Receding hairlines, thin, fuzzy hair and bald patches at the back of the head: this is the typical picture of hereditary hair loss. If men’s hair becomes thinner over the years, doctors speak of androgenetic alopecia.
Up to 70 percent of men are affected. Hereditary hair loss can also occur in women. However, this is much rarer and the progression is usually different: their hair often becomes thinner at the crown.
This hair loss is not dangerous, but it can be a psychological burden. “Hair loss is an unmistakable sign of aging,” says Kristina Fronhoffs. She is a dermatologist in Rheinbach with additional qualifications in specialist psychotherapy. “Those affected often have the feeling: ‘I’m not that old yet,'” she says. Being perceived as older than they are also bothers some people.
Is there anything that helps against hair loss? The most important questions and answers:
Why does hair fall out at all?
Everyone loses hair every day, that’s completely normal. Hair loss is generally when more than 100 hairs are lost from the head every day. Those affected then notice hair on the pillow, in the brush or in the shower drain.
The reason for hereditary hair loss: Over the years, hair becomes oversensitive to a form of the male sex hormone, dihydrotestosterone – DHT for short. As a result, its life cycle is shortened. This means that hair falls out sooner and grows back thinner, until the head becomes increasingly bald over time.
It’s all down to genes: the time when hair falls out is determined at birth. For some, this happens earlier, for others it only happens at an older age.
This means that the head is missing an important protection: the hair acts as a small buffer if you bump your head and, above all, it shields you from the sun. When your hair gets thinner, it is therefore important not to forget to apply sunscreen to your head on sunny days or to wear a hat.
Lifestyle changes, special shampoos: Can this help?
The bad news: There is little you can do about thinning hair. Exercise, a healthy diet, regular check-ups – none of these can prevent or delay hair loss. The same applies to head massages. Special shampoos containing caffeine, for example, are advertised with great enthusiasm, but: “Not a single one of the over-the-counter products has provided scientifically sound evidence that it actually has any benefit,” says Kristina Fronhoffs.
What about medication?
There are certainly medicines that can counteract hair loss. In Germany, several active ingredients are approved for use against hair loss. The three most commonly used are minoxidil, alfatradiol and finasteride.
Minoxidil was originally a blood pressure reducer until studies showed that it improved hair growth and a new approval was applied for. It is available over the counter and is applied to the scalp morning and evening. How it works is not entirely clear. To put it simply, it probably stimulates blood circulation and thus hair growth.
“Alfatradiol is a chemical derivative of a female hormone that counteracts dihydrotestosterone (DHT),” explains Ursula Sellerberg, deputy spokesperson for the Federal Chamber of Pharmacists. The active ingredient is also approved for women, and medicines containing it are also available without a prescription. It is also applied to the scalp.
Finasteride is a prescription drug, taken as a tablet or, more recently, applied locally as a spray. It also inhibits the effect of DHT on hair. However, the drug can have significant side effects: depression and sexual dysfunction are possible. Important to know: All three drugs take weeks to months to take effect. And: “The effect stops when you stop taking the drug,” explains Sellerberg. “So it is a long-term treatment that requires a lot of discipline.”
What other options do I have as an affected person?
Another permanent way to counteract hair loss is a hair transplant. “This involves taking small pieces of hair from the back of the head and placing them upwards,” explains dermatologist Kristina Fronhoffs. “This can achieve a good effect that is permanent. How good the result is depends on the surgeon – it takes skill.”
Another requirement is that the hair on the back of the head is thick enough. As with all procedures, there are risks associated with a hair transplant. For example, scars can form or the wounds can become infected.
There are also indications from case reports that a special laser therapy and a certain type of autologous blood therapy can be beneficial for hereditary hair loss, says Kristina Fronhoffs. “But more research is needed here, and the studies on this topic are poor so far.”
