The newest side effect of hair loss — more public anxiety

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Amid photos of balding scalps and eager gossip about new remedies on a Reddit thread about hair loss, you’ll often find cries of distress.

“I don’t feel at peace, ever. My nervous system is constantly in fight or flight,” read one in response to a question last year about the “absolute worst part about balding.”

The site, on which all of the pictured scalps are male, highlights an age-old phenomenon: While women may also lose hair, men do so in greater numbers, earlier and, on average, more obviously.

What’s different today, experts say, is that male anguish about it has never been more evident. Social media, dating apps, “Zoom dysphoria” and a sometimes predatory marketplace are stoking the anxiety.

“I’m seeing more of a visible mental breakdown all over social media,” says Spencer Kobren, founder of the American Hair Loss Association, a national nonprofit dedicated to educating the public about “the emotionally devastating disease of hair loss.” “These are desperate, angry guys.”

While the increasing sway of social media may be relatively new, what hasn’t changed is experts’ best advice about coping with thinning hair. Namely: Don’t wait to investigate the reasons; see a doctor to rule out any contributing illness; use only evidence-based remedies; and if you find yourself obsessing, get psychological help.

“Many young men end up with anxiety and depression, so they not only need dermatological treatment but antidepressants and talk therapy,” says Mohammad Jafferany, a professor of psychiatry at Central Michigan University.

Jafferany is a leader of the emerging field of psychodermatology, which focuses on how psychological factors such as stress or anxiety can affect skin conditions and vice versa. He worries that concern about non-life-threatening hair loss can spill over into body dysmorphic disorder, a relentless focus on perceived superficial flaws.

“Some people may have very mild hair loss but cannot tolerate it,” says Jafferany, who adds such stress has become more common thanks to the “rise of rejuvenation culture” and aggressive marketing of purported hair loss cures. “They want any kind of treatment in the world, and they want to get it by whatever means they can,” he says.

A major industry

Hair restoration was an $8.85 billion industry in 2024, and growing rapidly, according to IMARC Group, a global market research and management consulting firm. It includes topical scalp treatments, prescription pills, Botox injections and hair transplants, while clinical trials are testing strategies including androgen receptor inhibitors, low-light therapy, platelet-rich plasma and monoclonal antibodies. Many men risk their money and health chasing not-ready-for-prime-time remedies.

Two-thirds of American men will have noticeable hair loss by age 35, with some 85% having significantly thinning hair by age 50, according to the American Hair Loss Association.

Up to 40% of women, by age 50, will also lose hair – and clinicians attest to their suffering. “Our female hair loss patients would walk over glass to get to their appointments,” says Rodney Sinclair, a dermatology professor at the University of Melbourne department of medicine in Australia.

Still, Sinclair and others say men may carry an extra burden. “It’s the last bastion of political incorrectness, that people can make fun of guys losing hair,” says Kobren.

Androgenetic alopecia, male pattern baldness, is the most common kind of hair loss in men. It’s a hereditary condition caused by an excessive response to androgens, hormones involved in male reproductive development.

Other causes include autoimmune disease, chemotherapy, poor diet and trichotillomania, an anxiety disorder that leads people to pull out their hair – a potential vicious cycle in which stress over hair loss leads to more stress and hair loss.

Treatments, trade-offs

While waiting for a breakthrough, many men and women try to keep baldness at bay with a limited choice of evidence-based treatments that don’t help everyone and may have side effects.

The best-known Food and Drug Administration-approved medications for pattern hair loss are topical minoxidil (Rogaine), originally developed to treat high blood pressure; and oral finasteride (Propecia or Proscar), developed to treat prostate enlargement. The FDA has also approved drugs for much rarer severe hair loss.

Studies have found that topical minoxidil helps restore hair in 40% of users when applied twice a day, with relatively mild potential downsides including excessive hair growth and scalp irritation.

Finasteride, which lowers blood levels of a hormone known as DHT, is a prescription drug and approved by the FDA only for use by men. Yet finasteride may also cause decreased sex drive, erectile problems, low sperm count, depression and suicidal thoughts.

Adam Friedman, chair of dermatology at the George Washington University School of Medicine and Health Sciences, says his first-line treatment of choice is to combine oral minoxidil and finasteride, which studies suggest can be highly effective. (Many dermatologists prescribe oral minoxidil off-label, i.e., without FDA approval to treat hair loss.) Friedman says he thinks reports of lowered sex drive and depression from finasteride are exaggerated but says he still wouldn’t prescribe it to patients planning to start families.

Hair transplants continue to be a popular option, with more than 700,000 surgical procedures performed annually throughout the world by licensed clinicians, according to the International Society of Hair Restoration’s 2022 survey.

While the average U.S. cost for a transplant varies by person and procedure, the data research company Statista estimated the average at $13,610. This explains the allure of Turkey, where reportedly some 1 million travelers throughout the world come for transplants every year, according to the Turkish Health Tourism Association, and according to Statista pay an average of $2,676.

U.S. professionals warn of the risks of substandard and overaggressive procedures by unlicensed clinics in the United States and abroad, illustrating their advice with grisly online photos of scalp necrosis, the death of hair follicles.

Prescribing patience

Considering the downsides of available options, it’s no wonder that hope for a breakthrough is a poignant constant.

“Did UCLA Just Cure Baldness?” proclaimed one recent press release, referring to a decade-old effort by stem cell researcher William Lowry and colleagues at UCLA.

Their strategy involves a molecule called PP405, which targets the metabolism of hair follicle stem cells.

On June 17, Pelage Pharmaceuticals, which has raised more than $30 million from investors led by Google Ventures, announced positive results from the most recent clinical trial, which enrolled 78 men and women who applied either PP405 or a placebo on their scalps once daily for four weeks. The drug was well tolerated, the company said, and after eight weeks, nearly a third of those treated with PP405 had a greater than 20% increase in hair density. The next phase of the trial will take place in 2026, meaning that the product isn’t likely to be publicly available for at least another two years.

Two cautionary notes: Any oral or topical remedy for hair loss must be used indefinitely to prevent further thinning.

Additionally, in April, the FDA warned of reports of harmful side effects from compounded topical finasteride, which has been sold in on-the-spot prescriptions by some telehealth platforms. Some patients said they had been told by prescribers that the topical drug was safe, while in fact it can be absorbed through the skin into the bloodstream, the agency noted. The reported effects were similar to those from oral finasteride, including erectile dysfunction, anxiety, suicidal ideation, brain fog, depression, fatigue, insomnia, decreased libido and testicular pain.

Asked his advice for panicky, balding young men, Friedman first stressed the importance of addressing the problem early, when there’s more hair to save.

“It’s great for this to be at top of mind for younger individuals, because if they have any family history of hair thinning, or balding, it will be easier to prevent if they start early,” Friedman says. That may be a hard sell, he acknowledges, for someone whose hair hasn’t already noticeably thinned, but “what they don’t realize is, if they come back three years later and look exactly the same, that’s a win.”

Friedman also recommends being patient with a process that can take several months to show results.

“Hair grows a centimeter a month, so whatever we do is going to take time,” he says. “Just like you would not watch your grass grow with angst and bated breath, the same should be true for hair loss. Trust the process, and keep in mind that stress can worsen hair loss.”

Jafferany, the psychodermatologist, suggests that short of seeing a psychotherapist, those with hair loss limit their social media consumption.

“Set boundaries by unfollowing the accounts or unfriending friends that make you feel less-than,” he says. “Also, avoid checking your hair constantly or comparing old photos or using mirrors all the time.”

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