Why is my hair Thinning: Mens Edition


Male pattern baldness is a common complaint for many men, medically speaking it is known as androgenetic alopecia and affects half of all males by the age of 50. Losing your hair is such a nuisance, a cruel trick used by nature to destroy your confidence. When men approach doctors they are often told it is genetics or testosterone levels, but there could be other reasons for their misfortune.

To be as comprehensive as possible, we have used up-to-date research when it comes to hair thinning, some causes may be easily identified, while others require blood work conducted by a doctor in order to diagnose the issue.

What causes Hair Thinning in Males?



Male Pattern Baldness
Of all the causes of hair loss in men, this is probably the most common, there are some other disorders like tinea capitis which is a fungal infection of the scalp. Another reason might be stress-induced alopecia areata which results in clumpy hair-loss. We will discuss all of these conditions next, as well as some less common ones.


Male pattern balding


Even though there are many reasons for hair-loss, male pattern baldness if probably the most common. About 40 percent of men will have this before the age of 59 and it is purely related to genetics. It creates the classic "M-shaped" pattern which occurs on the crown and temples. In general, Asian and African men are less likely to suffer from frontal hair-loss while Caucasians are more prone to hair thinning.

What causes Male Pattern baldness?
For most men, DHT is one of several hormones known as androgens, it is a subset of testosterone. Some men have a genetic predisposition that reacts to dihydrotestosterone (DHT) and the hair follicles stop growing new hairs. Any male who is post-puberty can develop Male pattern baldness, which can cause different degrees of thinning around the bitemporal and frontal regions, as well as across the crown.

In most men, the regions of the head that are most sensitive DHT are the temples and crown. All hairs on the scalp go through phases including the anagen (growing phase), Catagen (middle stage), Telogen (resting phase). For some men, hormones like DHT send signals to the hair-follicles to shut-down, and the growing phase becomes shorter over time. This means hairs are not actively growing for long periods, and they simply fall out.

What age does male pattern baldness start
In a study of European men published in the Journal of Dermatology, 1717 men were surveyed, the average man said they noticed hair loss between 24 - 30 years of age Although Italian men reported they noticed thinning at 20 years of age. American men are almost the same, you can expect to begin losing your hair from about 25 years of age, and as time goes by you are more likely to notice the difference.

As you can see from our infographic below, the graph shows the steady increase of hair loss in males, most men will start losing hair in their 20s.

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Can a bald man regrow hair?
Currently, there are a few treatments that claim they can regrow hair, some treatments that contain minoxidil are known to promote hair growth. In a study using rats, the active ingredient minoxidil significantly increased the density of hair. This product is actually available for human use and is known as Rogaine. At least 26% of men who used this product had seen moderate hair regrowth, and a further 33% had minimal hair growth.

Rogaine Hair Loss & Hair Thinning Treatment Minoxidil Foam, Three Month Supply


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Stress and Hair thinning


Stress has been linked to a condition called telogen effluvium, it is usually present in men who have suffered from emotional or physiological incidents. These events cause the hair to enter the regression phase, and later the resting phase (telogen). When more hairs enter the rest phase they tend to fall out easily. One problem for patients is the delayed onset of this condition, you might have a very stressful period, and only start losing your hair a few months later.

Will my hair grow back?
Most cases of telogen effluvium are not permanent so your hair will eventually grow back. Some patients who have multiple attacks may develop permanent hair-loss over time. Telogen effluvium can also be caused by illness, fever, major surgery, malaria, and pneumonia.


Thyroid causing Hair loss
Thyroid deficiencies and more specifically iron deficiency anemia is more common in women, but can also affect men to some degree. Low iron levels in men could be caused by lack of nutrients, donation of blood, or any form of internal bleeding. Your doctor will probably need to order a blood test to check for ferritin, low levels of ferritin can cause iron deficiency anemia.


What are the symptoms of iron deficiency?
Hypothyroidism is the medical term for an underactive thyroid and is more common in women, however, Hashimoto's thyroiditis affects both men and women and causes your immune system to attack your own thyroid gland. If you have issues with your thyroid, you might display the following symptoms:

  • Light-headedness
  • Fatigue
  • Cold sensitivity
  • shortness of breath
  • Constipation
  • Muscle aches and pains
According to studies, Iron deficiency anemia is present in 2% of adult men, so it is important that you get your iron levels checked if you have any of the signs. The recommended daily intake for adult men aged 18 is 8mg per day. You can supplement your diet by eating plenty of Spinach, Liver, Legumes, beans, and fish.


