SIIM LAND – How to Prevent Male Pattern Baldness

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How to Fight Male Pattern Baldness

Halt that encroaching bald spot, whether you’re just starting to thin or you think you’ve left it too late

While the search for follicle fuelling wonder-cures is a big research market, male pattern baldness is a grooming issue that’s unlikely to recede any time soon. Around 7.4 million men are dealing with a thinning thatch in the UK at any given time, and two thirds of all blokes will be affected by male pattern baldness in their lifetime.

“Male pattern baldness is by far the most common cause of hair loss in men,” says Dr Adam Friedmann, consultant at Stratum Clinics. “This condition is also referred to as androgenetic alopecia. Although scientists are not completely certain what determines who gets male pattern hair loss, there’s a genetic component that can be inherited from either side of the family.”

While there’s currently no cure for male pattern baldness, rest a-sheared the latest research is promising. Scientists from the University of California discovered that removal of regulatory T-cells, or Tregs, would stop hair regrowth in mice, with the hair returning only when the Tregs were reintroduced. A solid discovery for balding rodents, and potentially life-changing news for the nation’s thinning lids.

Researchers are currently exploring the mechanism as a potential remedy for male pattern baldness, but what’s a man to do in the interim while science catches up? Here, we walk you through the causes, risk factors, and early signs of male pattern baldness, and share treatment options to tackle every stage of hair loss – however bountiful or bare your current mop may be.

What Is Male Pattern Baldness?

Put simply, male pattern baldness refers to a loss of hair on the scalp in men. It can be identified by the hair it affects – the condition wreaks havoc upon the top of your head, Dr Friedmann explains, while the back and sides are spared.

“Male Pattern baldness generally progresses in one of three ways: a receding hairline, thinning of the hair on the crown, or a general thinning of the hair all over the top of the head,” he says.

What Causes Male Pattern Baldness?

Male pattern baldness is caused by a combination of genetics and circulating male sex hormones called androgens, particularly dihydrotestosterone (DHT). Derived from testosterone, DHT plays a huge role during puberty – deepening your voice, changing where you store fat and muscle, and, yes, regulating body hair growth

In men with inherited intolerance or sensitivity to DHT, “the hair-producing cells, or follicles, shrink and become less efficient and productive,” says Arran Isherwood, senior trichological specialist at FUE Clinics. “This causes the hair produced to thin and, eventually, if left untreated, cease altogether, resulting in baldness.”“There are various clinically proven ways to prevent and slow down the rate of hair thinning associated with male pattern baldness,” says Isherwood. “Anti-androgen medications such as Finasteride and Dutasteride are available. They inhibit the body’s ability to produce the hormone DHT, which plays a primary role in follicular miniaturisation, resulting in hair thinning and eventual loss.”

Who’s at Risk of Male Pattern Baldness?

Male pattern baldness is genetic, so you don’t need a crystal ball to gauge your personal risk. If your old man is bald, it’s a question of ‘when’, not ‘if’. Hair loss can start in your teens, but it’s more common in adulthood, with the likelihood increasing as you age. The size and shape of your head can contribute to how quickly DHT shrinks your follicles.

How to Tell If You’re Losing Your Hair

It can be tricky to spot the first hints of male pattern baldness, but there are a few signs to watch out for. This type of hair loss often begins at the temples or the crown of the head. Some men will notice a single bald area of thinning strands, while others will see their hairline recede in an ‘M’ shape.

“Determining whether you are losing hair can be very difficult as it’s pretty typical to shed anywhere from 25 to 100 hairs per day,” says Isherwood. “This is all part of the natural growth cycles your hair goes through.” However, if you notice increased shedding, male pattern baldness runs in your family, and you can see your scalp, it’s a sign to take action.

How to Deal with Male Pattern Baldness

Found yourself spending less and less on shampoo while your face takes longer to wash? Don’t cut your losses just yet – below, we’ve broken down the existing options for tackling male pattern baldness.

Full Head of Hair

It’s not only your innocence that puberty heralds the end of. As soon as that first pimple erupts forth from porcelain skin, the days of guaranteed follicle abundance are over. “It’s unlikely for male pattern baldness to set in before the age of 18, but as soon as you notice an increase in the amount of hair shedding, or some thinning, you should act,” says Leonora Doclis, senior hair loss specialist at the Belgravia Centre. “The earlier the better as the more hair that’s lost, the more difficult it is to restore the original density.” Check your hairline and crown frequently for signs of thinning using your phone’s camera.

Every strand present and correct? Do your best to keep things that way: everyone – even those with a flawlessly dense thatch – should adhere to some basic follicle-friendly tenets, says Dr Raghu Reddy, hair loss specialist at The Private Clinic, Harley Street. “First, don’t wash your hair in hot water, use lukewarm. And don’t traumatise wet hair – just dab it dry.” Also, get at least seven hours sleep every night: “Growth hormone levels shoot up at night,” explains Reddy. And there’s a fair few other benefits to additional shuteye, too.

