How to Handle Men's Thinning Hair: Here is what you can do about it

—Eric Bandholz
How to Handle Men's Thinning Hair: Here is what you can do about it

Ok guys, a lot of us bearded dudes have thinning hair, and we need to have an ultimate guide on how to handle it. So, I figured I'd address a bit of the process and what you can do about it.

What Causes Hair Loss?

Now, here's the thing, male pattern baldness (MPB) is caused by your sensitivity to dihydrotestosterone (DHT) and it's totally determined by your genetics. A boost in DHT will help with the growth of your beard, but it'll also hinder your ability to keep your hair. This is why you see a lot of guys who are losing their hair, but have great beards.

So, almost every man goes through hair loss or male pattern baldness. Off the top of my head, I think 50% of men will see MPB by their 40's and 67% of men will see it by their 60's. When and the degree it affects you is up to your genetics. While your mother's father will play a role into your hair loss, it's not a 100% indicator. Ultimately, if a bunch of people in your family are bald, chances are it'll happen to you, too.

I'd like for you to think of your hair loss like any other genetic factor - such as your height, eye color, or skin color. There are things you can do to work with it, but at the root of the issue, you'll have to love the person looking back at you in the mirror. IE, you're going to have to be cool with balding because that's part of what makes you, you!

Secondary Factors in Hair Loss

Yeah, it’s true that MPB is primarily driven by genetics and the other three-headed (bald, that is) monster, DHT. But there are other things that potentially figure into the mix, too.

Age – We’ve kind of touched on this one already, but the bottom line is that the rate of hair growth slows as you get older. An elderly guy with a full head of hair is worthy of our praise because he has somehow defied the odds of aging and genetics. Bravo, kind sir!

Smoking – You know that smoking is bad for you, but we’re not here to lecture. Among smoking’s many negative health effects, heavy smokers are more likely to experience hair loss than non-smokers. By heavy smoker, we mean someone who smokes 20 cigarettes a day, or more. Why? Because smoking messes with your blood circulation and that means less blood flow to your hair follicles.

Alcohol – Many men enjoy a cocktail or two at the end of a long day of a work or a long week, and there’s absolutely nothing wrong with that. But unrestrained alcohol consumption may contribute to hair loss because alcohol raises estrogen levels while Zinc levels are reduced. And Zinc is an essential mineral for growing hair.

Poor Diet – Maintaining a healthy diet is excellent for a lot of reasons, including that it’s good for hair health. For instance, protein is essential for prolonging your hair’s growing (anagen) phase, so making sure that your diet includes a sufficient amount of protein is important. A diet that doesn’t include enough iron can lead to hair loss, as well.

Medications – Studies show that certain medications can contribute to hair loss. It all depends on the type of drug, the dosage, and your sensitivity to it. Drugs included on the list are antidepressants, cholesterol-lowering medication, high blood pressure medication, non-steroid inflammatory drugs, weight-loss drugs, certain antibiotics and anti-fungal drugs, and thyroid medications.

Stress – You’re probably familiar with the expression about how something or someone is causing you to “pull your hair out.” Well, that kind of stress can, indeed, lead to hair loss, so it’s best to chill, always.

Other Causes – There are other issues associated with hair loss including: skin disorders such as; psoriasis and dermatitis, fungal infections, along with medical conditions such as; diabetes, anemia, lupus, and thyroid disease.

Maturing Hairline

Now if you are still young (16 to 21) you need to understand the difference between MPB and a maturing hairline. The majority of guys will see receding of their temples and slight thinning of their hair as they wrap up puberty. The way I like to look at it is that you're going to experience hair loss in some form or you're going to die young. I'd rather live until I'm 100 and be bald, than die at 18 before my hair goes out; very few men in retirement homes have a full head of hair.

