What to do about hair loss in men?

You stare into the bathroom mirror. You have parted and styled your hair in various ways, but it can no longer be hidden. Slowly but surely, you realize that you are losing your hair.

Does this sound familiar to you?

And it is, because it is. Hair loss in men is incredibly common. A few are lucky enough to survive into old age before succumbing to the consequences, but the odds are against everyone else. Around 30 % of all men will be affected by hair loss in their 30s - and this percentage continues to rise with age.

Hair loss can be a distressing, worrying experience. But what can you do about it?

With more than 10 years of experience in the Treatment of hair loss In our dermatology practice, we thought we should present and compare the best solutions for men and women.

What is hair loss?

Simply put, hair loss (or, to use the medical term, alopecia) is the loss of hair from the head or body. It is common in both men and women - most people lose up to 100 hairs a day without realizing it.

This is because hair has a natural life cycle that consists of three phases:

1. Anagen phase (growth phase): It lasts 2-7 years and determines the length of our hair.
2. Catagen phase (transition phase): Lasts about 2-3 weeks. In this phase, the hair stops growing, detaches from the blood supply and becomes a club hair.
3. Telogen phase (resting phase): Lasts about 2-4 months. The old hair rests while the new hair begins to grow. At the end of this phase, the old hair falls out.

In some people, hair loss can increase so that the hair loss becomes more noticeable.

But what are the causes of increased hair loss? We'll take a look at this in the next section.

Types of hair loss in men

There are many different types of hair loss in men. The most common are

• Androgenetic alopecia
• Telogen effluvium
• Alopecia areata
• Traction alopecia

Androgenetic alopecia

If you suffer from hair loss, it is very likely that the cause is hereditary. Unfortunately, you can't outrun your genes.

Hereditary hair loss (or androgenetic alopecia) is the most common form of hair loss in men and affects 30-50 % of men over the age of 50.

Hereditary hair loss, often referred to as male pattern baldness, usually begins with a receding hairline and thinning of the crown before gradually progressing to complete hair loss on the scalp. Some men are affected by diffuse androgenetic alopecia, where the hair thins out evenly over the entire scalp and is not concentrated in certain areas.

In both cases, the hair on the sides and back of the head appears to be more resistant and can remain largely unaffected by androgenetic alopecia - resulting in the horseshoe shape seen in balding men.

Although hereditary hair loss cannot be stopped, there are things that can be done to slow down or even temporarily reverse the process.

Telogen effluvium

Telogen effluvium is a temporary form of hair loss.  

Triggered by stress factors such as illness, childbirth, medication or drastic emotional events, it occurs when an above-average percentage of hair follicles enter the telogen phase (resting phase). The resulting hair loss usually affects the entire scalp and not just individual sections.

Fortunately, most people affected by telogen effluvium regain their lost hair once the triggering event has passed or been resolved.

Alopecia areata

Alopecia areata is an autoimmune disease in which the body's own immune system mistakenly attacks the hair follicles, leading to hair loss. The result is small, round bald patches on the scalp, which is why it is also known as circular hair loss.

The exact cause is still unknown and the condition can be unpredictable: Hair can grow back and then fall out again. While there is no cure, treatments such as corticosteroid injections/topical steroid injections or topical immunotherapy can help stimulate hair growth.

Some people may experience more extensive forms of hair loss, such as alopecia totalis (complete baldness of the scalp) or alopecia universalis (hair loss all over the body).

Traction alopecia

Traction alopecia is a form of hair loss caused by persistent tension or pulling on the hair follicles.

This form of hair loss occurs much less frequently in men than in women, but with the increasing popularity of the "man-bun" hairstyle, men are affected more often.

It can cause irreversible damage, which is why early detection is essential.

Comparison of the types of hair loss

State	Androgenetic alopecia	Telogen effluvium	Alopecia Areata	Traction alopecia
Cause	Genetically determined	Reaction to physiological or emotional stress factors	Autoimmune disease	Persistent tension or pulling on the hair
Patterns of hair loss	Mostly receding hairline and thinning of the crown.	Sometimes diffuse hair loss.	Diffuse hair loss on the entire scalp.	Along the hairline and wherever tension is exerted.
Duration	Chronic and progressive	Typically transient, disappearing months after the trigger is removed.	Can be chronic with unpredictable episodes.	Can be transient if detected early; chronic if persistent
Affected population	Both sexes, but different patterns	Both sexes, often after a drastic life event	All age groups and genders, more common among young people	More common in people who wear tight hairstyles

Hair loss is often a frightening experience for those affected. It's even worse if the doctors you see don't take your concerns seriously or don't have enough expertise to diagnose the problem.

