Loss in Men
Meet Tony Maleedy our hair specialist with 25 years experience
in clinical practice and hair research. Tony will be regularly
contributing to his column on UKHairdressers and helping you
care for your hair.
Tony Maleedy, tells us why hair loss happens in men
There are dozens of reasons why we lose hair. Some are common
to both sexes like those caused by illness or, indeed, the
drugs used to treat an illness. Others are exclusive to women
such as hair loss following childbirth. Stress is a common
cause of hair loss, as is dieting, or a poor diet, both of
which can cause the hair to become thin. But the most common
form of hair loss is experienced by men and sometimes older
women, commonly referred to as ‘male pattern hair loss’.
common is hair loss in men?
Hair loss in men is very common. In fact, every man in the
UK will experience some hair thinning in his life. The only
difference is the degree to which it affects them, and this
can vary enormously. Some young men start to lose hair in
their teens and may be bald before they are twenty-five, yet
others have an almost full head of hair when in their seventies.
Male hair loss or Androgenic Alopecia to give it its proper
name (andro: male, genic: genetic/hereditary, alopecia: hair
loss) is caused by the effect of the male hormones, called
androgens, on genetically predisposed hair follicles. Or,
in other words, the tendency to develop this type of baldness
runs in families and can be passed down by either parent to
a child, male or female.
Within these genetically programmed hair follicles, testosterone,
the main male hormone, is converted by an enzyme called 5-alpha
reductase into a much more potent hormone, dihydrotestosterone
(DHT). It is the effect of this hormone which inhibits the
growth of new hair cells, resulting in a finer hair being
In male hair loss successive hairs become progressively finer
and their growing periods become shorter, resulting in only
short fine hairs being produced. These fine hairs may, in
time, stop growing completely.
The growing phase of the hair cycle (anagen) will be of a
shorter duration than for unaffected hairs and may last for
a period of only months rather than the average of 3-5 years.
When these hairs fall out they are replaced by finer hairs
with an even shorter growing period. This process can continue
until the hair follicles degenerate and are unable to produce
any further hair.
What are the first signs of hair thinning?
Usually a slight recession of the hair at the front of the
scalp along the hairline is noticed at first. Later, thinning
over the crown can develop, these areas may ‘join up’ causing
the entire front and top of the scalp to be bald.
scalps, however, which appear totally bald actually contain
hair follicles which are either still producing very fine
hair, or are capable of producing it. These are fine vellus
hairs, however, with a diameter below 40 microns which means,
in effect, that they are no longer clearly visible to the
naked eye. So from a distance, a man may appear bald, but
in fact he may still have a large number of fine hairs growing
on the ‘bald’ area of his scalp. These hairs are, therefore,
no longer ‘cosmetically useful’ as they are too fine to add
to the persons appearance.
there any effective treatments?
In most cases, yes, but not all. It really depends on how
strong the genetic factors are. If a man has inherited a strong
genetic predisposition to this type of hair loss where, for
example, hair thinning starts in his teens and baldness is
obvious in his twenties, then nothing will prevent the loss
of most of his hair. If’ however, the genetic factors are
much less strong there is the possibility of reducing, stopping
or even reversing the hair loss.
This treatment, sold in the UK as the product Regaine, has
proven to be a quite effective at stopping hair loss and in
many men. When applied to the thinning region of the scalp
twice a day it can have an improvement on the quantity and
quality of a man’s hair although its abilities to re-grow
hair are limited. It tends to have a better effect in the
early stages of hair loss and on younger men. Good results
can be obtained in older men, but it may take somewhat longer
to see new any hair growth. Regaine is available from chemists
without prescription at a 2% or 5% strength. I would only
recommend the 5% because it is far more effective.
Some people experience some flaking of the scalp, and possibly
some inflammation and tenderness of the scalp tissues. If
this happens they should use the 2% solution and the Juniper
Mint Scalp Therapy Shampoo (see below) to ensure that the
scalp quickly returns back to a healthy condition.
Cost of Minoxidil: £300 - £500 per year.
