Hair Loss Causes – Why Do We Go Bald?

For many of us, it’s a worry that starts as soon as we hit adulthood. How long will that lovely bouffant of hair stay around?

There’s plenty of theories and hearsay, about how your everyday lifestyle can affect hair growth and lead to balding… -over washing, stress, styling, too much testosterone and even too much sex are suggested culprits to name but a few. So what can we really do, or avoid doing, to try and keep hold of our luscious locks?!

Worryingly, hair loss can start as early as your teens, with 20% of men suffering some form of balding by the age of 20. And then it just gets worse from there, because, 30% of men will experience hair loss by 30 years old, 40% by 40 and half of men will see their follicles fall by age 50.

 

 

You don’t have to be a genius to see the pattern here. So what’s going on? Well, we tend to lose our head hair in one of 3 ways, on different areas of the scalp: It recedes We develop a bald patch. Or, it thins out The factors that decide the type of hair loss we experience are believed to be genetic, for example studies have shown that twins will lose their hair at the same age, over the same period of time, and in the same pattern.

Okay, so now I’ve set the scene, let’s drill down into some science and take a look at that first type of hair loss I mentioned – the good old receding hairline. This is termed bitemporal recession and is characterised by the triangle of hair that we slowly lose over each temple.

Starting at the anterior hairline and moving backwards creating the familiar ‘M’ shape we associate with receded hair. This can precede any other form of hair loss by many years, and in fact, this happens to some degree in most boys as they hit puberty, though the hair loss is usually quite mild.

If you’re in your teens and have begun to notice your hairline retreating, don’t panic, this is a perfectly natural phase of development and your hair is unlikely to continue receding with any great urgency.

In fact, less than 5% of men retain their straight anterior hairline that they have in boyhood, so don’t feel too bad if you’re among the 95%. The next form of hair loss is the development of a bald patch on the crown of the head, that spreads out in all directions, creating a circular baldness.

In some cases an area at the bottom of the circle can remain, creating a sort of hoof shape. What’s interesting about these two forms of hair loss, is that the hair we lose, seems pre-programmed to behave in this way.

Experiments have shown that when hairs next to an increasingly balding area are transplanted to another location on the body, the hair follicles continue to shrink and fall out on schedule, as though they were still on the head.

The third common form of hair loss is thinning, which occurs at the top of the head and is the most typical form among women, affecting over 75% of the female population and 85% of men, as they age. With this kind, you could lose up to 50% of your overall head hair before you even noticed any balding.

For women, they may realise that their ponytail, for example, is less full, whereas for men it’s harder to remain camouflaged, as we tend to have shorter hair, so an actual bald patch may be the first thing we see.

To find out why we lose our hair, it’s important to first understand the natural cycle of hair growth, and to know when it is perfectly normally for hairs to fall out, and when it’s not.

Hair is made up of two main parts, the hair follicle and the hair shaft. The follicle includes the dermal papilla, which supplies blood and nutrients, and the bulb, where cells divide to grow new hair.

The hair shaft is what is made from these cells, and is pushed out of the follicle, resulting in the new hair growth we see appearing through our scalp. Now we know what we’re looking at, here’s how the 3 phases of each hair’s life cycle happens. The growth phase.

This is called ‘Anagen’, the longer your follicles continue in this phase, the more hair it will produce and the longer it will grow. This tends to last 2 to 6 years, which is why we can end up with such long hair. The regression phase.

Lasting up to 2 weeks, this is a transitional stage called ‘Catagen’, where the hair detaches from the dermal papilla (and blood supply) and growth comes to an end. The follicle shrinks and a bulb of keratin is formed acting as a root to keep the hair in the scalp. This is know as a club hair. The resting phase, called ‘Telogen’.

At this stage the follicle lies dormant for around 3 months, basically doing nothing with your hair not growing. There is actually a proceeding sub-phase to this, referred to as ‘Exogen’, this is where the hair actually falls out. And then, the cycle starts again. Your hairs will all be at different points in the cycle at different times, so that you tend to have a full head of hair at any one time.

During this cycle however, the average adult will lose roughly 100 hairs per day, but with around 100,000 hairs on your head, you’re unlikely to notice losing 0.1% of them, unless your hair’s long enough to clog up the drain.

When the number of hairs that fall out start to significantly increase, you are likely to be suffering from Androgenetic Alopecia which is more commonly known as Pattern Hair loss or Pattern Baldness. This occurs when the hair follicles slowly shrink, the growth phase reduces and the resting phase gets longer. The now smaller hair follicle produces a thinner hair, and as the follicle continues to get smaller with each new cycle, it becomes less and less well anchored to the scalp making it easier to fall out.

