Hair Loss In Men

There are numerous reasons why males may lose hair. A trichologist is able to examine the hair and scalp, identify distinct patterns of hair loss, and then make a diagnosis on the type of hair loss that is being experienced. Problems can include genetic hair loss, diffuse hair loss, and patches of hair loss such as alopecia areata and less common conditions - folliculitis decalvans and lichen planus. 

Genetic hair loss, or male-pattern hair loss is the most common male hair loss condition. The development of genetic hair loss depends on three main factors – genetic predisposition (it can be inherited from either parent), the presence of normal levels of post-puberty male sex hormones (androgens) and an immune reaction at the bulge region of the hair follicles. This immune reaction is characterised by inflammation around the hair follicle, which can be easily seen when the scalp is viewed with a trichoscope at about a magnification of 50. Inflammation/swelling around the hair follicles indicates that one group of white blood cells is attacking the stem cells of the hair follicles. This is very common, and can also impede the hair growth. Therapy to reduce this inflammation is important. Testosterone also increases ROS (Reactive Oxygen Species) which are free radicals that can trigger the production of transforming growth factor ß1 (TGFß1), a substance that can reduce hair growth. This is one reason that antioxidants can benefit hair growth. There are a number of therapies available to people with androgenetic alopecia. These include some drugs and some external therapies.

Diffuse hair loss refers to excessive hair loss from all over the scalp. In such cases, we will try to pinpoint the internal cause of the problem and, if need be, work with your doctor. So, we will sometimes ask for some blood tests to be run to help pinpoint the cause of the problem. Once the cause of the hair loss has been pinpointed and corrected, the hair should fully recover. Sometimes a short-term diffuse hair loss is experienced, often from some kind of shock to the body. With such hair loss, we will try to pinpoint the cause. Often, no therapy is required and the hair loss corrects itself.

Alopecia areata is a common problem whereby patches of hair loss can occur quite quickly. It is an autoimmune problem, whereby a group of white blood cells attacks the hair. It is a hair loss problem that can correct itself. However, if necessary, we will give treatment that reduces the autoimmune reaction. 

Scarring or cicatricial alopecias are where patches of permanent baldness are caused by destruction of the hair follicles in the areas in question. The scalp appears smooth because the follicles have disappeared. These problems are autoimmune problems, sometimes associated with bacterial infections. Therapies aim to reduce or stop the autoimmune reaction.

David Salinger IAT

Member, International Association of Trichologists

Chelcey Salinger IAT

Member, International Association of Trichologists