Hair loss Dr Rob Hicks Hair loss is probably the one thing that causes men more anxiety than anything else in their lives. A receding hairline or the arrival of a bald patch can have a dramatic effect on men's confidence and self-image.

In this article

What happens? Why does it happen?

Can I stop it? Should I see a doctor?

Treatments

Hair may start to disappear from the temples and the crown of the head at any time. For a few men this process starts as early as the later teenage years, but for most it happens in their late 20s and early 30s. A little thinning of the hair may be noticeable first, followed by wider hair loss allowing more of the scalp to become visible.

Some men aren't troubled by this process at all. Others, however, suffer great emotional distress associated with a lack of self-confidence and sometimes depression.

In male pattern baldness, which tends to be inherited, the hair is usually lost at the temples and the crown. This happens because of an excess of a chemical called dihydrotestosterone, or DHT, which causes the hair follicles to make thinner and thinner hair until they eventually pack up completely.

Other causes of hair loss include:

• iron-deficiency anaemia
• under active thyroid
• fungal scalp infection
• some prescribed medicines
• stress

These are usually reversible.

If there's a reversible cause, it's normally possible to stop hair loss. For instance, if it's caused by anaemia you can stop hair loss by replenishing the body's iron stores.

A huge number of treatments have been tried to slow down and even reverse the process of male pattern hair loss - some are successful, others aren't. But many men find their hair loss slows down or stops for no apparent reason at a certain age anyway.

It's a good idea to ensure an illness isn't responsible, particularly if the hair loss is patchy rather than being in the typical male pattern distribution. Moreover, if the hair loss is accompanied by other symptoms (such as tiredness) then blood tests may be necessary.

• Wigs and hair transplants are, obviously, the most direct form of treatment. Different hairstyles can create the appearance of a fuller head of hair.
• Herbal preparations that contain zinc, magnesium, iron, vitamin E and other substances in various combinations can help.
• Minoxidil is a lotion available from the pharmacist that you rub on to the scalp. It slows down the process of hair loss and can cause new hair growth but you have to keep on using it or it will stop being effective.
• Finasteride (Propecia) is the latest drug treatment. It comes in tablet form and works by slowing down hair loss; it's also reported to cause new hair growth. In the UK it's only available on private prescription from your GP.

Hair-raising alternatives

Bizarre treatments have included rubbing curry into the scalp or having a cow lick the scalp.

This article was last medically reviewed by Dr Rob Hicks in May 2005.
First published in October 1997.