Hair loss in men

Do not think that beautiful thick hair, are a matter of pride only for women. Men, just like the weaker sex, want to have a fine head of hair, but their desires do not always coincide with reality. Progressive hair loss in men - this is not a new problem, but it not only does not lose its relevance, but, on the contrary, it acquires new dimensions. More and more young people suffer from the fact that their appearance is distorted by early bald patches. And although men are not so intrusive to their appearance as women, baldness at an early age is often a serious psychological trauma, although it is not customary to speak about it publicly.

[1]

Epidemiology

If you do not go into such details, and stop at baldness in men, as one of the actual problems of our time, you can see that the pathology is not limited only to older people. Statistics  say that 50-70% of men face the problem of baldness in middle age (40-50 years). But at the same time, just under 1/3 of the stronger sex have the same problems at the age of 20-25. And baldness in men at a young age in 80% of cases is due to a hereditary predisposition, which in the weaker sex is a rarity (although recently this figure is steadily growing, both in women and in boys).

[2], [3], [4], [5], [6], [7], [8], [9], [10], [11]

Causes of the baldness in men

If a person drops 100 hairs a day, there is no special reason for concern. But more active hair loss, especially young and growing, can not be assessed as a normal condition. This is a pathology, which always has certain reasons, in which it is necessary to understand, because without this it is impossible to effectively treat the disease. A stable result can only be achieved if the cause of the disease is combated, not its consequence.

But what factors can provoke active hair loss in men of different ages? Let's try to understand each of them:

• Hereditary predisposition. We have already noted that according to statistical data, most young men are balding for this very reason. Hereditary alopecia in men is one of the biggest problems that can not be cured by traditional treatment.

If the father, grandfather, great-grandfather on the maternal or paternal line were in their youth problems with hair, they are more likely to be in the next generation. The reason for this predisposition is the gene for baldness, which can be found in both men and women.

The gene of baldness, which becomes the most common cause of hair loss in still young men, was discovered by German scientists about 13 years ago. This is a gene in the X-chromosome Sox21, which both daughters and sons receive during conception from their mother. This spoke in favor of the fact that hereditary alopecia in men is transmitted through the maternal line, in other words, in the baldness of the son, the mother whose father had a bald head and passed such a gene to his daughter, and she to his son, is to blame.

But three years later, the gene for alopecia was detected in the 20 chromosome of men. This gene is also able to be inherited, and its impact on the future of the boy is stronger than the genetic material of the female X chromosome. Obtaining such a gene by a child increases the risk of baldness at an early age almost sevenfold.

And what to say about those guys who get both gene baldness from their father and mother. According to some estimates, the risk of alopecia in this case is still twice as high as when obtaining only the male gene, i.e. A young man in this case, the chances of wearing a beautiful head of hear before old age is extremely small.

• Failures of hormonal background. It is a mistake to think that such failures are inherent only in women, causing many female problems. Hormonal disorders can also occur in men. Scientists have long discovered a connection between the male sex hormone testosterone and baldness in men. Testosterone itself is responsible for the presence of hair on the head and body of men, but this kind of dihydrotestosterone, on the contrary, contributes to hair loss.

By converting testosterone to dihydrotestosterone, men are obliged to the enzyme 5-alpha-reductase. Thanks to this enzyme, an active fraction of dehydrogenase enters the bloodstream, which blocks the flow of nutrients carried by blood into the hair bulb. That is, this enzyme does not destroy hair and hair follicles, but it helps to make the hair become thinner and weaker.

Hormonal hair loss in men takes place in several stages. At first, the hair is simply thinned and discolored (become thin and colorless, like a fluff). Then weakened hair falls out, and in their place there are even more subtle and weak specimens, which are practically not visible on the head. Over time, in place of the affected hair follicles (follicle), hair in general ceases to grow.

So far we have only talked about the imbalance of sex hormones, i.e. About an increase in the level of dihydrotestosterone, which can be caused by pathologies of the pituitary, hypothalamus and adrenal glands, congenital diseases and syndromes, tumors, androgen therapy. But the growth and development of hair affects the hormones of the thyroid gland.

Hormones shchitovidki triyodtironin (T3) and thyroxine (T4) affect the activity of hair growth and limit their death, and thyroxine also prolongs the growth phase of hairs (anagen). With the normal functioning of the thyroid gland, usually less than 10% of the hair is at rest. But if the development of thyroid hormones (both hypothyroidism and thyrotoxicosis) is impaired, the anagen period decreases, and the telogen is prolonged, while at the last stage there is already much more hair, which leads to a thinning of the head of hear. By the way, hair loss is often the first sign of a violation of the thyroid gland, which the person did not even think about.

• Stressful situations. Despite the fact that men often remain outwardly calm even in the most dramatic situations, they are subject to stresses no less than women. It's all about coping with your emotions. But experiencing stress in the soul is no less dangerous than splashing out your emotions for everyone to see.

Under the influence of stress there is a spasm of blood vessels, including those that feed the hair follicles. Disturbance of nutrition and respiration of hair leads to their weakening and growth retardation. Mature hair begins to fall out actively, and new ones do not rush to grow.

