For Men, Hair Loss is Common, but Very Treatable

Losing your hair is a common worry among guys, who may think baldness is inevitable. Some estimates show two out of three men will see the signs of hair loss by 35.

Hair loss can be devastating and upend good self-esteem. Most men would like to do something about their hair loss, but understanding exactly what to do can be a challenge.

The good news is that doctors now know more about the underlying causes, and therefore understand how to better treat this condition.

Everyone loses hair; in fact, shedding is part of the hair growth cycle.

Sometimes, however, people start losing more than they can regrow. And if you’re noticing this, perhaps it’s time to book an appointment with a dermatologist.

A board certified dermatologist can determine the cause of hair loss and help decide on the best course of action to slow, stop or even reverse the hair loss.

While there are multiple causes of male hair loss including autoimmune conditions like alopecia areata, 95 percent of cases are caused by male pattern hair loss (AKA androgenetic alopecia), according to the American Hair Loss Association.

Male pattern baldness is caused by hair follicles that are sensitive to a hormone called dihydrotestosterone, or DHT. The 5-alpha reductase enzyme converts testosterone to DHT and DHT can cause the slow process of hair loss in susceptible hair follicles. Hairs that are susceptible to male pattern hair loss are usually located in the crown and hairline of a person’s head, said Dr. Vlad Ratushny, MD, PhD, a dermatologist and hair restoration surgeon at Massachusetts Dermatology Associates. Susceptible hair follicles undergo a process of miniaturization during which they shrink in diameter over time. Eventually, hair becomes sparser and thinner throughout the affected areas of the scalp leading to late stage baldness.

Fortunately, the stigma surrounding treating a man’s baldness has waned substantially.

There are two common FDA approved medications to treat hair loss. The best-known is a topical medication called minoxidil, or commonly known as Rogaine. The other is finasteride, sold under the brand name Propecia.

“Rogaine is best used at the early stages of hair loss because it is most effective at keeping the hair you already have,” Dr. Ratushny said. There will be some re-growth, but probably not a lot.”

On the other hand, Propecia “stops hair loss in its tracks,” he explained.

The caveat is that once you start either Rogaine or Propecia, you’ll need to continue taking them for life because your hair loss will resume upon their discontinuation.

There’s plenty of speculation about a few famous men who have undergone hair restoration surgery to fight baldness — NBA star LeBron James, Kevin Costner, John Travolta, Jeremy Piven and Matthew McConaughey, just to name a few.

New England Patriots quarterback Tom Brady even inspired a fan to get a hair transplant. He chronicled the experience in an article for the New York Post.

Numbers from the International Society of Hair Restoration Surgery show a 27 percent increase in transplants in the US since 2012, with patients spending about $2.5 billion for hair-restoration surgery every year. More than 80 percent of the increase comes from men.

Hair transplantation offers patients the only permanent solution to hair loss, Dr. Ratushny said.

During the procedure, a hair transplant surgeon harvests “donor hairs” from the back of the scalp, where hair follicles do not undergo male pattern hair loss. The hair restoration surgeon will transplant those hairs to the balding areas and recreate the hairline according to the patient’s goals and expectations.

Surgery can cost anywhere from $4,000 to $11,000 and can take up to 12 hours. Modern hair transplantation does not use hair plugs. Instead, fine microsurgical techniques are used to transplant individual follicular units, made up of 1 to 4 individual hairs. “The angle, direction and curl of the hair is considered as each follicular unit is meticulously placed in the scalp,” states Dr. Ratushny.

“The great part about hair transplants is that it’s your real hair and you can do anything to it as you would with your non-transplanted hair,” Dr. Ratushny said. “You can dye it, cut it, run your fingers through it because it’s your own real hair.”

Though the price tag may sound like a lot, he explained that the price of years of oral or topical treatments can add up.

“It might be cost-effective to get the transplantation,” Dr. Ratushny said.

He noted the technology is so good that it should be hard to differentiate transplanted hair from a patient’s normal hair.

“If someone gets a good hair transplant, it should be difficult for others to even know that he’s gotten a transplant, other than having a fuller head of hair,” he said.

If you would like to make an appointment with a Lahey Health dermatologist to discuss hair loss treatments, check out our website.


*The content on this website is for informational purposes only and is not medical advice. Please consult a physician regarding your specific medical condition, diagnosis and/or treatment.

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