June is Men’s Health Month. An expansion of Men’s Health Week—which was officially designated in 1994—June was chosen because it’s the month in which Father’s Day is celebrated. During this month, men are encouraged to celebrate themselves by taking charge of their physical and mental well-being to live happier, healthier and longer lives—and to seek help when needed.
How does hair loss figure into this? In addition to the most common cause of male pattern balding—known as androgenetic alopecia (AGA)—hormonal changes, medical conditions, prescription medications, anabolic steroid use, diet and stress can all affect the rate and severity of hair loss. Moreover, the loss of hair often results in a loss in self-esteem—which has a negative impact on mental health—which in turn affects physical health.
The Effects of Hormonal Changes and Lifestyle Choices on Male Hair Loss
Contrary to popular belief, testosterone itself doesn’t directly cause hair loss, but can contribute to it by increasing levels of dihydrotestosterone (DHT)—a hormone that can shrink hair follicles and lead to hair loss, particularly in individuals genetically predisposed to AGA. Testosterone is converted into DHT by an enzyme called 5-alpha reductase. DHT then binds to hair follicles, causing them to shrink (miniaturize) and eventually stop producing hair. However, not everyone experiences hair loss from DHT. It’s primarily those with a genetic sensitivity to DHT who are affected by AGA.
According to the American Hair Loss Association (AHLA), hair loss affects two-thirds of American men by age 35. AGA is responsible for over 95% of hair loss in men. By the age of 50, approximately 85% of men will have significantly thinning hair. Around 25% of men with male pattern baldness begin losing hair before the age of twenty-one.
While the cause of male hair loss is largely genetic, lifestyle and health play an important role. No element of the human body exists or functions independently of the others—including hair follicles. The following lifestyle factors can impact hair loss:
Smoking—Nicotine is a vasoconstrictor, which makes blood vessels contract. This restricts the delivery of oxygen to every cell of the body, including the skin and hair follicles. Over time, this makes hair regrowth harder, so when strands fall out, they aren’t replaced as readily—or at all. In addition to nicotine starving cells of oxygen, the numerous toxic substances in cigarettes have been implicated in causing damage to the DNA of hair follicles. Moreover, a research study conducted on 1,000 healthy males ages 20 to 35 found that nicotine and its derivative, cotinine, might be responsible for accelerating AGA progress.
Diet—Americans tend to go to extremes when it comes to diet and nutrition—either making high-fat, high-calorie fast food the mainstay of their diet, or following every quick weight loss fad. Hair is sensitive to nutritional imbalances. An inadequate intake of essential vitamins or minerals can impact the hair growth (anagen phase)/rest cycle (telogen phase). For this reason, a junk food diet high in saturated fat, salt and sugar—and low in essential vitamins and nutrients—not only leads to hair follicles being poorly nourished, but increases the risk for type 2 diabetes. High uncontrolled blood sugar levels in those with type 2 diabetes can damage tissues, organs and blood vessels. Damage to blood vessels can restrict blood flow, resulting in certain cells receiving less oxygen and nutrients than they need. This deficiency can negatively impact the normal growth cycle of hair follicles, which can lead to hair loss.
As for the other extreme, fad diets tend to be imbalanced in food varieties and essential nutrients. Such deficiencies can lead to a type of hair loss called telogen effluvium. Fortunately, this condition is generally reversible, so adopting healthier, less restrictive eating habits will allow hair to grow back.
Excessive alcohol use—Although not a direct cause of hair loss, this type of substance use disorder promotes it due to the tendency toward poor nutrition—as well as the body’s inability to absorb the proper nutrients because of alcohol consumption.
Steroid use—Despite their dangerous side effects, anabolic steroids have been the drug of choice among some bodybuilders and others looking to increase muscle mass and athletic performance. Steroids can quickly accelerate hair loss progression in those genetically predisposed to AGA. Hair loss accelerated by steroid use is permanent.
Our blog post—“How Lifestyle Affects Hair Loss”—covers these topics in greater detail.
How Hair Loss Affects Men’s Mental Health and Confidence
Although the majority of men experiencing hair loss seem to resign themselves to balding, resignation is not the same as acceptance. As the AHLA states, “Contrary to popular belief, most men who suffer from male pattern baldness are extremely unhappy with their situation and would do anything to change it. Hair loss affects every aspect of a sufferer’s life, from interpersonal relationships to professional opportunities. In fact, the … AHLA has received countless reports from young men who felt so overwhelmed and distracted by their progressive hair loss that they were forced to change their career paths.”
