Hair Loss: The Early Signs and Treatment Options

Male pattern baldness is an incredibly common condition, it is estimated to be experienced by more than two-thirds of men.

Published: Monday 07 December 2020

Male pattern baldness (also known as alopecia androgenetica) is experienced by more than two-thirds of men over the course of their life, and is more likely to occur with age^[1]. Male pattern baldness typically develops gradually, it’s caused by increased levels of dihydrotestosterone (DHT) which is produced from the enzyme 5a-Reductase when it interacts with the male hormone testosterone.

The most effective way to prevent hair loss is by taking action as soon as possible. Therefore, it is important to know how to recognise the early signs of hair loss so that treatment can be started.

If you are already taking hair loss treatment, this article may help you identify the different stages of hair loss which can help you to evaluate the results of your treatment.

Before we explore the early signs of hair loss, it’s important to understand the possible causes of hair loss.

Common causes of hair loss

There are many causes or factors that contribute to hair loss, we list some of the common causes below.

Genetics - Male pattern baldness is often referred to as hereditary pattern baldness due to the significant role played by both parent’s genes that contribute to the likelihood of inherited hair loss.
Age - The likelihood of experiencing hair loss tends to increase with age due to age-related hormonal changes.
Smoking - Research has suggested that smoking can increase the likelihood of hair loss^[2]. While findings are still yet to be widely corroborated, it is thought that smoking can decrease the blood circulation to hair follicles, interfere with the hair growth cycle and directly damage hair as a result from repeated contact with smoke.
Stress - Emotional stress and anxiety can be a cause of hair loss. When the body elicits a stress response, commonly known as the body’s flight or fight response, the hormone cortisol is released which can interfere with the growth cycle of hair follicles.
Depression - Clinical depression is also known to contribute to hair loss. Hair loss can be caused by possible side effects of antidepressant medication in addition to stress-induced hair loss as a result of depression.

Identifying hair loss is often thought to be easy, however, spotting hair loss early is more difficult. We have identified the key essential signs to look for when it comes to spotting the early signs of male pattern baldness.

How to identify the early signs of hair loss

Common signs related to hair loss:

Receding hairline - One of the first indications that you may be losing your hair due to male pattern baldness is a receding hairline. A receding hairline forms an ‘M’ shape, where hairs begin to shed and thin around the temples and forehead. Shedding and thinning of hair is a prominent early sign of male pattern baldness - it indicates that hair loss is occurring without sufficient hair regrowth. A receding hairline most commonly occurs in men who are over the age of 25, but some men in their teens and early 20’s may start to experience it if it’s hereditary.
Thinning hair - Some men will experience thinning hair before a receding hairline is noticeable. Thinning hair usually affects the whole scalp or the crown of the head, resulting in balding from the back or top rather than from the hairline. This process is gradual and can be difficult to observe in men, especially those that have shorter hair naturally. That’s why closely monitoring it is the best way to observe any significant changes; taking pictures of your hair in a mirror every month or couple of months is the best way to observe changes.

Signs not related to hair loss:

Seeing a few hairs on your pillow - It’s normal to shed 50 - 100 hairs a day, seeing a few hairs on your pillow is not an indicator of hair loss as a condition.
A white bulb on the hair strand - The white bulb that’s sometimes observable on a hair strand that’s fallen out indicates that the hair was in the telogen phase of growth. This is not an indication of hair loss.
Widow’s peak hairline - This type of hairline is characterised by a distinct point in the centre of the forehead. The sides of the hairline are higher than in the middle of the forehead. Widow’s peak is thought to be due to the expression of a dominant gene although this is not scientifically corroborated. It can give the impression of a receding hairline, however, this is not the case.
Hair looking thinner when it’s wet - When your hair is wet, it tends to clump together revealing more of your scalp which can make it look like the hair is thinning. It is best to check your hair and compare photos when it’s dry and not styled.
Itchy scalp - An itchy scalp is not a sign of hair loss. Usually, an itchy scalp is caused by dry, irritated skin possibly due to a new or different type of soap used to wash your hair.

Hair loss treatment options

If you think you might be losing your hair and have recognised some of these early signs, then treatment is available to help prevent further hair loss and even promote hair regrowth.

If you are already using a hair loss treatment, make sure you monitor the results - it may be worthwhile trying some treatments in combination or switching to a different treatment in order to find one that works best for you. So what are the treatment options and how do they differ?

Oral Treatments

Finasteride

Finasteride (and the branded version Propecia) is acknowledged as one of the most effective medications for treating hair loss in men.

Finasteride works by blocking the role of the enzyme 5a-Reductase, preventing it from converting testosterone into dihydrotestosterone (DHT). DHT is the hormone responsible for causing hair loss in men.

Finasteride is taken in tablet form and begins to work immediately, results are often observable from three to six months. Finasteride is highly effective, it works for 9 out of 10 men that take it.

Propecia (branded Finasteride)

Propecia is the branded version of Finasteride, it works in exactly the same way but is typically more expensive.

Topical Treatments

Topical treatments consisting of products that are rubbed into the scalp such as medicated foam, solution and shampoo are also effective at helping treat hair loss. They are massaged into the scalp and work on contact with the hair follicles.

REGAINE® Foam and Solution (Minoxidil)

REGAINE® Extra Strength Foam is one of the most popular topical treatments, it contains the active ingredient Minoxidil which helps to promote blood flow to the hair follicles to increase follicle size and diameter. The efficacy of REGAINE® is similar to Finasteride and is reported to work for 90% of men.

REGAINE® Extra Strength Solution is an effective hair loss treatment that also contains Minoxidil. The main difference from REGAINE® foam in that it is applied as a liquid solution rather than a foam. The efficacy of REGAINE® solution is equivalent to the foam alternative, helping roughly 90% of men that use it keep or regrow their hair.

Alpecin Caffeine Shampoo and Liquid

Alpecin Caffeine Shampoo contains caffeine, it is engineered to help stimulate hair regrowth. While the evidence for its effectiveness is debated, it can be regarded as a supplementary hair loss product to finasteride or REGAINE®. You can also purchase Alpecin Double Effect Caffeine Shampoo, which has the dual effect of treating dandruff in addition to supporting hair regrowth.

Alpecin Caffeine Liquid Hair Energizer is another alternative product to Alpecin shampoo. It’s different to a shampoo in that Alpecin Liquid is left in the hair for 24 hours rather than being washed off in the shower. The efficacy of both products is still equivalent.

Use of oral treatment and topical solution together