Stop hair loss: how to prevent baldness

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When a look in the mirror reveals receding hairlines and the beginnings of a bald spot, the good mood is over. For many men, hair loss is like the loss of their own potency. In the Bible, Samson lost his superhuman strength when his hair was cut off. To prevent this from happening to today’s men, around 200 million euros a year are spent on hair care products in cosmetics stores.

How much hair loss is normal?

Half of men over the age of 20 have to reckon with losing their hair. Whereby the loss of up to 100 hairs a day is no reason to panic, but quite normal. Only when this amount is significantly exceeded over a longer period of time, one speaks in medicine of pathological hair loss. So that you don’t have to pull out your – remaining – hair, we have compiled the best methods, active ingredients and remedies against hair loss in men for you, and inform you about the latest scientific status of laser therapy against hair loss, hair transplantation and toupee technologies.

What types of hair loss are there?

There are three particularly common forms of hair loss in men: genetic hair loss, circular hair loss and diffuse hair loss. How you can recognize which form you suffer from and what helps against it, we decode in the following.

1. Genetic hair loss in men (androgenetic alopecia)

The medical profession calls it androgenetic alopecia, for those affected it is receding hairline and the circular tonsure at the back of the head, which slowly but surely move towards each other – in short: male pattern hair loss. The male aspect? The cause of continuous hair loss is the male sex hormone testosterone or its breakdown product dihydrotestosterone (DHT): testosterone is broken down into dihydrotestosterone in the scalp. It shortens the growth phase of the hair until the follicles, the growth engines for hair, finally die off. The result: the hair thins.

With a 95 percent probability, DHT is the most common cause of hair loss in men. Genetically determined hair loss usually begins at the age of 20 to 30 years. Depending on personal hereditary factors, the hair on the head first thins out on the forehead or the back of the head. Rarely a complete baldness develops, often a crown of hair at the back of the head remains.

Do you want to know how you look in old age? Then a look at the ancestral gallery helps: Often one’s own hair loss resembles the pattern in one’s father and grandfather. Three factors determine the course of the disease: hereditary factors, age and the sensitivity of the follicles to male hormones.”According to statistics, 60 percent of all Central Europeans must reckon with thin hair or baldness,” says dermatologist Hans Wolff of the Ludwig Maximilian University in Munich.

By the way: The extent of hair loss is not related to the natural level of the male hormone testosterone: Bald men are no more potent than full-haired men. However, as a rule, they tend to have more body hair.

2. Circular hair loss in men

An extensive and rapid loss of hair occurs in the case of alopecia areata, or circular hair loss. Identifying signs are circular gaps in the hair about the size of a coin. It occurs in one to two percent of hair loss cases and can even affect children. Particularly insidious: it begins in perfect health and sometimes not only the head is affected, but also other body hair, such as beard, eyelashes or genital hair. If you are unlucky, you suddenly find yourself completely hairless.

The good news: with circular hair loss, the follicles do not die, only their growth stops. Hair can grow back at any time, even without therapy. It is assumed that a malfunction of the immune system plays a role in circular hair loss. Defense cells are misdirected and directed against components of the hair. The result is that the hair roots are paralyzed.

Genes also play a role here: Circular hair loss occurs more frequently in affected families, often together with neurodermatitis, hay fever, white spot disease (vitiligo) or thyroid disorder.

3. Diffuse hair loss in men

Diffuse hair loss (effluvium diffusum) can occur regardless of age and hormone levels. Typical for it is a rapid onset without any particular localization. There are no receding hairlines or circular bald patches, the hair becomes thinner all over the head. 

The causes, which drive the hair from the growth into the resting phase and after some weeks from the head, are scientifically not clarified to 100 percent. Possible causes include fever attacks (over 39 degrees Celsius), flu-like infections or chronic inflammations, which usually precede the hair loss by several months. In addition to health, the lack of protein or trace elements can also lead in the long term to an undersupply of important nutrients – especially iron or zinc – to the hair roots. Likewise, the intolerance of medications can force the hair to flee from the scalp. In addition, psychological causes are also triggers of diffuse hair loss. Many sufferers report that stress led to the loss of the fuzzy head of hair.

