5 Facts About Men’s Hair Loss You Need to Know

One of our other stories…10 myths about hair loss…dives deeply into common misconceptions about losing hair. In this article, we’ll discuss 5 truths about men’s hair loss. This is by no means exhaustive…but does offer a starting place for the potential hair loss patient to start their investigation into what is happening, why, what the options are, and some things to avoid.

1. Men’s hair loss almost always has a genetic component. It’s been said that you can’t escape your genes when it comes to many things in life…looks (one often has physical traits of one or both parents), lifespan (many chronic illnesses appear to run in families…not that one is destined to get what a relative has…but a person with a family history of conditions probably should be screened regularly for these illnesses developing, and modify behavior to decrease the environmental or dietary components of getting the disease), temperament (many people take after one or the other parent in terms of demeanor)….and the list could go on for a while. AND hair loss. One of the first questions we ask a new patient is to describe how much hair loss is in the family. If a young person with minimal hair loss comes in and everyone in their family is “bald” by 40…we try to avoid surgery, consider medications, and plan for the future use of surgery as a later option. On the other hand, if a 50 year old comes in with a little hair loss, and nobody has gotten very bald in the family…well hair transplantation may be an early choice…the odds of that person needing a lot of hair in the future is probably pretty low. Note that we say PROBABLY….one really never knows. There are various tests available to try and predict one’s hair future but to date, they are not an accurate option that we use. And there are exceptions to every rule…for example our patient today…40 year old with class 5 hair loss….(we discuss the Norwood scale of hair loss in many of our videos)…has a brother with him, one year older…with a full head of thick hair, and another brother at home who is balder at class 6…and 5 years younger. Why is one brother not afflicted with hair loss? Not an answerable question at this point. As the human genome is more completely understood, and we get knowledge of how various factors encourage or repress certain genes…this is likely be discovered.

   So to summarize, the doctor has to use the family hair traits as a guide for advising the patient what MIGHT happen, and suggest options, somewhat based on age, medical conditions, and tolerance for side effects….to help the patient make a plan that will last decades. Meaning we would not recommend a hairline lowering procedure for a young patient with a significant family hair loss pattern. We do offer surgery to younger patients…but only if they already have significant hair loss, or very low familial hair loss tendencies…and realize that they may need multiple surgeries over their lifetime. That is a common theme of our over 500 YouTube videos.

