Why Do Men Go Bald? Is There Anything You Can Really Do About It?

Hair is an integral part of a person’s appearance . Hereditary baldness (baldness that runs in genes) always raises concerns. Let’s learn more about baldness and ways to prevent it.

About Baldness

How common is baldness in India? According to a demographic study held in 2011, around 46% of men in their 20s have experienced baldness. Numbers haven’t decreased since then because the cause is largely inherited . Your chances of going bald increase if your maternal or paternal family members have also had the issue of balding . This baldness that runs in families is called androgenetic alopecia, or male pattern baldness. Although alopecia (hair loss) can have multiple causes, male pattern baldness  is the most common.

Hair grows in our body in a cycle. It follows four phases:

1. Anagen( Growing Phase): This is the growing phase of the hair. During this phase, hair grows actively from the follicles (structures on our scalp from which hair grows).
2. Catagen( Transition Phase): During this phase, hair stops growing and starts loosening at the hair follicles. This phase lasts for 10 days.
3. Telogen( Resting Phase): During this phase, the loosened hair rests in the respective hair follicle for around two to three months before starting to fall off.
4. Exogen( Shedding Phase ) :The exogen phase is essentially an extension or a part of the telogen stage of hair growth. During the exogen phase, hair is shed from the scalp, often helped along by washing and brushing. Losing 50 to 100 hairs per day during the exogen phase is normal.

So hair loss is a natural physiological process. Hairs grow, loosen, fall, and grow again. But the normal amount of hair fall each day due to this hair cycle is 50 to 100. If the number exceeds this, the condition is called alopecia. Hair loss or alopecia is a disorder resulting from impaired hair production. Hair loss can be grouped into certain types:

• Frontal fibrosing alopecia: This is the most commonly seen pattern among patients complaining of hair loss. In such patients, hair recedes at the hairline on the forehead gradually. 
• Alopecia areata: In these patients, hair loss occurs in patches. Patchy bald spots start appearing on multiple areas of the scalp. Initially, there is itchiness and pain on the skin, followed by hair loss.
• Tinea capitis: It is one of the common causes of hair loss among children. Tinea capitis or scalp ringworm is a fungal infection of the scalp. Children usually present with a red, scaly, and itchy scalp associated with hair loss. Sometimes, it is also associated with pus-filled blisters.
• Sudden loosening of hair: Usually, hair loss is a gradual process, but sometimes patients with a healthy scalp and no family history of hair loss complain of hair loss. This could be due to stress or other factors .
• Full-body hair loss: This is seen in cancer patients receiving chemotherapy. This type of alopecia isn’t scalp-specific, and hair loss occurs in the entire body.

What Are the Other Causes of Hair Loss?

• Hormonal changes: This is one of the most common causes of hair fall among women. This can happen during pregnancy, childbirth, menopause, or contraceptive pills. Such events are associated withhormonal imbalance, leading to hair loss.
• Drug and chemotherapy: Chemotherapeutic drugs (drugs used in cancer), antidepressants, and certain antihypertensives (drugs that lower blood pressure) are some drugs where alopecia (hair loss) is a side effect.
• Stress: Stress can be due to anything – academics, work, personal issues, etc. Stress is quite commonly associated with alopecia (hair loss). Stress due to hair loss can also trigger hair loss.
• Hairstyling procedures: This includes changing your hairstyle by curling, straightening, or bleaching (applying chemicals). Such procedures beautify your hair but also damage it.
• Fungal and bacterial infections: Infection of the scalp due to certain fungi and bacteria can lead to alopecia (hair loss).
• Telogen effluvium:  Excessive shedding of hair can sometimes happen about 2 to 3 months after some sort of shock to the system or stressful event. Hair loss may be triggered by an accident, surgery, illness, drastic weight loss, or some kind of psychological stress. Hair usually grows back within about 2 to 6 months.
• 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.

When Do You Need to See a Doctor?

Certain types of hair loss are reversible in the beginning but become irreversible if left untreated. For instance, frontal fibrosing alopecia, the receding hairline, needs to be treated early to prevent permanent disfiguration. Sometimes, alopecia may indicate other conditions. Hence, seek medical attention immediately at the first sign of alopecia.

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What Are the Ways to Prevent Balding?

The most common cause of baldness is genetics, i.e., androgenetic alopecia. And there’s not much that you can do with your genes. But you can take measures to prevent further damage.

• Stop smoking: Studies show an increased incidence of hair loss among smokers. If you’re a smoker and see the first signs of hair loss, you should stop smoking.
• Deal with your hair gently: Sometimes, when running late to college or work, we comb our hair when it’s still wet. This can damage your hair strands and precipitate hair loss.
• Avoid direct sunlight: Although sunlight is the chief source of vitamin D, too much direct, harsh sunlight can damage your hair. Also, avoid ultraviolet rays.
• Cooling cap: To avoid alopecia among cancer patients on chemotherapy, scientists have developed a cooling cap. This can reduce the incidence of hair loss due to chemotherapy.

How is Baldness Diagnosed?

Patients presenting to the clinic with hair loss need to undergo certain tests to find the cause of hair loss.

• Scalp biopsy: In this test, a skin scrape sample is taken from the scalp. It is examined under a microscope to find whether hair loss is due to infectious causes like fungus.
• Light microscopy: Your doctor might take a sample of your hair and examine it under a light microscope to check if your hair loss is due to a shaft disorder.
• Blood tests: Sometimes hair loss is due to other underlying diseases. Your doctor might perform certain blood tests to check for such conditions.

How Is Baldness Treated?

• Medications: Certain medications can effectively treat hair loss. These drugs include Minoxidil and Finasteride in different formulations and strengths . Certain sprays and topical ointments are also available that combine these drugs. These medications have effectively reversed hair loss in many patients.
• Hair transplantation surgery: This is the most effective cure for permanent hair loss. Dermatologists or cosmetic surgeons perform such surgeries. In this surgery, hair is transplanted to a bald spot from a normally growing area.
• Platelet- Rich Plasma( PRP) Therapy : PRP (platelet-rich plasma) therapy for hair loss is a three-step medical treatment in which a person’s blood is drawn, processed, and then injected into the scalp.
• Nutritional Hair Supplements : This can be used as supportive therapy in baldness,cwhere  hair supplements containing amino acids,cbiotin,minerals etc can be used
• Wigs:These are a more temporary solution but less expensive and versatile. Wigs that are synthetic are generally cheaper when compared to human hair wigs. Human hair wigs look more natural and are easier to style and maintain because polymers hold the structure longer and better under natural fibers.

Conclusion

Hair loss affects your physical appearance. Contact your dermatologist at the earliest to avoid problems.

Frequently Asked Questions (FAQs)

1. Is it normal to lose hair every day?

Hair growth follows a certain cycle. Every day, hair grows and dies. It is normal to shed some hair every day. But if the number exceeds 100, it needs to be checked.

2. Are drugs for hair growth  safe?

Medically, no drug is entirely safe. Every drug has some side effects. Minoxidil and finasteride also have some. Drugs are administered to the patients after estimating the risk-reward ratio. If the risk is high, the drug is withdrawn. Additionally, these medications come in the form of sprays or topical ointments. This mode of application prevents systemic side effects, as the drug acts locally on the scalp and does not reach the bloodstream.

3. Can vigorous brushing have a good effect on my hair by improving circulation in my scalp?

This is partially incorrect. Better circulation can make your hair healthy, but not by vigorous brushing. You can massage your scalp with hair oil to improve circulation. Vigorous brushing damages your hair and increases hair fall.