But you need to understand that this process is not every minute. It may take several weeks after a strong nervous shock before the hair begins to drip off aggressively.

• Disturbances in nutrition.  The imbalance in the diet causes various disorders in the body. Hair, like other tissues of the body, requires adequate intake of micronutrients (zinc, iron, calcium, phosphorus, etc.) and vitamins (vitamins A, C, E, group B) with blood. The lack of these substances, due to the prevalence of semi-finished and fast-food in the diet, weakens the hair (and along the entire perimeter of the head) and leads to their premature fall, while new hairs do not rush to grow again due to a lack of nutrients.
• Metabolic disorders.  But that the hair was getting enough nutrition is not enough to just enter the necessary substances into your diet. It is very important that they are then absorbed in the body. Disturbances in the metabolism of individual substances will lead to the fact that nutrition of the hair is inadequate.
• Infectious diseases. And acute infections that occur against the background of fever, and the chronic course of infectious pathologies are associated with intoxication of the body with the products of vital activity of pathogenic microorganisms. It is clear that toxic substances will have a harmful effect on the hair follicles, which receive toxins with blood.
• Acceptance of some medications. Yes, drugs can also have toxic effects and adversely affect the growth of hair.
• Skin trauma in the head area. Violations of the integrity of the skin (burns, deep wounds and cuts) are associated with the formation later on the spot of damage to the scar or scar, the tissues of which are only intended to cover the defect and are not capable of reproducing new hair.
• Skin diseases. The situation here is identical to injuries. On the site of the lesion a hearth is formed, the growth of hair on which stops or slows down. In the head region, seborrhea, lichen, pustular lesions of hair follicles, infectious cutaneous leishmaniasis, leprosy, scarring pemphigus and other pathologies can be diagnosed, in which a dense crust forms on the skin, preventing normal breathing and nourishing of the hair.
• Some autoimmune systemic diseases. In this case, there is an inadequate response of the immune system to some internal factors. Hair loss in small areas of the head is possible with psoriasis, lupus erythematosus, scleroderma, skin sarcoidosis, Adison's disease and some other pathologies.

In addition, baldness in men and women can develop against the background of:

• diabetes mellitus (metabolic disorders),
• iron deficiency anemia (micronutrient deficiency),
• fungal skin lesions (formation of scar tissue, toxic effect of microorganisms, artificial deficiency of nutrients),
• diseases of the cardiovascular system (violation of blood circulation and nutrition of hair),
• oncological pathologies, for example, alopecia is possible with basal cell carcinoma, syringoma (changes in cell properties and formation of scar tissue),
• developmental defects such as skin aplasia, facial and scalp hemiaphrophy, epidermal moles, hematomas of the hair bag.

Before that time, we mainly talked about internal factors that affect the growth and loss of hair. But we can not exclude the impact of certain external conditions. From this perspective, the following external risk factors for baldness in men and women can be considered:

• use of low-quality shampoos and not intended for washing the head of detergents containing harmful substances or affecting the skin condition,
• traumatic damage to the scalp and hair, due to which there is a disturbance of blood circulation and the nutrition of the hair follicles is deteriorating,
• adverse environmental conditions (negative impact of exposure to ultraviolet, contaminated air, water containing salts of heavy metals),
• ionizing radiation (radiation therapy).

The causes of baldness in men at a young age are usually reduced to a genetic predisposition and hormonal disorders, as a result, already in the 20-30 years they have bald spots. Although it is impossible to exclude the contribution that other factors can make to the process of balding.

For example, one-fourth of the population suffers from seborrhoea, the beginning of which is noted as early as adolescence during puberty. First, the young man notes that his hair has become fat, quickly foul and glued together in bundles, and on the scalp appeared yellowish fatty scales. First, the person is tortured by unaesthetic fatness of hair and itching on the head, then on the skin appear crusts, reminiscent of manifestations of eczema. If the disease is not treated, a slight loss of hair is noted later. In their place, new hairs are formed, which gradually become thinner and drop out before time, forming a bald head with a clearly defined border.

It is clear that stress, medication, unfavorable environmental conditions, poor nutrition, head injuries can also leave their mark on the head of a young man. And the more there are such factors acting simultaneously or one by one, the more noticeable will be this trace of thinning hair. If we talk about the treatment of cancer, which can affect even children, then chemotherapy and irradiation of the body can deprive a person of hair, even in the absence of hereditary predisposition. But this is a forced measure, when you do not have to choose between life and a beautiful hairdo.

[12], [13]

Pathogenesis

So, the daily change of hair does not need to be considered something unnatural and frightened of it. The fact is that the life cycle of the hair is limited to about three years, after which a new hair comes to him, which pushes out the obsolete, freeing his way.

Folk wisdom says: "A holy place is never empty". With regard to changing hair, it is particularly relevant. When the obsolete hair falls out at the site of its growth, there remains a hair sac, in which a new hair is formed, which replaced the old one.

The life cycle of the hair consists of 3 main stages:

• the anagen period, when there is an active division and growth of young hairs,
• the period of the catagen with the reverse development of the root (atrophy of the papilla located at the bottom of the follicle and regulating hair growth, begins already at the end of this period)
• the telogen period, when the hair follicle is at rest (as it hibernates), obsolete hair falls out, and young hair begins to appear in their place.

