Hair Loss 101: A Primer for Battling Baldness
Hair loss is an issue that we live and breathe at Hims. We’ve immersed ourselves in the science behind it, and we exist to help guys overcome it.
That’s why we’ve put together the ultimate guide to hair loss: the symptoms, causes, and what you can do about it.
What is Hair Loss?
‘Hair loss’ is a term which you are likely to have heard said by many people in many different forms. Generally speaking, it means a loss of hair from your head, or anywhere on your body.
It can affect men of any age and has many causes, some more common than others.
The most common cause of receding hairlines and bald spots in men is known as Male Pattern Baldness.
What is Male Pattern Baldness?
Male pattern baldness (MPB), also known as Androgenetic Alopecia, is the most common form of hair loss that men experience.
MPB is extremely common. It affects about Two-thirds of men by the age of 35, but can begin much earlier than that in some guys.
Typically, when we talk about alopecia, we are describing the loss of hair from the head. However, while it is less common, hair loss can actually occur anywhere on your body.
What causes male pattern baldness?
The term Male Pattern Baldness describes a complex set of processes involving hormones and genetics and which result in receding hairline and growing bald spots for a large number of guys. We’ll try to break it down in the next few paragraphs.
Hormones and Hair Loss
Hormones, the same ones that regulate most aspects of our physiology and behaviour, are also one of the primary causes of balding amongst men. One hormone, in particular, is responsible for most cases of male pattern baldness, and this is known as DHT.
What is DHT?
Dihydrotestosterone (DHT) is a byproduct of testosterone. It is important for men’s development during puberty, playing a vital role in areas such as sexual development and skeletal development.
While it is extremely useful, exposure to DHT molecules also causes hair follicles to become weaker, thinner, and eventually leads to receding hairlines and bald spots in men.
Several studies have analyzed the effects of reduced DHT levels in men, by introducing inhibitors (which stop the production of the DHT molecule). The studies show that lower levels of DHT frequently prevent further progression of baldness, and can even result in hair regrowth.
As a result of pioneering studies like these, reducing the levels of DHT is now widely accepted as one of the most effective treatments for both preventing hair loss, and hair regrowth.
This is most commonly achieved through the use of a product called Finasteride, which we’ll cover in a later section.
Genetics and Hair Loss
Genetics are another common culprit when it comes to balding in men. Looking more closely at your genetics can often predict whether or not you will experience hair loss later in life.
While genetics play a large role in male pattern baldness, its influence is often misrepresented and misunderstood.
It’s not as simple as looking at the men on your mother’s side of the family when judging whether or not you will experience hair loss.
Various studies have shown that genetics play a large role in whether or not men will experience Male Pattern Baldness.
However, while many believe that only the maternal side of the family has an influence, these studies have also shown that MPB is a polygenic condition, meaning different genes come into play, and there is not one single ‘baldness gene’.
One of the key genes involved does originate from the maternal side of the family, and is called the AR gene.
This gene determines how sensitive your hair follicles are to the presence of androgens such as DHT, and studies have shown that increased expression of this gene is often found in men who are experiencing MPB.
Lifestyle and Hair Loss
While genetics and hormones are the primary causes of Male Pattern Baldness, they’re not the only factors.
Your day-to-day lifestyle can often have a greater impact than you might realise, and could provide insight into preventing future hair loss.
Ever heard the expression ‘pulling your hair out’? Well, anxiety does often lead people to pull out their hair.
Trichotillomania, or hair-pulling disorder, is characterised by excessive hair pulling and is often linked to an increase in stress or anxiety, and is treated as a mental health disorder by the NHS.
When we pull our hair out, we cause other strands of our hair to break, or fall out. Over time, continuous hair pulling can permanently damage your hair follicles. All this increases the chances of developing permanent hair loss.
Nutrition and Hair Loss
What you put into your body has an impact on your hair, too. A deficiency in some vitamins and minerals can affect the condition of your hair, causing it to be thinner, or more brittle.
On the other hand, an increase in some foods can actually help prevent hair loss, at least to some degree.
Many studies have shown that Iron deficiency can often lead to hair loss, and this can be found in many green vegetables.
