What are the Causes of Hair Fall

Look around you in a busy place. Do you see a middle-aged or older gentleman who is balding? Chances are you probably will. Hair loss is something that affects a significant proportion of men as they age.

What are the Statistics for Hair Loss?

Statistics vary from country to country, but the American Hair Loss Association states that, by the age of 35, two-thirds of men will experience some degree of appreciable hair fall, and by the age of 50 approximately 85% of men have significantly thinning hair. But hair fall does not just affect males. It can affect females as well.

Hair Follicles

Each person on average has about 100,000 hair follicles on their heads. If everything is intact, you will have a nice crop of hair.

Hair follicles go through 3 main phases of growth – anagen, catagen and telogen.


Anagen Phase

The first is the anagen phase, where the root of the hair is dividing rapidly, adding to the hair length. Hair grows at about 1cm every month during this phase, and this phase can last anywhere from 2-7 years.

Catagen Phase

The next phase is the catagen phase, where at the hair itself is cut off from its blood supply and from the cells that produce new hair. This lasts for about 2-3 weeks.

Telogen Phase

Lastly, the telogen phase where the hair follicle rests, and the hair that was grown is released and falls out. Not all the hair follicles are in the same phase at the same time, and about 100 hairs are shed daily from a normal scalp.

If everything is normal for you, the telogen phase would not last too long, and re-enter the anagen phase after about 3 months.

Why Do People Lose Head Hair?

There are a variety of reasons why this may be so. Sometimes, the hair follicles are forced to cut short their anagen phase and enter the telogen phase prematurely. This can happen during times of extreme stress or if you have fallen ill.

In some people, the hair follicle may be killed off by the body’s own defence systems. The hair follicle may also be affected by fungal or bacterial skin infections.

Hormone DihydroTestosterone (DHT)

The majority of head hair fall that affects men is due to the hormone dihydrotestosterone (DHT).

In men, the 5-alpha-reductase (5-AR) enzyme converts testosterone into DHT in the testes and the prostate.

Up to 10 per cent of testosterone is normally converted into DHT. DHT is more powerful than testosterone as a male hormone. It attaches to the same receptors as testosterone, but more easily and for longer periods of time.

The hair follicles on the head contain this receptor and when DHT binds to them, the follicles slowly become miniaturized, the anagen phase is reduced, and the telogen phase becomes longer.

Over time, the anagen phase becomes so short that the new hairs do not even grow past the surface of the skin. Telogen hair is less well-anchored to the scalp, making it easier to fall out. As the follicles become smaller, the shaft of the hair becomes thinner with each cycle of growth.

Eventually, hairs are reduced to soft thin hairs, and can eventually stop growing. For reasons that are not well understood, DHT is essential for most other bodily hair growth, but it is detrimental to head hair growth. That is why you can see a bald man with a full beard.

How your hair follicle responds to DHT and how long your anagen phase is are usually genetically predetermined.

Also Read: Male Pattern Hair Loss Treatment 

What Can We Do About Your Falling Crop of Hair?

So knowing the above, what can we do about your falling crop of hair? We know that stress can affect your hair.

Late nights, poor diets and stress can disrupt hormonal balances and reduce your blood circulation to your scalp, leading to hair fall. So a healthy lifestyle is a solution to that – reduce your stress, exercise regularly, eat healthily, and sleep adequately.

Washing your hair too much can strip your scalp of natural oils needed for a healthy scalp. If you do not wash enough and it may cause a build-up of oils in follicles and prevent hair growth. To find the balance with appropriate shampoo and frequency of wash. Active people may need to wash their hair more often, and less active people may only need to wash their hair every other day.

If you use hair products, ensure they do not contain too harsh chemicals as that might irritate your hair follicle causing your hair to drop. Make sure these products are washed off completely at the end of the day as well.

Chemical treatments like hair dyes and heat therapies may also affect your hair follicle, so space these treatments apart. Brushing your scalp (gently) can stimulate blood circulation to the scalp which is essential for hair growth.

Medical Hair Loss Treatment

Should all of these lifestyle changes not work, one thing you have to understand is that prevention is better than cure. Once your hair follicle is dead, there is very little we can do about it.

At this point in time, medical care can play a part. Treatment for hair fall can start even as early as the 20s to prevent or slow down the process of follicle miniaturisation before it’s too late.

There are a variety of things doctors can do. Topical medications can be applied to the scalp to stimulate hair growth.

There are non-invasive methods like hair serums, light therapy and laser therapy.

There is another hair fall treatment known as Regenera Activa. This is a hair growth technology from Europe that has gone through clinical trials and has achieved approval as a medical device.

Visible results can be seen in a few months and effects can last for at least a year. There are also medications that we can prescribe to block the formation of DHT.