Characteristically, the clearing on the head begins only a few months after the triggering event. So if you want to know the cause of your sudden hair loss, you need to develop a detective’s instinct.

Other causes of hair loss in men:

  • Androgens, the male hormones, are not the only cause of baldness. You can also lose hair when doping with anabolic steroids for performance enhancement or muscle growth.
  • Fungal infections on the scalp disrupt hair growth.
  • You suffer strongly from stress? Get more rest. Stress can also lead to (mostly temporary) hair loss
  • An unbalanced diet low in vitamins and nutrients affects the hair roots. Particularly important for hair growth: iron, zinc, biotin, omega-3 fatty acid, vitamins A, C and E as well as B3, B6 and B12. In practice, this means: eat lots of vegetables, fish from time to time, and don’t forget the fruit. Positive side effect: Your health also benefits from it.

What helps with hair loss?

As you now know, there are not only different forms of hair loss in men, but also numerous causes. So before you rush to the drugstore or pharmacy and invest a lot of money in promising hair growth products, you should clarify the exact cause of your hair loss.

Which doctor do you go to with hair loss?

The best addresses for this are the Hair consultations with hair doctors. They examine the scalp under the microscope, analyze the hair roots (trichogram), take tissue samples (scalp biopsy) and create a hormone status. Their services are not always covered by health insurance. Nevertheless, it makes sense to have an exact diagnosis made by a specialist in order to start an optimally coordinated therapy. And as early as possible! Because even the best therapies can usually only stop hereditary hair loss, for example, but cannot bring back the lost hair.

What really helps against hair loss in men?

Not every hair loss remedy delivers what it promises. However, the following active ingredients and methods against hair loss are scientifically proven.

Finasteride for hereditary hair loss

The drug finasteride, which has been scientifically proven to be effective in hair loss, is considered to be the most promising for men with hereditary hair loss. In higher doses it is also prescribed for prostate enlargement. The active ingredient influences the male hormone balance: taking it causes less dihydrotestosterone (DHT) to be produced from testosterone, which attacks the hair roots and eventually causes them to die off. By taking finasteride, men can slow down and prevent hereditary hair loss (the active ingredient is not approved for women). But patience and perseverance are prerequisites for success. Because it can take a few months before the effect is visible. And as soon as finasteride is discontinued, hair loss resumes. Finasteride is available only on prescription and should only be taken in consultation with a doctor. Possible side effect may (but need not) be loss of libido.

Minoxidil for hereditary hair loss

Minoxidil came on the market in the 1970s as a drug to treat high blood pressure. Common side effect: increased hair growth. The pharmaceutical industry took advantage of this and developed a 5% Minoxidil solution that men apply to their thinning hair twice a day – with scientifically proven success in many, if not all, cases. Today, minoxidil products sold over the counter in pharmacies are among the most popular anti-hair loss products (one daily dose costs about 1 euro).

Possible side effects are dizziness and drop in blood pressure. Those who start the therapy first need strong nerves: Before hair growth starts again, there is increased hair loss. As a consolation, this so-called shedding shows that the therapy is working. But: As soon as minoxidil is discontinued, hair loss resumes.

Topical immunotherapy for circular hair loss

In the case of circular hair loss, the body’s own defense system is directed against its own hair follicles. Hair growth stops, but the hair root remains in place. Topical immunotherapy is a targeted contact sensitization of the scalp with diphenylcyprone (DPC) or squaric acid dibutyl ester (SQADBE). The chemicals are applied to the scalp and are intended to trigger an allergy called contact dermatitis. The resulting inflammatory reaction is intended to “distract” the immune system so that the hair root can produce hair again. The maximum 2% DPC solution is applied to the scalp once a week in the doctor’s office, side effects are slight redness and scaling on the treated areas.”This treatment method is scientifically recognized and is now considered the most successful form of therapy for circular hair loss,” says Dermatologist and hair expert Dr. Frank-Matthias Schaart from Hamburg, “The cure rate of this form of therapy is about 40%.”A DPC treatment usually lasts from 1 to 1.5 years and is gradually discontinued. The cost of about 230 euros per quarter is not covered by all health insurance companies.

