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Balding is a fact of life for men as they age.
But if you are only in your late 20s and notice that your frontal hairline is receding or that you’re gradually losing hair at the crown, you might be suffering from male-pattern hair loss (MPHL).
“MPHL is also known as androgenic alopecia or androgenetic alopecia,” says Dr Lynn Teo, Consultant at the Department of Dermatology, Changi General Hospital. “It is an inherited condition, which means that if someone – whether male or female – from your family suffers from it, you are likely to have it too.”
“Actually, all men will experience some form of MPHL in their lifetime. The extent of hair loss will depend on how long they live,” Dr Teo adds.
Can hairstyling products like gels and sprays cause hair loss?
Dr Teo explains: “If the chemicals contained in hairstyling products irritate the scalp such that hairs become brittle or eczema appears, that can contribute to hair loss. Theoretically, an oily scalp can also contribute to hair loss, so in our humid climate, it’s best to keep the scalp clean and dry with daily washes.”
But usually, the main culprit in MPHL is a highly active form of testosterone, known as dihydrotestosterone (DHT), which affects the hair follicles.
DHT helps to control and boost the development of male characteristics, so every man needs it. The problem occurs when there is an excess of, or a hypersensitivity of receptors to, DHT. “When this happens, hair grows for a shorter period of time before it sheds,” explains Dr Teo. “As time passes, the duration of hair growth becomes extremely short – it might only peek out of the scalp before shedding. This is called miniaturisation of hairs.”
If this process continues, the affected hair also gets thinner and finer. Soon, these “vellus hair” as they are called, are so fine that they are barely noticeable. Eventually, they fall out, and the hair follicles shut down for good.
Hair loss can also occur due to environmental and other external factors. “This includes certain infections and illnesses, severe emotional stress, and major surgery,” says Dr Teo.
“Sometimes, medications like steroids and cholesterol-lowering drugs can also cause a sudden excessive loss contributing to a thinning hairline. So if you are taking certain medications, ask your doctor whether they might be causing your baldness.”
Medically-proven hair loss treatments
A receding hairline or balding scalp can undermine a man’s self-image, lead to a drop in confidence, and even cause anxiety and depression.
If you are losing hair, do consult a doctor. “Your doctor will be able to determine the cause of your baldness, and help you to improve your hair and scalp condition,” says Dr Teo.
“For instance, if you are losing hair in patches instead of the typical male-pattern distribution, you may not be suffering from MPHL at all. Your doctor might need to run tests to check if the hair loss is caused by certain illnesses.”
The treatment options for MPHL include:
- Topical drugs: These refer to approved medications, such as tablets and solutions. An example of this is minoxidil (Rogaine), a lotion or foam formulation that’s used on the scalp twice a day, says Dr Teo. “It slows the progression of hair loss and stimulates hair regrowth. But there can be side effects, such as itchiness, oiliness and headaches.”
- Oral drug: Finasteride (Propecia), a prescription-based drug treatment that comes in tablet form, has been used for more than a decade to slow down hair loss.
- Medical laser device: There is an approved laser light device that can prolong the duration of hair growth and thus thicken and lengthen the individual hairs. It is to be used over the area of potential hair loss. Dr Teo adds: “The best results are obtained in combination with another treatment option.”
- Hair transplant: This is typically recommended as a last resort, after detailed counselling with your doctor. Dr Teo says: “I prefer patients to try medications first. Suitability of options should also be assessed, for instance, based on medical history. Also, if patients do not have enough hair to distribute around the head, they may still not look so good after.”
Ultimately, patients should be aware of the treatment’s limitations. Dr Teo adds: “The treatment options are meant to improve the appearance of a balding scalp – patients’ expectations must be realistic.”
Debunking hair myths
| Standing on your head can reverse hair loss. |
Some believe that doing so will promote blood flow to the head, which in turn boosts hair growth. Dr Teo says: “This is not true at all.” |
| Hair loss comes from your mother’s side of the family. |
This is not strictly accurate, but also not entirely wrong. Dr Teo states: “Genetic hair loss can come from either or both sides of the family”. |
| Washing your hair too often causes hair loss. |
Washing your hair once or twice a day is fine, especially if you exercise in our hot and humid climate. “Just remember not to pull on your hair as you shampoo,” says Dr Teo. |
Ref. T12 |
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