So what can you do about it?

What can be done to prevent hair loss in men?

If you have noticed hair loss beyond the norm, there are two steps you can take:

1. analyze and diagnose the type of hair loss

2. decide on a treatment

Analyze and diagnose the type of hair loss

Before you can decide what action to take, you first need to find out what is causing your hair loss. To find out, you should first make an appointment with a dermatologist.

At our practice, for example, we will listen to your concerns and discuss your previous experiences with hair loss. We will then carry out a thorough analysis of your scalp and hair, which may include the following:

• Clinical examination - The pattern of hair thinning can provide important clues. For example, androgenetic alopecia usually follows certain patterns.
• Dermoscopy - We examine the scalp with a higher magnification. This allows us to detect the reduction of hair follicles, inflammation and other abnormalities of the scalp.
• Blood test - We carry out a blood test to determine possible underlying diseases.
• Trichogram - We take advanced images of your hair and scalp for computerized analysis.
• Scalp biopsy - In some cases it may be necessary to take a small sample of your scalp (although this is rare).

Decide on a treatment

Once your hair loss has been diagnosed, you can consider possible treatments and solutions.

Minoxidil and finasteride

There are two long-established treatments for hair loss: minoxidil and finasteride. There is extensive research for both, which has shown effective results for many users. Let's take a quick look at both.

Feature	Minoxidil	Finasteride
Kind	Topical solution or oral pill (both are available)	Topical solution or oral pill (both are available)
How it works	The exact mechanism is not yet fully understood, but minoxidil prolongs the growth phase of the hair follicles and promotes thicker hair.	Finasteride inhibits the action of an enzyme that converts testosterone into dihydrotestosterone (DHT). It is believed that DHT causes hair follicles to shrink and contributes to hair loss in men. By reducing DHT, hair loss is slowed down.
Advantages	Suitable for both sexesNo prescription neededSlows hair loss and promotes hair regrowth	Acts on the hormonal cause in menReduces DHT in the scalp and improves hair countHighly effective
Disadvantages	May cause initial hair lossEffects may be modestResults are lost if treatment is discontinuedPossible scalp irritation	Prescription onlyNot suitable for women of childbearing ageIt takes up to a year to see resultsPossible side effects

Important note: These treatments are readily available, but you should always consult a dermatologist first.

Hair transplantation

A hair transplant is a surgical procedure that aims to correct hair loss by transplanting hair follicles from one part of the body (usually the back or side of the scalp) to areas of thinning hair or baldness. The most common techniques are:

• Follicular unit transplantation (FUT): A strip of scalp is removed and individual follicular units are harvested and transplanted.
• Follicular unit extraction (FUE): Individual follicular units are extracted directly and then transplanted.

Advantages:

• Natural results: Because it's your own hair, the results look and feel natural.
• Permanent solution: The transplanted hair is resistant to the hormone that causes male pattern baldness.

Disadvantages:

• Expensive: One of the more expensive hair loss treatments.
• Scarring: FUT can leave a linear scar, while FUE can result in small punctate scars.
• Recovery time: As this is a surgical procedure, a certain period of healing is required, which may be associated with swelling and discomfort.
• Limited donor area: The number of grafts available depends on the density of the donor area.

Platelet Rich Plasma (PRP)

The Therapy with platelet-rich plasma (PRP) is a non-surgical treatment. It uses the body's own healing abilities to combat hair loss.

Blood is taken from the patient, which is then processed to concentrate the platelets. These are then injected into the areas of the scalp that are thinning or experiencing hair loss. Platelets are rich in growth factors, so injecting them into the scalp stimulates dormant hair follicles and promotes new hair growth.

Advantages:

• Natural approach: The patient's own blood is used, which minimizes allergic reactions or side effects.
• Minimally invasive: no surgery or scars.
• Short recovery time: Patients can usually resume their daily activities immediately after the procedure.

Disadvantages:

• Varying results: Effectiveness can vary from person to person.
• Maintenance required: Several sessions are often required, followed by regular maintenance treatments.
• Temporary redness: After treatment, the scalp may appear red or swollen.

