A Solution to Male Hair Loss

It’s estimated that two-thirds of men will suffer from hair loss at some point in their lives. Although an extremely common issue, it can be a cause of insecurity for a lot of men, lowering the quality of life for many, specifically when it comes to self-perception and relationships. According to a survey of 2,000 men, the majority would even rather have a small penis than be bald! To help rid you of your hair loss woes, or assist you to better inform your male friends and family, hair transplant surgeon Mr Greg

Williams and trichologist Dr Ingrid Wilson provide their advice on the different options available.

Non-invasive methods

So, if you aren’t ready to go full Jason Statham and rock the bald look, what options are out there? Dr Wilson explains there are an array of methods for treating hair loss which don’t involve going under the knife. She says, “Although hair transplants are probably the most widely known method for treating hair loss, there are actually many methods that don’t require invasive surgery which can help with your hair loss journey and I believe these should be considered first.” Below, she outlines some of the many treatment options she offers to her patients, although not every treatment is suitable for everyone.

Prescription medication

The most common treatment is minoxidil, Dr Wilson says, which can be applied topically onto the skin, or rarely can be taken as an oral medication. According to Dr Wilson, this treatment can help people suffering with baldness to slow down the rate at which they are experiencing hair loss. She advises, “Topical minoxidil can be purchased widely from pharmacies, but oral minoxidil needs to be prescribed to you by a medical professional. Typically it can take around six months for it to start showing results or for you to determine if it is working for you. Another common option for treating hair loss is finasteride, a prescription drug for men, which you take once a day. It takes three to four months to see the full effects and know if it’s working.” Finasteride can lead to a lowered sex drive in some men, and is not suitable for everyone. Dr Wilson notes that men should be assessed for their risk of sexual or erectile dysfunction, by being asked screening questions about their health, before they have it prescribed. Your response to all hair loss medications is determined by your genetics, according to Dr Wilson, who advises going to a medical professional for a DNA test first, which can help identify which ones might work for you. She says, “When looking for treatments, make sure you book a consultation with a medical professional who can carry out a private test. This will stop you wasting time on anything that might not work and point you in the direction of ones that will!” It is important to note that the test does not diagnose the cause of hair loss, so it is imperative to have a consultation with a suitably qualified professional first, Dr Wilson adds.

Dr Ingrid Wilson, trichologist, Crewe Hair and Skin Clinic, Cheshire

IG: @dringridwilson Low-level laser therapy

A newer method for treating hair loss comes in the form of non-invasive aesthetic devices. Dr Wilson says lowlevel laser therapy can help to stimulate the hair follicles and encourage growth by emitting light which can penetrate the scalp. Due to it being a relatively new option the evidence base is small, but it is gradually growing. Unfortunately, Dr Wilson explains, the most well-known devices have not been tested on darker skin tones. She notes, “Although there are some results showing that it does work, I would advise using laser light therapy in combination with other treatments, such as prescription medication, rather than on its own."

"You need to ensure that you have protein with every meal – even breakfast! This is because it builds keratin and without this your hair can become brittle"

Dr Ingrid Wilson

Platelet-rich-plasma therapy (PRP)

Another treatment that Dr Wilson advises using in combination with other treatments is PRP (platelet-rich plasma) therapy. This refers to a process in which a person’s blood is taken, processed, and then injected back into the area of concern. Increasing the growth factors from the PRP is thought to help natural growth, however results do vary and more studies are needed to determine the optimal treatment regime for different causes of hair loss.

Don’t underestimate your diet!

Dr Wilson notes that the first thing she does during a consultation is find out about a patient’s diet and lifestyle. She comments, “There are many everyday factors that can have an impact, such as hair pulling, smoking, hat wearing, and stress. Even something as simple as getting men to wash their hair more often can help, because it gets rid of the dead hairs and allows for new growth.” Dr Wilson also notes that nutrition can play a role in how

you experience hair loss, so now you have no excuse to put off cooking those healthy meals! She says, “You need to ensure that you have protein with every meal – even breakfast! This is because it builds keratin and without this your hair can become brittle.” Dr Wilson also recommends ensuring you have a wide variety of colours in your meals, so that all vitamins and minerals are consumed. “All vitamins are important for your hair in different ways,” she says, explaining, “For example vitamin A produces sebum to keep your head moisturised and vitamin B carries nutrients to the scalp. Biotin is a common B7 supplement that can help stimulate keratin production and is regularly used for treating hair loss – but it is important to know that there is only actually evidence for biotin improving hair growth in those with a deficiency."

Surgical treatments

Mr Williams explains that hair transplant surgery refers to a procedure in which hair follicles are removed from one part of the body (usually the back and/ or sides of the head) and transferred to the areas where hair has been lost. The results are usually long lasting. He says, "The harvesting of donor hairs can be done in two ways: follicular unit excision or linear strip excision (commonly referred to as strip follicular unit transplantation or, erroneously, just as follicular unit transplantation/FUT). Sometimes, the two techniques can be combined in one procedure." Mr Williams adds that the hair harvesting method does not have an impact on the appearance of the hair transplant or how many hairs you will get.