Antioxidants, which are found naturally occurring in many fruits and vegetables, have been shown to help prevent male pattern baldness in some people.
In general, it is best to speak to a nutritionist or some other form of expert before changing your diet significantly, as nutrition may not necessarily be the most significant factor at play if you are experiencing hair loss.
It’s not just male pattern baldness
While male pattern baldness is the most common form of hair loss, it’s not the only form of hair loss that men experience.
Hair loss can be defined in several different ways depending on the root causes, and while men will typically experience hair loss as a result of MPB, there are other ways the issue can present itself.
There are medical conditions such as telogen effluvium which can cause this thinning effect – this is typically caused by medical conditions during childbirth (which we appreciate guys will not experience),or mineral deficiency.
Your own behaviour can also have an impact on hair growth. As mentioned earlier, trichotillomania, a recognised mental health issue characterised by people pulling out their own hair, can lead to weaker hair follicles, in turn leading to permanent baldness.
Early Signs of Male Pattern Baldness
Before you start to think about undergoing treatment for hair loss in any form, it’s always best to check whether you are actually experiencing more than the normal amount of hair loss.
Male Pattern Baldness tends to begin with some common telltale signs which can be easily identified early on to ensure you’re ahead of the game when it comes to your hair.
This check for early hair loss is as easy as looking in the mirror. Take a look and see if you notice your hairline forming a rounded M shape pattern at the front, after which the hair loss tends to move towards your temples.
There, you are likely to see this change into a U shape as your hairline recedes further. This is what we typically call a ‘receding hairline’, (sometimes also called ‘widow’s peak’) and is one of the most common early signs of hair loss.
Hair on your pillow
This is another telltale sign of hair loss beginning. If you’re waking up with several hairs on your pillow – or on your shoulders and clothes – take note.
There’s a normal amount of hair shedding that everybody experiences, however above a certain amount could be an early sign of male pattern baldness.
Thinning hair on your crown
Your crown – the top-back of your head – is another area to keep an eye on. This is where you may start to form what most people call a ‘bald spot’, where the hair around your crown starts to thin over time.
If you notice this happening year after year you may want to take action. The sooner you seek treatment, the more hair you’re likely to keep.
How common is hair loss?
Male pattern baldness is the most common form of hair loss seen in men. It affects around 66% of men over the age of 35.
Hair loss, in general, is extremely common amongst older men. By age 60, most men will have experienced some form of hair loss, including thinning of hair, receding hairline and more widespread hair loss and baldness
Ethnicity also plays a role when it comes to whether or not you’re likely to experience hair loss. Studies have shown that Caucasian men are much more likely to experience baldness than men of Asian, American Indian, and African descent.
In addition, caucasian males are also likely to experience a greater degree of hair loss when they do start balding.
What Age Do People Start Experiencing Hair Loss?
In addition to there being common causes, there are also certain age groups which are affected by hair loss more than others.
Typically, it will take 15-25 years for someone to go completely bald, but this process can begin at any age. Some studies have shown a recent rise in the number of those experiencing hair loss between the ages of 21 and 30.
Typically, hair loss begins with hair thinning on the crown, or a receding hairline – both of which can be spotted and treated early on.
If hair loss is experienced at an earlier age, it’s important to treat it quickly, as an earlier age of onset may actually lead to quicker progression of hair loss.
Just because you have identified some hair loss doesn’t mean you are experiencing male pattern baldness, however.
By seeking clinical advice, you may discover this is happening for another reason, such as Alopecia areata, which causes patchy hair loss in children and young adults. ( It can lead to baldness, but in most cases does not.)
Hair Loss Treatments
There is a range of ways to deal with hair loss, once you have identified the root cause (no pun intended).
Some of these treatments are more invasive than others, and it’s important that you know which treatment is right for you before you begin.
How Well Can Hair Loss be Treated?
Unfortunately, there is no ‘cure’ for baldness. Please don’t believe any company that tells you otherwise!
However, modern scientific developments mean that there are very effective ways that hair loss can be prevented, and in many cases hair regrowth can be promoted, too.
