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Hair loss in men: causes and treatments
Hair loss in men is a common ailment that can have a significant impact. Both on quality of life and psychological well-being. There are many different types of hair loss that can affect men at different stages of their lives. Each with their unique causes and characteristics.
Research suggests that up to 70% of men experience some form of hair loss in their lifetime. They vary in severity and rate of progression. To develop effective prevention and treatment strategies, it's necessary to understand the underlying factors and mechanisms.
Statistics and prevalence
A large number of men around the world are affected by hair loss. According to research, nearly half of all men suffer from significant hair loss by the age of 50. The frequency of this condition increases with age, reaching about 80% in men aged 70 and older.
Androgenetic alopecia, better known as male pattern baldness, is the most common form of hair loss in men, occurring in about 95% of cases. Other forms, such as alopecia areata and telogeneeffluvium are also common, but less than the androgenetic form.
Types of hair loss in men
Androgenetic alopecia
Androgenetic alopecia, also known as male pattern baldness, as mentioned above, is the most common form of hair loss in men. This condition manifests as a gradual decrease in hair follicles due to the action of androgens on the epithelial cells of genetically predisposed hair follicles in areas sensitive to androgens.
Despite uncertainty about the exact origin of androgenetic alopecia, numerous studies have shown that it's a so-called polygenic condition. That is, multiple genes are affected simultaneously.
Alopecia areata
Alopecia areata is a common autoimmune disease that causes localized hair loss in specific areas of the scalp, but in some cases can also lead to generalized baldness. The skin areas affected by hair loss look normal, and although all body hair can be affected, it's most common on the scalp and beard.
About 0.2% of the world's population suffers from alopecia areata. The overall risk is estimated at 1.7%. It's a common cause of sudden hair loss, but is less common than androgenetic alopecia or telogen effluvium.
Alopecia areata is seen in both men and women. According to scientists, there is thought to be a genetic cause, as this type of hair loss often occurs in several members of the same family. Although the severity of the condition may vary between family members.
Telogen effluvium
Telogen effluvium is a disruption of the hair growth cycle that manifests as severe hair loss. This condition is often seen as a result of stressful events, surgery, serious infections, hormonal disorders or medication. It can also be associated with circulatory problems, thyroid disorders or vitamin deficiencies.
The phenomenon comes in two forms. Acute telogen effluvium usually disappears spontaneously within a few months of the event that caused it. Chronic telogen effluvium, on the other hand, persists for at least 6 months and may even persist for several years without specific treatment. Treatment consists of identifying and treating the underlying factors.
Traction alopecia
This form of alopecia occurs when the hair is subjected to being pulled out repeatedly. It's especially commonly seen in people who have hairstyles that are particularly under traction. Think of a tightly pulled ponytail, braid, hair extensions or wigs.
In rare cases, people are also seen doing this themselves. If the hairstyle is not changed or one does not stop doing this, the constant pulling on the hair can lead to inflammation of the hair follicles. This in turn can result in permanent damage to the follicles resulting in hair loss.
The goal of treatment is to stop the traction by adjusting the capsule and using milder hair products. In advanced cases, intralesional corticosteroid injections may be necessary to reduce inflammation and promote hair growth. When the person is self-responsible, psychological counseling is instituted.
Causes of hair loss in men
Genetic factors
Hair loss in men is often caused by genetic factors. This form of hair loss usually begins with a receding hairline at the level of the face and a reduction in hair density at the crown of the head.
A man's susceptibility to hair loss is mainly determined by his genes. Male pattern baldness can be inherited from both parents. Traditionally, it was thought that the gene responsible for baldness came mainly from the mother, since the AR gene was located on the X chromosome and inherited from the mother.
However, recent studies show that paternal elements also have an important influence. Androgenetic alopecia has been linked to genetic variations in several regions of the genome, including autosomal chromosomes, as shown in a study published in PubMed (PMID: 36479473).
Single nucleotide differences (SNPs) in different parts of the genome have been associated with a higher risk of developing baldness. For example, a particular change in the region 20p11 has been associated with androgenetic alopecia, suggesting that this region contains important genes for the growth and health of hair follicles. In addition, research conducted by Harvard Health highlights that these genetic differences may affect the sensitivity of hair follicles to androgenic hormones, leading to miniaturization of follicles and progressive hair loss.
Hormonal changes
Hormonal changes, on the other hand, are also often responsible for hair loss in men. In particular, changes related to androgens, a group of male sex hormones. Baldness according to the male pattern is affected by androgens such as testosterone and its more potent derivative, dihydrotestosterone (DHT).
A hormonal imbalance such as hypothyroidism or hyperthyroidism affect hair loss. Disorders of the adrenal gland, e.g., Cushing's syndrome, can also be affected by high cortisol levels. Some men lose their hair earlier or more than others. This is because the level of DHT and the sensitivity of the hair follicles to this hormone varies from person to person.
