Male Hair Loss

Androgenetic alopecia is the most common form of hair loss and is responsible for 95% of hair loss cases in men.

While there are many possible reasons why a man may develop hair loss – such as chronic and/or autoimmune diseases, skin conditions, reaction to certain medications, seasonality, stress, poor diet, environmental pollution and other aspects of modern life – the largest percentage is due to heredity, reaching up to 81%. This means that genetic factors contribute more to the risk of male pattern hair loss than environmental factors. Hereditary predisposition is the most powerful determinant of male pattern hair loss, as genes largely determine whether a person will develop hair loss, what the age of onset will be, what the pattern of onset will be and what the degree of progression will be.

See here more information about the causes of hair loss and find out about diagnosis and available treatments.

Diagnosis & Treatments for Hair Loss

The diagnosis of male pattern hair loss is extremely important in order to get the right treatment that will stop thinning and help strengthen the hair follicles. The medical history, the photochemical hair test or even a skin biopsy if deemed necessary will help the dermatologist to arrive at the cause of hair loss, as the prognosis of hair loss depends on it to a great extent.

At Advanced Hair Clinics, hair loss is treated separately and individually for each man who seeks our advice. Our clinic is one of the most specialized clinics for the treatment of male hair loss with experience of thousands of cases in Greece and abroad, from Europe to the Middle East.

Minoxidil is a proven effective treatment for hair loss and is widely used as a first-line treatment option. It is the most common treatment option regardless of age or gender. It can be given intravenously, topically or in pill form in order to promote hair growth. The action of minoxidil results in the widening of blood vessels and an increase in the supply of nutrients to the hairs. This prolongs the duration of the hair growth phase, resulting in healthier and thicker hair.

Dutasteride is a treatment with extremely high efficacy in treating hair loss. In particular, its administration is a key part of best practices for the treatment of almost all forms of hair loss in men, and in women after the menopause. Dutasteride can be combined with other conservative treatments, such as PRP mesotherapy. It can be administered either in pill form or by topical application.

Finasteride is another effective treatment against hair loss, promoting the growth of hair follicles and enhancing the density of existing hair. Its effectiveness is confirmed by clinical studies, which have shown that the use of this treatment leads to an increase in the number and diameter of hairs in people suffering from androgenetic alopecia, the most common form of hair loss. Finasteride may also be combined with other conservative treatments, such as PRP mesotherapy. As a treatment it is recommended in men of all ages and in post-menopausal women.

PRP hair mesotherapy is a proven and reliable treatment against hair loss and is applied to men and women of all ages. The treatment is performed injectably and involves the patient’s own blood plasma. The regenerative properties of the plasma enhance hair follicle growth, whether it is either androgenetic alopecia or female pattern hair loss. PRP mesotherapy can be used alone or in combination with other forms of conservative treatment. In addition, it is considered essential in the follow-up of individuals who have undergone hair transplantation. Finally, PRP for hair is also a safe and effective option for the treatment of alopecia pedis.

A highly effective and painless approach to treating hair loss in men and women is the nourishing and strengthening hair follicle treatment using Dermaroller. This microneedling device creates micro-injuries in the scalp, helping to better penetrate the treatment substance, usually minoxidil. At the same time, it promotes local blood circulation, improving oxygenation and nourishment of the hair follicles. In addition, it activates natural regeneration processes in the area, enhancing the recurrence of hair loss. The result is hair that is stronger, thicker and healthier. The first application of the treatment is always done in a dermatological clinic. Dermaroller is then given as a gift to patients to use at home, usually in conjunction with topical medication, following the doctor’s instructions.

Hair transplantation is a permanent and definitive solution for hair loss, offering thick hair and a natural result, provided that it is performed by an experienced medical team and with the use of the most advanced techniques and tools. Today, the most advanced method of hair transplantation is FUE (Follicular Unit Extraction), a technique in which healthy hair follicles are carefully removed from an area with sufficient hair growth (donor country) and implanted in a way that mimics natural hair growth in the selected area with thinning or hair loss (recipient country).

RESULTS

Hair loss treatment & Hair Transplantation

Male Hair Loss

Clinical symptoms

The most common pattern of androgenetic alopecia is anterior and temporal thinning, with a tendency for the thinning to extend to the top of the head. Over the years, the area of thinning at the top of the head widens and in many cases merges with the anterior thinning. Male pattern hair loss occurs in 25% of the male population with apparent thinning by the age of 30 years and in 50% by the age of 45-50 years.

In the majority of men with hair loss, thinning occurs at the end of puberty and progresses rapidly between the ages of 20-30 years, with a slowing down after 30-35 years. At older ages, the course of hair loss slows down even further, following the same course as the stabilisation and gradual decline of male hormone levels in the blood.

Androgenetic Alopecia

Men who suffer from androgenetic alopecia inherit in the hair follicles a genetic sensitivity to the hormone dihydrotestosterone (DHT). Dihydrotestosterone (DHT) is a derivative or by-product of testosterone. Testosterone is converted to DHT by means of the enzyme 5-areductase which enters the hair follicles, shrinks the hair follicles and by causing changes in their function, suppresses their growth. Hair follicles sensitive to the DHT hormone become thinner and their lifespan is reduced, resulting in hair loss and a decrease in scalp density.

