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Hair loss in men: causes and treatment

by Josephine Andrews
Published: Last Updated on 177 views

Receding hairline is often the first sign when men suffer from hair loss. In most cases, hereditary hair loss is behind it. Read here what treatment methods are available and what else is the reason when men lose more hair.

When men lose hair, they suffer greatly. The loss affects the self-confidence and attractiveness of many of those affected. In some cases it even leads to depression.

Doctors speak of hair loss when someone loses more hair over a longer period of time – a guideline is more than 100 hairs a day.

In order to effectively combat hair loss in men, it is important to know the causes. Depending on the trigger behind it, the treatment is different. Those affected can go to the dermatologist for diagnostic clarification. In addition, there are now special hair consultation hours in Germany.

Causes of hair loss in men

There are three main reasons why men lose their hair. We present them in more detail.

Hereditary hair loss (androgenetic alopecia)

Hereditary hair loss , also called hereditary hair loss, is the most common form of hair loss in men. In Europe, 80 percent of men are affected and about 40 percent of women. The first signs of this often appear in men in their teens.

In hereditary hair loss, the hair follicles are overly sensitive to dihydrotestoterone (DHT). This male sex hormone is a breakdown product of the hormone testosterone.

The result of this hypersensitivity: the blood vessels that supply nutrients to the hair follicles shrink and atrophy. The growth phase of the hair is also shortened. As a result, new hair grows back shorter and weaker. They drop out one by one. This type of hair loss is inherited through several largely unknown genes.

It is typical of androgenetic alopecia that men initially develop a receding hairline . Later, there are increasingly bald spots on the back of the head, and the hair thins more and more.

Circular hair loss

Circular hair loss is rare. The specific cause is still unknown. The triggers for this are probably autoimmune diseases and hereditary factors. This type of hair loss often occurs in phases. The round, bald spots do not itch and do not show any skin changes such as scaling or inflammation.

Diffuse hair loss (diffuse alopecia)

In the case of diffuse hair loss, the hair roots are damaged. The result: the hair falls out relatively evenly over the entire scalp. As a result, the hair density decreases and the scalp becomes visible. As a rule, there is no complete baldness, rather individual hairs remain distributed over the head.

Diffuse hair loss can occur at any age. The causes include the following:

  • malnutrition
  • strict diets
  • Stress
  • poisoning or environmental influences
  • drug side effect, for example during chemotherapy
  • Accompanying symptoms of general diseases such as diabetes

This helps with hair loss

Depending on the cause of the hair loss, different means and procedures are used.

Therapy for hereditary hair loss

Drugs, laser light or hair transplants: men who suffer from hereditary hair loss have these treatment options.


Hair foams or solutions with five percent minoxidol are regularly used for hereditary hair loss in men. The substance is originally a blood pressure reducer. When treating patients with high blood pressure, a surprising side effect was that they often got a fuzz.

The manufacturers reacted to this finding and produced clear, fat-free and unscented solutions and foams that those affected apply directly to the scalp. According to scientific studies, regular use of minoxidol stops hair loss, activates the hair follicles and stimulates the production of new hair.

For successful therapy, it is important to start treatment on time and apply the solution for at least three months. It should be noted: Minoxidol only works as long as the person concerned uses it.

Minoxidol is only available in pharmacies. Side effects such as redness, itching or dandruff occur in some cases. Before using it, talk to a doctor about it.


The drug finasteride inhibits the conversion of testosterone into dihydrotestoterone, to which the hair follicles are particularly sensitive. It is a so-called hormone-modifying 5α-reductase blocker.

International studies that ran for years with 1,500 male participants showed that around 80 percent of those who used finasteride stopped the progressive hair loss. In about 65 percent, there was even a thickening of the hair on the head.

Those affected usually tolerate one milligram of finasteride per day in tablet form well. Rarely did they experience reduced libido , ejaculation disorders or erectile dysfunction

A visible improvement usually occurs after three to six months. The same applies to finasteride: If you stop taking the tablets, you have to struggle with the original hair loss again. Accordingly, it must be taken for as long as the men want to keep their hair. It is important to go to the doctor regularly for check-ups during this time.

Finasteride tablets require a prescription. The health insurance companies do not cover the costs.


Like finasteride, dustasteride is a hormone-modifying 5α-reductase blocker. The drug is mainly used to treat benign prostate enlargement. Since it has a similar mechanism of action as finasteride and inhibits the conversion of testosterone into dihydrotestoterone, it can also help with hereditary hair loss.

Studies have shown that 0.5 milligrams of dutasteride per day is even more effective than the same amount of finasteride. However, dutasteride currently has no official approval in Germany for the treatment of androgenetic alopecia.

Autologous blood and laser light

Injections of autologous blood are among the newer treatment options for hereditary hair loss. The active ingredient is called PRP and is an abbreviation for “platelet rich plasma”. In this treatment, the nutrient solutions are injected into the scalp. This should stimulate hair growth again.

eLaser therapy was also added to the list of treatment methods in 2018. A low-dose laser light (low-level laser therapy) promises great success in androgenetic alopecia.

However, there is not yet sufficient data from controlled clinical studies for therapies with autologous blood or with laser light to give a clear recommendation. There are also no reliable results for external therapies with aloe vera , bergamot, caffeine or a diet with omega fatty acids, vitamins and nutrient combinations.

hair transplant

Men have the option of concealing a receding hairline and a bald spot at the back of the head, which are caused by hereditary hair loss, with a hair transplant . For this purpose, small pieces of tissue with hair follicles, which are usually not sensitive to testosterone, are cut out at the back of the head and placed on the bald spots.

You can read more about this in this text on hair transplants .

Therapy for circular hair loss

So far there is no standard therapy for circular hair loss. For a flare that isn’t that severe, doctors often prescribe topical cortisone creams or solutions that can be combined internally with zinc compounds.

In the case of severe hair loss, those affected sometimes also take cortisone tablets. In this case, the side effects are only often stronger. Weight gain or a weakened immune system are possible, among other things. Therapy with cortisone is only successful as long as those affected take the drug.

After the acute phase has subsided, the active ingredient dithranol is often used. It is said to stimulate blood circulation in the scalp and thereby ensure new hair growth.

In severe cases, topical immunotherapy also comes into play. The active ingredient diphencypron (DCP) is supposed to distract her immune cells from attacking the hair follicles. With this therapy option, however, in some cases excessive eczema forms on the treated skin areas.

There are also many other therapies in the trial stage for the treatment of patchy hair loss. However, none of them have caught on at the moment.

When treating circular hair loss, those affected should always discuss with their doctor which treatment methods are suitable and which side effects they would like to accept.

Therapy for diffuse hair loss

If you are suffering from diffuse hair loss, it is important to know what is causing it. If a nutrient deficiency is the trigger, a change in diet or supplements from the pharmacy may help.

If a disease is responsible, it should be treated with appropriate medication. If you suffer from stress, it is best to integrate relaxation units such as yoga into your everyday life. Talk to your dermatologist about what works best for you.

When to the doctor?

If you notice that you are losing more hair over a longer period of time, always consult your doctor first before taking any supplements or medication. Together with a doctor, you will find out what is causing the hair loss and choose the appropriate therapy together.

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