Cortisone against hair loss in men

Cortisone suppresses immune reactions and is therefore also used as a remedy for circular hair loss. Hair doctors inject it under the hair root or prescribe it in tablet form to stop hair loss. However, the relapse rate is very high once it is discontinued.

Mesotherapy for diffuse and angrogenetic hair loss

“This form of therapy uses microfine needles to inject highly effective growth factors into the cooled scalp to stimulate new hair growth,” explains Schaart. The procedure is performed twice a week for a period of up to 6 weeks. The procedure promises good results especially for men with diffuse and hereditary hair loss. However, usually only private health insurance companies pay the therapy costs of about 150 euros per session.

Laser for diffuse and hereditary hair loss

The therapeutic possibilities of lasers have increased immensely in recent years. In his Hamburg practice, hair doctor Schaart treats men with diffuse and hereditary hair loss with the successfully with the diode laser. Laser light from the infrared wavelength range is irradiated into the scalp. This increases the blood flow to the hair root and thus its nutrient and energy supply. “On the one hand, this counteracts hair loss, on the other hand, a powerful activation of new hair growth is achieved,” says Schaart.  A single laser session lasts about 30 minutes and costs about 55 euros. In total, one should expect 6-12 months of treatments with 2 sessions per week in the beginning, later with appointments every 2 weeks.

For Circular hair loss the doctor uses the fractional laser to. Schaart: “With its help, the activity of the tiny, complex motor of the hair root is maximally stimulated by microfine injury stimuli deep under the scalp, thereby stimulating the new growth of hair.”Treatments must be performed every 4 weeks, the cost varies from 50 to 350 euros (whole head) depending on the size of the area. 

Shampoos and hair tonics with caffeine for fuller hair

Highly dosed hair tonics containing caffeine are able to stimulate blood circulation in deeper layers of the scalp, so that still active follicles can produce stronger hair, resulting in a fuller head of hair. The best known representatives of this product group are Caffeine Shampoo from Alpecin or Dove Men+Care Energy Boost Shampoo.

An overview of other products specifically for hair loss can be found here:

Hair transplantation as a last resort

Since men like Jürgen Klopp and Wayne Rooney officially admit to their hair transplants, transplanting their own hair has become a serious option for many men with a remaining crown of hair (and a lush bank account).

Since hair at the back of the head is less sensitive to hormones, it is usually retained despite hair loss. About half of the hair from the crown of hair can be removed without the loss being obvious. The surgeon (recently a robot can also do this) transplants healthy hair roots from densely hairy areas at the back of the head further forward. “Hair transplantation is usually performed on an outpatient basis under local anesthesia and takes 3 to 6 hours,” explains Dr. Frank Neidel, President of the Association of German Hair Surgeons. The costs are between 3.000 and 10.000 euros and are not usually covered by health insurance.

There are two common Hair transplantation methods: the removal of hair roots from a narrow strip of skin with hair root separation under the microscope (Strip method) as well as the extraction of single hair roots with the help of thin hollow needles (Follicular Unit Extraction, FUE method). Both methods have advantages and disadvantages.

“Beware of providers who advertise only one method,” warns Neidel. “An experienced surgeon masters all techniques, will find out the best one and will be able to justify his decision.”

