Going Bald

What Causes Hair Loss? And How To Stop It Before You Go Bald

In a market flooded with hair loss “solutions,” beware of ineffective and unproven treatments.

Originally Published: 
A girl kissing her bald father's head.
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If you’re going bald, you’re far from alone. Nearly 70% of American men experience some amount of noticeable hair loss by their mid-30’s, according to the American Hair Loss Association. By age 50, about 85% of men’s hair is significantly thinning. And sure, you can always shave your head and let bygones be bygones. But many men love a full mane, making hair loss “a disease of the spirit” that leaves sufferers vulnerable to dropping cash on treatments that often leave them disappointed, says Spencer Kobren, founder of the American Hair Loss Association and the International Alliance of Hair Restoration Surgeons. So what causes hair loss, and how do you stop going bald?

“Ninety-nine percent of all products and services that claim to stop, prevent, or treat hair loss don't work,” Kobren says. He notes that social media has attracted additional “medical misinformation and phony, bogus products and services.” These products don’t get at the root of the problem. But there are real ways to prevent hair loss, once you cut through all the BS. This is what you need to know.

Types of Hair Loss

The most common type of hair loss is called androgenic alopecia, which is sometimes referred to as “male” or “female” pattern baldness, depending on the sex of the person who has it. This condition, which affects about 98% of people with hair loss, is caused by a combination of genetics and levels of androgens, a type of sex hormone. The main “culprit” of male pattern baldness (including a receding hairline) is dihydrotestosterone, a byproduct of testosterone that “shrinks hair follicles of those who are genetically predisposed,” Kobren says.

Alopecia areata universalis is far rarer, with fewer than 200,000 people living with it in the United States. “It’s a very difficult disease to treat,” Kobren says. Its exact cause is unknown. However, researchers think that the condition, which causes the complete loss of hair on the scalp and body, occurs when someone’s immune system “mistakenly attacks the hair follicles,” according to the National Institutes of Health’s Genetic and Rare Diseases Information Center. This type of hair loss often results in bald patches, and their hair that regrows may stay intact or may be lost again.

Traction alopecia is hair loss caused by frequently wearing hairstyles that create a lot of pulling on the hair and scalp, such as heavy braids or tight ponytails. “That causes a type of scarring alopecia. And once that happens — once the scalp and the hair follicles are damaged to that degree — hair no longer grows,” Kobren says. As many as half of all Black women experience this type of hair loss, according to Johns Hopkins Medicine. But there are steps people can take to prevent or slow traction alopecia, such as wearing looser braids or dreadlocks and removing braids, weaves, and extensions within a certain time period (three months for braids; two months for the other styles).

How to Stop Going Bald

If you’re noticing hair loss, “don’t panic,” Kobren says. Bring the issue up with your doctor so they can determine what’s causing the hair loss and discuss treatment options with you.

If you’re hoping to to manage hair loss with medication, “early intervention is key,” Kobren says. A few different types of medications are available, including finasteride and minoxidil. Other medications are also sometimes used off-label. It’s important to buy these medications through a physician rather than purchasing them from an online supplier, because the latter could switch the type of generic you receive without telling you, which could impact the effectiveness of the treatment, Kobren notes.

Hair transplant surgery “is a last resort,” he says. Two types of hair restoration procedures are currently available, but 70% of people who have them end up with results that make them feel anywhere from “dissatisfied” to “disfigured.” These surgeries also typically aren’t covered by insurance unless the hair loss is due to a severe injury.

An alternative to treating hair loss is embracing it. “Shave your head and see how you fare, if you can deal with that,” Kobren says. “Because the road to recovery and trying to treat hair loss, whether it's surgical procedures or even FDA-approved medication, that's a long road and it's a real commitment.”

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