Unfortunately, such feelings aren’t the result of imagination or an overly sensitive nature. According to Thomas Cash, emeritus professor of psychology and author of The Body Image Workbook, societal bias against men experiencing hair loss is real. In a study that looked at bias, Cash showed people photographs of bald or balding men—as well as men with a full head of hair—asking them to rate the men for qualities such as self-assertiveness, social attractiveness, intelligence, life-success, personal likability, physical attractiveness and perceived age. He found that “… the bald or balding models were perceived more negatively on every dimension except intelligence.”
Cash is far from alone. Multiple studies have linked male pattern hair loss to lowered self-esteem and decreased confidence. An article for WebMD by Marta Manning and medically reviewed by Jennifer T. Haley, MD, FAAD, cites a 2019 study published in the International Journal of Trichology. The study found that AGA lowered the quality of life for many men, with particular effects in the areas of self-perception and interpersonal relations. A 2018 research study published in the Journal of Cosmetic Dermatology identified low self-esteem in many patients with AGA and found that confidence can improve after hair transplantation treatment.
“Hair loss in men can affect self-esteem to the extent that a man believes his appearance to be an important part of what makes him a worthwhile or valuable person,” psychologist Paul Greene, PhD, says. “For men who are very invested in their appearance and who identify as a younger-looking man, hair loss can significantly impact self-esteem.”
In the same WebMD article, general practitioner and medical advisor Nikola Djordjevic, MD, says, “Hair loss has been affecting men’s self-esteem for centuries, if not longer. Long thick hair during ancient times was a symbol of masculinity and vitality, so it makes sense that men are psychologically affected by hair loss nowadays as well. Hair loss symbolizes aging and debility, which is why I think that men start feeling more depressed as their hair starts falling out.“
Hair Restoration as Part of Your Wellness Journey
Regardless of what well-meaning family members and friends may tell you, it isn’t “just hair,” so you shouldn’t feel bad to lose it. You know that your hair is an important part of your identity—and you’re not the only one who feels the same.
Society has always expected men to be emotionally strong and impervious to self-doubt, anxiety and insecurity. But experiencing hair loss can have an effect that’s more demoralizing than most care to admit. The purpose of Men’s Health Month is to recognize and acknowledge the importance of your own well-being, and to take the steps toward achieving it. Understanding that you have the right to pursue an appearance that makes you feel better about yourself and your place in the world is essential in taking action to improve your self-esteem and emotional health.
When performed by a skilled, conscientious hair restoration surgeon—such as Dr. Marco Barusco—Founder and Chief Medical Officer at Tempus Hair Restoration—a hair transplant can restore your self-confidence as well as your hair. Dr. Barusco is an award-winning board-certified hair transplant surgeon with more than 25 years dedicated to hair restoration. His extensive credentials include Assistant Professor of Surgery—University of Central Florida College of Medicine; Fellow of the International Society of Hair Restoration Surgery (ISHRS); Global Clinical Scholars Researcher, Harvard Medical School; and author of chapters for numerous medical textbooks and clinical studies.
Dr. Barusco performs the following hair transplant procedures:
Follicular Unit Excision (FUE) — In this procedure, follicular units (hair grafts) in groupings of one, two or three hairs are individually extracted from the back of the head (donor area) using small circular punch blades instead of a scalpel. The grafts are then transplanted to the thinning or balding areas of the scalp. Once the desired number of grafts are obtained, the donor sites are left to heal without suturing. The resulting scars are not readily visible and are easily concealed even by very short hair.
No-Shave FUE — Developed by Dr. Barusco, the no-shave FUE completely conceals harvested donor sites immediately, allowing you to resume your regular activities with virtually no evidence of the procedure.
Follicular Unit Transplantation (FUT) — Also known as the “strip” method, the FUT procedure has undergone refinements over the years so that the only evidence is a pencil-line linear scar easily concealed by hair—even at a shorter length. Although many hair transplant practices encourage patients toward the FUE, there are circumstances in which the FUT will produce the more successful outcome.
Combination FUE and FUT — This technique covers large areas of baldness in a single surgery. Patients with advanced hair loss are typically required to undergo multiple hair transplant procedures to obtain coverage of their entire bald scalp—having to wait one year or more between procedures. This allows patients to achieve their ultimate goal sooner, with one procedure versus many.
No matter what month of the year it is, you deserve to live your best life! If Men’s Health Month has helped you think about your needs, and take the necessary action to achieve optimum physical and mental wellness, you can start here if hair loss has been eroding your sense of self-worth. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device.
Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!