A naturally dying hair has a thickening on the end of a white color, which is not found if you forcefully pull out a healthy, young hair. If this thickening is not present, then the cause of hair loss is its increased brittleness, which is evidence of unhealthy hair. But the presence on the fallen hair of a dark bulb says that a healthy, strong hair has been lost, which has not yet outlived its. And if this is not a mechanical effect, then you need to look for internal causes leading to alopecia.

Doctors consider hair loss in men as a polyethological disease. Thus, there are many reasons that can correct the process of natural hair replacement in such a way that on the site of multiple drop-down hair does not appear, new or they will be very weak, like a cannon. It is not surprising that there are different types and degrees of baldness, the approach to treatment which is significantly different, because the causes of baldness in this case are different.

It turns out that you need to consider not the general concept of alopecia, but certain types of disease, which in each case can have unique manifestations. After all, often it comes to a multifactorial effect, and each of the factors may impose its imprint on the clinical picture of pathology.

When they talk about alopecia?

Different people have different concerns about the problem of hair loss. Some do not puzzle at all with this question, calmly brushing off single or multiple hairs from the scalp from the shoulder, while others directly panic when they see at least one hair on their clothes. Which of them is right, and when do you need to start worrying about hair loss?

There is nothing surprising in the fact that the hairs existing on the head and body periodically drop out there. A living organism is not eternal, but even during its existence, the body constantly experiences the processes of renewal, and they concern not only the skin and nails. Our hair is also updated once every 3-5 years. And this applies to both women and men.

And since the hair grows unevenly, their shift also occurs at different time periods, so we notice hair loss almost daily. To be frightened in occasion of the dropped out 1-2 hairs it is obviously not necessary. In fact, they get 50 to 150 pills a day, we just do not notice it. Particularly noticeable this moment is during head washing or scratching, which is quite natural, because the mechanical effect on the scalp helps to remove the obsolete hairline.

We must understand that losing such a quantity of hair per day, we do not risk baldness, because on the head of an ordinary person there are from 60 to 160 thousand hairs. And at the moment when some fall out, others start to grow; there is a natural process of updating the hair.

The rate of hair loss in men for a day varies between 80-150 hairs, depending on the color of the hair. It is believed that blondes are the owners of the thickest hair, so the loss of 150 hairs a day is natural for them. For brown and dark-haired people, a daily loss of the order of 100 hairs is considered normal. The least lucky red, because their hair density is usually the smallest (80-90 thousand hairs), but they rarely lose more than 80 hairs a day.

When counting the hair that has dropped out for a day, you need to understand that only those hairs that fall out with the root (bulb) are taken into account. If the hair is unhealthy and prone to brittleness, there will still be a certain amount of broken hairs that are not related to the process of hair loss and alopecia. We only consider hair that leaves the hair follicle completely, which corresponds to the natural process of hair replacement or the pathological process of alopecia (alopecia).

The rate of hair loss is an indicator that does not affect the density of the hair and is explained by the natural physiological process of renewal of individual components of the living organism. But the excess of the norm already speaks about certain violations that cause excessive hair loss. If the hair began to fall out more actively, it's time to think about the reason for this state of affairs, which leads to baldness in men, because involvement in this process is not suitable shampoo, comb, too hard pillow, etc. Scientifically not proven.

[14], [15]

Symptoms of the baldness in men

The influence of various factors on the health of a man causes the appearance of different types of baldness, the manifestations of which also differ somewhat. There is no uniform classification of alopecia in doctors, but nevertheless it is common to distinguish several types of baldness in men.

Despite the fact that different types of baldness can have different manifestations, the first sign of pathology can be considered hair loss above normal, which can be seen from the increase in the number of hairs on clothes, hairbrush, while washing the head. And you can just not wash your head for 3-4 days, and then gently pull the hair on your head. If a decent bundle of 5-10 hairs appears in your hand, this is an occasion to be examined for the danger of baldness.

The appearance of bald patches on the temples or zones with sparse hairs on the vertex is observed somewhat later. And this allows you to determine the type of alopecia, because the localization of zones of pathological hair loss also has great diagnostic value. However, this is already a question for specialists, and we will talk about what types of baldness a man can be diagnosed by a doctor with what they are related and how they manifest themselves.

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Androgennia alopecia

As prevalence among the male population, this type of baldness has no equal. Androgenic alopecia is called male pattern baldness, since this type of pathology is peculiar to men. This is just the case when problems with hair are not associated with a particular disease. And the reason for this condition lies in the form of the male hormone - dihydrotestosterone

The level of dihydrotetstosterone in different men is not the same. And it's not even always in pathological processes that promote increased production of testosterone or an enzyme that converts it into a hydrolyzed fraction. The fact is that certain features of the endocrine system, responsible for producing sex and other hormones, are inherited. And it is not surprising that some people are given a thick head of hair, and others suffer from a lack of hair from a young age.

