as you are taking them. When you discontinue treatment, the balding will soon continue at the same speed as before. However, these hair loss drugs actually are designed for multi-year use and have a long record of helpings millions and millions of men with generally mild to moderate side effects.
In the USA, two FDA approved prescription medications are available to treat male pattern hair loss.
- Finasteride, which Merck has marketed as Propecia since 1997 but now also is available in generic versions. The drug is taken orally once a day and studies have shown that even for durations of up to 10 years of daily use finasteride is fairly well tolerated. The success rate is about 85%, which means for 85 of 100 finasteride users the hair loss will stop. Moreover, some 65% of users even noticed that some hair can regrow. It takes a couple of months though for the drug to take effect and the first signs of improvement to show in your hair.
- Minoxidil is the second option available to you, whose most well-known branded version is Rogaine. It’s a topical medication that comes as a liquid or spray and is put straight on the scalp. Minoxidil doesn’t stop the aforementioned testosterone-to-DHT conversion process and thus doesn’t halt balding as such. However, it enlarges the blood vessels on the scalp and thereby facilitates faster hair growth in the still healthy hair follicles. Minoxidil thus can complement a finasteride treatment, making healthy hair grow faster while finasteride stops or slows the hair loss.
Talk to a dermatologist to find out more about these two options, if you think you might have pattern hair loss.
- Adil, Areej, and Marshall Godwin. “The Effectiveness of Treatments for Androgenetic Alopecia: A Systematic Review and Meta-Analysis.” Journal of the American Academy of Dermatology, vol. 77, no. 1, 2017, pp. 136-141.e5, www.ncbi.nlm.nih.gov/pubmed/28396101, 10.1016/j.jaad.2017.02.054. Accessed 26 Feb. 2020.
- Finasteride Male Pattern Hair Loss Study Group. “Long-Term (5-Year) Multinational Experience with Finasteride 1 Mg in the Treatment of Men with Androgenetic Alopecia.” European Journal of Dermatology?: EJD, vol. 12, no. 1, 2002, pp. 38–49, www.ncbi.nlm.nih.gov/pubmed/11809594. Accessed 26 Feb. 2020.
- Cranwell, William, and Rodney Sinclair. “Male Androgenetic Alopecia.” Nih.Gov, MDText.com, Inc., 29 Feb. 2016, www.ncbi.nlm.nih.gov/books/NBK278957/. Accessed 26 Feb. 2020.