Ask HN: Coping with Hair Loss

23 points by HairMeOut ↗ HN
I'm losing my hair and it is bringing me down. I know "just shave it". Ok, easy if you have a body like Bruce Willis or Jason Statham. Not so easy if you are pale and pudgy. Hair loss is natural and there are millions of people with more important problems in the world... I know, I know. But still. I get envious when I see men in their 60's or 70's that have full hair that is not even thinning. I catch myself comparing my hair with other balding men. To see who is "furthest" or who has lost the most. Sometimes I wish I had lost it in my early 20's like my brothers cause then it wouldn't have become part of my identity. I liked having hair.

Prescriptions or miracle cures that actually work? Affordable hair transplants? Maybe I can't except much as I'm over 40...

55 comments

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Look, you are over 40. Who exactly are you trying to attract with a full head of hair. At this point in your life other accomplishments should dominate others' opinion of you rather than hair.

Anyways, if this is an emotional thing for you, the big three.

1. Propecia

2. Rogaine

3. Transplants (since you seem to have hair and are over 40).

hair transplants do work, but it depends what you have left I believe. I found out recently Dave Portnoy got his done (https://www.thefocus.news/celebrity/barstools-dave-portnoy-c...).

But outside of that getting in shape is for sure a big task, but it's something that can really aid in confidence. Once you see some results its addicting imo.

Just my 2 cents. Hope you have a great week.

Firstly, so sorry to hear it. I am bald but probably on the attractive end of things, so have it comparitively easy. I feel for your tough position.

Some things facts that may help assuage your discomfort:

1. Male weaves are becoming all the rage. Could be worth a shot.

2. I'm sorry you don't have a beautiful bald head, but the good news is- you're a guy! We aren't expected nor do we need to be beautiful to be successful in life and love. Just go out to dinner at a nice restaurant and you'll likely come across one or more ugly oafish looking men with a vastly more attractive or even extremely hot companion by his side. Character + ability to provide a good life > looks.

3. Self-assurance and self-confidence are sourced from within. Not from hair fibers.

How about some empathy?
Empathy won't grow back any hair.
Can't argue with that, but in my experience it can help with the underlying issue: Feelings.
Hmm I think in some cases its actually a more empathetic advice to just get over it as a non-issue and think about other things.
Come on, I won't flag you but it seems clear doesn't need tough love. It rarely helps.
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How about you captain your own soul instead of aspiring to the admiralty of mine?
Was your purpose to tell someone things they probably already knew, or were you trying to encourage them? It came off as the former, but the advice is solid - if it came with some empathy.

If you think any of those things are easy, I disagree. To someone with the wrong genetics or habits, you may as well suggest growing a foot taller.

They're not easy. They certainly weren't easy for me, but I'm putting in the work and seeing results. My genetics and habits aren't that great either, but habits can be fixed and genetics are a cop-out. Am I gonna end up jacked like a Hollywood action star? No, but that's not genetics; that's money and steroids.
Grey hair is so much easier to fix/hide than going bald though. They aren't comparable at all.
Grey hair is easily fixed when you can afford to dye your hair. I couldn't do that until I was out of college and had a real job.
Hair loss "cures" do nothing else for your health, and are also unlikely to work.

Exercising outdoors more, to become less "pale and pudgy", is good for your health, even if for some reason it fails to make you less pale and pudgy. Being outdoors, and exercising, also both improve one's mental health in a way that baldness "cures" will not.

Speaking as a pale balding dude, I get what you're saying, but chasing baldness cures is unlikely to help. Trying to do something about "pale and pudgy" is more likely to work, and also likely to have side-benefits as well even if it doesn't work.

Finasteride is real medicine that delays baldness as long as you start it before you have already lost too much hair.

Ask your doctor about it ASAP if hair loss is an issue for you

Agreed. I’m not sure why you’re getting downvoted. Finasteride isn’t snake oil; it’s been around for a while now, and is known to be very effective. I’ve been using it for twenty years, and I’m one of the few guys in my group of college friends who isn’t visibly balding.

It can have side effects, as I mentioned in an earlier comment. Talk to your doc and do your research, but I think Finasteride might be the first thing you would want to try here.

I personally would give nutrition a try for a year or two before turning to drugs. [1] I believe that prescriptions should be a last resort when all else has been tried and failed.

[1] - https://www.youtube.com/c/DrEricBergDC/search?query=alopecia

It's pretty much a genetic thing, I recommend radical acceptance. Don't give hair hucksters your time or hard earned cash.
Eating healthy isn't giving money to a huckster. There is nothing but benefit to eating healthy. In fact one can reverse most age related illness by making simple dietary changes. It is true that some people are more epigenetically vulnerable to Alopecia but it can still be reversed in them.
I wasn't proposing to eat unhealthily (not recommended for anyone).

