Age Men Lose Hair: Causes, Treatments, and Prevention

Hair loss is a common concern for men as they age. While often associated with getting older, hair loss can begin much earlier in life and can be caused by various factors. Understanding the causes of hair loss and available treatments can help men address this issue effectively.

Understanding Hair Loss

Hair loss, also known as alopecia, can affect just the scalp or the entire body, and it can be temporary or permanent. It can result from heredity, hormonal changes, medical conditions, or simply be a normal part of aging. Baldness typically refers to excessive hair loss from the scalp, with hereditary hair loss with age being the most common cause. People typically lose 50 to 100 hairs a day, which usually isn't noticeable because new hair is growing in at the same time.

Common Types of Hair Loss in Men

Young men can experience hair loss for a variety of reasons. The most common types include:

• Male Pattern Baldness (Androgenetic Alopecia): This is one of the most common causes of hair loss in young men and can start at any age after puberty. It is a hereditary condition that affects the majority of men at some stage in their lives. Approximately 25 percent of men with hereditary male pattern baldness start losing their hair before the age of 21. By the age of 35, approximately 66 percent of men will have experienced some degree of hair loss, and by the age of 50, approximately 85 percent of men will have significantly thinner hair.
• Telogen Effluvium (Stress-Related Hair Loss): Traumatic events or periods of prolonged stress can trigger this form of hair loss, causing the hair to enter the “telogen phase” of the hair growth cycle, during which hair is released from the scalp and falls out.
• Traction Alopecia: This type of hair loss can occur if young men have hairstyles that are styled particularly tightly, such as man buns, cornrows, and ponytails.

Causes of Hair Loss in Men

Several factors can contribute to hair loss in men, including:

• Genetics (Heredity): The most common cause of hair loss is a hereditary condition that happens with aging. This condition is called androgenic alopecia, male-pattern baldness, and female-pattern baldness. Male pattern baldness is often genetic, with one in four men starting to lose their hair before age 21, and this proportion increases with age. The vast majority of men who go bald do so because of a hereditary condition known as androgenetic alopecia, more commonly known as male pattern baldness. According to the American Hair Loss Association, 95 percent of hair loss in men is caused by androgenetic alopecia. This inherited trait that tends to give guys a receding hairline and a thinning crown is caused by genetic sensitivity to a byproduct of testosterone called dihydrotestosterone (DHT).
• Hormonal Changes and Medical Conditions: A variety of conditions can cause permanent or temporary hair loss, including hormonal changes due to pregnancy, childbirth, menopause, and thyroid problems.
• Medications and Supplements: Certain medications and supplements can lead to hair loss as a side effect. Some of the known drugs associated with hair loss include chemotherapy drugs, acne medications such as isotretinoin (Accutane), antifungal drugs, in particular voriconazole, anticoagulants such as heparin and warfarin, immunosuppressants, blood pressure medications such as beta blockers and ACE inhibitors, cholesterol-lowering drugs such as simvastatin (Zocor) and atorvastatin (Lipitor), and antidepressants such as sertraline (Zoloft) and fluoxetine (Prozac).
• Radiation Therapy to the Head: Radiation therapy can cause widespread hair loss, but usually, your hair will grow back with time, once the treatments end.
• A Very Stressful Event: Many people experience a general thinning of hair several months after a physical or emotional shock.
• Hairstyles and Treatments: Excessive hairstyling or hairstyles that pull your hair tight, such as pigtails or cornrows, can cause a type of hair loss called traction alopecia. Hot-oil hair treatments and permanents also can cause hair to fall out.
• Alopecia Areata: This condition causes your body’s immune system to mistakenly attack healthy hair follicles, which leads to hair loss. Hair typically falls out in small patches on your head, but it can also affect other parts of your body.
• Nutritional Deficiency: Optimal levels of iron and other nutrients are essential for good overall health, as well as healthy hair growth. Protein, vitamin D, as well as adequate intake of other vitamins from your diet are also important to maintain healthy hair. A deficiency in one or more of these nutrients may cause you to lose more hair than normal.

Male Pattern Baldness: The Role of DHT

Male pattern baldness is caused by the action of a specific molecule the body makes called dihydrotestosterone (DHT). This causes hair follicles to produce hair that becomes progressively smaller, shorter, and lighter. During this process it's common to experience hair thinning at the temples and crown of the head, as well as along the hairline. As the body continues to produce DHT, the follicles in the scalp keep shrinking until they stop making hair altogether, potentially leaving patches on the scalp with little to no hair.

