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Does a baseball cap cause hair loss? What are the myths and facts when it comes to men and baldness?

We were delighted to sit down with Dr. Peter Young, dermatologist and the Medical Director for Keeps, which focuses on treatments for hair loss in men. He shares insights into the latest developments, what men should know, and share the facts (and urban legends) when it comes to this issue affection millions of men. Nutrition? Genetics? What really matters when it comes to baldness? 

What are the numbers – how many men suffer from hair loss?

According to the American Hair Loss Association, 2 out of 3 men will experience some form of Male Pattern Baldness by the age of 35.

We hear things like don’t wear a hat all the time or you get your hair from your mother – What are the myths about men’s hair loss?

There are many hair loss myths that unfortunately continue to be perpetuated.  One of the most common ones is that you inherit the “baldness gene” only from your mom.  Although your mom’s side of the family can be responsible for the hair loss trait in your family, your dad’s side can be just as responsible for it.  It’s possible to inherit the baldness trait from either or both sides of your family. A recent study found that there are actually 287 genetic regions that contribute to male pattern baldness!

Another common myth I hear often is that wearing hats causes hair loss.  While people who are losing their hair tend to wear hats to hide their hair loss, the hat has really no effect to worsen hair loss.  

Other myths about things that cause hair loss include shampooing, sun exposure, masturbation and natural high testosterone levels.  None of these causes hair loss.

What are some of the latest developments when it comes to men and regrowing hair?

Treatments for hair loss include various medications, laser, as well as hair restoration surgery.  The most common treatment options for treating male pattern (hereditary) baldness include minoxidil (brand name Rogaine) and finasteride (brand name Propecia).  There are many studies being done to find a cure for male pattern baldness, including use of embryonic stem cells, but we still have a long way to go.    

What are the known causes of hair loss?

Genetics is the most common cause of hair loss which can be an inherited trait from either side of your family.  A recent study found that there are actually 287 genetic regions that contribute to male pattern baldness.

External factors can also play a role.  Using harsh chemical dyes and relaxers can exacerbate the situation, while stress or an unbalanced diet can also lead to additional hair loss.

Is it easier to regrow hair if the subject is younger? Let’s say a 30 year old opposed to a 50 year old.

Treating hair loss can effectively happen at most any age but it’s most important to start the treatment earlier than later to prevent further hair loss.  It’s not uncommon for men to start losing their hair as early as their mid-twenties therefore it’s advisable to begin treatment as early as possible rather than putting it off as you grow older. That being said, if you’re over 50 years old, it’s not too late to start treatment, but you may not see the same results as someone who starts their hair loss journey at a younger age.  

Does treatment need to be different between men and women, or is this a myth?

Topical minoxidil is an over-the-counter option which is FDA-approved to treat both male and female pattern hair loss.  It is available in 2% and 5% concentrations.  Topical minoxidil (brand name Rogaine) is the only FDA-approved medication for hair loss in women.  

Finasteride brand-name Propecia) is a pill taken by mouth which is FDA-approved only for male pattern hair loss.  Several studies have shown it to be the most effective medication for male pattern baldness.  Finasteride has been used off-label to treat women with hair loss, but it’s not as effective as it is for men.  Since it can cause birth defects, it should not be used in women who are pregnant or may be pregnant.  

Spironolactone is an oral medication commonly used off-label to treat female pattern alopecia.  It was first approved under the brand name Aldactone to treat high blood pressure way back in 1960, but has also been shown to block androgens (the “male” sex hormone that both men and women have in varying quantities) from binding to hormone receptors in the skin.  These hormones cause the skin to make too much oil, which can clog your pores and lead to acne.  

Low-level light therapy (LLLT) is a device that uses laser light to increase blood flow to the hair follicles and stimulate hair growth.  It is approved to treat hair loss in both men and women.  

Hair restoration surgery (hair transplant) is an effective treatment for hair loss in both men and women.  It tends to be a very expensive procedure, and does involve surgery, but can lead to dramatic improvements in hair loss.  

Can an organic compound, like rosemary, work as well as chemical-based pharmaceuticals?? Is there a composed list of extracts/compounds/elements in nature that can be effective against hair loss and regrow hair

There are no extracts/compounds/elements in nature that have been shown to be effective against hair loss and to regrow hair.  This can only be accomplished with use of chemical-based pharmaceuticals, such as topical minoxidil and oral finasteride.  That being said, there are several natural organic compounds that boost and protect hair health, and can make thin or thinning hair look thicker.  Many of these compounds are used in thickening shampoos (and other hair care products).  Plant-based, organic, and raw shampoo ingredients like rosemary oil, biotin, caffeine, green tea, and saw palmetto are natural, science-backed ingredients designed to support hair growth and give the appearance of thicker, healthier-looking hair.  While thickening shampoo can’t treat hair loss on its own, it can really help you maximize the hair you have.

What are your feelings about Dihydrotestosterone (DHT)?

While you can go down an internet rabbit hole and read about all kinds of “DHT blockers,” there’s only one that is proven to work – Finasteride (generic Propecia®).  It’s a prescription tablet that effectively blocks DHT and helps to reduce further hair loss, including receding hairlines.  DHT blockers are the most effective hair loss treatment.  A study by the American Academy of Dermatology found that finasteride is effective at DHT blocking.  Not only does it halt hair loss, but it can even help with future growth.  Another study, this one published by the Journal of Investigative Dermatology, showed that up to 83% of men taking finasteride 1mg per day for two years experienced no further hair loss on their crown, and 66% experienced some regrowth.

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Written by Dr. Peter Young

Dr. Peter Young, dermatologist and the Medical Director for Keeps, which focuses on treatments for hair loss in men.

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