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.
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.
“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.
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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.
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.
Where to buy: Propecia is now available online at Lloyds Pharmacy. A six-month supply costs £285. Side effects are very rare and always stop when you cease taking the drug, but if concerned see your GP to discuss a prescription.
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.
Once an area of your scalp is completely bald, it becomes impossible to regrow hair there. But provided a little fuzz remains, even if it’s very thin (vellus hair), there’s a chance of winning back some decent coverage. The Belgravia Centre produces a special, extra-strength Minoxidil solution (12.5%), designed to target areas that are starting to seriously thin. And this may also be the time to bring on the lasers...
The HairMax LaserComb sounds like exactly the kind of dubious gadget gullible men might fruitlessly trail over their head for years. But, in fact, clinical studies have proven it is effective in encouraging regrowth. A 26-week trial involving 110 patients with male pattern baldness found those who used the HairMax LaserComb rather than an identical sham device showed a significantly greater increase in hair density.
How does it work? “Every cell in your body needs adenosine triphosphate (ATP),” explains Reddy. “It’s the body fuel for cells. The evidence suggests lasers can increase the ATP available for hair growth – basically increasing blood supply to the scalp.” Unfortunately, playing Star Wars with your bonce doesn’t come cheap – the latest 12-laser comb is £350.
If you have left things too late for pharmacological intervention to be satisfactory, a transplant might be your best bet. As always with hair loss, the earlier you tackle things, the better. An average man starts with around 100,000 hairs, explains Reddy, and you need at least 25,000 skilfully grafted about your dome in order to achieve a decent look.
The fewer hairs still hanging around up top, therefore, the less likely it is even the most skilful hair surgeon will be able to get you back something resembling those flowing locks of yore. “You can’t take 25,000 just from the back because the back will look too thin. So catching it early is always better,” says Reddy.
What’s the process? Hairs are extracted one by one from the back of the head and then grafted into your scalp. A six or seven hour session will see around 8000 hairs relocated in this way, so you may require more than one visit. It’s not particularly painful: you should, says Reddy, be able to head back into work the next day. Transplanted hairs aren’t subject to the follicle-thinning effects of male pattern baldness, but those old hairs still clinging on are, so you’ll need to continue a prevention programme involving propecia and/or minoxidil. Which, after splashing out at least £3,000 on surgery, may smart a little.
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Once short back and sides is the only hairstyle that remains an option, it’s too late for a transplant. But you’re not necessarily condemned to a sunburnt scalp every holiday from here on in. As well as the promising news about astressin-B, Dr Reddy is confident that the incipient science of gene manipulation will soon banish baldness for good.
“We can clone hair at the moment, but the problem is rejection,” he explains. Today, a single hair can be removed, cloned 10,000 times, and all of them transplanted into the head. The problem is they’ll only stay there for around two weeks. “After that, for some unknown reason, there’s a reaction and the hair sheds,” says Reddy. The cure is coming, but until then it’s all about stalling.
Can Hair Loss Be Prevented?
While there are ways to curb your losses, at the moment, there’s no known way of preventing male pattern baldness. “The key is to catch it as early as possible, ideally,” says Dr Friedmann. “As soon as you notice any thinning, the sooner you can begin treatment, the greater your chance of achieving a good recovery. ”