Overtime, a reduced growing phase means the hair can not grow as long, and eventually the growth phase becomes so short, that the hair doesn’t even have a chance to peek through the surface of the skin.

Which is a roundabout way of saying, ‘You’re going bald’. So what causes the follicle to start shrinking? Well this brings us on to what Clinical Professor Neil Saddick claims is one of the most common misconceptions. Namely, that having lots of sex and overflowing with testosterone can cause baldness.

This, you’ll be glad to hear, is untrue. But you can see why this myth gained traction, because it is instead a sensitivity to testosterone, where it is converted into a hormone called dihydrotestosterone or DHT, which actually causes the folicular downsizing.

Although you shouldn’t be too resentful of DHT, as this hormone helps form your male characteristics like a deep voice and increased muscle mass. But hey, a lot of guys manage to rock this look. Nevertheless, why are some of us converting more testosterone into DHT and so balding earlier than others? One culprit is an enzyme called 5-alpha-reductase or 5-AR. You see, testosterone is secreted into the body and finds its way into the sebaceous glands under your scalp.

Inside these sebaceous glands is where 5-AR resides waiting to cause you a heap of trouble, because it is here that the testosterone is converted in to the dreaded DHT. As levels of 5-AR increase, more and more of your testosterone will be converted into DHT, this in-turn stimulates more production of the skin’s natural lubricant, Sebum, and more hair loss will occur.

Now if you’re not already bald, then how would you possibly know if you have any of these worryingly high levels? This is where family heritage comes into play, because the best way to identify if your DHT levels are likely to be high, is to look back at your family history, i.e. if your dad’s bald you’re likely to have higher levels of these substances too and so be in the same situation as him.

On the other hand, your father can’t take all the blame, as you may also be able to point the finger at your mother. One of the largest studies on male hair loss was conducted by the University Of Edinburgh in 2017.

It looked at 52,000 men and identified 287 different genetic signals that link to hair loss. Their findings suggest that the long standing theory that men inherit hair loss from their mothers side, often thought to be from her father, does genuinely, hold some weight.

In the study researchers identified that while most of the genetic signals were scattered across the genome, 40 of them were linked directly with the X chromosome which we inherit from our mothers. On the plus side, if your mom’s father had a full head of hair through to a ripe old age then you might be lucky, but if he was as bald as an egg, then I’m afraid you may be heading the same way.

It is common though, for these traits to skip a generation, so there’s still hope yet. Either way we can’t do a great deal about any of this this as it’s all just genetics, unless you go down the route of using anti-DHT medication.

However, it’s not a great idea to mess with your DHT levels, as this is the sex hormone that essentially makes you male, so blocking or reducing the production of this before you have finished developing as an adult is seriously not recommended. Heritage and medication aside, if you know that your hair tends to get oily or greasy quickly, you most likely have a higher production of Sebum.

So the best thing you can do is to try and manage the amount on your scalp by washing your hair regularly, otherwise this can lead to issues like blocked pores that can consequently be detrimental to hair growth.

Leading Trichologist, or ‘Hair Doctor’, Anabel Kingsley as well as specialists at the UK’s leading hair loss clinic, recommend washing your hair daily and claim that the long standing myth that ‘over-washing strips your scalp of its natural oils’ is just that – a myth. Your scalp is skin, just like your face, and it’s it important to keep it clean each day.

If you are finding that washing your hair regularly causes your scalp to be dry, then switch to a more sensitive shampoo. Aside from DHT, there are other factors at play when it comes to hair loss. A survey in 2016 found that 22% of men were concerned that frequent use of their hair styling products would cause them to go bald. The theory goes that caking your hair in a chemical based gloop like gel will block your hair follicles and inhibit hair growth.

So, is there any evidence to suggest that these lifestyle choices are actually causing harm? Well the hair itself is not a living material, it’s made up of dead cells. The only living part of the hair is made up inside the follicle, formed from living cells to make Keratin.

Once it sprouts out, it’s essentially dead. And, so long as you only apply your prefered styling gloop to the hair, not the scalp, then all you are doing is coating the strands and then washing it off at the end of the day.

This will not normally cause the hair or the follicle any damage. It is highly recommended however, to avoid applying or massaging any hair styling products to the scalp itself, as this can irritate and inflame the skin, causing itching and flaking, and could be detrimental to hair growth. But, even in a fairly extreme example Trichologist Vanessa Bailey says that they won’t cause long term damage.

« I once came across a patient who did ruin their hair with excessive use of hair gel. The product was applied in excess to the hair every day without the hair being shampooed for a period of three weeks.” « However, this was only cosmetic damage, of course – and didn’t mean he became more susceptible to baldness.

Once the damaged ends were removed, a healthy head of hair remained. » On the other hand, if you do have a sensitive scalp it’s worth staying away from styling products that contain a high level of alcohol, as this will just dry and irritate your scalp.

