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How to (Actually) prevent baldness

 Find out what types of hair loss there are, whether you have hair loss and what really helps if you are threatened with baldness

Flat-hand drawn hair loss concept

When the look in the mirror shows a receding hairline and the beginnings of a bald head, the good mood is over. For many men, hair loss is like losing your own potency. Even in the Bible, Samson lost his superhuman strength when his hair was cut off. So that today's guys don't feel like that, around 200 million euros for hair care products pass over the checkout counters in cosmetic stores every year.

How Much Hair Loss is Normal?

Half of the men over the age of 20 can expect to lose their hair. The loss of up to 100 hairs a day is not a cause for panic, but quite normal. Only when this amount is clearly exceeded over a longer period of time does medicine speak of pathological hair loss. So that you don't have to pull your - remaining - hair, we have put together the best methods, active ingredients, and remedies for hair loss in men, and inform you about the latest scientific status on laser therapy against hair loss, hair transplantation, and toupee technologies.

What types of hair loss are there?

There are three particularly common types of hair loss in men: genetic hair loss, circular and diffuse hair loss. In the following, we will decipher how you can recognize what form you are suffering from and what helps against it

1. Genetic hair loss in men

Doctors call it androgenetic alopecia, for those affected it is the receding hairline and the circular tonsure on the back of the head that slowly but surely move towards each other - in short: male hair loss. What is masculine about it? The cause of continuous hair loss is the male sex hormone testosterone or its breakdown product dihydrotestosterone (DHT): Testosterone is broken down into dihydrotestosterone in the scalp. It shortens the growth phase of the hair until the follicles, the growth motors for hair, finally die. The result: the hair thins out.

There is a 95 percent chance that DHT is the leading cause of hair loss in men. Genetically caused hair loss usually sets in between the ages of 20 and 30. Depending on personal genetic makeup, the hair on the head only thins on the forehead or the back of the head. Complete baldness develops rather rarely, often a fringe of hair remains on the back of the head.

Do you want to know how you look when you are old? Then a look at the ancestral gallery helps: Often one's own hair loss is similar to the pattern with father and grandfather. Three factors determine the course of the disease: the genetic make-up, age, and the sensitivity of the follicles to the male hormones. "According to statistics, 60 percent of all Central Europeans have thin hair or a bald head," says dermatologist Hans Wolff from the Ludwig-Maximilians- University in Munich.

By the way: The extent of hair loss is not related to the natural level of the male hormone testosterone: Bald heads are no more potent than full-haired people. However, they usually tend to have increased body hair.

2. Circular hair loss in men

The so-called alopecia areata, or circular hair loss, leads to an extensive and rapid loss of head of hair. Identification marks are about the size of a coin, with circular gaps in the hair. It occurs in one to two percent of hair loss and can even affect children. Particularly insidious: it sets in when you are completely healthy and sometimes not only the head is affected, but also other body hair, such as beard, eyelashes, or genital hair. If you are unlucky, you suddenly find yourself completely hairless.

The good news: With circular hair loss, the follicles do not die, only their growth stops. Hair can grow again at any time and without any therapy. It is assumed that a malfunction of the immune system plays a role in circular hair loss. Defense cells are misdirected and directed against components of the hair. The result is that the hair roots are paralyzed.

Here, too, the genes play a role: Circular hair loss occurs more frequently in affected families, often together with neurodermatitis, hay fever, white spot disease (vitiligo), or a thyroid disorder.

3. Diffuse hair loss in men

Diffuse hair loss (effluvium diffusum) can occur regardless of age and hormone levels. A quick start without any particular localization is typical for him. There are no receding hairlines or circular bald spots, the head of hair is thinner all over the head.

The causes that drive the hair from growing into the resting phase and after a few weeks from the head have not been fully scientifically clarified. Possible causes include fever attacks (over 39 degrees Celsius), flu-like infections, or chronic inflammations, which usually precede hair loss by a few months. In addition to health, a lack of protein or trace elements can lead to a long-term undersupply of the hair roots with important nutrients - especially iron or zinc. Likewise, drug intolerance can force the hair to escape from the scalp. In addition, psychological causes are also the trigger for diffuse hair loss. Many sufferers report that stress led to the loss of the curly head.

Characteristically, the clearing on the head does not begin until a few months after the triggering event. So if you want to know what causes your sudden hair loss, you have to develop detective skills.

Other causes of hair loss in men:

  • It is not only androgens, the male hormones, but that can also cause clear cuts. You can also lose your hair when doping anabolic steroids to improve performance or gain muscle.
  • Fungal infections on the scalp interfere with hair growth.
  • Do you suffer a lot from stress? Get more rest. Because stress can also lead to (mostly temporary) hair loss.
  • Unilateral, vitamin and nutrient-poor diet affects the hair roots. Particularly important for hair growth: iron, zinc, biotin, omega-3 fatty acids, vitamins A, C, and E as well as B3, B6, and B12. In practice, this means: lots of vegetables, often fish and don't forget the fruit. Positive side effects: Your health also benefits from it.