It should be understood that with androgenic baldness, the hair on the head of a young man falls out not in a single moment. This process is gradual, it just starts prematurely. First, a change in the appearance of the hair is observed: they become thinner and lighter, stop their growth, eventually turning into an almost imperceptible fluff. After such hairs finish their life cycle and drop out, their place remains empty, because dihydrotestosterone does not allow the follicle to accumulate enough nutrients to reproduce the new hair.

Since not all bulbs are simultaneously affected, then first the hair is thinning, and then a full-fledged bald spot is formed. The process usually begins with the forehead and temples, gradually moving towards the parietal region. It is these zones that are most affected by the male sex hormone, so it is not surprising that most men of the bald spot begin to appear on the forehead. But for different men the picture may be slightly different, so consider several types of androgenic alopecia:

• Horseshoe type, when the process of formation of the bald areas affects the zone of the temples, gradually moving deeper into the frontal-parietal zone.
• Nest type, when hair loss in men is noted in different places, but on the vertex necessarily forms a bald patch of round shape, resembling a bird's nest. It must be said that this form of the bald spot is temporary, because gradually all the lesions fuse and converge in the form of a horseshoe, just the first line of hair growth in the parietal zone, like the frontotemporal zones, is more sensitive to testosterone than the rest of the head.
• Mixed type (in this case, hair loss on the temples, forehead and crown is simultaneous and begins with a simple thinning of the hair, which turns into a bulk bald head).

A variant of androgenetic alopecia can be considered as baldness, caused by genetic factors, i.e. Transfer of the gene Sox 21, which significantly increases the risk of baldness. The carriers of the gene in the X chromosome can be both women and men, because this kind of chromosome is in the chromosome set of any person. That's only for women X-chromosomes two, so if the second m does not have a gene for alopecia, the compensatory mechanism works and the risk of alopecia becomes small. In men, there is nothing to compensate for this defect, because there is only one X-chromosome in their set, which means that it can be of decisive importance.

But even the presence of such a gene does not necessarily lead to early baldness in men. No wonder, androgenetic alopecia is often called androgenetic. The fact is that very often the genetic factor is superimposed on the endocrine, associated with the content of testosterone in the body, and this combination greatly increases the risk of baldness.

It must be said that in men with androgenetic alopecia, partial loss of hair is observed in men, i.e. Hair falls not on all head, but mainly on the temples, frontal and parietal zone, while on the nape and on the sides of the head of the head of hair is rather thick.

[17], [18], [19], [20], [21]

Symptomatic alopecia

Alopecia of this kind has completely different roots. Here we are talking not about genetics or features of the endocrine system, but about the effect on the body of certain internal and external conditions. Among the reasons for this balding consider:

• intoxication of the body with harmful and poisonous substances,
• negative impact of ionizing radiation,
• drug therapy:

• often baldness occurs after chemotherapy, because antitumor drugs can kill active cells of hair follicles,
• the cause of increased loss of mature hair can be anticoagulants, interferon preparations, retinoids, interferons, beta-adrenoblockers,
• but the loss of growing hair is associated with the use of bromocriptine, allopurinol and drugs used to treat cancer.

• lack of vitamins and trace elements due to chronic diseases or malnutrition,
• various pathologies of health, affecting the metabolism in the tissues of the scalp,
• stress factor.

At the last moment, it is worthwhile to dwell in more detail, because it's not a secret for anyone that it is precisely stresses and experiences caused by most of the various health disorders in a person. In our body, everything is interconnected, therefore it is not surprising that the load on the nervous system causes malfunctions in the work of other organs, depresses the immune system, leads to the development of neuropsychic disorders, one of the first signs of which can be hair loss for no apparent reason.

The fact that men react to stressful situations is not as emotional as women, does not mean that they remain indifferent. There are situations that knock out a strong gender, which can subsequently lead to loss of hair.

The psychosomatics of baldness in men, although expressed to a lesser extent than women, but can still act as a major and secondary factor in hair loss:

• A strong nervous shock, especially sudden, can provoke increased hair loss by itself. The sensation of stirring hairs on the head and body is not accidental, they cause a spasm of blood vessels and muscles. Even at this point, the hair becomes less stable, so it's easy to break out under any mechanical action. If the situation does not happen again, the restoration of the hair will not last more than 4 months.
• Chronic stress acts more secretly. Hair loss in this case will be gradual. If a person is constantly in a state of nervous tension, this leads to malfunctions in the work of various systems, including the circulatory system. The cause of hair loss is a violation of blood circulation, resulting in hair follicles do not get enough nutrients to grow a healthy and strong hair. The more a person is in a state of stress, the harder it will be afterwards to restore the scalp on his head.
• But even if we are talking about situational experiences, against the background of a male gene for alopecia, they also become a risk factor for premature hair loss.

How to understand that baldness has become a psychosomatic disorder? I will point to this:

• Long periods of hair loss, i.e. They fall out gradually, but the deeper the person is immersed in their experiences, the longer the depression, the more hair falls every day.
• Along with hair loss, there is a deterioration in their appearance and condition of the scalp: the skin is quickly greasy, and the hair begins to look greasy and dull, the haircut loses its former volume, and the fragility of the hair intensifies. Blame for all the hormonal disruptions, which also draws a constant nervous tension.
• The place with hair and scalp begins to change the nails (become brittle), the skin of the rest of the body (acquires an unhealthy color, it becomes more dry and less elastic).