A water based product is often considered the best option and it will be easier to rinse out without the need for shampoo. Yet our worries don’t stop there, with a now freshly washed sopping wet head, the next concern is whether towel drying will cause hair to fall out? Interestingly, it does, but not in the way you may think. Our hairs are protected by cuticles, not these (point to finger) but these (points to head).

You see, each hair strand is essentially made up of fibres, and these are covered by a protective outer layer known as ‘cuticles’. When our hair is wet, the strand swells making the cuticles open. Then when it is dry the cuticles close back down. If you rub a towel vigorously across your wet hair when the cuticles are open, this protective layer is vulnerable to friction damage, and will eventually be eroded away, exposing the fibres.

Without the protective outer layer, these fibres are no longer held together and will then fray and break away. This then appears to us that our hair is falling out. But the damage is only being done to the actual hair shaft, not to the follicle itself, so towel drying will not lead to permanent hair loss. If, like most guys, you do dry your hair like this, then it is highly recommended to use a conditioner, as this is designed to protect the cuticles and close them back down. Some Trichologists recommend patting your hair dry instead, but the practicalities of this aren’t great as you still end up with fairly damp hair, and interestingly letting your hair air dry naturally isn’t the next best option.

A study in 2011, experimented with different hair drying methods and observed the damage they caused. The results showed that the best approach was to blow dry your hair in a continuous motion with a hair dryer held 15 centimeters, roughly 6 inches, away from the hair. It also found that the hair cuticles suffered more damage as the temperature increased, so a medium to low temperature setting was preferable.

Right, so now that we have a clean and dry healthy head of hair, what other factors are out there trying to rob us of our prized locks? A poll we recently conducted with our audience showed that 33% of people have real concerns about how stress can cause hair loss. The good news for the 33% is that this doesn’t cause Androgenetic Alopecia (or Pattern Baldness), the common hair loss we’ve been talking about.

But there is an autoimmune disease known as Alopecia Areata, which causes you to lose hair in unpredictable circular patches. This form of hair loss has traditionally been considered a stress-induced disorder, however there is very little scientific evidence to support this theory.

Severe stress may be a trigger in a small number of cases, but there are other factors like hormones, viruses, allergies and toxins that all play a part. And it’s believed, it is when several factors combine, that prompts the development of Alopecia Areata.

Now I don’t want to stress anyone out, for obvious reasons, but there is another form of hair loss that you may be more susceptible to, known as Telogen Effluvium. This is a reactive type of hair loss and can be induced by stress.

With all your hairs happily going about their individual life-cycles, each with their own schedule, stress or trauma can disrupt this cycle and shock a large percentage of them directly into the resting phase, no matter what stage they were at.

By resetting or re-synchronising these hairs back to this phase, it means that the hairs won’t actually fall out for another 3 months, once they reach the Exogen phase. And when they do, it will give the appearance of thinning.

Dermatologist Dr Lauren Ploch explains the theory behind why our body reacts to stress in this way… “When our body experiences stress, it essentially goes into survival mode and diverts resources away from functions that are nonessential for life such as hair growth” On the positive side, this form hair loss is rarely permanent; it will normally grow back and return to it’s regular life cycle within 3 to 5 months of the initial shedding.

So, now that we have a decent understanding of most of the environmental and genetic factors that do and don’t cause hair loss, what can we do when our hair is genuinely on the way out? Well, there is a $3.6 billion hair regrowth industry in the US alone, so surely some if must work? Luckily a discovery in 2018 by Dr Nathan Hawkshaw may have finally got to the root of the problem.

During his investigations, he found a useful side effect of a drug called ‘Cyclosporine A’. Primarily used for organ transplants to stop the patient’s body rejecting the new organ, this drug also enhanced hair growth. Hawkshaw identified that it was effecting a protein called ‘SFRP1’ in particular, which promotes follicle regrowth.

With further exploration, he discovered a pre-existing osteoporosis drug that targeted this protein, and so, he applied it to scalp samples. “We usually do experiments for over a week. We put the hair follicles in a dish and this drug enhanced hair shaft elongation within two days. But it also kept the hairs healthier.

When you look at them, they’re larger, thicker hair follicles. So, it’s quite promising.” Though for many, this discovery feels like yet another fruitless promise, as scientists have been announcing that the cure for baldness is only around the corner for years.

Spencer Kobren author and founder of the American Hair Loss Association is continually skeptical, having heard these claims for the past 20 years. “When I wrote my book in 1998, they had just found the hair loss gene.

There was talk of hair clones. [We were like,] this is it! We’re going to cure this in five years!’” Alternatively, the upside of having only specific areas of the head that are prone to the common types of balding, is that there are areas, namely the back and sides of the head, that do not go bald.