If all else fails, then the last resort is usually a hair transplant.

I hope this short introduction to hair fall, its prevention and some of the treatments have given you some information that is useful.

When in doubt, consult your doctor, and don’t be shy about it. We too, want a full crop of hair for you!

If you are interested in this service and wish to find out more, please call or visit our clinics or drop us an email at hello@dtapclinic.com.sg

What Causes Male Pattern Hair Loss (Androgenic Alopecia)

What is Male Pattern Hair Loss (Androgenic Alopecia)?

It is a very common form of hair loss which can affect up to 50% of men by age 50. It is usually inherited (meaning that your father or mother is likely to have it as well). It can start as early as after puberty in some cases.

What are the causes of Male Pattern Hair Loss (Androgenic Alopecia)?

In most cases, it is due to the genes you inherited from either your father or mother or both. Typically, if you are affected by the condition, the hair follicles start to shrink with time under the influence of male hormones.

and then what happens?

As the condition progress, the hair thickness also starts to become thinner and over time, the hair is lost.
In most cases, it starts with the recession of the hairline around the temples and also around the forehead area. Then hair around the top of the head (the crown) also becomes less. In time, the areas of baldness will join together. However, hair at the back of the head is usually not affected in this condition.
See other types of Hair Loss Conditions

Is male pattern hair loss only a cosmetic concern?

No. There are studies that show a link between those affected by the condition to be at higher risk of cardiovascular disease (i.e. hypertension, heart attacks, strokes)
Also, it is associated with benign prostate hypertrophy (BPH) which is a non-cancerous enlargement of the prostate, which can cause symptoms like, an increase in frequency to pass urine, waking up multiple times at night to pass urine and as a result affect the quality of your sleep.
In addition, it has been found in studies that men who use anabolic steroids are also associated with increased risk of the condition. Similarly, persons on testosterone replacement therapy for hypogonadism are at increased risk of the condition as well.
Some studies also found that increased levels of DHEA (another sex hormone ) or low levels of SHBG (sex hormone binding globulin) which in turn means that there is more free man hormones that your body can use are also associated with the condition as well.
There are also studies to show that there is a link between the condition and prostate cancer. A large Australian study suggests that loss of hair at the top of the head at age 40 may be an early marker of prostate cancer.

What are the available treatments for Male Pattern Hair Loss (Androgenic Alopecia)?

Medical Treatment for Male Pattern Hair Loss (Andorgenic Alopecia)

1. Topical Solution for Hair Loss

This Hair loss treatment works by slowing the shrinkage of the hair follicles
The Advantage of using  Topical Solution for Hair Loss

  • Simple to use
  • Apply on hair daily up to twice a day

The Disadvantage of using  Topical Solution for Hair Loss

  • Takes up to 6 months to notice the effect
  • Need to use it on a permanent basis as hair loss resumes after stopping
2. Oral Medication for Hair Loss

This Hair loss Treatment works by blocking the conversion of male hormones to DHT which causes shrinkage of the hair follicles
The Advantage of using Oral Medication for Hair Loss

  • Unlike lotion which only slows the shrinkage of hair follicles, it has been suggested that medication is able to reverse the shrinkage of hair follicles

The Disadvantage of using  Oral Medication for Hair Loss

  • In about 1-2% of men who take the medication, they reported a decrease in sex drive or erectile dysfunction.
  • A decrease in PSA levels which may cause an underestimation of risk of prostate cancer
  • Takes up to 6 months to notice effects
  • Need to use it on a permanent basis as hair loss resumes after stopping
3.) Hair Transplant for Hair Loss

Strips of hair from the back of your head are removed and then individually transplanted to the area of hair loss.
The Advantage of Hair Transplant

  • Can notice effect around 3 months

The Disadvantage of Hair Transplant

  • Downtime (recovery time after hair transplant)
  • Can take up to few hours for the procedure depending on the area that needs to be transplanted
  • Expensive (Average cost > $15,000)
  • Failure of the hair grafts may occur
4.) Regenera Activa for Hair Loss

Similar to hair transplant, hair from the back of the head is removed and then using a specialised machine, hair follicular units are harvested and then injected into the area of hair loss.
The Advantage of Regenera Activa

  • It has been approved by FDA for medical treatment
  • Much smaller area of hair (3 x 2.5 mm) needed to be removed from the back of the head compared to hair transplant
  • Can notice effect around 3 months
  • Faster than hair transplant procedure (generally takes about 30 mins)
  • No downtime
  • Cheaper than hair transplant
  • Last for 18 months to 24 months depending on individuals

Learn more about Regenera Activa Hair Loss Treatment.

If you think you may have male pattern hair loss, please speak to any of our friendly doctors at any of our clinics to discuss further, or Drop us an email at hello@dtapclinic.com.sg