It must be said that symptomatic baldness can equally be observed in both men and women. And the reasons for this pathology can be different.

The influence of the above external and internal factors, not related to the hereditary predisposition, leads to the fact that the hair thinens and falls over the entire head, i.e. Diffuse hair loss occurs in men and women. In this case, the success of treatment depends on how quickly it will be possible to remove the cause of hair loss, but the situation rarely turns into a hopeless one.

Nesting (focal) baldness in men

It is considered the opposite of diffuse alopecia, because total hair loss in this case is not noted. On the head of the patient, limited foci of alopecia of different localization are formed. Such foci most often have the form of a circle or oval and are relatively small in size.

The cause of focal alopecia in men (and a similar pathology can also occur in women and children) is the malfunctioning of the immune system, which begins to perceive its hair as something alien, pushing them out like a splinter. It is clear that such violations in the immune system are not accidental. They can cause chronic stress, nervous exhaustion, pathologies of an infectious nature, and other factors. Sometimes the inadequate response of the immune system is associated with the effects of anesthesia and autoimmune diseases.

The problem of  nest baldness in men is that over time foci can increase, appear in other parts of the head, merge with each other, move, which indicates the progression of pathology and presents difficulties in the treatment of alopecia.

A sharp strong hair loss in men is observed in the generalized form of nested alopecia. This is possible with the progression of pathology, causing a malfunction in the immune system. This form of the disease can be called the terminal stage of focal alopecia in men. Hair loss in this case is rapid and for a couple of months a man can completely grow bald.

Cicatricial alopecia

This type of baldness is associated with inflammatory-degenerative processes in the scalp. Skin diseases, infectious processes, mechanical and thermal damage to the skin, head injuries and surgical interventions, malignant tumor processes can cause inflammation of the hair follicle tissues, as a result of which fibrous tissue is formed at the site of injury, the function of which does not include the cultivation of the hair. At the site of scars and scars, hair usually does not grow.

Cicatrical baldness is equally found in men, women and children, however diffuse and focal. According to statistics, such variants of alopecia are quite rare (no more than 3% of those who see a doctor with a problem of hair loss), but like androgenetic alopecia they are a serious problem for young men whose head does not look bald at all.

[22], [23]

Stages

Considering the variants of balding in men, you can see that the process of hair loss with different types of baldness has its own peculiarities of the current. With diffuse and generalized alopecia, uniform hair loss throughout the head is observed, differing only in timing. With focal and cicatricial form of alopecia, the foci are usually small, but they may have different localization, and the dynamics of the development of pathology are rather difficult to foresee.

The only type of alopecia, in which the stages of development of pathology are clearly seen, is androgenetic alopecia in men. Its cause is considered to be a gene for baldness and a negative effect on the growth of the hair of the male sex hormone. This type of loss of hair is inherent in different data from 90 to 97% of men, so studied by scientists most thoroughly.

According to the classical scheme of Hamilton-Norwood, the following stages of the development of the process are considered:

• Stage 1 can last quite a long time, manifesting itself only by a slight increase in hairs that fall daily. In this case, the hair extends particularly actively along the hair growth line in the fronto-temporal part of the head, forming small bald patches on both sides of the forehead.
• 2 stage. There is a progression of hair loss on the forehead in men: an increase in the bald patches, which now go deeper from the line of hair growth by 1-2 cm. The bald patches are symmetrical in most cases and do not seriously damage the appearance of the male face.

At this stage, hair loss gradually begins in the crown area, but the situation is still almost invisible from the side.

• 3 stage. The bald patches increase in size and deepen already by 3 or more cm, forming 2 unsightly peninsula. Zalysinka on the top of the head can become more noticeable, although still covered with thinning hair every day.
• 4 th stage. The bald patches in the frontotemporal zone stop their active growth, but at the same time the hair growth zone is raised, which indicates the hair loss in the central region of the forehead. But the process on the vertex is actively developing with the formation of increasing in size proletin. On the balding areas of strong hair are replaced by a barely noticeable downy.
• 5 th stage. The hair between the bald areas of the frontal part is noticeably thinning, and the bald patch on the vertex increases in size and becomes more noticeable. In the center of the head from one ear to the second stretches a strip, which retains a practically normal density of hair, which makes it possible to hide the bald patch on the crown of the head.
• 6 th stage. Foci of alopecia in the frontotemporal and parietal zones gradually begin to merge due to hair loss between these areas. When a single bald spot is formed, the process begins to descend to the back of the head and to the side of the head, reducing the band of normal hair.
• 7th stage. Usually by this time there is only a thin strip, which runs along the sides of the head and the back of the head.

It is necessary to understand that alopecia in androgenetic alopecia can last several years, beginning at a young age. And this means that a man has enough time to visit a doctor and take all necessary measures to preserve a hairstyle that gives self-confidence. This type of baldness in men is not considered a desperate situation and can be treated fairly well in the early stages.