Here is me when I was about 18 years old:

Eric Bandholz at 18 years old with no beard

Here is me not too long ago at age 35:

Eric Bandholz with sunglasses in suit

Here is my thinning crown at 33 years old (looks worse because of greasy hair):

Eric Bandholz balding crown

Now my crown has been thinner for a while and it appears that my genetics allow for a slow approaching MPB. There is no normal way to experience hair loss. Some guys recede early at the temples and then it just seems to stop, other guys start at the crown and grows from there, and some guys tend to thin across the top.

But if you’re wondering whether you’re experiencing MPB rather than a mature hairline, here are some other early signs of balding:

  • Large amounts of shedding hair in the shower and on your pillow. Keep in mind though that MPB isn’t necessarily about how much hair you lose each day, but more about how quickly you replace them. DHT causes hair to go into a resting or dormant phase so hair that falls out isn’t replenished.
  • An itchy, flaky scalp may be another early sign of MPB. It can be caused by an excess of the natural oil (sebum) on the scalp, which can cause hair loss and dandruff. Remember, however, that dandruff and hair loss don’t often go hand-in-hand.
  • Thin, wispy hair may be a sign that hair follicles are shrinking. If you notice the hairline around your temples and forehead becoming thinner, then this could be a sign of MPB.
  • We’ve touched on it already, but another potential sign of MPB is that your hair takes longer to grow back after hair sheds naturally.

A Quick Look at Hair Growth's Phases

Hair growth takes place in three phases, Anagen, Catagen, and Telogen:

Anagen – This is the growth phase of hair and the longer the phase lasts, the longer the hair. Typically, 85% of your hair is in the anagen phase.

Catagen – This a shorter phase that lasts no more than two weeks and lets the hair follicle renew itself.

Telogen – The telogen phase is when hair follicles remain dormant. This phase can last from one to two months and it ends when the anagen phase kicks in again and new growth pushes out old hair, which then naturally sheds.

Probably the most important thing to remember about hair growth phases is that the anagen phase is reduced – and hair fair follicles grow smaller – for men with male pattern baldness. In turn, the telogen phase is expanded.

How Long Will it Take to Lose My Hair

There’s no real timeline for hair loss other than your risks of experiencing it go up as you age. But hair loss can begin after puberty. For most men, MPB really takes hold in their 20s and 30s. After that, it’s anyone’s guess how long it will take for you to lose your hair and, again, depends on genetics and a variety of other factors. The bottom line is that the rate of hair loss is different for every man.

Slowing down hair loss

Unfortunately, in 2018, there aren't any cures for MPB, but there are some things that have been scientifically proven to slow down or stop hair loss. The best solution is the "triple crown" of hair loss management, which in a few cases will actually help hair grow back.

Rogaine/Minoxidil

Minoxidil, better known as Rogaine, is a topical drug that affects cardiovascular, was developed in the 1950s to treat high blood pressure, but one of its “side effects” was that it caused hair growth. Soon enough, a topical solution of Minoxidil was developed for treating hair loss.

Rogaine works by widening blood vessels to allow more oxygen, nutrients, and blood to reach the hair follicle. When used consistently, Rogaine should produce noticeable results in two to six months. The recommended dosage – at least with Minoxidil foam – is twice a day while leaving an 8-hour window between doses.

You should strongly consider using Rogaine for taking action against hair loss. The foam is easy to use, non-messy, and easy to integrate into your morning routine because it doesn’t take much time at all. You can also use it with your usual styling products and it doesn’t leave your hair looking greasy or oily.

Minoxidil also comes in other brand names: Rogaine, Lipogaine, Kirkland Minoxidil, Regenepure, etc.

Finasteride/Dutasteride

You may know Finasteride or Dutasteride by its most common name – Propecia. It's an oral medication that affects hormones. Scientifically speaking, Finasteride inhibits the process by which testosterone is converted into DHT and, as we know, DHT shrinks hair follicles until they become smaller and smaller, or just fall out.

Propecia is said to suppress as much as 70% of DHT and may slow, halt, or even reverse hair loss in some cases. Some users begin to see results within three months but it may take up to a year.