These are some of the most popular medical procedures men use to tackle hair loss. Note that all these procedures may not work well for everyone.
Hair grafting, or a hair transplant, involves a surgical procedure where areas of your scalp which grow hair well – usually from the back of the head – are removed in small segments, and transplanted to the balding area of your head, giving a ‘natural’ look of regular hair growth.
Several sessions are usually needed to make sure that the hair transplant procedure works well, followed by a few months of healing once the process is complete.
Wayne Rooney made headlines when he revealed that he had undergone a hair transplant procedure. Indeed, some footballers and celebrities are reportedly paying as much as £30,000 for hair transplants.
Because of the high price of getting the procedure done in the UK, many men are choosing to travel to Turkey to get their transplants. There is a thriving hair transplant industry in Turkey, with over 350 clinics in Istanbul, the capital of Turkey.
It’s important to do your research before you travel and choose a reputable clinic with a long track record. One such clinic is GetHair, who have thousands of case studies of successful treatments and predominantly cater to UK clients.
Another surgical method for dealing with hair loss is known as scalp reduction. This process involves a dermatological surgeon taking skin from a bald part of the scalp, and stretching the hair-bearing skin to cover the bald areas of the scalp.
Like with hair transplants, several sessions may be required to get the desired results.
Platelet-rich plasma (PRP) has been popularised over the last decade, and was first used to help those recovering from joint surgery. This process involves injecting plasma – taken from the blood – into areas of the scalp which have been affected by hair loss, which promotes cell growth.
These sessions last for around two years, and can be very expensive.
Low-Level Laser Therapy (LLLT)
Low-Level Laser Therapy (LLLT) is a non-invasive treatment, which uses lasers to boost blood flow to your hair follicles, in turn making them more likely to grow stronger, and thicker.
The lasers have been shown to be safe, and may be effective in stimulating hair growth in some cases.
Hair Loss Products
For those who prefer a non-invasive form of treatment, there are medicines which have been scientifically proven to be highly effective in preventing hair loss, and promoting hair growth.
Minoxidil, which is sold under many different trade names around the world including Regaine ®, is a solution that is applied directly to the scalp in order to combat hair loss.
The solution works by dilating blood vessels around hair follicles, which in turn increases the nutrient supply to them.
Over time, this makes the hair follicles stronger, allowing the hairs to grow thicker and longer. This increases the overall volume of hair and helps prevent further hair loss.
Finasteride, which is sold under different trade names around the world including Propecia ®, is a tablet which is taken once a day to help reduce hair loss.
The tablet works by reducing the levels of DHT, the hormone most commonly responsible for male pattern baldness.
It can be used in combination with Minoxidil or by itself. Because it works to directly block the mechanism causing male pattern baldness, it is most effective for balding around the hairline.
Other products that may help with hair loss
while scientifically-backed medicines such as those mentioned above are generally the most effective for treating hair loss, there are other everyday products which may help with overall scalp health.
Several shampoo brands have recently ‘infused’ their shampoos with substances that are claimed to promote hair growth, such as caffeine.
However, there is little clinical evidence that topical application of caffeine does anything to stop hair loss or promote hair growth. Look out for shampoos containing Stemoxydine, for example, a substance which has been shown to increase hair density.
Ketoconazole (sometimes called Nizoral) shampoos have also been shown to be effective in treating hair loss, if the hair loss is caused by poor scalp health and dandruff.
For a less scientific, more quick-fix approach, these products involve literally spraying ‘fibers’ over your scalp which provide the appearance of real hair by filling the gaps left on balding scalp areas.
While it may not be the most satisfying solution for some, and doesn’t last long, it’s certainly a quick and easy option.
How Nutrition Comes into Play
What you eat and drink can have an effect on your hair, too. While the effects are not as significant as those seen with medical treatments, nutrition still plays its part.
Vitamins, in addition to being essential for proper metabolism function, are also influential when it comes to hair growth.
Look out for your vitamin Bs: B1, B2, B5, B6, and B12 all help keep your hair follicle cells well-nourished, and a deficiency can lead to weaker hair.
The same goes for vitamin C, which helps strengthen connective tissue in hair, and vitamin E, which acts as an antioxidant.
