Hair loss is an extremely common condition in men, but this doesn’t mean it is any less stressful when it happens to you. It may be worth mentioning that baldness and higher levels of testosterone are also linked to higher fertility and virility in men, so there are plus sides! You need to decide how you feel about your hair loss. It is important to try to accept it for what it is – something natural. Attitudes to baldness have changed drastically over the past few decades, and now many men treat their baldness with pride. It’s self-confidence that matters, not how many hair follicles you have.

What is male hair loss

Male pattern baldness, or Alopecia, affects 6.5 million men in the UK – up to 30 per cent of 30-year-old men and 50 per cent of 50-year-old men. However hair may start to disappear from the temples and the crown of the head at any time. For a few men this process starts as early as the later teenage years, but for most it happens in their late 20s and early 30s. A little thinning of the hair may be noticeable first, followed by wider hair loss allowing more of the scalp to become visible.

Some men aren’t troubled by this process at all. Others, however, suffer great emotional distress associated with a lack of self-confidence and sometimes depression and high levels of anxiety can occur. If you feel this way about your own hair loss, you are not alone!

Causes and risk factors

Male baldness is generally believed to be genetic, and so is inherited and therefore often unavoidable in those with the ‘baldness’ gene. Hair loss, particularly sudden baldness, can also occur due to anxiety, trauma and extreme stress. Loss of hair at the temples and crown happens because of an oversensitivity of hair follicles to a hormone called dihydrotestosterone (DHT), which the body makes from testosterone (present in normal levels in the blood). This causes the hair follicles to make thinner and thinner hair until they eventually pack up completely. The receding hairline will gradually meet the bald patch to leave a ring of thinning hair, which for some men eventually is lost, leaving a completely bald scalp.

Other causes of hair loss, which may not follow this pattern, include:

• Iron-deficiency (anaemia)
• Under active thyroid
• Fungal scalp infection.
• Some prescribed medicines.
• Stress and trichotillomania where the anxious person pulls so much on their hair that it breaks or comes out.

Can I stop it?

If there’s a reversible cause, it’s normally possible to stop hair loss. For instance, if it’s caused by iron deficiency you can stop hair loss by replenishing the body’s iron stores.

If it is genetic baldness, then prevention is less likely. A huge number of treatments have been tried to slow down and even reverse the process of male pattern hair loss – some are successful, others aren’t. But many men find their hair loss slows down or stops for no apparent reason at a certain age anyway.

Should I see a doctor?

Male-pattern baldness is not a disease, so it won’t affect your health. However, if it’s causing you distress, consult your GP to get a diagnosis. Your GP can refer you to a dermatologist for further analysis and, if necessary, to a psychologist to help with the trauma of hair loss.

It’s a good idea to ensure an illness isn’t responsible, particularly if the hair loss is patchy rather than being in the typical male pattern distribution, or happens suddenly or over a short period of time. Moreover, if the hair loss is accompanied by other symptoms (such as tiredness) then blood tests may be necessary.

Your doctor will examine you to look for any evidence of skin disease affecting the scalp or fungal infection. He may request a blood count and ferritin level to look for low iron and anaemia, and thyroid function tests. Skin scrapings may be done if there is skin disease, in order to look for fungal infection.

Treatments

• Wigs, weaves and hair transplants are, obviously, the most direct form of treatment, while some advocate shaving or close cutting which simply makes the hair loss less obvious. Different hairstyles can create the appearance of a fuller head of hair, or a close shave cut can make baldness less apparent.
• Minoxidil is a lotion available from the pharmacist that you rub on to the scalp. It comes in two strengths – 2% and 5%. The latter is more effective, although it does not seem to be effective for everyone. It is not clear exactly how it works but it may slow down the process of hair loss and can cause new hair growth but it usually takes at least four months to start to show an effect you have to keep on using it or it will stop being effective.
• Surgical techniques. Scalp surgery was originally used, moving flaps of skin with hair to areas without, but is less used now because hair transplant techniques have become refined, transplanting hair follicles from areas such as the back of the head by the removal of a thin strip of scalp and then the follicular units in it are replanted into the bald area.

Whatever your attitude and approach to your own hair loss, it is important to remember that it is entirely normal and understandable to feel distressed, upset or concerned about it. The majority of men feel the same way. How you deal with losing your hair is also entirely up to you, but you should feel comfort in the knowledge that you are not alone!