Traction Alopecia (Tight hairstyles)


If you are one of those guys who wear cornrows, dreadlocks, ponytails, or even the man bun. You may be at risk of developing Traction Alopecia. This condition is known to cause a receding hair-line. The constant tension causes damage to the hair follicles and without removing the cause you will cause permanent damage to the hair.

Don't go running to get your hair cut, if you must use a bun or pony-tail then simply tie your hair in a loose manner, this will limit any stress placed on the roots. On the other hand, cornrows and dreadlocks are a serious hazard to your hair-line. Long-term use of these styles are known to cause irreversible damage to the hairline, so it might be a good time to change your look.

Scarring Alopecia (cicatricial alopecia)
With so many different types of Alopecia, we thought we would add another one. Scarring Alopecia is known to cause thinning in over 5 percent of cases. It forms small clumps of hair loss that develop over time, you might feel burning or itching on your scalp. Doctors will need to perform a skin biopsy to diagnose the condition, which can identify inflammation around the hair follicles.

In some cases, there is no scarring and the bald spot will produce hairs again, in other cases it will not grow back since the hair follicles are replaced with fibrous tissue. Some treatment options try to target the inflammation using topical steroids or oral corticosteroids.

Trichotillomania in men


This is another possible cause of hair loss, some men may pull at their hair in frustration or due to some mental condition. Even though this condition usually affects women, a recent study showed that men are also likely to suffer from hair pulling disorders. Trichotillomania causes men to yank at their hair, including on the head, eyebrows, arm hair, and leg hair.

It is thought to affect less than 2 percent of men and can result in chunky bald spots on the scalp. It is caused by depression, anxiety, or emotional distress and has also be linked to obsessive-compulsive disorder. There are some tools including Habit reversal training and Cognitive therapy that can help those who suffer from this condition.

The appearance of Hair Loss and the Possible Causes
We have classified the different types of hair loss seen in men, how to identify them:

Hair loss having a defined pattern

  • Androgenetic alopecia: A defined "M-pattern" on the head which has a medical name of male pattern baldness
  • Syphilis: A moth-like appearance including irregular areas of hair loss that can be caused by Syphilis
  • Trichotillomania: You have incomplete paches and thinning, with stubble
Hair loss over a larger area (diffuse)

  • Alopecia universalis: can result in total a loss of scalp and body hair, it is a more severe form of alopecia areata
  • Telogen effluvium: Hair loss across the entire scalp, although complete loss of hair can be due to toxic substance exposure or chemotherapy
  • Alopecia totalis: Complete baldness of the scalp, but not of the body as seen in Alopecia universalis
Hair loss in a specific area (focal)

  • Alopecia areata: Patchy hair loss, which are well defined and easy to spot, usually the immune system attacks the hair follicles
  • Tinea capitis: Causes Dry scaling, crustsm it is known as ringworm of the scalp, mostly in children, not that common in men past puberty
  • Trichotillomania: Can be smaller patches or patchy in appearance, incomplete thinning, with stubble.
  • Traction alopecia: Frontal/temporal, hair loss moving backwards from the frontal hairline, caused by right fitting hairstyle
  • Cicatricial alopecia: Slow onset of hair loss which can result in scarring, a condition that can destroy hair follicles

Conclusion


There are many conditions that can cause hair thinning in men, none are as prominent as male pattern baldness. It will affect almost everyone to some degree, and if you are over 50 you are almost certain to have some form of hair loss.

References:

January 2010 Case Study-Severe Anemia
The effects of hair loss in European men: a survey in four countries
Topical Products for Human Hair Regeneration
Example Drug Facts Label for Minoxidil Topical Solution 2% for Men and Women: fda.gov
How to Avoid Hair Loss from Traction Alopecia: belgraviacentre.com
Primary cicatricial alopecia: diagnosis and treatment: Jones, and Sinclair
Adult men and women with trichotillomania. A comparison of male and female characteristics: Christenson, MacKenzie, Mitchell.
Common Hair Loss Disorders: Brown, Springer




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