Minerals are also essential when it comes to your body’s ability to grow healthy hair. Zinc and Iron are two of the best examples of this.
Polyunsaturated fatty acids (PUFAs)
A deficiency of fatty acids can cause a drying-up of the scalp, which can lead to hair thinning. PUFAs are found in products including walnuts, fish oil, and flaxseed oil.
Hair Loss Myths
There are many popular (and less well-known) myths around hair loss, some of them going back centuries.
The most common myths about hair loss tend to circulate around the causes. As we established earlier, there’s not one single ‘baldness gene’, as many genes come into play.
In addition, contrary to popular belief, hair loss is not only experienced by men; the NHS estimates that 70% of women over the age of 70 experience female-pattern baldness.
What (probably) won’t Prevent Hair Loss
In addition to the myths around genetics, over the years people have also presented several weird and wonderful ‘cures’ for hair loss. Some of these include:
At a cow shelter in Agra, Northern India, worshippers regularly drink freshly-squeezed urine from virgin cows, claiming the substance contains ‘powers’ which can cure hair loss.
Despite there being no scientific evidence to back up the claims, worshippers at the shelter, led by Mr DD Singhal, founder of the Agra Gaushala Foundation, also believe that cow urine can cure diabetes and cancer.
Japanese water Chestnut
This unusual fruit – or to be more precise, aquatic vegetable, has been hailed as a new treatment for alopecia by researchers at Hannam University in South Korea.
A study conducted in 2019 claims that during their tests on hair follicles they did manage to stimulate growth, however, this is the newest and least tested treatment of all those listed here and by no means clinically proven or widely accepted.
There are some that believe that hot sauce can help ‘cure’ hair loss in men. The main reason for this odd belief is that sauces such as Tabasco contain capsaicin, a substance which has been linked to hair growth.
There has been evidence in some studies that suggest hot sauce may promote hair growth, but we’d recommend taking the results with the same amount of caution as you would the hot sauce.
Coping with Hair Loss
Hair loss can affect men in many different ways, not just physically. Men experiencing hair loss, no matter what age, often feel less confident and more stressed about dealing with the condition.
It has also been shown that politicians with a full head of hair have a statistically significantly higher probability of getting elected than their peers who are balding.
But it doesn’t have to be that way. Remember, there are two treatments that are clinically proven to stop hair loss and promote growth for up to 90% of guys. The sooner you start treatment, the more hair you’re likely to keep.
Embracing Hair Loss
People have arguably never felt more pressure to look good, with social media appearance playing an increasingly important part of our lives. This leaves many men experiencing hair loss feeling insecure and lacking confidence.
However, many men embrace their hair loss, and even make it a part of their image. Celebrities including as Dwayne “The Rock” Johnson, Bruce Willis and Jason Statham have embraced balding as part of their iconic look, and you can of course make the decision to do the same. Sometimes acceptance is the most effective tool in our toolbox.
Hair Loss and Mental Health
Mental health is often linked to balding in a number of ways. First of all, hair loss is often shown to be a symptom of stress and anxiety, which leads to almost a chicken and egg situation, where further stress experienced as a result of hair loss can bring about further hair loss.
This is why it’s important that if you start to experience anxiety as a result of hair loss, you talk to a clinician.
Secondly, men who experience more severe hair loss or complete baldness are more likely to experience psychological symptoms than those whose hair loss is less advanced.
A German study showed that hair loss can cause self-esteem issues, and even trigger psychological disorders like body dysmorphia and trichotillomania – excessive hair pulling.
It’s very common
Most men will experience hair loss at some point in their lives, so if you’ve noticed your hairline receding or hair thinning on to, you’re not alone!
There are many people going through the same journey of hair loss as you every day, so why not reach out to our expert hair loss team at Hims?
Get Expert Advice
In addition to getting support from those around you, it’s also always a good idea to talk to an expert if you can, such as a registered clinician or your GP.
There are many ways to deal with hair loss, including accepting it, and whatever path you choose, there are options.
Above all else, it’s important that whatever decision you make about your hair feels right for you.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.