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Hair Loss

Information about alopecia and male pattern baldness

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Dr Hilary Jones discusses hair loss and the preventative treatments available at HealthExpress

Am I suffering from hair loss? Whilst this can be an unsettling question most men and women do not want to ask themselves, it's important to know that you're not alone. The majority of people realise they are suffering from alopecia (medical term for hair loss) when they notice thinning hair in the mirror, or more hair shedding whilst brushing or in the shower. Levels of hair loss differ based on the type of alopecia the individual is suffering from as well as other hereditary or external factors.

Alopecia (hair loss) affects approximately 60% of men (and 30% of women) at some point during their lives, with around 25% of men beginning to lose their hair before they reach the age of 30. It is mostly characterised by a receding hairline, with the hair mainly thinning out around the crown and temple.[1] As proven prescription treatment is only available for male pattern baldness, we can only provide hair loss treatment for men at present.

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What is male pattern baldness?

Typically when men suffer from balding, they experience an M-shaped configuration of thinning hair, known as male-pattern baldness. Women on the other hand, typically feature thinning on the top of the head, and this most commonly occurs post-menopause. The method in which men lose their hair is commonly seen in the 'horseshoe' shape of the hairline, though, hair loss can also occur where it begins from the crown of the head, or all over simultaneously.

Thinning hair in men usually appears in successive different stages, and is scientifically known as androgenic alopecia (commonly referred to as male pattern baldness). Researched in 1951 by Dr James B. Hamilton, and later revisited by Dr O'Tar Norwood, these stages can be seen below:

Stage I: Normal state

Stage II: The slight receding hairline

Stage III: The stronger receding hairline

stage IV-VI: The increasing clearing at the top of the head

Stage VII: The maximum pronounced baldness

Where there is the odd hair remaining on the top of the head, it will be thin and won't grow back as quickly as it used to – this is sometimes known as "peach fuzz". Eventually, it will stop growing back altogether.

Types of hair loss

Alopecia can occur in different ways and can often be classified into different types, each with varying levels of occurrence. Some of these include:

  • The hereditary male pattern hair loss (androgenic alopecia) is often described as an inherited trait as it forms over 90% of male hair loss cases. Often the hair often begins to thin out already in the mid-twenties, which is often characterised by a receding hairline. This is also the most common case for female hair loss also.

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    This type of hair loss is also referred to as hormonal-hereditary hair loss as it is caused by genetic hypersensitivity of the hair root cells to androgens, in particular the male hormone testosterone. When the enzyme 5-alpha reductase converts testosterone to at a higher than normal level, the DHT then attacks the hair follicles at the root, preventing any further growth of strong hair.

  • The second most common form is spot or patch baldness (alopecia areata). This is often an autoimmune diseases caused by the body attacking certain areas of the body with hair (usually the scalp) believing there to be a threat. This resulting attack usually causes inflammation in the set area causing the hair to fall out.

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    The patches may be of different sizes or shapes but are often round or oval. Alopecia areata (AA) can occur over a small period of time or on a longer term basis with a certain side of the scalp being affected compared to the other. Approximately 1-2% of all men are affected by alopecia areata.[2]

  • Another form of hair loss closely linked with alopecia areata is total hair loss (alopecia totalis). It is often known as complete hair loss loss of hair on the scalp and is also caused by an autoimmune disease similarly to alopecia areata. It is often seen as being in-between alopecia areata and alopecia universalis (total loss of hair across the whole body).

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    It is often difficult to assess the main cause or trigger for this type of hair loss, but it is said to affect mainly young people, those under the age of 40 and those who have just completed chemotherapy. There is a small chance that hair regrowth can occur if the condition is treated, but this is not often.

  • Traction hair loss (traction alopecia) is mainly prevalent in women and occurs mainly due to hair styling procedures. Excessive pulling, heating, bleaching, dyeing braiding and binding can put too much strain on the scalp and hair follicles. These in effect can cause inflammation of the scalp and result in increased loss of hair in that area. Fortunately this can be remedied through the use of better hair products and adopting safer styling practices.

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  • When an individual goes through bouts of high stress or psychological issues, they might shed or lose more hair than normal for a short while, this is often known as temporary hair loss (alopecia effluvium). The loss of hair is usually more prominent at the top of the head and sometimes around the temple but there is rarely any chance of hair line recession. This condition is more evident in women who have just given birth or those with extremely poor diets. Alleviating such stressful situations can see the hair returning back to its previous level.

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What are the causes of hair loss in men?

Male pattern baldness is primarily genetic and/or hormonal. Usually hereditary, it used to be a commonly held belief that it was passed down the maternal line, though more recently this has been brought under question.

Associated with an overabundance of the testosterone-related male hormone DHT (dihydrotestosterone) that attacks hair follicles causing them to shrink, some of the best hair loss treatments operate by targeting this hormone's production – thus reducing its potency.