My intention is to drive home the fact that unless you're severely malnourished, have alopecia, or are taking chemo drugs, hair loss is most likely genetic and not something "fixable" with current technology.

The hair cling drugs come with serious side effects.

In addition to the link I provided I would also suggest reading up on Dr. Fahy's research on the Thymus. [1] And yes I would stay far far away from any hair related drugs. I would add that genetics are not a fixed thing. Most genetic traits can be altered through epigenetics by changing environmental inputs.

[1] - https://www.youtube.com/watch?v=KukRAXnNOJM

Just curious- have you had success with reversing hair loss through environmental adjustments?

For me it seemed like a 199% genetic time bomb :)

Not me personally. I have not experienced hair loss. I have reversed gray hair however. Most of Dr. Bergs followers with Alopecia have had success with reversing it.
I've been taking thymus hormones most days for seven years. Confirm it reduced hair loss.
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As someone who lives with someone dealing with hair loss I understand OP's feelings. I also agree that giving nutrition, sleep and getting your body in shape a try. The whole prescription thing might work but if the hair loss you're experiencing is nutrition/sleep/stress/etc related it may be easier/cheaper to take care of the source of the problem.
Check out the reddit community /r/tressless including their wiki
You did not mention if you've spoken to dermatologist. I'd give that a try before turning-in for a hair transplant
Go to a derm/doc to see if there are any nutritional deficiencies (unlikely though). Once that's ruled out, get on Finasteride. 99% of people maintain their hair. Unless you're slick bald, this is a must if you're getting a hair transplant. After a year you can do a hair transplant, but really read reviews, maybe even meet patients in person. The hair transplants today are really good in the hands of a good doctor.
Your bald future self can be much more attractive than your current hairy self.

It's cliche advice but it works. Start strength training, walking, and diet off some of the weight.

Runs in the family for me. My hair stylist told me that many men don’t brush their hair enough and large parts of their head aren’t stimulated enough which makes the roots weak which can exaggerate the issue. I started brushing every day after that. She also told me that tea tree shampoos are beneficial to the issue, so I now use those exclusively, but couldn’t say if it’s working. She also mentioned the more heavy hormonal type medications with undesirable sets of side effects which I’ll just pass on ¯\_(ツ)_/¯
I hate to break it to you but your hair stylist more than likely hasn't followed the scientific process to determine whether what she says is true. If it was that easy everybody would do it. Anecdotally, I personally have brushed my hair a few times (tried everything except the drugs) and the hair just all fell out even more.
Who cares if the scientific method was involved if it a) makes this guy feel better or b) happens to work for him? It’s not like rubbing a potato on a tumor and hoping it goes away. The worst that can happen here is he goes bald anyway.
I like having hair but recently noticed mine is thinning now, it kind of sucks but we made it into our 40s so I think we got pretty lucky because at our age nobody is ever going to really care if we have hair or not. It doesn't even really disadvantage us, especially compared to the changes other people have to endure like obesity, amputation, heart attacks, strokes etc.
I never understood why people are so terrified of losing their hair, like they have a choice or a say in the matter. Your body is going to do what it was programmed by your dna to do, no matter how uncomfortable with being bald. Just own it and put your focus into something besides your own appearance. Yes I’m likely going to lose my hair too in the near future. Who cares?
This. I do emphathize with the OP. Its natural to feel a little scared in the beginning stages, but after awhile you just slowly accept it, and move on with the rest of your life. Life is too short to worry about things you dont control. Plus, nobody really cares about it more than you, trust me.
It depends on how old you are. Going bald at 18-19 can be absolutely destructive and painful. It's almost completely out of your control too.

It also depends on how extensive the hairloss is. A receding hairline is one thing, "losing" your hairline entirely is another.

You don't care. OP does. It's also about options: if you look good or really good with hair but you don't have that option because you have a spot, it's hard.

It changes your face.

Pick any good looking actor. See how they look with a shaved head vs. with hair. Even those who look good without hair, they often look better with hair. When you shave your head.

Right, who cares? Why are you comparing yourself to models and actors?
That was to drive the point with a common reference point. The moon in this is comparing yourself with yourself. Maybe OP looks gorgeous with hair but banal without and it's frustrating him.

If shaving your hair gets you from an "8" to a "6" on a "hotness scale", that's two "points" wasted for nothing and OP may be looking at some quick win to get those two points back.

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Testosterone fluctuations will cause rapid hair loss. 40 is the age at which this seems to start happening and you start randomly feeling weepy for no reason.