[24], [25]

Forms

Lysina on the head - this is certainly unpleasant, but not so rare. Therefore, the appearance of bald patches and bald spots does not cause such violent emotions as the appearance of hair loss sites on other parts of the body where it is customary to observe more or less turbulent vegetation. On the face are cheeks, eyebrows, beards and mustaches, on the body: breasts, intimate zones, armpits, and arms, legs.

If the appearance of hairless areas on the head can blame the bad heredity, then the baldness of the face, body and limbs always have some pathological processes in the body at its core, therefore, should especially alarm the man.

The most visible are such defects on the face. Recently, beards and sideburns began to return to fashion, besides many men try to emphasize their masculinity with the help of a mustache. But such men's jewelry will seem attractive only if the beard and mustache are dense, well-groomed, without flaws. After all, only in this case they talk about good health. The appearance of unaesthetic bald spots speaks about the opposite, and this is an occasion to ponder.

It is not necessary to talk about the hereditary predisposition for balding beards in men. Heredity usually manifests itself in the density of the hair on this site. But the appearance of individual foci with missing hair is usually associated with the influence of pathological factors:

• stress,
• nervous and physical overwork,
• Infectious diseases (both local skin and systemic infections),
• various types of skin diseases (ringworm, dermatitis, mycosis, etc.),
• metabolic disorders (eg, diabetes mellitus) and hormonal failures,
• deficiency of vitamins and minerals,
• autoimmune diseases,
• taking certain medications,
• skin trauma in this area,
• poor quality means for caring for the beard and mustache,
• radiation, poor environmental conditions, etc.

There are a lot of such factors and often they are about their joint influence, which only complicates the situation.

It is not difficult to notice the balding pockets on the beard, it is only necessary not to shave for several days, and then assess the condition of the hair on the face. Usually hairless foci are of limited size and round shape, as in focal alopecia. "Naked" patches can differ in color, acquiring a pinkish, whitish or reddish hue, the skin on them can be either excessively soft and tender, or rough depending on the cause of the pathology.

In place of bald spots can be felt itching or burning, which is typical for fungal diseases. If, in addition to bald foci on the beard, there is a change in the appearance of the hair on the head and a change in the structure of the nails, one can suspect a deficiency of vitamins or hormonal disorders.

Hair loss at the same time on the head, eyebrows, beard, mustache indicates the generalization of the process. In this case, baldness most often occurs rapidly.

Due to the high content of testosterone, it is common for men to have quite abundant vegetation on their feet. At the same time, hair loss in this area becomes an alarming factor, since for the most part it has pathological causes:

• deficiency in the body necessary for normal hair growth of vitamins and trace elements,
• the use of strong drugs, the side effect of which is baldness of legs and other parts of the body in men,
• elevated blood sugar (while on the legs, hair will fall out, and on the face on the contrary grow more active),
• hormonal disorders caused by disruptions in the thyroid gland.

But before you start to panic about your health, you should pay attention to your clothes. Fashion for tight jeans and pants can do a disservice, because the fabric can rub the skin, erasing or breaking the hairs on it, hence the formation of "bare" areas on the legs. An identical situation is observed when wearing coarse boots.

Simultaneous or progressive hair loss in men on arms, legs, head, chest and face speaks most likely of serious autoimmune problems, characterized by the appearance of focal alopecia, which can take different forms:

• if there was a single bald head on the head, which has a round or oval shape and does not increase in size, this is the most innocuous local form of focal alopecia,
• the appearance of a large number of small bald spots on the head speaks of point-like alopecia areata,
• about subtotal alopecia speak in the case of the appearance of multiple large foci on the head and their spread to the face, body, axillary cavities,
• universal alopecia areata characterized by the appearance of hairless, clearly defined foci on the head, body and extremities, accompanied by changes in the state of the skin and nails, as well as the development of neurasthenia and VSD,
• with bare focal alopecia, large hairless zones appear on the head and body,
• total alopecia areata - a loss of hair on both the head and body, which is considered to be the most serious degree of the disease, almost uncontrollable.

Hair loss on the face, body and limbs rarely appears on its own. Usually it is a joint process affecting the head and body, just a man in his time drew attention to only one symptom (hearth), while the problem can exist on other parts of the body, as well as inside the body.

[26]

Complications and consequences

It must be said that in itself, baldness in men is more a problem of aesthetic plan (unless of course it is skin infections). The lack of hair on the head, even to some extent facilitates the care of her, for good reason, young guys like to get a haircut "under the counter." The truth in this case is to pay more attention to protecting the head from active sunlight.

But jokes are jokes, and for the appearance of balding areas on the head, serious health problems can disappear, which later will not only affect the hair. Fungal diseases, dermatitis, leading to the appearance of wounds with a high risk of infection on the skin, cardiovascular pathologies, diabetes mellitus, malfunctioning of the thyroid gland and some other pathologies require serious treatment until they cause complications far from aesthetic.