Hair loss and age

Often hair loss is just an inevitable part of the ageing process, so it's nothing to be concerned about. As you age, your hairline will almost always recede and 2 out of 3 men experience significant hair loss by the time they reach the age of 60. Whilst there are some contributing lifestyle factors, such as diet and stress, androgenic alopecia is largely genetic and an inevitable part of the male ageing process.

However, there are some men, approximately 1 in 5, who will experience very little hair loss even into their 80's.

Other factors effecting hair loss

Diet -

Poor diets can also contribute to hair loss, with the artificial sweetener 'aspartame' said to cause thinning hair as well as high alcohol consumption and foods with a high glycemic index such as fruit juices, white bread and white rice.[3] On the other hand there are certain foods that have been known to support healthy hair growth, and also to slow down or prevent thinning hair.

Walnuts – These contain essential oils, which encourage hair growth. You can substitute walnuts for flaxseeds, salmon, and rapeseed oil – as these all contain the important Omega-3 fatty acid nutrient.

Spinach – Spinach contains high levels of iron, deficiency of which can hasten hair loss. It also contains many important vitamins and minerals, which help to maintain healthy follicles. Other foods high in iron include broccoli and potatoes.

Chicken (or any protein) – Since your hair is almost entirely made up of proteins, it makes sense to keep your protein reserves stocked up, right? Exactly. Even if you're not a meat eater, there's plenty of ways to consume enough protein. These include kale, beans and nuts…which are also suitable for vegans.

Balanced diet

Stress

High levels of stress are positively correlated with greying and hair loss. However, it depends on the type of stress you're experiencing. Worrying about that important presentation isn't necessarily going to make your hair fall out, however stress that strongly affects your sleep and diet can sometimes lead to hair thinning due to by-products such as fast, excessive weight loss.

Chemotherapy

Cancer treatments such as chemotherapy can cause baldness. The way the drugs operate means that as well as targeting cancer cells, they also target all rapidly dividing cells – this includes hair follicles.

However, it's important to remember that hair loss caused by chemotherapy is only temporary. Your hair may begin to regrow during treatment, but in most cases it can take up to 12 months for your hair to return to it's previous thickness, texture etc.

Myths about male hair loss

Over the centuries, various myths surrounding the causes and effects of male pattern baldness have arisen. Below we take a look at some of them and dispel the falsehoods.

You inherit baldness from your maternal grandfather - Despite being a widespread notion, it doesn't stand up to scrutiny. Men with a father who has experienced male pattern balding have a two and a half times higher chance of experiencing it also, regardless of the cases on the mother's side of the family.
Weight training causes baldness - If you spend any time on online male-orientated forums organised around themes such as boxing or weight lifting, you've probably read that working out can sometimes lead to thinning hair. This is due to the overly simplified notion that testosterone on it's own contributes directly to hair loss.

There are no clinical findings that correlate balding with too much exercise. In fact, studies have shown moderate exercise to be beneficial in preventing balding, in contrast to none at all.
High intelligence causes baldness - In ancient times, it was a fairly commonly held belief that intellectual pursuits led to baldness. Social theorists have postulated that baldness would have occurred more often in people with higher amounts of fat in their diet, which was an indicator of wealth in ancient times – and thus, meant a higher level of education.
Bald men are more sexually virile - Despite bald men the world over using this myth to boast about their apparent abundant masculinity, it simply doesn't stand up to science. Whilst a high 'free' testosterone level does indeed strongly point to increased libido, unless a man has close to zero free testosterone, it has not been proven to lead to a greater sex drive.

What are the effects of alopecia?

Whether you're in your late teens, early twenties, or even in middle age - losing your hair can have negative effects on your self-esteem and self-confidence. Negative moods, feelings of inadequacy, along with feeling unattractive to the opposite sex aren't uncommon.

Recovering from hair loss

If you're under 25 years old, it might feel as though your world is going to end, or that a potential partner will not find you attractive. Rest assured, it's never anywhere near as bad as you think it is. Often, due to the effects premature receding may have on your confidence, it could help to develop certain esteem-building behaviours. These may include taking up a hobby, improving your body via exercise, or making some positive lifestyle changes. It could be the perfect time to pursue a new career goal or even change career paths to do something more congruent with who you are.

The benefits of treating hair loss

Due to the psychological effects of losing your hair, the benefits of treating alopecia are far reaching. Once you've succeeded in slowing down the balding process, hair regrowth is possible. Not only will your hairline begin to restore to how it was before the thinning process began, your confidence and self-esteem may also see an increase also.

Since your hair is such an important part of your identity, finding a convenient and safe-to-use remedy can be extremely valuable. Whilst there isn't a proven cure for male pattern baldness, there are certain treatments that can positively improve the health of your hair and can aid in the prevention of further thinning.

