Crown Clinic’s surgeon Asim Shahmalak answers eight of the most common questions about hair loss

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Crown Clinic's surgeon Asim Shahmalak is one of the UK's leading hair transplant surgeons.  Patients often ask him questions about hair loss and we thought it would be good to detail his answers to eight of the most common questions.

At what age is hair loss most common?

Hair loss is a continual process which affects men at different ages. It can start as early as the late-teens and affect men right through to old age.
Two-thirds of men face hair loss by the age of 35, and a bad genetic hand is often to blame. Male-pattern baldness is an inherited sensitivity to dihydrotestosterone (DHT, a by-product of testosterone), which leads to finer hair, a receding hairline, and finally a deserted scalp.
The most common age for the onset of hair loss is between the ages of 30 and 50.

Is it only hereditary or  can men suffer hair loss for other reasons?

Male Pattern baldness, medically known as androgenetic alopecia, is overwhelmingly caused by your genes. It is a myth that the baldness gene passes down more commonly on the mother's side – both sides of the family can cause it. Yes, there are lots of other causes for hair loss, but none of the others is nearly as significant as the hereditary cause.

What other factors can cause hair loss in men?

There are lots of other reasons for hair loss and a few include:
* Stress – severe physical stress (like surgery) or severe psychological stress (like a death in the family) can cause profound changes in the body and lead to telogen effluvium, a shedding of the hair. The good news is that the hair may well go back when the stress goes away.
* Vitamin/mineral deficiency – red blood cells are important because they carry oxygen to nearly every cell in the body, helping those cells maintain normal function. Deficiencies in other nutrients such as vitamin B and protein are thought to contribute to hair loss as well.
* Medication – we all know chemotherapy can lead to hair loss but lots of other drugs can also make your hair fall out. These include anti-thyroid medications, hormonal therapies and anti-convulsants (for epilepsy).
* Trichotillomania – this is an obsessive compulsive disorder in which sufferers rip out their hair.

What do you recommend a man suffering from hair loss to do?

It really depends how bad his male pattern baldness is. Take Prince Harry for example. He is showing the early stages of male pattern baldness – particularly around his crown. He has a strong baldness gene and if he allows this hair loss to carry on without treatment he will eventually suffer from significant hair loss – just like his brother (Prince William), his father (Prince Charles) and his grandfather (Prince Philip).
One thing men losing their hair shouldn't do is nothing if they are interested in keeping their hair. Once it starts falling out, it is likely to continue.

Are there are any tips or advice you can share to help or reassure men suffering from hair loss?

My main advice to men losing their hair is don't be down-hearted. Around half the middle-aged male population suffer from hair loss.
There are ways you can halt this hair loss – through a transplant or by taking clinically proven medication.
A transplant offers a permanent solution to the problem. The transplanted hair is permanent and should last a patient for the rest of his life.
Look at my patient Calum Best, who has had three hair transplants at Crown Clinic. He would be almost almost completely bald on the top of his scalp if he had not taken action.
But Calum has completely restored his lost hair and, aged 35, is able to maintain a successful career as a model.
Calum didn't get down-hearted; he took action and was able to completely change his life.

How much is your hair loss solution, what does it involve and how much is it?

We offer two types of hair transplant at Crown Clinic.
FUT (follicular unit transplantation), or strip harvesting, involves surgically removing a strip of skin from the back or side of the scalp to obtain the donor hair which is then replanted in the balding areas – typically the hairline, temples, mid-scalp and crown. FUT prices start around £6,000. Well-known FUT patients include the TV doctor Christian Jessen who has had two FUT procedures at Crown Clinic. The main drawback from this procedure is that the removal of the strip of skin can leave scarring on the scalp. It is not advisable for men who like to wear their hair short.
FUE (follicular unit extraction) – around 80% of Crown Clinics clients use this method, favoured by celebrities such as Crown Clinic patient Calum Best and Wayne Rooney. With FUE, hair grafts are removed individually from the donor area, leaving small red dotted scars immediately after the operation which normally go away after a few days. These grafts are then replanted in the balding areas. The main drawback for this method is that it is a time-consuming, involving grafts being removed one-by-one rather than en masse in a strip. For that reason it is more expensive than FUT – with prices starting at around £6,000 (the cost goes up according to how many grafts a patient has).