Since 2015, the FUE method (single extraction) can also be done with the help of a robotic system. The advantage of this system is the precise automated removal of the individual hair roots from the hair crown. As with any single removal technique (FUE), the removal area must be shaved short over a large area to a hair length of 1 mm for this purpose. Neidel: “This means that this technique is usually ruled out for most women or for managers and executives who don’t want to suddenly appear at work as a baldy. Especially young men aged 20-30, who wear ‘undercut’ or ‘bald’, benefit from this technique.”

Now 20% of all hair transplants worldwide are performed using the FUE harvesting technique, and 80% of all patients have their hair treated using strip harvesting. Important: Be sure to seek out a specialist who is recognized (licensed) by the medical association and who performs hair transplants on a daily basis, if possible. “Also very important: Be sure to get advice from the attending physician and ask him about training and continuing education,” advises Neidel. Get a second opinion if you are unsure. If you are still not sure, it is better to wear a toupee or bald head!

Is a toupee really an option?

Do you remember André Aggassi, how he played his Grand Slam tournaments with long, wild mane of hair and headband? What nobody knew at the time: the hair was fake, the tennis pro wore toupees. In his biography “Open,” he gives an impressive description of how it felt during sweaty matches, as well as his fear of losing the hairpiece during a match. How fortunate that toupees have evolved in recent years, so that wearing them can be comfortable even for athletes. The advantages: no health risk as with a hair transplant, zero side effects as possibly with pills or tinctures for hair loss. These two methods achieve amazingly real effects:

  • Artfully braided The creation of an invisible wig starts with a plaster cast of your head. Based on this impression, specialists make a fine mesh that lies on the head like a second skin. This ensures that the hair replacement fits like a tailor-made suit. Thousands of hairs are woven into the mesh, whose color patterns are exactly matched to your hair color. In Germany, this technique is known under the names Skinlight and Sensigraft.
  • Waterproof glued The company ContactSkin manufactures custom-made hairpieces, which are invisibly and durably applied to the hair gaps by certified specialized dealers or hairdressers. A hairpiece lasts on the wearer’s head for 4-6 weeks, after which it is detached by a professional, disposed of and a new one is applied. The toupee holds even in water, you can swim with it, ride a bike, go to the sauna, have sex, sleep. The price per hairpiece is about 350 euros plus service costs.
  • With the Folium Step-by-Step method especially for men by hairdreams a small toupee is glued on first, which becomes larger every month when it is replaced, so that the transition to more hair is inconspicuous and the impression is created that the hair is growing back.

Why unfortunately men suffer so much from hair loss?

By the way: Compared to their European neighbors, Germans suffer psychologically significantly more from their hair-related problems, according to a survey of 1500 European men conducted by the GALLUP Institute. Thus 62 per cent of all Europeans say that hair loss impairs their self-esteem. In Germany it is however even 76 per cent. And while hair loss depresses an average of 21 percent of those affected across Europe, in Germany the figure is 43 percent.

Many also perceive hair loss as a barrier to flirting: 46 percent feel inhibited in approaching women because of their light hair. More than one in three Germans also believe they are less likely to be noticed when flirting because of their hair loss (38 percent). 68 percent say hair loss makes them insecure.

Do women still find bald men attractive?

Fortunately, it is unlikely that hair combed into the forehead à la Donald Trump ever become a trend. These tricks will make you look much more confident and attractive despite progressive hair loss:

  • Part your hair on the side. It will accentuate the receding hairline on one side, but a quiff on the other side will create an impression of fullness.
  • Wear baseball caps or hats that hide advanced hair loss. Underneath, however, the remaining hair should not be longer than 5 to 6 millimeters long.
  • Combine the bald top of your head with a 3-day beard sheared to the same length.

Before you embark on the adventure of hair transplantation or spend a lot of money to grow your hair back, you should at least have thought about whether a bald head would really be a visual disadvantage for you. Not every type of man looks good with a bald head, no question about it. But more and more men stand to their light head hair. And more and more women find bald men sexy.

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Alicia Vargo Author
Consultant seller in an off-line sex toy store
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