What helps with hair loss?

As you now know, not only are there different types of hair loss in men, but also numerous causes. Before you storm into the drugstore or pharmacy and invest a lot of money in a promising hair restorer, you should clarify the exact cause of your hair loss.

Which doctor do you go to with hair loss?

The best addresses for this are the hair consultation hours with hair doctors. For example, they investigate the scalp under the microscope, analyze the hair roots (Trichogramma), take tissue samples (scalp biopsy), and establish a hormone status. Using your services is not always covered by your health insurance. Nevertheless, it makes sense to have an accurate diagnosis made by a specialist in order to begin an optimally coordinated therapy. As early as possible! Because even the best therapies can usually only stop hereditary hair loss, for example, but cannot bring back the lost hair.

What really helps against hair loss in men?

Not every hair loss remedy does what it says on the tin. However, the following agents and methods against hair loss have been scientifically proven.

Minoxidil for hereditary hair loss

Minoxidil came on the market in the 1970s as a drug used to treat high blood pressure. Common side effect: increased hair growth. The pharmaceutical industry took advantage of this and developed a 5% minoxidil solution that men apply to thin hair twice a day - with scientifically proven success in many, if not all, cases. Today, over-the-counter minoxidil products are among the best-selling anti-hair loss products in pharmacies (a daily dose costs around 1$).

Minoxidil is contained, for example, in the well-known: 🛒 Regaine men

Possible side effects are dizziness and a drop in blood pressure. Those who start therapy first need strong nerves: before hair growth starts again, there is increased hair loss. As a consolation: This so-called shedding shows that the therapy is working. But: As soon as Minoxidil is discontinued, the hair loss starts again.

Finasteride for hereditary hair loss

The drug has long been considered the gold standard against hair loss. The results were and are impressive. Unfortunately, there are also side effects. Because finasteride was often associated with depression and erectile dysfunction, there is now the "Red Hand Letter" for the drug.

Topical immunotherapy for circular hair loss

In circular hair loss, the body's own defence system is directed against its own hair follicles. Hair growth stops, but the hair root remains. Topical immunotherapy involves targeted contact sensitization of the scalp with Diphenylcyprone (DPC) or dibutyl squarate (SQADBE). The chemicals are applied to the scalp and are said to cause an allergy known as contact eczema. The resulting inflammatory reaction is supposed to "distract" the immune system so that the hair roots can produce hair again. The maximum 2% DPC solution is applied to the scalp once a week in the doctor's office. Side effects are slight redness and flaking on the treated areas. "This treatment method is scientifically recognized and is now considered the most successful form of therapy for circular hair loss," says dermatologist and hair expert Dr Frank-Matthias Schaart from Hamburg, "The healing rate for this form of therapy is around 40%." DPC treatment usually lasts 1 to 1.5 years and is gradually discontinued. The costs of around 230 euros per quarter are not covered by all health insurance.

Cortisone for hair loss in men

Cortisone suppresses immune reactions and is therefore also used as a remedy for circular hair loss. Haircare professionals inject it under the hair follicle or prescribe it in tablet form to stop hair loss. However, the relapse rate is very high once it is stopped.

Mesotherapy for diffuse and androgenetic hair loss

"With this form of therapy, highly effective growth factors are injected into the cooled scalp using microfine needles in order to stimulate new hair growth," explains Schaart. The procedure is carried out twice a week over a period of up to 6 weeks. The procedure promises good results, especially for men with diffuse and hereditary hair loss. However, the health insurance companies usually do not pay the costs of around 150 euros per session.

Laser for diffuse and hereditary hair loss

The therapeutic possibilities of lasers have increased immensely in recent years. In his Hamburg practice, hair doctor Schaart successfully treats men with diffuse and hereditary hair loss with the diode laser. Laser light from the infrared wavelength range is radiated into the scalp. This increases the blood flow to the hair roots and thus their supply of nutrients and energy. "On the one hand, this counteracts hair loss, and on the other hand, a strong activation of new hair growth is achieved," says Schaart. A single laser session lasts around 30 minutes and costs around 55 euros. A total of 6-12 months of treatments with initially 2 sessions per week, later with appointments every 2 weeks.

In the case of circular hair loss, the doctor uses a fractional laser. Schaart: "With its help, microfine injury stimuli deep under the scalp stimulate the activity of the tiny, complex motor of the hair root to the maximum, thereby stimulating new hair growth." Treatments must be carried out every 4 weeks, the costs are between 50 and 350 euros (whole head) depending on the size of the area.

Shampoos and hair lotions with caffeine for fuller hair

Highly dosed caffeinated hair lotions are able to supply blood to deeper layers of the scalp so that still active follicles can produce stronger hair, which results in a fuller hair appearance. The best-known representative of this product group is 🛒 the caffeine liquid from Alpecin. You can find an overview of other products specifically against hair loss here: The best products against hair loss.