Now, you may have heard of some of Finasteride’s side effects, such as erectile dysfunction and a loss of libido, and that may make you hesitant to try it. But, the chances of a man experiencing those side effects are extremely low – some say 1% - and issues such as ED and a loss of libido are overwhelmingly due to other factors.

That said, make sure you purchase your Finasteride from a reputable source, such as a doctor or dermatologist, because you cannot buy it over-the-counter.

Ketoconazole

Ketoconazole shampoo also comes in a variety of names but the most popular is Nizoral. Ketoconazole acts as an antifungal medication, in the form of a shampoo, which helps to reduce inflammation that may contribute to hair loss. It also cleanses the scalp and is convenient to use because it’s a shampoo.

Ketoconazole comes in 1-percent and 2-percent varieties, with 2-percent being the stronger of the two. You can buy 1-percent over the counter, while 2-percent requires a prescription, but produces better overall results. Nonetheless, many men have reported positive results using the 1-percent version. For best results, massage the shampoo into your hair and scalp, leaving it on for one to five minutes before rinsing.

A potential side effect of Ketoconazole is an itching and stinging sensation when you first start to use it. Call your doctor if those side effects persist.

Now, these are all drugs and have side effects. The percentage of guys who have side effects is small, but there are also a portion who may have placebo effects of the side effects. IE, they think they are going to have erectile issues, then end up having it even though the drug didn't cause it. Every individual is different when it comes to tolerance to side effects and their desire to slow down hair loss.

You can get minoxidil & ketoconazole over the counter, but will need a prescription for finasteride or dutasteride. When it comes to slowing down or stopping your hair loss, it's best to start early. With this option, I strongly recommend you reach out to your trusted dermatologist and understand how to use the products, the side effects, and realistic expectations.

Cosmetic & Surgery Alternatives

If those drugs don't help, you still have some alternatives. There are powders / concealers you can spread into your hair to give the appearance of thicker hair. There are downsides to that application as it can be messy.

There are toupees, which have really come a long way. Pretty much it'll be integrated into getting your haircut; Karl Pilkington did an entertaining segment on it for his show The Moaning of Life.

Another alternative could be to tattoo of "stubble" on your scalp to give the appearance of stubble. It's called scalp micro-pigmentation and can work if you rock the bald look.

Most scalp micro-pigmentation treatments are typically split over three sessions, although the actual time may vary depending on the severity of your hair loss, the style you’re trying to achieve, and additional factors. Micro needles used during the procedure layer pigment dots on your scalp in a process much like getting a tattoo, which is why scalp micro-pigmentation is sometimes called a “scalp tattoo.” The tiny dots create the illusion of a full head of shaved hair.

While it sounds kind of painful, most men usually experience only mild discomfort during the SMP procedure. Besides, most patients focus on the benefits of the treatment rather than any discomfort they may feel. Also, there are few, if any, side effects associated with scalp micro-pigmentation beyond some slight redness on the skin for a couple of days after the procedure.

The downside of scalp micro-pigmentation is its cost, as procedures typically cost several thousand dollars.

The most serious solution is a hair transplant, which essentially relocates hairs from the back and side of your head, to the crown and top of your head. If you do this too early, you could end up with a weird hairline and will need to continue to get surgeries to fix the issue. It's also pretty damn expensive. TV announcer Joe Buck has dealt with an addiction to hair surgeries and it nearly cost him his career.

While the number of men who choose hair transplants is growing, as well as clinics that perform them, always make sure to thoroughly research the clinic and its physicians before you decide to have the procedure. Remember, a hair transplant is a more permanent solution compared to other methods for dealing with hair loss.

With any of these treatments, I say own it, and be proud of the decisions you've made. There are tools available to fight hair loss and there is no shame in using them. In my opinion, it's no different than choosing clothes to look a certain way, or getting tattoos, or getting braces for your teeth.

More Options for Managing Hair Loss

We’re all about taking action when it comes to dealing with hair loss. By that, we mean don’t just throw up your hands and say, “There’s nothing I can do about my hair loss!” It’s like when you have a cavity in a tooth – you don’t sit back and live with it, but you go to the dentist, change your brushing and flossing routine, and so on.