Treating hair loss in men

As of now, there is no permanent cure for baldness, but there are ways to slow and even reverse the process in some cases.

Herbal hair loss products

Out of all the available herbal hair loss treatments available online, the most popular is Saw Palmetto. Made famous by Native Americans, Serenoa palm is also used as an alternative medicine to treat prostate cancer.

Despite its popularity, clinical studies have shown it to be no more effective than a placebo for treating baldness or progressive hair loss.

Over the counter treatments

There are many natural remedies and creams available to buy over-the-counter that claim to help restore your hair. These range from creams to hair loss shampoos. However, of all these apparent hair loss cures, many of them have little clinical data to back up their claims.

Minoxidil lotion (sold as Regaine) is one exception. This is a topical lotion, which, if applied directly to the scalp twice daily, helps you to combat male pattern balding. Some men find that Regaine can be useful for both slowing hair loss and regrowing hair, but needs to be applied straight to the scalp, which can often be inconvenient.

Regrowth will normally take a few months and the results are usually noticed around the crown of the scalp. Regaine is for genetic hair loss only; it is not effective for hair loss due to other causes.

Hair transplant surgery

There are three main surgical treatments, which can be used to treat hair loss. A transplant involves taking hair from the back of your head, and moving it to the front of the scalp. Another treatment is scalp reduction, which can reduce a mild bald patch by removing a piece of your scalp and stretching the area where hair is thicker over it. Flap surgery involves stretching healthy scalp over a small area of hair loss.

Besides being expensive and invasive, each of these treatments may need to be repeated at a later date. If you're unsure about whether this kind of treatment is suitable for you, it's always recommended to speak to a medical professional or to call a reputable hair loss clinic.

Wigs

If you're suffering from hair loss as a result from cancer and chemotherapy, wigs are an excellent choice, and are available on the National Health Service if you meet certain criteria. Even if you don't, there are various support options available to help with the cost of your wig.

If you're in this situation, the NHS has some important information that can offer advice about wigs and hairpieces.

Prescription hair loss medicines

Whilst there are many over-the-counter remedies for assistance in preventing male pattern baldness, the only one to be clinically proven to be effective is Propecia.

Propecia is the first and only proven medication to treat male pattern hair loss on the vertex (top of head) and anterior mid-scalp area (middle front of the head). Propecia uses the active ingredient finasteride to inhibit the activity of DHT, the primary cause of male pattern hair loss. In tests, 99% of men who took Propecia experienced no further hair loss, and over two-thirds of them experienced significant hair regrowth.

Propecia is an easy once a day medication, which causes very few side effects.

Preventing further hair loss through lifestyle changes

Preventing hair loss can be difficult, and will largely depend on your type of hair loss. Male pattern baldness (androgenic alopecia) is usually caused by hereditary factors, and therefore it's difficult to physically prevent, at least without prescription treatment.

The following lifestyle tips may not be guaranteed to prevent hair loss, but can improve the quality of your hair follicles and hair itself:

Follow a balanced diet - Hair follicles are made up of proteins and because of this, specialists recommend that you fit plenty of protein in to your diet. Beans are also a major source of protein, as are fish, soya, dairy, cheese and nuts.

Avoid certain shampoos - Some hair care products contain chemicals that can be harmful to your hair. For this reason, it's often best to choose organic shampoos that don't contain any chemicals.

Increase the calcium in your diet - Calcium has also been hailed as a valuable vitamin for hair loss, and has also been shown to be beneficial for hair strength, thickness, and overall health.

What options we have to offer for baldness

HealthExpress are among the leading online healthcare providers in the UK, offering branded prescription medicine to help you treat your hair loss. We understand the importance of starting treatment against hair loss as soon as possible and offer a cost effective (compared to hair transplant surgery) and medically proven method to stop hair loss and promote regrowth of healthy hair. The only availble prescription treatment approved by the MHRA is Propecia, which is suitable for use for men over the age of 18. Th earlier the treatment is used, the higher the chance of hair regrowth.

It is easy and simple to order this treatment online today, simply take our free online consultation and our registered doctor will assess your details to ensure you are safe to use this male hair loss treatment.

Sources

Dr Hilary Jones, HealthExpress Medical Advisor

How can prescription hair loss treatment help me?

If going bald has affected your confidence, then you may wish to consider getting treatment.

Studies have suggested that prescription medication can increase hair count and, therefore, improve the way you feel about your hair. If you're suffering from male pattern baldness, the first step will be to find a treatment that suits you.

Often, many men are either to busy or embarrassed to see their GP in regards to hair loss, here you can complete our free confidential online consultation which will be reviewed by one of our registered doctors who will then recommend whether you are suitable for the use of Propecia.

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