Gone are the days when men experienced hair loss in their 50s and 60s; the modern man is confronting the same demon faster. A cocktail of pollutants, stress, anxiety, work pressure, and harmful chemicals is intensifying the receding hairline problem among men in their 20s and 30s.
While it is a definite cause for concern, wait before you enter panic mode. Like most predicaments, there are ways out of this one too. But first, let’s understand the biological processes that cause hair growth and loss in the first place.
Understanding hair growth
Did you know that your hair goes through a three-phase growth cycle? First comes the anagen phase, where your hair actively grows. According to an article in the National Library of Medicine, it can last six years before entering a period of rest. Next comes the catagen phase, where your hair stops growing and separates from the follicle—the minuscule cavity beneath the skin that holds the hair in place—lasting about 10 days. Finally, there’s the telogen phase, where the follicle rests for two or three months before the old hair falls out and new strands begin sprouting in its place.
We lose around 50 to 100 hairs daily in this natural cycle. However, if this cycle is disrupted or a follicle is damaged, your hair may begin to fall out more quickly than it grows back, leading to a receding, M-shaped hairline, patchy hair fall, and overall hair thinning in men.
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Causes of hair loss in men
Genetics play a crucial role in the onset of hair loss. But to assume you’re destined for baldness because your parents lost their hair with age is a fallacy. Androgenetic alopecia (AGA), also called male pattern baldness, can manifest at any point after puberty and escalate over years or even decades.
In people with a genetic predisposition to AGA, a hormone called dihydrotestosterone (DHT) can bind to and miniaturise follicles, making hair thinner and shorter till the follicle stops producing hair altogether. This is because DHT is produced from testosterone by an enzyme called 5-alpha reductase. Sadly, many men with this condition eventually end up permanently bald.
Next come hormonal imbalances. In men, hormonal imbalances can occur on a spectrum, ranging from minor to significant. Such shifts can arise from various factors, such as age, environment, lifestyle, emotional distress, and underlying medical conditions. Interestingly, hair loss can stem from either inadequate testosterone levels or excess oestrogen.
Underlying health conditions can also intensify hair loss in men. Ailments such as Telogen effluvium (excessive hair shedding), Anagen effluvium (abnormal hair loss caused by drugs or chemotherapy), Alopecia areata (patchy hair loss), Tinea capitis (fungal infection on the scalp), Cicatricial alopecia (destruction of follicles), Lichen planopilaris (follicle inflammation) and hair shaft abnormalities are commonly observed in men who complain of poor health.
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How can men treat hair thinning?
Natural remedies are a good way to start treating your hair loss. Bhringraj, which belongs to the sunflower family, is known for its hair growth benefits in Ayurvedic medicine. Some studies have even shown that extracts of this herb are better than minoxidil (a medication used for pattern hair loss treatment) for hair regrowth.
Chinese hibiscus is also considered a miracle remedy for hair loss in India. A 2003 study assessing hibiscus leaf and flower extracts for hair growth potential showed positive results. Introducing saw palmetto into your diet may also aid hair growth with few side effects. However, we still need more research to confirm its effectiveness.
If natural concoctions don’t work for your scalp, you can always opt for treatments containing minoxidil. I have observed that in India, doctors tend to prescribe minoxidil to their patients twice a day for hair growth. However, having undergone fellowships in Germany and Iran, I have been trained to exercise caution and not recommend excessive use. While the regular use of this medication can lead to noticeable improvements in hair growth, discontinuing use can result in rapid hair loss. Therefore, I recommend limited usage (about twice a week) to avoid adverse consequences.
Weekly steaming on the scalp can also help reduce the miniaturisation of hair follicles by promoting blood circulation, which in turn can nourish hair follicles. When the scalp is exposed to steam, it unclogs the pores and reduces the buildup of oils. Meanwhile, the heat causes blood vessels to dilate, increasing blood flow to the scalp. This increased blood flow can bring nutrients and oxygen to the hair follicles and stimulate new hair growth.
The Platelet Rich Plasma (PRP) technique can also bear positive results. PRP is a procedure for treating hair fall and thinning with little to no adverse effects if done correctly. Here, platelet-rich plasma is extracted from a patient’s blood sample via a centrifuge machine and injected into the scalp to stimulate hair growth. Results depend on the techniques of centrifugation and the content of the tube used, apart from the expertise of the dermatologist. PRP injections have been found to prevent hair fall and thicken the roots of thinning hair, promoting healthy hair growth.
The next method involves treatment through prescription pills. Finasteride and dutasteride are two tablets commonly prescribed by doctors to treat hair loss. These medications can take at least three months to perform and should only be taken under a doctor’s supervision. Many men fear experiencing side effects such as impotence. However, when taken properly, these medications are safe and do not cause such drastic issues. As a precaution, doctors usually do not prescribe these pills for more than six months.
Also read: Hair transplants don’t work for balding women. But don’t lose heart
Last resort: Hair transplant
When all else fails, hair transplant is always an option for men. It is relatively easy and can be performed safely, but choosing a qualified and experienced doctor is essential to avoid mishaps. If the donor region is healthy and the doctor is competent, it’s almost certain that positive results will be obtained.
However, in recent times, the market has been flooded with non-specialists doing quackery with different names for the same procedure, leaving many people confused about the ideal approach to take. To add to the confusion, some clinics charge absurd amounts—ranging from Rs 20 to 100 per hair graft—making it challenging to discern reliable, value-for-money clinics.
The only acceptable hair transplant techniques are Follicular Unit Transplantation and Follicular Unit Extraction (FUT and FUE). So, choosing a trained dermatologist or plastic surgeon with years of experience in these transplant methods is vital. It’s also crucial that the doctor showcase their work by providing pre and post-transplant photos of at least 20 patients, and make you speak to at least one of their previous clients. This way, you can gauge their level of expertise, the quality of their work, and whether or not they are the right fit for you.
A balanced lifestyle, with reduced stress, chemicals, smoking cessation, and controlled hair gel and colour usage, can help with hair thinning. In the early stages, PRP, minoxidil, or any other hair tonic with a hedonic effect can help. The key is to increase vascularisation (reinvigoration of blood vessels), which can be done through light scalp massage with a mild shampoo in the shower. And let’s not forget the importance of water quality. Opt for soft water to ensure the best results for your hair.
Dr Deepali Bhardwaj is a dermatologist, anti-allergy specialist, laser surgeon and internationally trained aesthetician. She tweets @dermatdoc. Views are personal.
(Edited by Zoya Bhatti)