The Root of the Problem

Male hair loss – let’s be clear, is not a problem. It’s a fact of life for most men – some of us lose our hair earlier than others, and the majority will experience some thinning during our lives. At Ape to Gentleman we always maintain no one should worry about it, it’s so common – and really not a problem. However, we know many of you to worry – and there are some answered questions, treatments and such like which need addressing.

In light of this, we spoke to leading trichologist, Richard Spencer of The Spencer Clinic, London to find out what the real deal is with hair loss.

GJ: When do most men start to notice their hair thinning?

RS: Most men are prone to genetic hair loss between the ages of 16 and 60. Yes, this is a wide band of age grouping but, depending on the genetic ‘strength’ passed on and how early a family relation began to suffer with hair loss will influence the start of the problem for younger relatives. Some will see hair loss in their early 20, most will see it in their 30s-40s, and others be much older before they experience hair loss.

GJ: What makes men more susceptible to hair loss than women?

RS: Naturally, men have much higher levels of male hormones, which give them their male characteristics. Increased levels of testosterone and dihydrotestosterone allowed into the system will promote a loss of hair in most men. The intensity of these levels will determine at what rate the hair will be lost. Women can also suffer with genetic hair loss, but this is more to do with the decrease of certain female hormones such as Oestrogen and Progesterone. One must also find out if certain female relatives have thinner hair.

GJ: If your Dad lost his hair quite young, does this mean that you will too?

RS: It’s not always the case, but most male hair loss is caused by genetic influences, and 99% of the men I see at my clinic come to see me because they have male pattern baldness syndrome. Certain genetic influences can be passed on to offspring from fathers, grandfathers, even uncles. The variation of who gets what in the genetics pool is very unpredictable, so there is no straight formula. As example, a balding father may have two sons, of which only one son has experiences loss, or both experience hair loss or neither. However, the next generation of male offspring (their grandchildren) could indeed experience hair loss at some point, even if their fathers haven’t. You can see this is a complex question.

GJ: What’s the biggest myth about male hair loss?

RS: The biggest myth is that nothing can be done to help the problem. It is difficult to treat the cause of genetic hair loss, but the condition can be treated by stimulative therapy to increase blood supply to keep hair follicles active. Whilst hair cannot grow from a follicle, which is no longer active, a follicle takes time to degenerate, usually about a year and a half after first affected. If a patient has only had noticeable hair fall for a few months, with treatment, hair regrowth is easily achieved in a short space of time. Alternatively, if someone has been gradually losing hair for some years, regrowth will be less of an option and help will be in the form of control, containment and minimisation of the condition. There is no ‘magic’. The logic is simple, once explained.

GJ: Some men lose a lot of hair on their head, but not on their body. What’s the reason for this?

RS: Unfortunately, dear Mother Nature got things the wrong way round on this one!! The increase of testosterone appears to increase body hair and decrease scalp hair in many cases. Very bad luck I am afraid.

GJ: When is the best time to start thinking about treating hair loss?

RS: Many GPs recommend Propecia as a treatment for male hair loss. GJ: Is it true that this can be responsible for side effects such as erectile dysfunction?

RS: Naturally, the best possible time to act is when a loss of hair is first noticed. This could happen in two ways. Either hair fall is noticeable, or hair fall is gradual. If gradual, hair loss will not be noticed until enough hair is lost to enable the person to either see or feel the hair is less dense. In either case, as soon as a problem is noted, one should act immediately by arranging a consult with a registered trichologist.

Almost one in ten propecia users suffer with either erectile dysfunction, a lowering of the ejaculate or a possible decrease in the size of the genitalia, so it pays to be cautious with this treatment. However, sometimes simple diet modifications can help so ensure you eat plenty of protein to help the hair repair and grow, essential fatty acids from fish, nuts, and soy to hydrate the follicles, and vitamins B6, B12 and biotin, found in eggs, salmon, bananas, and spinach, which strengthen your hair’s outer layer. Iron is also essential to stimulate hair growth. Alternatively I recommend a natural supplement called Nourkrin MAN (£50.95 for 60 tablets. Available from Boots), which is formulated to reduce thinning hair and help it re-grow.

If it’s a genetic form of hair loss is, certain steps can be taken to help to minimise and contain the condition. If the hair is falling out too much, we run a stimulative therapy treatment in our salon which will help to reduce and minimise the hair fall. One of the best home-use stimulants is Minoxidil (Regaine), which can also be taken alongside Nourkrin for best results. We have been suggesting this treatment to our patients since it came about and have found it continually helpful in the battle to keep hair.

GJ: What do you think of hair transplants – do they work? Lots of people seem to lose their hair again shortly after.


RS: This is a huge subject. To simplify, the technology now used during a hair transplant process almost guarantees close to 100% regrowth with hair follicles taken from the donor area (usually the lower back or nape area) and transplanted to the recipient area. There are a few methods to achieve this and it is argued which method is best. In my opinion, having worked closely with a clinic in Harley Street, the best procedure is called Follicular Unit Extraction (FUE). They take out one follicle at a time. Very effective but laborious work, which is why it is so expensive. Hair will only be lost after a procedure if the follicle is not properly placed or it is placed too close to existing hair. It is a form of over-crowding and known within the profession as ‘shock loss’.