Linear strip excision: This is regarded as the more traditional method where a surgeon will cut out a strip of scalp skin with healthy hair. The wound is then sutured or stapled closed, resulting in a linear scar which, ideally, will be hidden by the surrounding hair. The strip is then dissected into the naturally occurring groups of hairs known as follicular units which will have one to four (occasionally five or six) individual hair follicles. These follicular units are then implanted into tiny incisions in the recipient area using either forceps or implanters. The hair has to be permanently worn long enough to cover the linear scar but the surrounding hair density is not significantly affected. Follicular unit excision: This method involves the follicular units being extracted individually in the donor area rather than as a part of a strip, so instead of leaving a single linear scar, follicular unit excision leaves multiple small round scars that are much easier to hide with a short haircut. The number of small round scars equates to the number of follicular units excised. The follicular unit grafts are then transplanted in the same way as strip grafts. Whilst this method is less painful post operatively than using the linear strip excision method, usually fewer hairs are available Mr Greg Williams, for transplantation both in a single procedure and over Hair transplant multiple procedures, which can be a problem if large areas surgeon, Farjo Hair Institute, Manchester of balding scalp require coverage. In addition, the density IG: @drgregwilliamsuk of the hair in the donor zone is decreased which can be visually apparent if very large numbers of follicular units are harvested and the hair is worn short.

Who is suitable for a hair transplant?

When getting a hair transplant, it is not as simple as just booking in. When being considered for the procedure, your age; current hair loss rate; hereditory factors, the

amount of hair available at the donor site; lifestyle choices; and your general medical health, are taken into account according to Mr Williams. He explains there is no universally agreed formula for deciding on suitability for a hair transplant – each patient’s needs and expectations should be considered on a case by case basis. Crucially, the surgeon also needs to try and predict whether the patient is likely to have progressive hair loss and how quickly this might occur. Mr Williams adds, "This is because hair transplants can take up to 18 months for the final results to be apparent, and by the time the transplanted hairs are fully mature, the rest of the non-transplanted hair might have deteriorated. This is particularly important when transplanting to the hairline, temples or crown because by the time the transplant procedure result is judged, the surrounding hair might have receded behind or around the transplanted hairs, leaving gaps." Mr Williams emphasises that if the hair is in a rapidly progressing phase of deterioration, it might be better to delay getting a transplant and instead try some of the nonsurgical treatments that are available and to slow down or prevent further hair loss.

Considerations for hair transplants

Like many other aesthetic procedures, hair transplant surgery has limited regulation in the UK. Mr Williams explains that this has led to many patients being exploited. He comments, “Currently in the UK, hair transplants are labelled as being ‘cosmetic’ instead of ‘medical’. In addition, the FUE technique of donor hair harvesting is seen by some doctors as non-surgical which has led to the inappropriate delegation of the skin incisions to non-doctors.” He also says, “If you are looking into getting a hair transplant done, I advise you check that the clinic is registered with the Care Quality Commission in England, The Regulation and Quality Improvement Authority in Northern Ireland, Healthcare Improvement Scotland or Healthcare Inspectorate Wales depending on where you are having it done.” Mr Williams advises that the doctor who will be performing the treatment should be listed on the clinic website, along with their qualifications and experience. He explains, “Sadly a lot of patients are not told from the onset who will be carrying out their surgical procedure – they may just have spoken to a non-medical advisor or business person who owns or manages the clinic. It is important to know who the person is who will be operating on you. It is this practitioner who should be making the surgical planning decisions including the number of follicular unit grafts (or hairs) required, the donor harvesting method, and the transplant design. As part of informed consent, the non-surgical options should be discussed as well as the option of doing nothing, and after having a medical consultation." He adds that it is important for you to also have a cooling-off period to reflect and make sure it is definitely something you want to go ahead with, emphasising that you should not be swayed by hard pressure sales tactics or financial inducements.

"There is no universally agreed formula for deciding on suitability for a hair transplant – each patient’s needs and expectations should be considered on a case by case basis"

Mr Greg Williams

Look at your options

Both Mr Williams and Dr Wilson note that men are often anxious or embarrassed to seek help for their hair loss, but says there is no shame in looking at your options. Dr Wilson says, “About 60% of men experience hair loss by age 60 – it’s extremely common! There are so many different treatments out there, so if it’s bothering you, book in with a professional to get yourself a proper diagnosis. The sooner you make the appointment with your doctor or dermatologist, the quicker your concern can be remedied! Getting your hair back or at least slowing down its thinning can be a huge confidence boost for lots of men, and it really can change your everyday life.”

For more information on hair restoration treatments, and what you should consider, you can visit the websites of the below associations.