Mild Thinning

There are just two clinically proven drug treatments which can prevent further hair loss and promote regrowth. Finasteride (most famously marketed as Propecia) and minoxidil (most famously marketed as Regaine). “A combination of both is the best basis for any course of treatment,” advises Doclis.

Propecia

How does it work? Propecia inhibits DHT. Take a 1mg pill every day and, provided you’re not one of the around 15% of men who are propecia non-respondent, your hair loss should soon stall – and in time you might well see some regrowth as well. A two-year study of 1553 men with mild to moderate thinning found 83% maintained or increased their hair count. Want to save a bit of cash? “Propecia lasts for about 16 hours so even if you take it every other day it should still work,” says Reddy. Just stick to a regular programme to avoid messing with your hormone levels unduly.

Minoxidil

How does it work? This antihypertensive, widely available in 4% and 5% formulations, is marketed under a variety of brand names (Regaine, who have released a foam format, is the most well-known).

Applied directly to the scalp, minoxidil prevents further hair loss and encourages regrowth, but it’s not known precisely how. “Research is ongoing,” says Marilyn Sherlock, chairman of the Institute of Trichologists. “It appears to be connected with activating potassium pathways, but we don’t know any more than that at the moment.” What’s certain is the stuff works: clinical tests found 85% of men who applied 5% minoxidil twice a day had improved their hair count after four months. Don’t be surprised if new hair is downy at first – and be prepared for some extra shedding in the first few weeks of use.

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Which nutritional supplements are best for treating hair loss?

Hair loss is a common problem, with nearly 80% of men and half of all women experiencing hair loss during their lifetime.

Although nutritional supplements are commonly used for treating hair loss, there are limited data on their efficacy and safety

A recent review summarizing data from 30 prior human studies suggests that nutritional supplements could potentially treat certain types of hair loss while having generally tolerable side effects.
The authors noted that these studies included a limited number of participants and showed variability in design, suggesting the need for larger randomized clinical trials.
A recent systematic review published in the journal JAMA DermatologyTrusted Source synthesized data from previous research, including randomized clinical trials, on nutritional supplements that could treat hair loss.

The study found that an array of supplements ranging from pumpkin seed oil, zinc, vitamin E, omega fatty acids, and certain commercial formulations like Viviscal and Nutrafol, among others, showed promise in the treatment of specific types of hair loss.

The studies included in the review were generally small and used subjective inclusion criteria, emphasizing the need for larger, more robust randomized clinical trials.

Common types of hair loss

The hair growth cycle can be divided into three phases. The first phase, known as anagen, is characterized by the growth of hair and can last several years.

Around 85–90% of hair follicles in a normal scalp are in the anagen or growth phase. The growth phase is followed by catagen, the transition phase involving the slowing of hair growth.

The catagen phase lasts about 14 days and is followed by the telogen or resting phase which lasts 3–4 months. Hair growth remains dormant during the resting phase and is followed by hair shedding. A loss of about 50–100 hair strands normally occurs every day.

Hair shedding in excess of these normal values is referred to as hair loss or alopecia.

Hair loss can occur due to many reasons, including genetics, aging, autoimmune disease, hormonal changes, and stress. Some of the common types of hair loss include androgenetic alopecia, alopecia areata, and telogen effluvium.

Androgenetic alopecia, referred to as pattern baldness, is the most common cause of hair loss that is estimated to affect 50% of men and women by the time they reach the age of 50 years. Alopecia areataTrusted Source, another common form of hair loss, is an autoimmune disease that results in the loss of small patches of hair.

Telogen effluvium is characterized by hair follicles prematurely exiting the growth phase and entering the telogen phase. This results in excessive shedding of hair in the resting phase.

Telogen effluvium often appears in response to stress, illness, or the use of medications.

Use of nutritional supplements

Treatment of hair loss generally requires addressing the underlying cause, such as nutritional deficiency or disease. There are also Food and Drug Administration (FDA)-approved medications for androgenetic alopecia, namely oral finasteride and topical minoxidil.

Due to the potential negative effects of finasteride in females, only minoxidil is also used for androgenetic alopecia in females.

However, both drugs are associated with adverse effects that may result in the discontinuation of their use. Specifically, finasteride can cause sexual dysfunction in men, whereas minoxidil is associated with dermatitis.

More recently, the FDA also approved baricitinib, a drug that modulates the immune system, for the treatment of severe alopecia areata.

Given the potential side effects associated with pharmacological treatments, there has been an interest in the use of alternative therapies, including nutritional supplements, for hair loss.