How often would your patient need to keep coming back to you to keep the hair loss at bay?

This obviously depends on the patient. Most of my patients see me only once. 

Do you have anything else you might want to share?

Studies consistently show that male pattern baldness is men's chief worry about their appearance. Men with a full head of hair tend to earn more than those who are bald. They feel younger and more confident and this impacts positively on their relationships both at home and in business.
Men think nothing of spending £6,000-£10,000 on upgrading their car but are sometimes reluctant to make a similar investment in their appearance. It is a false economy. Men who invest in a hair transplant know that it is money very well spent.

Dr Shahmalak's clients include the TV doctor Christian Jessen, the model Calum Best and the former footballer Didi Hamann. He is the hair loss expert on the Channel 4 medical show Embarrassing Bodies.

Our Surgeon

Dr. Asim Shahmalak

Dr Asim Shahmalak is a world-renowned hair transplant surgeon who performed the UK’s first eyelash transplant in 2009. He runs Crown Clinic – one of Britain’s most successful and best known hair transplant clinics. He has treated a number of high-profile industry leaders and celebrities including the medical broadcaster Dr Christian Jessen, best known for Channel 4’s Embarrassing Bodies.

Expert hair transplant surgery by Dr Shahmalak

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When the sun comes out, we know that we need to apply sunscreen to protect our skin, but many people forget to pay the same care to protecting their hair. Between the sun, sea and swimming pools, many of our favourite summer activities can significantly damage our hair – so the next time you go out to enjoy the sunshine, find out what you can do to protect it.


Why does sun damage the hair?


Sun damage to the hair is caused by the harmful UVA and UVB rays, which damage the outermost layer of the layer – the cuticle – and weaken the protein structure of the hair, making it dry, brittle and more prone to breaking. Some people find that their hair lightens in the sun, as the rays act in a similar fashion to bleach, stripping the melanin from the hair.


Protecting your hair from the sun


Wearing a hat is an easy way to protect your hair and scalp from the sun, especially if you’re outside when the sun is at its strongest. Hair SPF is also an option, which can usually be bought as a spray to be misted over the hair. Pay extra attention to the scalp – many people forget that the scalp can burn just as easily as the rest of the skin, ending up with an itchy, flaky, burnt scalp. If you do burn your scalp, rinse your hair in cool water and apply aloe vera to the affected areas, and make sure to keep your head covered when going outdoors.

If your hair is looking dry, try a deep conditioning treatment to restore some of the lost moisture to the hair, and avoid wearing your hair in any tight styles that may pull on the scalp. Summer is also a good time to temporarily stop using hairdryers, straighteners and any other hot tools to avoid adding to the sun damage.


Protecting your hair from the sea


Salt water is notorious for drying out the hair. It leaches moisture out of it, making it incredibly brittle and tangled, which can cause significant breakage. Before you go swimming, saturate your hair with clean water to prevent it from absorbing as much salt water, and don’t let it sit in your hair – rinse it thoroughly as soon as you get out of the sea. Deep conditioners and hair masks will also help replenish the moisture.


Protecting your hair in a swimming pool


Just like salt water, chlorinated water is very harsh and drying on the hair, so you can take similar precautions to swim in the sea. You could also try a swimming cap, as this not only prevents the chlorine from damaging your hair, but it will also protect your scalp from sunburn. If you have highlighted or blonde hair, be especially careful when in a swimming pool, as the copper and chlorine in the water have been known to form a film that sticks to the proteins in hair, turning it a green shade. Thankfully, this isn’t permanent, but make sure to enter the pool with wet hair and rinse it as soon as you get out.

However you are spending your summer, if you have any questions or queries about your hair, take a look at our hair advice or give our team a call.