Hair transplant as a last resort

Since men like Jürgen Klopp and Wayne Rooney officially committed to their hair transplants, transplanting their own hair has become a serious option for many men with a fringe of hair left (and a lush bank account).

Since hair on the back of the head is less sensitive to hormones, it usually remains in place despite hair loss. About half of the hair can be removed from the fringe without the loss becoming apparent. The surgeon (recently a robot can do that too) transplanted healthy hair roots from densely hairy areas on the back of the head. "The hair transplant is usually carried out on an outpatient basis under local anaesthesia and takes 3 to 6 hours," explains Dr. Frank Neidel, President of the Association of German Hair Surgeons. The costs are between 3,000 and 10,000 euros and are usually not covered by health insurance.

There are two common hair transplantation methods: the removal of the hair roots from a narrow strip of skin with hair root isolation under the microscope (strip method) and the removal of individual hair roots with the help of thin hollow needles (Follicular Unit Extraction, FUE method). Both methods have advantages and disadvantages. "Be careful with providers who only advertise one method," warns Neidel. "An experienced surgeon has mastered all techniques, will find out the best and will be able to justify his decision."

Since 2015, the FUE method (individual removal) can also be carried out with the help of a robot system. The advantage of this system is the precisely automated removal of the individual hair roots from the hairline. As with every single removal technique (FUE), the removal area must be shaved over a large area to a hair length of 1 mm. Neidel: "This means that most women or managers and executives who do not suddenly want to appear bald at work are ruled out this technique. Especially young men between the ages of 20-30 who have the 'undercut' or 'bald head' wear benefit from this technology. "

In the meantime, 20% of all hair transplants worldwide are performed using the FUE removal technique, and 80% of all patients can be treated using strips. Important: Make sure to seek out a specialist who is recognized (licensed) by the medical association and who performs hair transplants as daily as possible. "Also very important: seek advice from the attending physician and ask about training and further education," advises Neidel. Get a second opinion if you are unsure. If you are still not quite sure, you better wear a toupee - or bald head!

Is a toupee really an option?

Do you remember André Agassi, how he played his Grand Slam tournaments with a long, wild mane of hair and a headband? What nobody knew at the time: The hair was wrong, the tennis professional wore toupees. In his biography "Open" he impressively describes how it felt during sweaty games, as well as his fear of losing his hairpiece during a match. How good that toupees have developed in recent years so that wearing toupees can be comfortable even for athletes. The advantages: no health risk as with a hair transplant, zero side effects as possible with tablets or tinctures against hair loss. These two methods achieve amazingly real effects:

  • Artfully braided The production of an invisible wig begins with a plaster cast of your head. On the basis of this imprint, specialists create a fine mesh that lies on the head like a second skin. This ensures that the hair replacement fits like a tailor-made suit. Thousands of hairs are braided into the net, the colour patterns of which are exactly matched to your hair colour.
  • Glued waterproof The ContactSkin company manufactures tailor-made hairpieces that are invisibly and durable applied to the hair gaps by certified specialist dealers or hairdressers. A hairpiece stays on the wearer's head for 4-6 weeks, after which a specialist detaches it, discards it, and attaches a new one. The toupee stays in the water, you can swim, ride a bike, go to the sauna, have sex, sleep with it. The price per hairpiece is around 350 euros plus service costs.
  • With the Folium step-by-step method especially for men by Hairdreams, a small toupee is first glued on, which turns out larger when replaced every month, so that the transition to more hair is inconspicuous and the impression is created that the hair is growing back.

Front view of elder senior man holding comb

Why do men suffer so much from hair loss?

According to the American Hair Loss Association, 95 percent of hair loss in men is caused by androgenetic alopecia.

Compared to their European neighbours, Germans suffer much more psychologically from their hairy problems, according to a survey by the GALLUP institute of 1,500 European men. 62 per cent of all Europeans say that hair loss affects their self-esteem. In Germany, however, it is even 76 per cent. And while hair loss across Europe makes an average of 21 per cent of those affected depressed, in Germany it is 43 per cent.

Many also perceive hair loss as a flirtation brake par excellence: 46 per cent feel that their light hair prevents them from addressing women. More than one in three Germans also thinks that they receive less attention when flirting because of their hair loss (38 per cent). 68 per cent say hair loss makes them unsafe.

Do women still find bald men attractive?

Fortunately, hair combed into the forehead like Donald Trump is unlikely to ever become a trend. These tricks make you look much more confident and attractive despite progressive hair loss:

  • Make a side parting. Although it emphasizes the receding hairline, on the one hand, a quiff on the other still creates an impression of fullness.
  • Wear baseball caps or hats that cover up advanced hair loss. Underneath, however, the remaining hair should not be longer than 5 to 6 millimetres.
  • Combine your bald top with a 3-day beard sheared to the same length.

Before you embark on the hair transplant adventure or spend a lot of money to let your hair grow again, you should at least think once about whether a bald head would really be a visual disadvantage for you. Not every type of man has a bald head, no question about it. But more and more men stand by their thin hair. And more and more women are finding bald men sexy.

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