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

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.