Read also: Managing Hair Loss from Chemo

Hair follicles that are sensitive to DHT have a tendency to shrink over time. As the affected hair follicles get smaller, the life span of each hair becomes shorter. Eventually, the affected follicles stop producing hair, or at least the type of hair you’re used to.

With male pattern baldness, hair loss typically follows a predictable pattern. The two most common patterns of hair loss include:

• Hair starts to thin on top of the head and around the temples, which may eventually leave a “horseshoe” of hair around the sides and back of the head.
• Hair starts to recede from the front of the hairline, pushing the hairline further back on the head.

The degree and progression of balding in men is assessed by the Norwood classification system, which has seven stages that measure the severity and pattern of hair loss and balding.

Hair Loss Patterns and Symptoms

Hair loss can manifest in various ways, depending on the cause. Common patterns and symptoms include:

• Gradual Thinning on Top of Head: This is the most common type of hair loss, affecting people as they age. In men, hair often begins to recede at the hairline on the forehead.
• Circular or Patchy Bald Spots: Some people lose hair in circular or patchy bald spots on the scalp, beard, or eyebrows.
• Sudden Loosening of Hair: A physical or emotional shock can cause hair to loosen, with handfuls of hair coming out when combing or washing your hair, or even after gentle tugging.
• Full-Body Hair Loss: Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body.
• Patches of Scaling That Spread Over the Scalp: This is a sign of ringworm.

Hair Loss Treatments

Although some young men may be worried about losing their hair to male pattern baldness, there are a handful of products for hair loss available that can slow - and even reverse - this form of hair loss. Hair loss treatments, for male pattern baldness in particular, range from products you rub into your scalp to more invasive treatments aimed at restoring hair growth or replacing lost hair.

Read also: The Connection Between Hair Loss and Cancer

Medications

There are both prescription and over-the-counter drugs approved for the treatment of male pattern baldness. The two medications proven to treat or stave off further male pattern hair loss are finasteride (Propecia, Proscar) and minoxidil (Rogaine, Ioniten).

• Finasteride: One clinically proven hair loss treatment commonly used to reduce and reverse male pattern baldness is finasteride. In a trial of 1553 men with male pattern hair loss, treatment with finasteride 1mg resulted in improved scalp coverage in around two-thirds of men and slowed the progression of hair loss in the other one-third. Finasteride comes in a pill form and is only available by prescription. As previously mentioned, finasteride helps to block the production of DHT (which shrinks follicles).
• Minoxidil: Another successful treatment that can precisely target the areas of the scalp most affected by male pattern hair loss (such as the hairline, crown, and temples) is minoxidil. It's a liquid that can be applied or sprayed directly to areas of thinning hair to promote hair regrowth and slow hair loss. One study showed that treatment with minoxidil (5%) resulted in improved scalp coverage in 62% of men with male-pattern hair loss after 48 weeks. The men also reported improvements in their quality of life and highlighted that treatment had a beneficial impact on first impressions made at work. Minoxidil is a topical treatment that’s available over the counter. Minoxidil works by encouraging the supply of nutrient-rich blood to the follicles. The British Association of Dermatologists also recommends minoxidil as a receding hairline treatment for those affected by traction alopecia, as it can be applied directly to the hairline or other areas of the scalp to promote hair regrowth.
• Hair Kits: For the best chances of hair regrowth success, a Hair Kit is recommended. They can contain both finasteride and minoxidil to help reduce hair loss and stimulate hair regrowth from all angles.

It can take at least 6 months for either treatment to start showing results.

Laser Treatment

Low-level laser therapy can be used to help invigorate circulation in the scalp and to stimulate hair follicles. Although this is a fairly new treatment option, it has been deemed safe and tolerable. It is also a less invasive option compared to hair transplant surgery. Although research is limited for laser therapy and hair growth, some studies have shown encouraging results. For instance, a 2013 study that included 41 men between the ages of 18 and 48 found a 39 percent increase in hair growth for participants who had laser hair surgery.

Hair Transplant Surgery

The two most common hair transplant procedures are follicular unit transplantation (FUT) and follicular unit extraction (FUE).