More specifically, the action of the hormone DHT shortens theanagen phase, during which the hair grows, and accelerates thetelogen phase, during which growth stops. This process weakens the hairs, causing them to fall out.

Often men who first experience thinning, initially show a reduction in hair density that is not due to hair loss, but to progressive hair thinning.

The affected hair follicles gradually degenerate, the hair life cycle becomes shorter and each new hair produced comes out thinner and thinner and weaker, with a shorter and shorter life span. This happens at different rates from man to man, until the hair follicle reaches a final stage of degeneration, where the hair appears thin and transparent like fluff.

Hair Loss DNA Test

Nowadays, it is possible to determine a young man’s likelihood of developing androgenetic alopecia with the help of specialised genetic tests that reveal the presence of genes in the individual’s DNA that are associated with male pattern hair loss.

FAQs

The hair life cycle includes the following stages: the anagen phase (hair growth), the catagen phase (hair stops growing and detaches from its root) and the telogen phase (hair fall). Hair loss occurs when the duration of the anagen phase decreases and the hairs rapidly enter the telogen phase (telogen hair loss or telogen effluvium). In this case, the hair loss is diffuse, i.e. it is not localised in a specific area but affects the whole scalp and results in thinning and thinning of the hairs. Such a form of hair loss is caused after childbirth, in chronic infections and in the administration of certain drugs.

Other cases of hair loss are caused by scalp conditions such as fungal infections, bursitis and other inflammations. Also hair thinning can be caused by thyroid gland dysfunction (hypothyroidism, hyperthyroidism) as well as in hyperparathyroidism and other chronic diseases. Hair loss also occurs after chemotherapy, radiation therapy and drug treatments, as well as in chronic diseases. In these cases by identifying and eliminating the causes, hair loss subsides.

Localised hair loss, which is permanent in most cases, can also occur in cases of traumatic alopecia, as a consequence of trauma or burns to the scalp, face or body.

The most common cause of male hair loss is heredity, which in combination with the action of the derivatives of the predominantly male hormone, testosterone, and age, bring about the so-called androgenetic alopecia. The genes that cause androgenetic alopecia can be passed on by both parents.

In men, hair loss of this type starts mainly on the forehead and temples, as well as on the top of the head, and is absent from the occipital region (back of the head). The occipital region and the sides of the head remain stable throughout life and do not show significant hair loss, even in old age, as they are not affected by male hormones. This area is called the stable hair zone and is used as the main donor area for hair follicle harvesting in hair transplantation.

Women have the same hereditary predisposition to androgenetic alopecia as men, but in women of reproductive age, due to the effect of female hormones, estrogen, the clinical manifestation of androgenetic alopecia (severe hair loss and obvious thinning of hair) is not particularly noticeable until the age of menopause.

Only in a small percentage of women, about 10-15%, does clinically visible hair loss occur. Androgenetic alopecia in women usually occurs in the form of diffuse hair loss and rarely do we have complete hair loss from one area. Hair thinning in cases of women with androgenetic alopecia becomes more pronounced after menopause. Learn more in our article on hair loss in women.

Male pattern hair loss with complete loss of hair by areas occurs in alopecia pedis, as well as in scarring forms such as trauma or scalp burn. Hair loss and scarring plaque formation in men also occurs in follicular lichen and lupus erythematosus. The characteristic feature of these pathological forms of hair loss is that they can affect any area of the scalp, even the zone of stable hair growth, and they progress in a random and unpredictable manner.

They may be localised, small in size and relatively stable, but rarely they may take on a universal form, as in some cases of alopecia areata, where there may be a complete loss of hair, not only on the scalp but also on the face, eyebrows or the whole body. Pathological hair loss conditions are much rarer than androgenetic alopecia and constitute less than 10% of all alopecia. See all types of hair loss here.

The diagnosis of male pattern hair loss should always be made by a qualified dermatologist. A key role in the diagnosis of androgenetic alopecia is played by the history of onset after puberty, gradual thinning in specific areas and the hereditary history of hair loss and alopecia in ancestors. Hair loss is diagnosed or confirmed at Advanced Hair Clinics with a phototrichosogram using a special microcamera and software.

The special Follysis photographic imaging and digital analysis diagnostic tool used by the clinic is one of the most complete and accurate tools for diagnosing hair loss and monitoring response to treatment, as it allows for precise measurements of hair density by area and measurement of hair diameter. In special cases, such as in alopecia pollen or scarring alopecia, special blood tests (hormonal tests, iron, vitamins, trace elements, etc.) or skin biopsy (punch biopsy) may be required to differentiate hair loss.

An important cause of hair loss today is the modern stressful lifestyle as well as intense emotional stress, stress, exposure to dust and pollution, excessive exposure to UV rays and frequent contact with seawater and chlorinated water.

Poor nutrition can also exacerbate hair loss, as a lack of protein, vitamins and trace elements – minerals such as iron or zinc – intensify the problem. In contrast, a balanced diet that includes protein and iron can reverse hair loss.

Yes, for example Traction Alopecia occurs in cases where there is excessive hair pulling, such as in very tight tresses or in some “ponytails”.