Men in their 20s are losing hair at a rapid rate.
Male pattern baldness is affecting an increasing number of young men, and lifestyle factors may be to blame. Here’s how to treat it.
The “pattern” will be familiar to anyone who has seen those iconic pictures of Albert Einstein in which the sides of his hair flare outwards but the front and top of his head remain bare. This is the formation that drives me to my local barber to this day.
At 60 years old, the sides and back of my head are covered in thick, fast-growing white hair while the front and top are blessed with a sparse and wispy fuzz — the hum of the clippers is always a relief. No one ever walks into a barber and asks for an Einstein.
Androgenetic alopecia or male pattern baldness affects 30 per cent of men under 30, and about 80 per cent of men over 70, according to the National Institute for Health and Care Excellence (Nice).
I was in my early 20s when my baldness moved incrementally from a future possibility to a present reality. Treatments were few and largely fictitious back then, so I embraced my fate with the number one/two crop I’ve worn ever since. Looking back, I now realise my university years probably weren’t helping – a life of toast, beer and late nights for “deep” conversation with fruit and vegetables deemed effete and suburban.
A recent study in Tsinghua University in Beijing found that young men who consume sugary drinks are more likely to experience male baldness. Although the mechanism was unclear, the researchers saw a correlation between sugar intake and male pattern hair loss.
I was lucky in that I was able to accept my new hair-free status but, says the consultant trichologist Anabel Kingsley of hair specialists Philip Kingsley, many young men find hair loss extremely distressing.
“I have had a couple of young men who have refused to get into photos with friends, they’ve been teased about it because it’s more acceptable to tease men. They will laugh but then be privately really self-conscious. I’ve met young men who have gone into depression. One man loved swimming but refused to swim because when his hair was wet his baldness became more visible.”
I asked Kingsley what role lifestyle plays in male pattern hair loss. She says genetics are behind the condition but the way we live can exacerbate the issue.
Chronic ongoing stress has a depleting effect on the entire system and is more associated with temporary hair-shedding conditions, but the impact on men’s hormones can affect hair and scalp, Kingsley says. “Stress is a big one. Men of all ages can be stressed, but especially when you’re young. The trigger for male pattern baldness is the production of testosterone. Stress can increase testosterone levels as well as impact scalp health to make dandruff more likely.” Dandruff can accelerate pattern baldness – an excess of yeast in the scalp creates too much skin turnover, which increases daily hair fall.
Kingsley says she has seen this impact her younger male clients in particular. “It’s common that I see nutritional deficiencies that crop up especially in college when they’re not eating very well or they’re not eating at all and drinking. Vitamin D deficiency is quite common in men generally, even more so in younger men who might not have the knowledge or awareness to take supplements.
“Older men tend to understand the importance of vitamin D, immune health and general wellbeing and younger men don’t realise this making their hair loss worse. If you’re drinking loads, you could be experiencing vitamin B12 deficiency too.” Vitamin D deficiency puts more hair into the “rest” phase, increasing shedding. Vitamin B12 deficiency affects the body’s ability to develop healthy growth by impacting blood flow.
Exercising to excess will exacerbate hair loss, says Kingsley. The effect of too much aerobic exercise is a form of stress on the body and has a similar depleting effect to psychological stress. However, a recent study carried out at Central South University in China found that 60 minutes of exercise on a regular basis “helps to delay the progress of male pattern baldness and improve the symptoms”. Weight training could increase testosterone, which progresses male pattern baldness, although the increase is only temporary and there is no evidence weight training is directly linked to hair loss.
Male pattern baldness
For male pattern baldness, Kingsley says she is seeing very positive results with a combination of drugs and hormone therapy but emphasises this technique is more effective at retention than regrowth. “The younger you start treatment and the harder you hit it, the more effective it is. We find the best treatment is minoxidil and finasteride [hormone therapy].” She combines minoxidil with hair-friendly female hormones.
She emphasises that the female hormones do not affect overall balance in a male client. “With the topical solutions, you would ideally apply the minoxidil and hormone drops in the morning, and then the minoxidil and finasteride drops in the evening. As our finasteride is topical, and not ingested, the chances of side effects are much lower, and we haven’t had anyone report adverse effects.” Topically applied, finasteride works in the same way as the pill form, she says, but acts only on the scalp – it’s usually at least three months before any benefit can be seen.
Alopecia areata
Hair loss caused by a condition like alopecia areata is a different beast. This is an autoimmune disease that creates temporary patches of hair loss and can be caused by a shock or bereavement and often clears up without treatment.
Louis Theroux is currently losing his eyebrows and patches of beard as a result of alopecia and Jada Pinkett Smith has been very open about suffering from this condition.
Research in Japan has found that lifestyle factors such as stress, excess alcohol and poor nutrition can also play a role in alopecia areata.
Kingsley says the most effective treatments are prescription Vitamin D, UV therapy, steroid injections (obtained at a dermatologist), and immunosuppressants – this is reserved for severe cases and can cause side effects, so it needs a doctor’s prescription and close monitoring. There are also topical irritants like dithranol, which work by tricking the immune system back into recognising hair follicles as healthy tissue.
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