But even if you do not take into account the pathological causes of the phenomenon, and consider hair loss from the point of view of psychology, the picture is not very comforting. It is clear that every man will treat the problem in his own way. Someone will just shave their hair and take for granted a new hairstyle, and for another, the bald patch will become a stumbling block, reducing self-esteem and confidence in their attractiveness to the opposite sex, which is very important at a young age. Elegant hair in any case will look more advantageous than a haircut nalyso.

Alopecia caused by eating disorders and worsening of the scalp may be accompanied by the formation of dandruff, which looks very unattractive against the backdrop of a sober hairstyle, hinting at the lack of proper care for the head and hair. Fatty, stuck together hair and crusted dandruff will repel people, and sometimes it is not so easy to explain to others that the cause of this state of affairs is a disease, and not a rare washing of the head. A bald patch on the parietal zone in young guys can be a reason for laughing behind your back and offensive banter.

The appearance of a bald spot on the vertex, among other things, increases the risk of sunburn and thermal shock in the spring-summer period, when the activity of sunlight is quite high. A balding man will have to wear headwear regularly to protect the skin from aggressive rays that can cause burns and even cancer. And in the absence of a headdress regularly use sunscreen in the hairless area on the head and where the head of hear has a poor density.

Alopecia can have the most negative impact on the quality of life of a man. Especially it concerns sensitive and emotionally labile individuals, in whom such a situation can cause a prolonged depression, only exacerbating the condition. After all, the stress factor can increase hair loss even against the background of a genetic predisposition, not to mention the pathological causes of alopecia.

[27], [28], [29], [30], [31], [32], [33]

Diagnostics of the baldness in men

Alopecia in men and women is a condition that has clear external manifestations. The bald patches on the forehead or the "nest" on the vertex are visible to the naked eye, and the thinned hair is conspicuous, it's only necessary to take a closer look at the hairstyle of a man. It is not surprising that the diagnosis of the very fact of alopecia development does not cause the doctor any difficulties, even if it is a simple therapist.

But in fact the statement of the fact of baldness is not a residual factor for the establishment of the final diagnosis and the appointment of appropriate treatment. It is important to establish the type and extent of alopecia, because the treatment scheme for different forms of alopecia will be different, which is not surprising due to the difference in the causes of early hair loss.

Questions related to hair problems are handled by a separate doctor - trichologist. It is to him and you need to contact about the thinning of hair. After all, neither the therapist nor the dermatologist can help, if we are talking about the most common cause of alopecia - the influence of genes. Another thing, if it comes to skin or internal diseases, but here the decisive word often remains for the trichologist. He, if necessary, will refer the patient to a consultation with the right specialist.

Although in practice it usually happens to the exact opposite. A man comes with complaints to the therapist, he prescribes all sorts of studies and consultations with various specialists depending on the diagnosed diseases, and if the cause of alopecia fails, the patient is referred to the trichologist.

To identify the problem of baldness, a physician needs a physical examination of the head of a man (and, if necessary, other parts of the body where abnormal hair loss is observed). But to identify the cause of this condition will need to study the patient's history and information about the presence or absence of the facts of early baldness in his family. If close relatives had such problems, you can immediately suspect androgenetic alopecia, as will tell and the form of bald patches or bald spots.

But even with androgenetic alopecia, it is difficult to say what caused the early loss of hair: the gene from baldness obtained from the mother or father or problems with hormones. The latter can easily be identified by laboratory tests.

Since the reason for baldness in a man may be not one, but a number of factors that may not even be related, the diagnosis of alopecia implies a comprehensive examination of the patient, which includes a number of laboratory tests:

• a common and expanded blood test,
• the analysis on hormones of a thyroid gland, allowing to estimate functionality of an organ,
• a blood test for the level of male sex hormones,
• the study of biomaterial for the presence of parasites, which often become the culprits of vitamin-mineral deficiency,
• the determination of the content of iron in the blood serum (the calculation of the concentration of ferritin in the blood, which makes it possible to estimate the iron stores in the body),
• to exclude syphilis, which often becomes the cause of hair loss, a blood serological test and a Vaserman reaction are prescribed, or a more modern technique is used - an anticardiolipin test,
• if there is a suspected skin lesion with a fungal infection, as indicated by desquamation and itching, samples are taken with potassium hydroxide (if the dermatophyte is positive, the test is positive), and a special lamp,
• a biopsy followed by a study of the biomaterial under the microscope also makes it possible to diagnose dermatomycosis, but this study is also informative in alimentary and cicatricial alopecia.

Separate foci of alopecia on the head and body can be found in fungal lesions and in alopecia areata caused by inadequate response of the immune system. Explain the situation helps the blood test, which will show a reduced number of T-and B-lymphocytes, which is typical for focal alopecia. Confirmation of the diagnosis will be a test, consisting in an easy sipping of the hair: with alopecia areata, hair is pulled out extraordinarily easily.

A lot of information about the causes of alopecia gives the doctor instrumental diagnostics: the study of the hair shaft under the microscope and the spectral analysis of the hair, which allows to reveal the disturbances of the mineral metabolism in the body. Spectral analysis allows not only to identify the deficiency of trace elements necessary for hair, but also to diagnose a variety of diseases associated with it: diabetes, osteoporosis, thyroid and gastrointestinal diseases, psoriasis, etc.