• Follicular Unit Transplantation (FUT): FUT involves the removal of a section of skin from the back of the scalp where hair is still growing. This section of skin is then divided into hundreds of tiny pieces called grafts. These grafts are then inserted into parts of the scalp where hair currently isn’t growing.
• Follicular Unit Extraction (FUE): With FUE, the surgeon takes individual healthy hair follicles out of the scalp and then makes small holes, where hair isn’t growing, and puts the healthy follicles into these holes.

Managing Other Types of Hair Loss

• Telogen Effluvium: Telogen effluvium can be managed by reducing stress levels. It's possible to avoid stress-related hair loss by doing things that minimise stress, such as meditation, yoga, or exercising regularly. All of these have been proven to reduce stress and each can improve your overall well being. Eating healthily and avoiding caffeine, nicotine, and alcohol can also help to keep stress levels low.
• Traction Alopecia: Traction alopecia can be remedied by avoiding tight hairstyles or using minoxidil on the affected areas of the scalp to encourage hair regrowth. To help yourself treat and avoid traction alopecia, tight hairstyles should be avoided. Hair regrowth is likely to occur around 3 months after discontinuing tight hairstyling, once the hair cycle is restored.

Prevention Tips

Most baldness is caused by genetics (male-pattern baldness and female-pattern baldness). However, there are steps you can take to keep your hair healthy and to prevent hair loss from other causes:

Read also: Coping with Hair Loss During Cancer

• Be Gentle with Your Hair: Use a detangler and avoid tugging when brushing and combing, especially when your hair is wet. A wide-toothed comb might help prevent pulling out hair.
• Avoid Harsh Treatments: Avoid harsh treatments such as hot rollers, curling irons, hot-oil treatments, and permanents.
• Stop Smoking: Older research suggests that smoking may be associated with hair loss.
• Manage Stress: Manage stress through exercise, mediation, or deep breathing exercises. Try doing regular scalp massages, which may help stimulate hair growth.
• Eat a Well-Balanced Diet: Eat a well-balanced diet rich in protein, iron, and vitamins.
• Switch Medication: If you think your medication may be causing hair loss, talk with your doctor about other options that may work better for you.
• Consider a Cooling Cap: If you're being treated with chemotherapy, ask your doctor about a cooling cap.

When to See a Doctor

See your doctor if you are distressed by persistent hair loss in you or your child and want to pursue treatment. Also talk to your doctor if you notice sudden or patchy hair loss or more than usual hair loss when combing or washing your or your child's hair. It’s important to consult a medical professional, such as a dermatologist or trichologist, for an accurate diagnosis and personalized treatment plan. Depending on your symptoms and overall health, your provider may run a series of different tests to uncover the reason(s) for your hair loss, including reviewing your medical and social history, ordering blood tests, and performing a scalp biopsy.

The Impact of Hair Loss on Mental Health

Hair loss can impact your mental health in many ways. It’s natural to experience a range of emotions, including distress and concern about your appearance. Open and honest communication with friends and family about how you’re feeling can provide comfort and support. Making time and space for healthy lifestyle habits and self-care can also help reduce stress and other hair loss triggers.

Age-Related Hair Changes

As we grow older, we need fewer calories to fuel our body’s daily functions. That means the food we do eat needs to pack a nutritional punch. At the same time, age-related changes to our digestion-as well as some chronic diseases and medications-can make it harder to get the vitamins and minerals we need. And certain deficiencies are linked to hair loss, such as protein, iron, vitamin B12, and calcium.

Hair color change is one of the clearest signs of aging. Hair color is due to a pigment called melanin, which hair follicles produce. With aging, the follicles make less melanin, and this causes gray hair. Graying often begins in the 30s, with scalp hair often starting graying at the temples and extending to the top of the scalp. Hair color becomes lighter, eventually turning white. Body and facial hair also turn gray, but most often, this happens later than scalp hair.

Hair thickness also changes with age. Hair is made of many protein strands, and a single hair has a normal life between 2 and 7 years. That hair then falls out and is replaced with a new hair. Nearly everyone has some hair loss with aging, and the rate of hair growth also slows. Hair strands become smaller and have less pigment. So the thick, coarse hair of a young adult eventually becomes thin, fine, light-colored hair. Many hair follicles stop producing new hairs.

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