Taking action when experiencing balding and hair loss means finding a hairstyle that works with thinning hair. It also means integrating products into your life – such as Rogaine – that slow down hair loss and may even generate new hair growth. It also means making due with what you have in terms of your specific kind of hair loss.

But taking action doesn’t mean shaving your head at the first sign of balding. Don’t do it. There’s nothing wrong with shaving your head if you’ve experienced significant thinning or balding, but there’s no need to when you first notice hair loss. So, be part of hair thinning men who are proactive.

Hairstyles for Men with Thinning Hair

Ok, now that we've established ways to deal with hair loss, let's talk about the hairstyle options you have. Many guys are quick to rush to the "shave it off" option when they start losing their hair. The thing is, you don't have to do that.

Because thinning hair is so common, there are a lot of hair styles that work for balding hair and a good barber will work with you to find a hairstyle that works for you. Find other guys who are having a similar balding style as you and use that as inspiration. Here's a short list of famous guys with thinning hair to get you started:

Keep in mind that these people make money with their image, so it's likely they've treated their hair loss with one of the solutions above. The biggest thing with thinning hair is to own it and not hide it. There's a difference between getting a hairstyle that looks good with MPB and one that is trying to cover up the baldness.

Men basically experience hair loss in three different ways: You’ll lose hair from the crown of your head, from your temples, or from a general overall thinning of your scalp. Let’s take a look at hair styles you can rock depending on what type of hair loss you experience:

With receding temples, which is probably the most common type of receding hairline, there a couple of good options for styling your hair. The key to rocking this look is to not be afraid of showing off those temples and to play up that type of look. Our first recommendation is to wear a side part, of which there are a million variations. It can be a more natural side part or one that’s blow dried into shape. Another popular style with receding temples is the messy crew cut, which is a shorter hair style – typically no more than an inch in length – that includes a structured look, such as a part.

You have plenty of options for a rocking hair style when for hair thinning at the crown. But the styles fit into two basic options: where the hair is shorter on the crown while bringing more attention to the front of your head, like a quiff. With a quiff, you blow dry it forward and then blow dry it up in the front. Or, you can leave it longer in the front and bring it back to the point of your crown, like a pompadour or a slicked-back hairstyle.

When your hair is thinning across the board all over the top, the last thing you want to do is wear a Prince William style that’s bushier around the sides of your head but has what amounts to a comb over on top. Instead, don’t be afraid to wear a very short stubble look, which depends on the severity of your hair loss. If there’s significant thinning on the crown, then you definitely want to bring it down to a much shorter style. Or, you can also try a longer, messy look with a longer side part.

The worst thing you can do with balding is the comb over! That being said, I've seen some guys who have thick curly hair and their thinning temples are covered up naturally without looking weird. We are all different, so there is no one perfect solution.

And There's Nothing Wrong With a Bald Head

We’re all about taking action when it comes to dealing with hair loss but when your hair loss becomes so extensive that you don’t have many options, such as those we’ve talked about above, then shaving your head is OK.

The good news is, if you’re bald you’ll probably be able to grow a nice thick beard, and the two go hand-in-hand. After all, the bald look by itself is pretty bland, but when you pair it with a beard, it takes on a different and much better look.

Now, like a patchy beard, a bald hairstyle will look better shorter. Some guys choose to go completely bald on the entire head and that can require a little more maintenance than a stubble style. The other advantage of the stubble bald look is if you wear a hat, others won't be able to tell you are thin up top. Other considerations of balding will be to grow a beard out and to accessorize with sunglasses or hats; which we talked about in this video on bald style techniques.

With that, hopefully you are well prepared to tackle your hair loss journey. Don't worry about it as most guys will deal with it in some shape. It sucks because it's out of our control, but many obstacles in life are. Hair or no hair, you'll still be able to find your soulmate, find friends, get a job, and live a long and healthy life.

TL;DR

Hair loss happens to most guys and there are tons of options out there for you!

Keep on Growing!

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