2. Hair transplant surgery is an option. Hair transplant surgery works by taking hair from the back of the head…where hair GENERALLY is not affected by chemicals causing hair loss. Just go to your local mall and look at men. You’ll see almost nobody that has no hair in the back of their head, no matter how bald they are. That is where we take hair from….and move elsewhere on the head. Those hairs retain their resistance to metabolites of testosterone that causes hair loss…no matter where you place them. Now immediately you see the problem. The hair transplant doctor is constrained by the quality and quantity of hair in the back of the head. For example…if someone is bald to about the middle of the top of their head and they have lots of hair in the back…generally with modern FUT surgery, good coverage can be achieved over the entire balding area. Conversely, if someone is really a class 7 hair loss (think Friar Tuck from Robin Hood)….there simply isn’t enough hair back there to cover much, and that person probably is a marginal candidate at best. We do operate on about 4 or 5 marginal candidates a year, simply to frame the face…and have a number of videos on it…but they are people we make go home and really think this through…as it may be better to do nothing surgical in that instance. Picking the hair transplant doctor to talk to therefore is critical. First, finding a doctor with a documented track record…can be difficult. Practices that are busy and good…usually post on their website MANY MANY results in different types of patients. Its exactly why we have lots of cases on the website, and hundreds of YouTube videos…so that prospective patients can see what an entire range of patients get as results. Some of our patients tell us they saw a clinic that had one or 2 results in patients who needed very little hair and the patients in the pictures had fantastic donor hairs to work with. NOT EVERYONE IS A PERFECT CANDIDATE… so we post patient results in guys with great, good, and not that great donor hair…and when we see patients for consultation, we try to show a case or 2 that is similar to the prospective patient’s hair condition. It is unethical to show a guy with class 6 hair loss and fine hair….a result in a patient with fantastic donor hair….it just isn’t going to be the same. I’m sure the doctors that have billboards showing a perfect hairline in a guy who probably didn’t even have surgery and who has great hair are busy…I just don’t know how they sleep well at night. We have so many videos…so that one can almost always find a case exactly like themselves if they look long enough, and in looking long enough…they will be an educated preop patient!
3. There is no miracle coming soon. Every week on my google feed, I get articles about hair cloning and other “miracles” that will both either put me out of business or make me so busy that I’ll want to retire…. The answer I give patients when they ask about cloning hair is that I definitely think it will come and change this field completely. I just definitely think its coming in about 15 to 20 years. I could be wrong, but my hunch is that with 2 billion diabetics on the planet…costing governments a fortune…that cloning of the pancreatic islet cells that produce insulin will be done FIRST….and after that is perfected, my hunch is that hair will soon follow. For 29 years the media and doctor organizations have popularized new fantastic treatment options. We have yet to see those pan out in such a way that it really changes the options a potential patient has…assuming the patient wants to incur the least pain, spend the least, and get the best result. For now, refined hair transplantation is the gold standard.
4. Vitamins and diet do not cause or fix hair loss. Now I say this to the average patient in the United States…where almost everyone has a diet that is supplemented with vitamins and supplements to the point where everyone is just peeing out expensive urine. For true vegans and some vegetarians, sure low protein intake could be a factor…so when we see those patients, before we offer surgery, we see if modifying the diet will help, and specifically to get enough protein intake to recover from any potential surgery…before the surgery is undertaken. If you took all 100000 hairs on the average young person’s head…and made them into ONE hair…and had it grow with the same amount of growth that the 100k hair would grow…every day that hair would grow 50 to 100 YARDS!!! And all that requires protein…so protein is likely the only limiting dietary factor in the average patient we see. The truth is, it’s not well established that vitamins beyond the daily recommended amounts, even make a difference in hair loss. There are so many sources of vitamins, at least in the Western world, that it is practically inconceivable that an otherwise healthy and normal person could be vitamin deficient to the point that it significantly affects their hair. It doesn’t take much to realize this is a massive myth. It would be nice to believe that one’s poor diet is the cause of their hair loss and can therefore be remedied through a change of diet. However, this is not the case. Even an obese sedentary person who eats the worst things will not likely suffer hair loss.
5. Nobody NEEDS to rush into a hair transplant. Just as with rare exceptions…heart attack, blocked bowels, brain trauma…nobody should rush into surgery without thinking about the alternatives and making sure they pick the best doctor for them….nobody should rush to a hair transplant. There are 3 other options. 1 Medicines. Minoxidil and finasteride/dutasteride are really the only options for most men, and we cover those in other articles and videos…but patients need to weigh the cost/hassle/potential side effects of those medicines and they often aren’t “regrowing” meds, but rather “maintaining” meds. 2. Hairpiece or wigs. In general, unless custom made and constantly adjusted, cleaned, and replaced….hairpieces that we see in prospective patients are uniformly obvious to everyone except the wearer. In fact, in 29 years, I can think of only 2 patients that didn’t look to the casual passerby…to be wearing an obvious hairpiece. Patients are advised to think carefully before choosing this route. Similarly, patients are advised to think carefully before choosing surgery too! 3. Just doing nothing, or shaving the head. Now shaving the head may not be an option for some patients. MOST men have fairly unremarkable skulls, and can get away with shaving the head, if they wanted to…however there are some patients who just can’t pull that off. Trying a crew cut first…and if one finds that the skull is awkwardly shaped…growing the hair back out is pretty easy…and cheap. Just seeing a competent hair stylist and asking them to help design a hairstyle to go along with a patient’s hair loss can be life changing and either delay the need for surgery or alleviate it altogether.

My practice also includes facial plastic surgery. No joke here. I’ve operated on at least 4000 women for facelifts and 7000 eyelid procedures. Most will ask something about hair transplants while in the office….it is obvious we do a lot of hair transplants. SO I usually ask the women what a man’s hair loss means to them…will it change there opinion, or would they not date a bald guy….etc.
I would guess, reflecting back over 29 years of practice that probably 8 to 10% of our female patients say they are not interested in a guy with significant hair loss. GUYS…that means 90+ percent don’t care! You don’t have to do a hair transplant.

Now, uniformly our female patients say they want a nice guy, good sense of humor, who treats a date nicely, and who is not smelly. Seriously, the only thing women…in my practice…consistently say is that they want a confident man. IF having more hair would make you confident…maybe a hair transplant can help, shoot we have at least 20 videos with that theme…the hair transplant gave the guy enough confidence to go out and get a better job, new girlfriend…etc. But really, men…90% of women don’t care about your hair. They just want you to be nice.

So these are 5 facts about hair loss….there are plenty more but these are the ones often asked about by potential patients. Good luck in making the best decision for YOU!