Over the past few months, there have been a significant number of reports in the news of people experiencing hair loss after being diagnosed with COVID-19. As a result, the Centres for Disease Control and Prevention (CDC) has listed hair loss as a possible long-term effect of the illness, along with symptoms such as fatigue, dizziness and joint pain. 

A study published by the medical journal The Lancet reported that 22% of the patients it had observed suffered from some degree of hair loss six months after falling ill, with women being more affected than men. 


Why does COVID-19 cause hair loss? 


Although there are several studies linking coronavirus and hair loss, many of the reports we hear about are anecdotal – at the moment, it’s too soon for scientists to officially establish a link between the two. 

However, the type of hair loss that COVID-19 sufferers are reporting seems to be consistent with telogen effluvium. Telogen effluvium occurs when more hairs than usual suddenly enter the shedding phase of the hair growth cycle at once, causing a more noticeable amount of hair to shed at once. It’s normal to lose up to 150 hairs per day, but if you spot that you’re losing much more than that – such as clumps coming out when you’re brushing or washing your hair – it could be telogen effluvium. 

Due to the length of the hair cycle, telogen effluvium typically occurs two or three months after a period of significant stress, which can include illnesses such as COVID-19. When undergoing stressful situations, the body puts all its resources into maintaining essential functions only – which, unsurprisingly, does not include hair growth. As a result, you end up with hair loss. 

However, several other conditions can cause hair loss – such as thyroid issues or nutritional deficiencies – so if you are concerned, visit your GP, who can rule out other underlying causes with a simple blood test. 


Will my hair grow back after having COVID? 


If the hair loss is the result of telogen effluvium, most people will find that the hair will eventually grow back without the need for treatment. Typically, once the trigger or stressor is removed, the hair will grow back on its own. 

If you notice that the hair loss is persisting, there are a number of medical, cosmetic and hair transplant treatments available to help – Crown Clinic offers a range of options to support those struggling with hair loss, so don’t hesitate to get in touch

When performed by a qualified, experienced hair transplant surgeon, hair transplants are a very safe procedure. Hair restoration is a minimally invasive treatment that allows patients to return home the same day, with the procedure only requiring local anaesthetic. 

However, if you undergo a hair transplant abroad – such as in Turkey – the risk attached is much higher. 


Risks of hair transplants in Turkey 


It’s no secret that undergoing hair transplant surgery in countries such as Turkey is a gamble. Every year, countless patients are reeled in by the low prices and package deals offered by overseas clinics. Many of the clinics boast ‘five-star’ ratings and an active social media presence, duping unsuspecting patients into thinking they are visiting a reputable clinic. Although, when you dig a little deeper, you may discover the reviews are faked and the ‘after’ pictures are heavily edited or taken from other clinics. 

Another trick that patients fall for is believing that a surgeon will be carrying out the procedure, as many of the clinics advertise that a surgeon leads them to convince patients that they are legitimate. Unfortunately, that doesn’t mean a surgeon will be carrying out the hair transplant itself. In fact, many clinics hire under-qualified technicians with little training to keep the costs down, only seeking the supervision of a surgeon if the procedure goes wrong. 

Over the years, Crown Clinic has fixed countless botched hair transplants, mainly from overseas clinics. The most common problems that we see are unnatural-looking hairlines and unsightly scarring as the result of the surgery being carried out by unlicensed practitioners. Other risks are infections, as sanitation is often extremely poor at the clinics and damage to the scalp due to the result of the incorrect tools being used to carry out the surgery. 


Are there any side effects to having a hair transplant? 


If you choose to have a hair transplant in the UK with a reputable surgeon, side effects will be minimal. The hygiene standards will be incredibly high, meaning the risk of infection is negligible, and you will be given clear instructions on how to take care of your scalp after the procedure. Crown Clinic has an excellent aftercare service, offering a day-by-day guide to ensure optimum healing and results.  

Unlike at overseas clinics, where it can be impossible to follow up after the procedure to discuss any concerns related to your hair transplant, Crown Clinic is more than happy to answer any questions you may have during this phase.