If you go with topical treatments like Midoxinil, have low expectations. There is evidence that they "work," but they're not magic-- at best you'll hide the extent of loss with short-lived new growth (forget having a ponytail). You must maintain daily usage to even get that much. Retail price is ridiculous but Costco sells it cheap.

Latisse (specifically, not some lookalike "serum") will make hair grow on literally anything, but it's a bit expensive to use on your scalp. Typically meant for eyelash lengthening and might require a prescription. But hey, if you're desperate...

Mahabhringraj oil blocks testosterone activity in your hair follicles. Also lots of other good stuff. Extremely effective when used as directed (e.g. in evenings or night and washed out of hair within 12 hours of use. Most effective when a micro needle derma roller (.2mm-.3mm needle) is used afterwards for increased absorption.

Infrared laser diode caps stimulate cell activity (both growth and graying--use with lots of antioxidants and pause if graying begins to increase)

The best thing you can do is just get over it. As somebody who's tried almost everything that seems like it has a chance, it's a genetic problem. It's aggravated by stress and other conditions.

The only "solutions" you consider are wearing a hair system (toupee of real hair), drugs (finasteride, minoxidyl, plus hair transplant if you want), or a care-free attitude. I personally go through phases of caring and not. Life's just better when I don't worry about it.

Also I want to add, I personally think that understanding baldness and "curing" baldness is one of the biggest solvable problems we have as humans today. It can't be that hard to stop the process of hair loss, scientifically. Or at least growing hair in the lab and transplanting it onto the head, which I'm sure most people would be willing to do once every 10 years for a hefty fee. I know I would, if anybody knows anything please let me know!
Finasteride is also used to treat male pattern baldness (androgenic alopecia) in men, a condition that develops in up to 80% of Caucasian men

4 out of 5 white guys are going bald. Finasteride can help but some have side effects.

I tried Rogaine (minoxidil) and it didn’t work for me. I thought about trying oral finasteride, but I read that a small percentage of people experience sexual dysfunction as a side-effect, which didn’t seem worth the risk to me.

But I did some more research and found some early studies on PubMed that suggest that topical finasteride works just as well without the negative side effects.

The only company I could find selling topical finasteride is from ForHims. I’ve been using the spray for about 3 months and my hair is definitely thicker now, but it hasn’t helped with my hairline yet.

I’m not a doctor, so you should definitely do your own research or better yet, talk to a doctor. I don’t work for Hims, but I’ve just been impressed by their products. Definitely cheaper than hair transplant surgery.

https://www.forhims.com/hair-loss/topical-finasteride

Bald person here.. I've been waiting for this question since I was 19; when I started to lose my hair.

When I was 14, my mom pulled back my hair line and asked my dysfunctional father if I was going bald. Talk about a "What the fuck are you doing" moment.

At 17, I was getting depressed about being bald. I would look in the mirror trying to see how much it changed. At 21, I said fuck it. I'm a sexy beast, see me shine!

I went through phases during my hair loss.

1. Keeping my hair wet to hide the fact it's thinning 2. Trimming it down, combing it forward and swirling the back so make it look "tight" 3. Trimming it very low and looking like a boss 4. Shaving it down to the skin and having people ask me why I don't grow my hair out

Here's how I coped with it. I was honest with myself.

Sure I would like to have hair, but I'm not Elon Musk. Did it impact my success with women? Yes, I think I get more women being bald. Why? I don't know honestly. Am I built like Jason Statham? More like a lean James Corden.

To make my situation, I'm a hairy man; pale (programmer) and I have a belly. I'm also seriously hairy... The only places I don't have hair is on my head, forehead, and palms; ironic right? Not on my palms? Wait until this shit turns gray... I'm going to look like a fucking Yeti.

Find your true source of confidence. It's not your hair, income, or job. It's the confidence you have in your ability to change.

I know you like having hair, but it's not what defines you. Plus, you're over 40 and thinning out. Congrats you lucky bastard :)

I hope you mentally get past your fears and concerns. Be honest with yourself buddy.

> Prescriptions or miracle cures that actually work?

First, it should go without saying, but I'm not a doctor. I'm just a random internet stranger offering pointers. Consider that anything I say may be wrong. Do your own research, and talk with a real doctor.

That being said, there's minoxidil[1], although it doesn't require a prescription. The original commercial name is Rogaine. It's a foam you apply twice a day. As I've heard, you'd lose all your hair in the first 6 months, and then it would regrow fuller. You'd have to apply it for life. If you stop, then you would go back to the amount of hair you had before taking it.

You may evaluate differently, but personally I don't think it's worth it. It's not a trivial expense, not easily available worldwide, and seems too bothersome.

