A Patient Journey for Hair Loss

The general medical term for hair loss is alopecia, but there are many different types of hair loss with different symptoms and causes. Male hair loss often referred to as male pattern baldness or male pattern hair loss is the most common type of hair loss and affects at least half of men over 50.

Other common causes include:

• alopecia areata – patches of hair loss about the size of a coin which is the result of a problem with the immune system. Hair loss is usually temporary; however some people may develop a more severe version.
• scarring alopecia - where hair loss occurs as a complication of another condition such as scleroderma (a disease that causes patches of the skin to become hard and puffy) or lichen planus (a type of itchy skin rash). This type of hair loss is usually permanent as the hair follicle (the small hole where the hair strand grows from) is damaged.
• anagem effluvium - the loss of hair across the body that often results from medical treatments, such as chemotherapy.
• telogen effluvium – a common type of baldness where there is thinning of the hair rather than bald patches. Usually the only hair affected by this type of alopecia is scalp hair and it may be triggered by long or short term illness, physical or emotional stress, lifestyle.

Join our free support programme on hair loss

The thinning of your hair is also a normal part of the aging process. Symptoms will usually begin in your late 20s or 30s, and you may notice a receding hairline at first. After that, your hair will begin to thin, and complete baldness may follow in some cases. Often male pattern baldness is hereditary (if someone in your family suffers from baldness, there is a greater chance you may experience symptoms). 

In the vast majority of cases, hair loss in men is harmless and there is no cause for serious medical concern. However hair loss, especially at an early age, can be very distressing and may affect your quality of life. If you experience feelings of depression or anxiety due to hair loss, you should make an appointment to speak with your doctor.  A visit to your doctor should also be considered if you suspect that you are experiencing the symptoms outlined above for alopecia areata or scarring alopecia.

A doctor will diagnose the cause of your hair loss with a physical examination of your hair and scalp, and by discussing your symptoms with you. If a cause such as alopecia areata or scarring alopecia is suspected, your doctor will discuss treatments for that condition with you – treatment for both alopecia areata and scarring alopecia usually includes steroids (in the form of creams, ointments, or injections) or immunotherapy (stimulating hair growth by causing an intentional allergic reaction to an affected area). You may be eligible for scalp reduction surgery (where areas of bald scalp are removed and the skin is stretched to replace what has been removed) if your doctor suspects you are suffering with scarring alopecia as part of your NHS treatment. This would need to be discussed with your GP during your appointment.  In the case of male pattern baldness, no treatment is medically necessary, but there are a number of treatments that many men prefer to take for cosmetic reasons. These tend to be invasive procedures and are often not available as an option through the NHS:

• Medication –available only on private prescription, there are medications that work by blocking the conversion of the hormone testosterone to dihydrotestosterone (also known as DHT, this can shorten the life of hair follicles). This type of medication allows hair follicles to enlarge to normal size, while others available at a pharmacy without a prescription are lotions applied directly to the scalp. It is not known how effective either treatment is as often the balding process will return once treatment is stopped.
• Scalp surgery – scalp surgery such as hair transplantation (where individual or small groups of hair are grafted onto the scalp) has been used for a number of years and techniques have improved over this time. Success rates vary and again the treatment is expensive and is not available on the NHS.

Your doctor can talk through the relevant options with you and may refer you to a specialist or recommend counselling. talkhealth works with a number of support groups for such issues, including the Men’s Health Forum also see our full list of charity partners for support groups specialising in, for example, mental health.

You can also find support from men with experience in this area in our men's hair loss forum.

Sources used in writing this article are available on request.

_{Last revised: 16 August 2016}

_{Next review: 16 August 2019}