Why is my hair falling out?
There are many potential causes of hair loss for men. So, if you’re in a state wondering why your hair is falling out, it’s useful to pay attention to the specifics – no matter how uncomfortable that might be…
Male pattern baldness (MPB) is by far the most common cause of hair loss in men – and it has specific features, in particular a gradual thinning of the hair on the scalp. Yet, there are other causes too – including stress, vitamin deficiency, thyroid problems, and other medical conditions. If you have questions that this article doesn’t answer, remember that your doctor is there to give you further advice about your own situation.
Types of Hair Loss
Hair loss is common among men as they age. But the way that it occurs depends on its specific causes.
As we’ve said, MPB is the hair loss cause that is most common in men. This is recognisable as starting with a receding hairline: the hair above your temples retreats, usually giving you a V-shaped ‘widow’s peak’ at the centre of your forehead. Alternatively, it can begin at the crown, where your hair will thin into a bald patch at the back of your head. The chances are that the cause of your hair loss is MPB; it’s responsible for 95% of male baldness. The good news is that, these days, a receding hairline is reversible.
However, if your hair loss is patchy, very quick and/or total, or if your scalp is inflamed or there are signs of infection, this isn’t MPB. Talk to a doctor, who can undertake a scalp evaluation and determine the right course of treatment.
The Role of DHT
MPB in men is caused by hormonal changes in the body as we age. This is why some people can even develop a receding hairline straight after puberty.
The hormone responsible for MPB is dihydrotestosterone (DHT), which is converted from testosterone by the enzyme known as 5α-Reductase (5AR). This happens when we age, becoming more active during puberty and it is a completely normal process. DHT is an androgen, a male sex hormone, and it is responsible for the development of male genitals whilst you’re still in the womb – among other things.
However, some men’s hair follicles are sensitive to DHT, too. In susceptible men, this hormone shrinks and weakens the hair follicles on the head, meaning that the follicles ultimately no longer produce hair. Predictably, those follicles most sensitive to DHT are the ones above the temples and on the crown – precisely the spots where MPB usually strikes first.
Important note: Finasteride targets the 5α-Reductase enzyme that produces DHT. Usually taken daily as a pill, it prevents the production of that hormone at its source – and is effective in 90% of cases.
The Role of Genetics
Your degree of sensitivity to DHT is largely genetic. If you have close family members with male pattern baldness, it’s pretty likely that it will affect you at some point in your life too. The conventional wisdom on this is that MPB is inherited from your maternal grandfather, your mum’s dad – because the particular gene responsible is found in the X-chromosome, which comes from your mother.
Yet, this is not necessarily true. Lots of different genetic factors go into determining the likelihood of your baldness – and it is too complex a picture to give any definite answer.
Other Causes of Hair Loss
Besides MPB, there are other hair loss causes that you should be aware of. If your hair is falling out in a way that doesn’t sound like a typical receding hairline, it might be something else.
Stress: Stress can cause hair loss in different ways – and you will likely know if they are happening. During times of serious stress, your hair follicles may simply rest, meaning they don’t produce new hair. You’ll notice this is if your hair falls out in clumps while washing or styling.
It is also quite common for people with stress to pull at their hair – on their head, beard, or eyebrows – without realising it. This can ultimately lead to hair loss.
Medical conditions and treatment: Some conditions can cause hair loss, including autoimmune conditions, like lupus – in which hair loss is accompanied by scalp and facial inflammation, but may present differently in individuals. Conditions like irritable bowel syndrome can also sometimes cause hair loss. And as you’re probably already aware, if you are undergoing radiotherapy or chemotherapy, hair loss is often a side-effect of the treatment.
Other hormone imbalances: Besides the production of DHT, other hormone imbalances can cause hair loss in men. For example, men with low testosterone might also see some thinning of their hair, accompanied by loss of hair on their body and face too. Hypothyroidism (underactive thyroid) can also be a cause of hair loss.
What vitamins support normal hair?
Another factor that might explain why your hair is falling out is vitamin deficiency. This is something that really shouldn’t be taken for granted.
Iron is one of the most well-known deficiencies that can cause hair loss. Iron plays a role in the blood’s transporting of oxygen around the body – and iron deficiency can cause anaemia, which can affect your hair. Zinc, meanwhile, helps hair grow and repair itself, by helping to produce oil in the glands around the follicles. Don’t go mad on the zinc supplements, however: an excess of zinc is just as damaging.
Vitamin A, B-vitamins including biotin, and selenium are also important for hair growth – and a deficiency in any of these can produce hair loss too.
Key Takeaways: What Can I Do About Hair Loss?
If you believe that your hair is falling out, there are many things you can do – depending on the cause of your hair loss. Nowadays, there are a number of effective hair loss treatments for those experiencing a receding hairline or MPB in general. These include the licensed products, Finasteride and Minoxidil, which work in different ways. Both, importantly, are inappropriate for other hair loss causes.
As we’ve already mentioned, Finasteride is taken as a pill and combats the 5α-Reductase enzyme – the one that actually produces the DHT. Minoxidil, on the other hand, is usually applied directly to the affected area. This encourages the flow of blood to the scalp, which brings oxygen and helpful nutrients that all promote healthy hair. A combination of both is the best regime for tackling MPB, by virtue of their independent mode of action having great synergy.
At the same time, a balanced diet – with all the right vitamins – will help. But if you’re experiencing hair loss for a reason other than male pattern baldness, visit your doctor as soon as possible.
While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.