Another medication is finasteride-1mg[2], many times sold under the brand names Propecia/Proscar. It's a pill taken daily. AFAIK, it only works to prevent further baldness and not to restore hair that's already been lost. It may or may not require a prescription depending on where you are, but you should check with a doctor to see if they think it'll work for you. Not all forms of baldness are the same. The 1mg version can be expensive, so I hear some people buy the much cheaper 5mg version and cut that in quarters for 1.25mg doses. A potential side-effect is possibly irreversible ED. You should evaluate on your own if the risk is low enough to be disregarded.

[1] https://en.wikipedia.org/wiki/Minoxidil#Hair_growth

[2] https://en.wikipedia.org/wiki/Finasteride#Scalp_hair_loss

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That really sucks. I’m sorry. I went through the same thing in my early twenties; noticed my hairline was receding, remembered that it ran in the family, and realized what was happening.

I was devastated. I really felt like I didn’t have a future anymore. I’d never thought of myself as being unusually attractive, but I was horrified at the thought of being unattractive. I became deeply depressed. It really was a period of darkness for me.

There is no such thing as a miracle cure—yet—but you have options. It’s been twenty years since I first realized I was losing my hair, but I still appear to have a full head of hair. I’m doing the following:

- Propecia (or generic Finasteride). That’s probably the most effective thing on the market right now. Might require a prescription where you are, and absolutely talk to your doctor before doing this. Side effects can include erectile dysfunction, and I’ve seen some people on forums talk about “brain fog”. I think it may have impacted my libido in the beginning, but I’m nervous, chronically single, and sexually inexperienced (hey, this is my throwaway account) so I honestly can’t tell if it really did anything. (To be clear, my lack of romantic success is not related to my hair, I’m just deeply introverted and awkward.)

- Toppik. After you try it, you won’t leave home without it. Toppik is a powder made of microfibers that stick to your hair and make it look fuller. Obviously if you’re completely bald, it won’t work, but you can be noticeably thinning and Toppik will hide that completely. (I’m not affiliated at all with the company, but I’ve been using this for two decades and it works.)

- I use Nizoral shampoo. A lot of people on forums say it helps. Can’t swear to it, but it does reduce dandruff.

- I wouldn’t be thinking about hair transplants just yet. If you are, research the *hell* out of this. There are way too many bad doctors out there. From what I’ve read, you want to avoid the Follicular Unit Transplant technique; that’s where they harvest a strip, which leaves a scar. The approach I (briefly) considered was Follicular Unit Excision (FUE), since there was less chance of scarring, but it’s been a little while since I researched this. Don’t rush into anything; if you’re not Picard-level bald yet, you likely have better options.

Also:

- I’ve realized that women really do seem less concerned with appearance than I would have thought, especially as you/they get older. I know a number of women I find attractive are with guys who are partly or completely bald. Comments like “find a hobby and just be confident”, as glib as they are, have a grain of truth to them; if you’re a decent person, have stuff you care about, and are articulate enough to make it sound interesting, your appearance might not be as much of an issue as you think it will.

- While I’m hardly an authority on fashion, the following have never failed me: dark jeans, Chuck Taylor high-tops, and an illustrated T-shirt from someplace like threadless.com. Hipster? It sure is. But at least in my experience, an ironic Star Wars illustration makes you look more interesting than something you’d wear to the gym (although I’m a web dev/designer; if you’re a banker, that might not be a good aesthetic). Yes, you can still wear this when you’re over 40.

- In short: fix the stuff you can fix. Dressing better, keeping up your appearance, and doing interesting stuff (hiking, having an online art portfolio, exploring abandoned places, etc) goes a long, long way.

- Finally, I’d say don’t lose hope. I really do believe that hair multiplication techniques and improved topical treatments are pretty close. They’ll be expensive, but I don’t think baldness is inevitable for people our age.

I just went with the flow and shaved my entire head as soon as I thought it wasn't looking very good. There was a phase of my life people went out of their way to tell me I look like Bruce Willis, so I guess it suits me. You've already decided that's not a good option for yourself.

Anyway, I wanted to say something more practical. I once saw a guy who's hair formed what looked like a thick "handle" straight across the front. Otherwise he was completely bald on top, and pretty much all the way back, George Costanza style. He regularly shaved that bar of hair off, but as it always grows back, you can see the pattern of plugs, which looks far worse than natural balding ever would.

Ends up he started with hair transplants to cover widow's peaks and "lower his forehead." It was fine for a few years, but later in life, most of the hair behind it receded away from the transplant areas, and he was unable to afford chasing after the continually receding hairline. So he resigned himself to having a really wonky looking hairdo for the rest of his life.

Keep that in mind, whatever solution you choose. Your current response needs to keep the future state of coif in mind.