By far, one of the most distressing things my male patients are concerned with is hair loss and the fear of going bald. From young men to older men, seeing thinning/bald spots, or an increasingly receding hairline, is very upsetting to them. They frequently ask me why they are losing their hair and what can they do about it?
The reason why men experience hair loss and baldness can be different for everyone. For the majority of men, however, most hair loss/balding is caused by male pattern baldness and that is genetic in origin. In fact, if a man's maternal grandfather was bald, there's a high chance they will experience the same type of baldness. If he wasn't bald, and his paternal grandfather didn't have male pattern baldness, then it could be that his specific hair loss might be nutritional, environmental, or even illness induced and may be reversible.
Most hair loss in men shifts into motion when a male hormone, dihydrotestosterone, or DHT for short, reacts with genetically predisposed hair follicles. This hormone works to progressively weaken these particular hair follicles so they become "miniaturized" versus lost altogether. In their miniature version, the hair follicle becomes very small, thin and fullness is lost. These hairs occur usually at the top, front and crown of the head in what is known as "male pattern" baldness.
There are 3 main factors that affect male pattern baldness:
1. Genes - as mentioned above, a dominant, male pattern baldness gene can be passed down from either parent with the mother's side predominating.
2. Hormones - The male hormone testosterone is responsible for hair growth on body and hair loss. A variant of testosterone, DHT, causes the hair follicles to weaken and become smaller and smaller with age. The more of this hormone a man has, the more likely he will go bald.
3. Age - Hair volume decreases with age naturally, even in men without male pattern baldness.
Treatments For Male Pattern Baldness
Treating male pattern baldness is most successful if you begin treatment in its early stages, when hair may be only in the "miniaturized" stage and progression can be slowed down or stopped. Here are some of your options:
Medications: Medications like Propecia (finasteride) and Rogaine (minoxidil) work best when used together for their combined effect. Finasteride acts to inhibit DHT and helps to reverse genetic baldness. Minoxidil helps to stimulate hair growth. Avodart (dutasteride) a drug typically used to treat prostate enlargement, has an "off label" use of stopping hair loss, but the FDA has not yet approved it for this use.
Low Level Laser Therapy (LLLT): Based on biophototherapy technology, laser therapy helps to stimulate the hair follicles to promote thicker hair shafts and fuller looking hair.
Hair Transplant/Hair Restoration Surgery: The only treatment that can actually replace hair once baldness has occurred. Hair transplant grafts from the past left a lot to be desired, leaving highly visible donor sites of hair and graft plug areas. New, advanced techniques can correct these hair restoration attempts for a better cosmetic result. One of these is FUE (follicular unit extraction), which is now used to camouflage wide donor scar. Hair from around the donor site is removed and actually placed back into the donor site, allowing for much shorter hairstyles.
When Hair Loss Is Not Genetic
As I mentioned earlier, sometimes a man's hair loss is caused by nutritional, environmental or illness factors. A man's diet can be deficient in crucial vitamins and minerals like zinc and anemia, which can cause hair loss. Sometimes the use of certain styling products and too-hot blow dryers or straightening combs can be drying, causing the hair to burn and break off close to the scalp, making it look very thin. Underlying illnesses like anemia, immune deficiency disorders, folliculitis, psoriasis/dandruff can also result in hair loss. The good news is, if you can get these causative factors under control, you should be able to reverse your hair loss and/or breakage.
Nutrition For Healthy Hair
To support hair health, optimal nutrition is crucial. The following are nutritional must-have's for healthy hair:
•Protein - Minimum of 50 grams a day, preferably 75, of high quality sources from chicken, fish, beef, legumes
•Vitamins - Hair health is greatly enhanced by the B vitamins, particularly folic acid, B5, B6 and B12. Supporting vitamins include C to help build collagen and hair follicle structure. Vitamin E helps stimulate hair growth by optimizing oxygen and the immune system. Be careful with Vitamin A! Too much can cause hair loss. Use only beta-carotene forms.
•Minerals - Zinc, sulfur, magnesium and iron all contribute to strengthen hair follicles and shafts. Get your iron levels tested to see if anemia might contribute to your hair loss.
•Other - CoQ10, fish oil and super primrose oil help nourish the scalp and follicle. Antioxidants neutralize free radicals, which can diminish general health.
As I tell my male patients who experience male pattern baldness and other forms of hair loss, I truly sympathize with them. The best way to treat their hair loss is to first talk to your doctor about blood work to rule out anemia and/or nutritional deficiencies as the cause. Next, visit a reputable hair restoration specialist and ask them what your options are. Remember, though, there are some pretty sexy men out there who don't have much hair up top like Bruce Willis, Stanley Tucci, Sean Connery and Vin Diesel, just to name a few. You may not want to mess with the baldness Nature has chosen for you and come to love it!
Jay Brachfeld, M.D.
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