A recent study involving patients from a hair loss clinic showed that nearly 80% of individuals used nutritional supplements. However, there are limited data on the safety and efficacy of these supplements.

In the present study, the researchers summarized evidence from 30 prior human studies, including 17 randomized clinical trials, examining the effectiveness of various nutritional supplements in the treatment of hair loss.

They excluded studies involving hair loss due to nutritional deficiency, use of medications, trauma, or physical stress.

The researchers also categorized the studies according to the quality of evidence, with randomized clinical trials representing the highest level of evidence in the review.

Vitamins and antioxidants

Studies suggest that various types of hair loss, including alopecia areata, androgenetic alopecia, and telogen effluvium, are associated with oxidative stress and a deficiency of micronutrients such as vitamins.

While the review found some high-quality evidence to suggest that zinc could enhance hair growth in individuals with hair loss, evidence supporting a role for vitamin D and vitamin B12 in the treatment of hair loss was of lower quality.

Although biotin (vitamin B7) is a common ingredient in hair loss therapies, there was an absence of studies examining the effects of biotin as a standalone treatment.

However, results from randomized clinical trials suggest that tocotrienols, antioxidant compounds belonging to the vitamin E family, and a combination of fish oil (omega-3 and omega-6), blackcurrant seed oil, and antioxidants such as vitamin E and lycopene, could improve hair density in individuals with hair loss.

Hormone modulators, immunomodulators

Androgenetic alopecia is associated with the excessive response of hair follicles to an androgen called dihydrotestosterone (DHT), which is derived from testosterone.

Among nutritional supplements that inhibit the formation of DHT, data from a randomized clinical trial suggests that pumpkin seed oil could stimulate hair growth in men.

A deficiency of other hormones, such as insulin-like growth factor-1 (IGF-1), is also associated with hair loss. Studies suggest that capsaicin, the active ingredient in chili peppers, and isoflavones, a subclass of antioxidant compounds, could potentially increase the levels of insulin-like growth factor-1.

In addition, a small randomized clinical trial showed that capsaicin and isoflavones together can enhance hair growth in individuals with alopecia.

Plant-based compounds that can modulate the immune response, such as glycyrrhizin (licorice) and extracts from the peony plant, have also shown promise in the treatment of individuals with alopecia areata, which is characterized by an immune response against hair follicles.

Similarly, studies also suggest that procyanidin B-2, an anti-inflammatory and antioxidant compound, derived from certain apple species, can also stimulate hair growth.

Multi-ingredient commercial formulations

Multi-ingredient commercial formulations including Pantogar, Nourkrin, Viviscal, Nutrafol, and Lambdapil have also shown positive effects on hair growth in randomized clinical trials.

Pantogar includes keratin, the major protein in hair, and its building block L-cysteine, which could help promote hair growth.

Viviscal and Nourkirn contain proteins derived from marine animals that can facilitate hair growth. Nutrafol contains DHT synthesis blockers, antioxidants, and anti-inflammatory compounds, whereas Lambdapil contains L-cysteine, plant-derived silicon, and DHT synthesis blockers.

There is a lack of sufficient or high-quality evidence to support the role of other multi-ingredient commercial formulations such as Omni-Three and FORTI-5 in stimulating hair growth.

Implications

Besides having beneficial effects on hair growth, the interventions reviewed in the current study generally had mild side effects. These results suggest that nutritional supplements could potentially help treat certain types of hair loss.

However, the authors noted that the studies included in the review had several limitations. For instance, a majority of studies had a small sample size or used subjective reports of hair loss at baseline.

The authors also cautioned that some of the studies included in the review were funded by manufacturers of the nutritional supplements

The authors further noted concerns about the lack of FDA regulations that cover the efficacy, safety, and quality of supplements. Thus, nutritional supplements could potentially contain inefficacious or adulterated ingredients, with the latter resulting in side effects.

This requires dermatologists to work with patients to weigh the risks and benefits of such nutritional supplements.

Dr. Justin Rome, founder of the Barber Surgeons Guild, commented for Medical News Today that:

“While nutritional deficiencies can lead to hair loss, supplementation of vitamins such as biotin to those who are not deficient has not been shown to promote hair growth. Other novel ingredients may have a beneficial result in certain circumstances; however, they also may have no result or worse, potential adverse effects. It is important to note that nutritional supplements are not regulated by the FDA, which means they do not undergo the rigorous safety and efficacy testing as medications.”

Similarly, Dr. Thivi Maruthappu, consultant dermatologist at the Cadogan Clinic and lecturer in nutrition science, cautioned:

“Be careful when choosing supplements, look for high-quality clinical trials supporting their use. High doses of certain nutrients can actually be harmful for example excess Selenium, can lead to toxicity and even worsen hair shedding, and high dose biotin can trigger acne and interfere with blood tests, so it’s important to do your research before you buy.”

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