Hereditary hair loss: what you can do

Some people still have a full head of hair in their 50s, while others noticeably thin out in their early 20s. The growth of hair on a man’s head depends primarily on his character. “The genetic code is crucial,” says Uwe Schwichtenberg, a specialist in dermatology and allergology from Bremen.

If a bald spot forms on the back of the head or the hair around the forehead thins and a receding hairline develops, this is called hereditary hair loss, says Schwichtenberg. Medically, it is impossible to predict who will be affected, when, how seriously and in what areas.

A look at your ancestors can provide clarity: what was it like for your father and grandfather? It is believed that the maternal grandfather in particular plays an important role in the inheritance of hereditary hair loss.

“The clearer the picture is, the clearer I can conclude what to expect,” says Schwichtenberg. You do not necessarily have to plunge into despair if only bald heads adorn the ancestral gallery. “The genes combine and this predisposition does not always develop,” explains Andreas Finner, specialist in dermatology and hair surgeon from Berlin.

But if you’re concerned because of your family history, Finner believes early detection during the hair consultation is recommended. There the hair is examined very carefully – early signs of hair loss are also visible.

This is often not visible in the mirror. Once there is significant hair loss visible to the naked eye, a lot has already happened without being noticed. “In this situation, treatment is of course more difficult,” says Finner. “The sooner you recognize it, the better.” This may be counteracted with medication – and there are other options as well.

In some men, hair loss begins before the age of twenty, in others later, and some are spared completely. “The frequency is difficult to determine,” says Finner. It is estimated that by the age of 25, approximately one in four people will have visible hair loss, and by the age of 50, more than half. Of course, this also depends on what you define as visible hair loss.

Either way, everyone affected deals with it differently. While one takes it easy, the other suffers immensely. One should not underestimate the influence of hair loss on the psyche. “Many men suffer from hair loss, especially at a young age, but often don’t talk about it,” says Finner. Sometimes partners or friends cannot understand the problem and downplay it.

Finner advises taking the emotional toll of hair loss on men seriously. “Some of my patients are still bothered years later by a funny comment about their increasing baldness.”

An important point that men who want to take countermeasures should take into account: “With therapy you can only preserve what is left,” says Uwe Schwichtenberg. This means: “You cannot regain lost hair.”

But if you decide to give it a try, you should start as early as possible – and then continue with it if the medication works as hoped. You must take into account that hair loss will largely resume after you stop using these products. Schwichtenberg estimates that it takes about a year for the man’s head to look as it would have looked without any therapy.

A more permanent, but at the same time more complex way to get fuller scalp hair is hair transplantation. But before this can be considered, several requirements must be met. On the one hand, there must be really visible holes or bald spots, explains dermatologist and hair surgeon Andreas Finner. On the other hand, there must be sufficient donor hair on the back of the head.

“You shouldn’t transplant them all at once,” says Finner. There should be a reserve left in case you want to transplant more hair at a later date.

In general, the amount of donor hair on the back of the head is limited. Only your own hair may be used; donated foreign hair roots are rejected, Finner explains. In exceptional cases, beard hair or body hair is also used for thickening.

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