After the pathological cause (or several causes) of baldness in a man is revealed, the trichologist can refer the patient to a consultation with other specialists: a cardiologist, an endocrinologist, a neurologist, a psychologist, etc. These doctors, depending on the detected violations, may prescribe additional laboratory and instrumental studies that will help to develop an effective treatment regimen for the underlying disease.

[34], [35], [36], [37]

Differential diagnosis

Since alopecia is considered to be a multifactorial disease and further causes of hair loss depend on the identified cause of hair loss, a major role should be given to differential diagnosis. The doctor's task is to differentiate androgenic alopecia caused by a specific gene from hormonal disorders. The manifestations of alopecia areata should be distinguished from the foci of fungal infection and the manifestation of secondary syphilis, for which the appearance of multiple small foci of alopecia is characteristic. In cicatricial alopecia, it is important to determine the nature of the skin, because the foci of fibrous tissue can appear both at the site of traumatic skin lesions, and against the background of diseases such as lupus erythematosus, sarcoidosis of the skin, lichen, etc.

It is very important to determine the cause of diffuse (symptomatic) baldness, which is associated not only with the negative impact on the scalp from the outside, but also with internal problems in the body, without the treatment of which it is impossible to restore the hairline.

Prevention

As for the prevention of baldness in men, there are no such measures and requirements that could with a 100% guarantee to protect a person from hair loss. If diffuse baldness has clear external and internal causes that can be prevented with the help of a healthy lifestyle, proper nutrition, timely treatment to doctors, then preventing focal and androgenic baldness is much more difficult.

Nevertheless, this is not an excuse to drop your hands and wait for what will happen next. Some moments in a person's life will help even weaken the hereditary predisposition, because it is known that not all men who have received a gene for alopecia from their parents are balding early. And the testimony that the bald patch was with grandfather, great-grandfather and dad is not at all an indication that the same fate awaits their descendants.

Such measures as short haircut (ostensibly it reduces the load on the skin and hair follicles, besides it is believed that the hair after that begin to grow more actively) and the rejection of headgear (because they do not allow to breathe the scalp) do not have under evidence base. Moreover, walking with bare head only increases the negative impact on the skin and hair of external factors.

But there are other measures that can really reduce the risk of early hair loss:

• Adequate hair care: regular washing with gentle cleansers, use of alternative recipes to strengthen hair, neat combing of hair comb with rare teeth. During and after washing with hair, you need to be extremely careful, because at this point they are most prone to injury. Do not rub too much and scratch your scalp during the procedure, and after washing, you just need to dab your hair with a soft towel and do not scratch it with wet.
• Regular massage procedures on the head in the hair growth zone. Combing can be considered only one of the variants of head massage, which activates blood circulation in the skin, strengthens the blood supply and nutrition of hair follicles, makes the hair healthy and strong.
• Balanced nutrition is the key to strong hair and nails, because what we eat depends on what our hair is eating. If food is depleted by vitamins and minerals, even if there is no predisposition to count on thick hair, it is not necessary.
• Active lifestyle, allowing to maintain a normal metabolism, in contrast to hypodynamia will only positively affect the condition of the hair on the head and body.
• Control of the neuropsychic state, the ability to respond correctly to stressful situations, to avoid strong feelings, and if necessary, and taking sedatives will help to avoid many health problems, including stressful diffuse alopecia.

But even compliance with all the above requirements does not guarantee that the hair at some point will not begin to drop out. And here it is important not to delay the trip to the doctor. After all, baldness in men, if it is not caused by the impact of severe stress, most often the process is gradual and progressive. It is much easier to treat it at an early stage in the first six months than after several years, when the bald spot becomes obvious. This is confirmed by the studies used drugs for the treatment of alopecia, most of which are simply not able to help if time was missed.

Forecast

Probably these are the most controversial points in studying the problem of baldness in men, which can have different origins. Even the course of the most studied androgenic alopecia is often difficult to predict, because the process of hair loss is delayed in this case for many years. In addition, the intensity of hair loss is largely dependent on the content of testosterone in the blood and the activity of 5-alpha-reductase, which in men can vary significantly.

Treatment of androgenic alopecia is a long process and does not always bring the desired results. The idea is to fight with baldness a man will have his whole life even after a hair transplant. Another option to look at the problem differently and love yourself in a new guise.

A more favorable prognosis for treatment of diffuse alopecia, because in order to stop hair loss on the head, it is enough to remove the factor causing such a violation. Thus, it is sufficient to remove external stimuli and treat internal problems, paying attention to the neuro-psychic state, so that the normal metabolism is restored and the hair receives normal nutrition for life and growth. The most difficult in this sense is patients with chronic pathologies, treatment of which is carried out by courses or constantly throughout life.

A controversial prognosis is also observed with focal alopecia. In most cases, it passes for 3 years, but there is always a risk of recurrence of the disease and a repeated course of treatment is required. Somewhat helps to solve the problem of hair transplant, but in this case there is no guarantee that the immune system will not reject transplanted hair.

But with cicatricial alopecia, surgical treatment is the only possible and effective method for restoring the scalp.