Medical conditions and treatments
Apart from hormonal changes and genetic factors, other medical conditions can also cause hair loss. Although the most common cause is male pattern baldness (androgenetic alopecia), the others are briefly explained here:
Diseases of the scalp
An example is “ringworm.” Ringworm can infect the scalp and lead to localized hair loss. Medical treatment is necessary to eliminate these infections and allow the hair to grow back.
Autoimmune diseases
Alopecia areata is an autoimmune disease that can cause hair loss. By mistake, the immune system attacks the hair follicles, leading to the formation of bald patches. Other autoimmune diseases, such as lupus, can also lead to baldness.
Lack of nutrients
An intake of important nutrients such as protein, iron, zinc and vitamins that is too low, can cause hair loss. Insufficient intake of nutrients weakens the hair follicles and hinders hair growth.
Medication and medical care
Hair loss can be caused by certain medications, such as drugs for arthritis, depression, heart disease and high blood pressure. Radiotherapy, for example, can also damage hair follicles and cause hair loss.
Physical or psychological stress
Intense stress, either physical (e.g., serious illness, surgery) or emotional (e.g., grieving, divorce), can cause temporary hair loss known as telogen effluvium, which we discussed above.
Lifestyle factors
Lifestyle can have a significant impact on hair loss in men. Excessive stress, as mentioned above, can lead to telogen effluvium. In addition, an unbalanced diet plan, lacking key nutrients, can weaken the hair follicles and also lead to hair loss.
Issues such as smoking and excessive alcohol consumption are still under further investigation for their impact on hair condition and possible hair loss. It's therefore crucial to follow a healthy lifestyle to minimize the risk of hair loss.
The role of dihydrotestosterone (DHT)
DHT plays an essential role in hair loss, especially in the context of androgenetic alopecia. 5-alpha reductase is responsible for the conversion of testosterone into DHT. DHT attaches to the receptors on the hair follicles, leading to the progressive narrowing of the hair follicles. This miniaturization process leads to a reduction in hair size, until eventually the follicles no longer produce visible hair.
The interaction with receptors on hair follicles, especially those in sensitive areas such as the scalp, leads to a progressive decrease in these hair follicles. This shortens the hair's growth period (anagen), causing the hair to become thinner and shorter until it stops growing. This process is more pronounced in parts of the scalp that are sensitive to DHT, such as the crown of the head and temples. Genetic factors greatly influence the sensitivity of hair follicles to DHT. Studies have identified several so-called “genetic loci” that explain increased sensitivity to DHT. Certain variants of this gene are more likely to cause androgenetic alopecia, due to an increased response of the hair follicles to DHT. In addition, other genetic research has shown that variations in one nucleotide in other parts of the genome can also affect sensitivity to DHT, leading to hair loss. Thus, DHT plays a major role in hair loss through its direct influence on hair follicles and genetic predisposition that increases the sensitivity of follicles to this hormone.
Psychological consequences of hair loss
Hair loss can have profound and very different psychological consequences. Hair is often seen as a symbol of youth and vitality. A lack of it can lead to low self-esteem and a negative body image. Many men report feeling embarrassed. Some even feel depressed about their baldness. These emotions can affect not only social life and personal relationships, but also professional performance, as some feel increased pressure to meet aesthetic standards.
Research has shown that alopecia can cause significant psychological stress, affecting quality of life. Therefore, it's important to be aware of these psychological consequences and deal with them by providing appropriate support. This can be psychological counseling or social contacts that help deal with the emotional consequences of hair loss.
Preventive measures and hair care tips
A good hair care routine is obviously very important. That way, a man can keep his hair healthier and already avoid a lot of its impact on hair loss. But what exactly does a healthy hair care routine entail? First of all, it's essential to eat a balanced diet with plenty of vitamins and minerals. These include vitamins A, C, D and E, iron, zinc and omega-3 fatty acids.
Proteins, especially keratin, play an essential role in the formation of hair. It's also advisable to limit the use of heated styling devices such as hair dryers, straighteners and curling irons, as excessive heat can damage hair follicles. To maintain moisture and reduce the risk of hair breakage and hair loss, gentle shampoos and conditioners that are suitable for the specific hair type are recommended.
Tight hairstyles, as mentioned earlier, are best avoided. They stress the hair follicles too much which can lead to traction alopecia. Chronic stress is also often associated with hair loss. Therefore, it's important to build sufficient relaxation into the daily routine. This is not only good for possible hair loss, but benefits overall health.
Preventive approach with Insentials Hair Support
To prevent hair loss and promote healthy hair, Insentials Hair Support offers innovative 360° support. This supplement is specially designed to meet the specific needs for healthy hair in men.
Insentials Hair Support contains pure Serenoa Repens or saw palmetto, biotin, quercetin, copper and zinc. This makes it a complete 360° formula for reducing hair loss and slowing down the process of baldness.
For example, research on the action of saw palmetto has shown that when taken long-term, it provides strong support for reducing hair loss.
The additional addition of quercetin, a bioflavonoid, ensures effective preservation of existing hair.