Find out more: PRP treatment for hair

Microneedling

Microneedling is another non-surgical treatment for hair loss. Tiny needles are inserted into the surface of the skin, creating micro-injuries that stimulate the body's natural wound healing processes and increase collagen production and blood circulation.

Advantages:

• Stimulates natural processes: Utilizes the body's own healing abilities.
• Combinative effect: Can improve the absorption and effectiveness of other treatments such as PRP.
• Minimal downtime: Most people can resume their daily activities shortly after the procedure.

Disadvantages:

• Discomfort: The procedure can be uncomfortable, but numbing creams can provide relief.
• Varying results: The results can vary from person to person.
• Maintenance required: Several sessions are often required, followed by regular maintenance treatments.
• Temporary side effects: Redness, irritation and slight swelling may occur after treatment.

LED light therapy

At the LED light therapy red or near-infrared light is emitted onto the scalp to improve cell function, increase blood circulation and stimulate hair growth.

Advantages:

• Non-invasive: no needles, no surgical interventions.
• Pain-free: Most users report that they do not feel any discomfort during or after the sessions.
• Combinative effect: Can improve the absorption and effectiveness of other treatments such as PRP.

Disadvantages:

• Varying results: As with many hair loss treatments, effectiveness can vary from person to person.
• Consistency required: Regular and continuous treatments are required to achieve lasting results.
• Limited evidence: Some studies suggest benefits, while others find only minimal effects. However, the amount of evidence is increasing.

Treatments in comparison

Feature	Minoxidil	Finasteride	Hair transplants	PRP	Microneedling	Laser light therapy
Kind	Topical/oral	Topical/oral	Surgical	Non-surgical	Non-surgical	Non-surgical
Functionality	Stimulates the hair follicles, prolongs the growth phase	Inhibits DHT production	Moves the hair follicles out of the donor area	Uses growth factors from the patient's own blood	Creates micro-injuries to stimulate growth	Uses light to stimulate the follicles
Advantages	Prescription-free; suitable for both sexes	Targets the hormonal cause	Lasting results	Natural & minimally invasive	Natural & minimally invasive	Natural & minimally invasive
Disadvantages	Requires consistent use and possible side effects	Requires consistent use and possible side effects	Costly; possible scarring; recovery time	Variable results and maintenance required	Variable results and maintenance required	Variable results and maintenance required
Frequency	Daily	Daily	Unique	Regular meetings	Regular meetings	Regular meetings

Summary

We know that losing hair can be a worrying and stressful experience. And unfortunately, it is in the nature of hair loss that worry and stress can accelerate the process.

But you are not alone, and thanks to advances in medical science and technology, there are now many ways to do something about it.

At-home medications such as minoxidil and finasteride and more intensive procedures such as hair transplants have dominated the treatment field for years, but non-surgical treatments such as PRP, microneedling and laser light therapy have also increased greatly in scope and effectiveness. You can now choose or even combine treatments to suit your lifestyle, goals and budget.

Of course, you can also simply accept your hair loss and opt for a shaved hairstyle. This is by far the cheapest and easiest solution.

Regardless of this, it is important to first accurately diagnose the cause of the hair loss. We strongly recommend a visit to a dermatologist. If you live in Zurich and would like to speak to one of our specialists, get in touch today.

This article is for information purposes only. Always consult a doctor before making any decisions about hair loss treatments.

FREQUENTLY ASKED QUESTIONS

Can diet and lifestyle affect hair loss?

Yes, diet and lifestyle can play a role in hair health. Nutritional deficiencies, particularly in terms of iron, vitamin D and protein, can contribute to hair loss. Likewise, habits such as smoking, excessive alcohol consumption and prolonged stress can affect hair growth.

Are the results of hair loss treatments permanent?

The results can vary depending on the treatment. With minoxidil and finasteride, for example, hair loss can resume when the treatment is discontinued. Hair transplants offer more permanent results, but hair loss can still occur in the untreated areas. Non-surgical treatments such as PRP, microneedling and laser light therapy may require regular maintenance sessions to achieve lasting results.

At what age should I start worrying about hair loss?

Hair loss can start at any age, even in the late teens or early 20s, especially if there is a strong genetic predisposition. However, it is common for men to experience some degree of hair thinning as they age. If you experience sudden, patchy hair loss or if you are concerned about the rate of hair loss, you should consult a dermatologist regardless of age.