Meaning procedures like transplants are now possible and easier than ever with modern scientific advances. Currently you can have 4,500 grafts in a single session, which is close to the amount you would need to cover the top portion of a completely bald head. So for some people, going bald is now optional, although it doesn’t come cheap, a hair transplant can cost anywhere up $40,000 depending on the level of hair loss.

For some, the next best option is is a pharmaceutical drug called Finasteride, better known by it brand name, Propecia. Across the whole of our research for this video, this is the treatment that seems to come up trumps, literally.

US President Trump puts his, albeit strange but, full head of hair down to the regular use of Propecia. In fact, the American Hair Loss Association claims that it stops the progression of hair loss in 86% of men. Except, again this is a DHT reducing treatment so should only be used after a certain age.

Remember DHT is a sex hormone, and there are potential negative sexual side effects of taking Finasteride, so consult a doctor when going down this path. But drugs like these only stop hair from falling out anyway, they are not considered to promote regrowth, But Propecia still isn’t exactly an affordable option for most, with 6 months supply of tablets costing around $360.

But if you do go down this root, Hair Transplant Surgeon Dr Raghu Reddy, offers a useful life hack… “Propecia lasts for about 16 hours so even if you take it every other day it should still work” So if medication is too costly, what about hair ‘boosting’ shampoos, like the ones that contain caffeine? « German engineering for your hair. Shampoo is too small a word for it.

Alpecin provides caffeine to your hair, so it can actually help to reduce hair loss. Simply apply daily and leave on for 2 minutes … to help the Caffeine Complex penetrate your hair and scalp. » Well the UK advertising standards authority have actually banned this brand from advertising that their products can reduce hair loss, as there is not enough evidence that it has any effect.

And according to Trichologist Anabel Kingsley… « Despite some of the claims, a shampoo or conditioner won’t be able to stop or slow hair loss, nor help with a receding hairline or thicken hair that’s becoming thinner » So if your hair is already on its way out, and unless you want to invest some serious dollar into keeping it, then Kobren’s advice may be more suitable.

“Cut your hair as short as you can. If you can own it, you can beat baldness.” As to why we actually go bald, no real genetic advantage has ever been identified. There are, however, theories that in the age of the hunter gatherers, when life expectancies were significantly lower and so a bald head rarer, it became associated with strength, wisdom and social maturity, making them the natural choice for leader in a group, although there’s isn’t really any science to back this up.

If you are lucky enough to have a full head of hair and are keen on keeping it that way, there are a few simple habits that you should adopt in to your everyday lifestyle: -Wash your hair daily with a sensitive shampoo (if you have dry hair then wash it every other day), and make sure you gently massage the shampoo in to your scalp as its primary purpose is to clean the scalp of any sebum build up.

Some dermatologist actually recommend simply rinsing your hair with water each day while massaging the scalp, and only applying shampoo every third day, this is said to still remove the excess Sebum. Shampoo-less or not you should still use a conditioner each time to protect the hair and it’s Cuticles. -Gently dry your hair, ideally with a hair dryer following these guides (ON SCREEN GUIDE), or by patting it dry with a towel, do not rub it forcefully. -Use a water-based styling product, and rinse it out at the end of each day. -Keep on top of your mental health so that you can deal with stress.

Meditation techniques like ‘mindfulness’ can go along way to helping you with the stresses of the everyday and it only takes a few minutes. -And finally, eat a healthy diet. Deficiencies in Iron, Vitamin D and B Vitamins have been closely linked to hair loss. Plus Biotin rich foods like nuts, seeds, sweet potatoes or tomatoes help condition the scalp to provide a healthy environment for the hair follicles. It’s also worth making sure you eat enough Protein, as the keratin hair is made from is actually a form of hard protein.

As leading Trichologist Anabel Kingsley puts it, “If you aren’t eating correctly, no matter what products you use on your hair, it simply won’t grow to its best ability.”

4 Comments - Write a Comment

  1. My father and his dad are bald, some of my uncles on my father’s side still have all their hair (47 – 55 years old). My maternal grandfather never started losing his hair until his 50s. Maternal uncles are going bald. Dear God, give a generation a break.

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  2. When there is no proper medical research to prove things, the modern medicine just goes on and blames the genes. I just wonder how the first person in the Earth got bald? Was it his genetics? Stupid ideology. There is something more to this and modern medicine has just made this a great market to make money by screwing male hormones down.

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  3. I would not mind being in a study on hair loss/baldness, but not because I am going bald. I am near 50 years old and have no signs of hair loss yet. It is still as thick as in my 20’s and no retreating hair line either. As I do not drink alcohol at all I am convinced alcohol consumption may play a part in balding compared to friends that I have observed that do drink.

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