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Hair loss
Most men will experience hair loss in their lifetime, with 66% of men aged 35 already thinning. There are two main causes, says Dr Marco Nicoloso, a hair loss expert and medical director at Ouronyx. “The most common form is androgenic alopecia, male pattern hair loss, which is genetic and hormone driven. About 80% of men will experience this at some point – it could begin when they are 16 or when they are 60. The second most common form is telogen effluvium: shedding related to a stressful event. If the stress resolves, then the hair grows back.” A trichoscopy, in which a dermatologist takes close digital images of the scalp, can establish the cause.
As with skin ageing, lifestyle factors can hasten hair loss. Since the rise of Ozempic, Nicoloso increasingly sees patients who are losing hair through restricting calories. “Hair is 80-90% protein, so it’s particularly important to be eating enough protein if you want to maintain it,” he says. It’s also crucial to keep the scalp clean. “It’s a very oily environment full of bacteria and fungi, and needs to be washed every day. Shampooing removes the sebum, balances the pH and protects the hair follicles.”
While many men are content to lose their hair, 62% say that hair loss negatively affects their self-esteem, with 21% reporting feelings of associated depression. “Some patients accept it: they shave their heads and are completely fine,” says Nicoloso. “For others, it has a strong psychological impact.”
While transplants have surged in popularity, beginning medical treatments at the early signs of thinning can “delay or even avoid the need”. Nicoloso suggests asking your doctor about finasteride, a private prescription medication that acts as a hormone blocker to reduce the progression of thinning (there are potential side effects, including problems with libido and erections, although these should improve during treatment and in most cases stop once treatment is discontinued). This should be paired with minoxidil, which stimulates hair follicles to encourage growth and thickness, and is available as a prescription pill or over the counter as a topical treatment. If you do decide to progress to a transplant, medications will maximise the outcome by ensuring you have thick hair in the “donor area” from which hairs are harvested.
Transplants can be transformational for “the right candidate at the right time”, says Nicoloso. “I see a lot of patients who have transplants too soon, and without going on medication first. Transplanted hair is not sensitive to the thinning progression, so it will stay thick. But the existing hair will keep getting thinner without medication, so you end up having gaps. A 360 degree approach – correcting any deficiencies, having a healthy lifestyle, taking care of scalp health and considering medication – will maximise your outcome.”
Most men will experience hair loss in their lifetime, with 66% of men aged 35 already thinning. There are two main causes, says Dr Marco Nicoloso, a hair loss expert and medical director at Ouronyx. “The most common form is androgenic alopecia, male pattern hair loss, which is genetic and hormone driven. About 80% of men will experience this at some point – it could begin when they are 16 or when they are 60. The second most common form is telogen effluvium: shedding related to a stressful event. If the stress resolves, then the hair grows back.” A trichoscopy, in which a dermatologist takes close digital images of the scalp, can establish the cause.
As with skin ageing, lifestyle factors can hasten hair loss. Since the rise of Ozempic, Nicoloso increasingly sees patients who are losing hair through restricting calories. “Hair is 80-90% protein, so it’s particularly important to be eating enough protein if you want to maintain it,” he says. It’s also crucial to keep the scalp clean. “It’s a very oily environment full of bacteria and fungi, and needs to be washed every day. Shampooing removes the sebum, balances the pH and protects the hair follicles.”
While many men are content to lose their hair, 62% say that hair loss negatively affects their self-esteem, with 21% reporting feelings of associated depression. “Some patients accept it: they shave their heads and are completely fine,” says Nicoloso. “For others, it has a strong psychological impact.”
While transplants have surged in popularity, beginning medical treatments at the early signs of thinning can “delay or even avoid the need”. Nicoloso suggests asking your doctor about finasteride, a private prescription medication that acts as a hormone blocker to reduce the progression of thinning (there are potential side effects, including problems with libido and erections, although these should improve during treatment and in most cases stop once treatment is discontinued). This should be paired with minoxidil, which stimulates hair follicles to encourage growth and thickness, and is available as a prescription pill or over the counter as a topical treatment. If you do decide to progress to a transplant, medications will maximise the outcome by ensuring you have thick hair in the “donor area” from which hairs are harvested.
Transplants can be transformational for “the right candidate at the right time”, says Nicoloso. “I see a lot of patients who have transplants too soon, and without going on medication first. Transplanted hair is not sensitive to the thinning progression, so it will stay thick. But the existing hair will keep getting thinner without medication, so you end up having gaps. A 360 degree approach – correcting any deficiencies, having a healthy lifestyle, taking care of scalp health and considering medication – will maximise your outcome.”