The treatment which can produce the best regrowth of hair
(excluding hair transplants) is Finasteride, sold in the UK
under its trade name, Propecia. Finasteride is a drug which
blocks the conversion of testosterone into dihydrotestosterone,
this means that there is much less DHT in the cells of the
hair follicles to prevent hair growth. The action of Finasteride
can be impressive, with the first effect being a reduction
in hair loss of up to 90%, this usually happens within a month
or two of starting the treatment. Within six months approximately
50% of men will have new hair growing, usually on the periphery
of the thinning regions. Within twelve months the re-growth
can be considerable over the entire region.
Propecia is only available on private prescription from a
doctor. There can be some minor side effects from Finasteride,
so consult your doctor about its use.
Many people find that the combined effect of taking Finasteride
internally and using a treatment which is applied to the scalp
has the best effect.
Cost of Finasteride: £300 - £400 per year.
Hair Transplanting is a surgical technique that involves moving
individual hair follicles from the donor site at the back
of the head to bald area of the scalp (the recipient site).
The reason this technique can be very successful is because
the hairs which are transplanted from the back of the head
are not genetically programmed to respond to elevated levels
of DHT and so will not be lost as the original hair were.
Hair transplantation has improved enormously over the last
15 years or so. Originally comparatively large grafts of skin
were transplanted from one area to the other and frequently
these ‘plugs’ of hair were unsightly. Indeed, in the past
I have come across hair transplants so badly done eventually
all the plugs had to be removed because they looked embarrassingly
In total contrast this, however, there have always been excellent
hair transplant surgeons who’s work was always superb; and
things have got even better with the last few years with a
technique called micro-grafting. This is where, instead of
the large plugs of skin, very small grafts containing 1 to
4 hairs are inserted into the thinning area of the scalp,
with often spectacular results. In the right hands this technique
results in totally natural looking hair which is virtually
undetectable even to an expert eye.
Cost: £4,000 - £10,000+ depending on the number of graphs
Juniper Mint Scalp Therapy Shampoo
The Juniper Mint Scalp Therapy Shampoo has been clinically
developed and can have dramatic effects on the scalp and hair.
It is rich blend of natural, therapeutic oils including juniper,
corn mint, thyme, tea tree and rosemary oils, these are combined
with coconut derived cleaners to create a unique shampoo that
not only ensures that the scalp is healthy and free from scale,
but creates the optimum conditions for hair growth. It does
this in three ways:
1. By generally improving the health of the scalp. This, in
many cases, allows the hair to grow better. Your hair is a
product of your scalp. It grows from the scalp and it depends
upon it for its nourishment and well being - similar to a
rich fertile soil needed for plants to grow and flourish -
so when the scalp becomes unhealthy more often than not it
shows in the hair, frequently in the form of hair loss, so
improving the health of the scalp can greatly reduce the quantity
of hair falling out.
Research by scientists at the Department of Dermatopathology,
University of Liège in Belgium published a paper showing that
when certain anti-microbial substances, traditionally used
to treat dandruff, are incorporated into a shampoo at elevated
levels they have a marked effect in the prevention of male
pattern hair loss.
The study states “When one of these substances, Piroctone
Olamine, is incorporated into an appropriate shampoo base
and used 2-3 times per week there is reduction in hair loss
by 16.5% and increase in hair growth of by 8%”.
The juniper mint scalp therapy shampoo contains 1% Piroctone
Olamine and stimulates hair growth as reported in the University
of Liège study.
3. As previously mentioned, the hair of many people responds
well to the use of minoxidil. There is, however, one great
drawback in the use of topically applied treatments such as
this. Much of the solution applied to the scalp is absorbed
by scale on the surface of the scalp, therefore preventing
the solution from flowing down the hair follicle to the target
site, the dermal papilla (the root of the hair) at the base
of the hair follicle.
To overcome this obstacle and allow Minoxidil to be more effective
the juniper mint scalp therapy shampoo clears the scalp surface
of absorbent scale (this scale is not just dandruff flakes,
but an ordinary, daily accumulation of dead skin cells) allowing
a higher proportion of topically applied Minoxidil to reach
the root of the hair and an stimulate hair growth.
The Juniper Mint Scalp Therapy Shampoo works extremely well
when used in conjunction with any of the other treatments
described here. In fact, the synergistic effect of combined
treatments gives the absolute optimum results for hair loss
prevention and hair re-growth.
Cost: A 250ml bottle of Juniper Mint Scalp Therapy
Shampoo costs £16.50 and lasts approximately 2 months. It
is available from UKhairdressers.com.