It was 2007 and I was sitting with a group of friends in our school canteen; the agenda of the immediate call for a meeting was only one–discussing and finding out how a boy in our group had the silkiest and healthiest-looking locks, even better than all the girls. He was often hounded by everyone, teachers included, asking what products and at-home care he used for his hair. ‘It’s in my genes, I believe,’ he’d say. This was no joke until we all met a couple years ago, the long locks were a thing of the past and receding hairline with evident side patches on his head is now a reality. It was a shocking revelation. What happened, we collectively asked, ‘my 30s haven’t been all good,’ he replied. So, are we now dealing with hair loss and baldness in our thirties?
What Causes Hair Loss?
While most of us know that genetics and hormones are major reasons behind hair loss in men, there’s a lot more to it. “It happens mostly because of hormonal and genetic causes. DHT, a hormone generated from testosterone, is associated with male pattern baldness, commonly referred to as androgenetic alopecia,” Dr Trishna Gupte, founder and owner, Cosmo-Square Clinic. Explaining further, Dr Jamuna Pai, cosmetic physician, author and founder of SkinLab, says, “The conversion of testosterone into DHT accelerates with age. What also adds to this process is the shortening of the growth cycle of hair, further leading to hair follicles not growing at all, resulting in baldness with time.”
Genetics also determine how sensitive your hair follicles are to DHT. So, why pattern baldness or alopecia does not affect as many women as men. “Women also produce androgens, but at much lower levels. Estrogen, which is more dominant in women, helps counteract the effects of androgens on hair follicles,” explains Dr Nidhi Singh Tandon, Board Certified Dermatologist and Founder of The Skin Art Clinic. However, factors that are not as well-known as common causes that play a major role behind hair loss and baldness are poor diet, scalp disorders, stress, and chronic smoking.
Understanding Early Signs
Apart from knowing the internal and external causes of hair loss, what’s important to understand is noticing early signs leading to male pattern baldness. What men often overlook is thinning of hair at the crown area, receding hairline around forehead and temple area, and excessive amount of hair fall. “Receding hairline around forehead forming a more noticeable ‘M’ shape, more hair falling out in the shower and on pillows are all early signs of hair loss. A crucial indicator is the general thinning of the scalp, where the hair gets thinner and less dense,” says Dr Gupte. On average, it’s normal to lose 50-100 hair strands a day, however there are other factors to keep in mind to understand when hair fall becomes concerning. Dr Tandon explains that when you start noticing large clumps of hair in the shower, pillow, or comb; or the shedding is persistent for more than three months; widening of the part, especially in the frontal hairline and visible thinning or bald patches.
To understand this better, it’s important to know phases of hair growth and shedding. Hair follicles go through four major phases–anagen (growth phase), catagen (transition phase), telogen (resting phase) and exogen (shedding phase). “During the first three phases, one notices hair growing and increasing in volume. For about 2-5 months in a year, while the hair is in the exogen phase, one will notice hair fall,” says Dr Pai. This, however, is completely normal. It is when the shedding continues beyond 6-7 months that one should be concerned about it. “When you start noticing hair on the pillow and clothes, or in the shower, for prolonged periods, it is a clear indicator that it should be investigated,” suggests Dr Pai. If early hair loss runs in the family and hair fall has been a concern for a prolonged period, that’s your sign to seek professional treatment. According to Dr Tandon, early intervention can help slow the progression of hair loss and improve the chances of restoration.
Treatments to Combat Hair Loss
The first step towards combating the concern is understanding the underlying issue behind it. It could be anything ranging from deficiencies to hormone imbalance. In case of deficiencies, a regular blood check-up can help. Experts suggest starting with supplements, “Vitamin B12, D3, iron, magnesium, selenium, and biotin. Prolonged stress and a poor lifestyle must also be consciously addressed. Certain topical applications like minoxidil help to regain the volume of the hair,” says Dr Pai.
Apart from at-home treatments and topical medications, there are multiple in-clinic treatments that have been beneficial for hair restoration. From Growth Factor Concentrate (GFC) or Platelet-Rich Plasma (PRP) treatments to Low-Level Laser Therapy (LLLT) and hair transplant, there are multiple invasive and non-invasive treatments available to help deal with severe hair loss. With age, and poor lifestyle the blood and oxygen supply to the follicles gets compromised, causing hair follicles to shed. “In GFC, a certain amount of blood is withdrawn, and processed to extract essential growth factors, plasma and stem cells which are then injected back into the scalp. This helps reduce the inflammation in the scalp, and nourishes the hair follicles, reducing hair fall,” explains Dr Pai. Depending on the age and severity of the issue, one may require three-to-six sessions of GFC/ PRP over the course of four-to-six weeks and the cost may range between Rs 5,000 to Rs 15,000.
On the other hand, LLLT is a non-invasive treatment that uses laser to stimulate hair growth. This treatment may require two-to-three sessions per week for at least three months and the cost for the same can range between Rs 3,000 to Rs 10,000 for each session. With this, Dr Pai also suggests microneedling as an effective option to stimulate hair follicles. “In microneedling, micro needles are used to cause micro injuries to the scalp which then increase the blood flow and production of growth factors in the scalp,” she explains. For microneedling, at least three-to-six sessions are recommended which can cost between Rs 2,500 to Rs 5,000 per session. For men who have a genetic predisposition to hair fall, experts suggest considering hair transplant, a one-time procedure, as an option. This can cost between 1-2 lakhs depending upon the extent of hair loss and baldness.
Are there any side effects of these treatments? Dr Madhuri Agarwal, celebrity dermatologist and certified expert explains that most of these treatments are completely safe if done with a certified doctor who is not only well-trained and maintains hygiene but also informs the patient about potential side-effects. “There could be transient side-effects like slight discomfort and pain. While PRP is potentially safe, a hair transplant can show no results, cause scarring, or could result in an infection or allergic reaction if not done properly or hygiene is not maintained,” she adds. Though hair loss and pattern baldness can take toll over one’s confidence and self-esteem, early intervention, consulting a certified doctor, and starting with treatments on time make sure you don’t have to suffer with it alone.
