Why Do Men Go Bald and What Can You Do About It?

The vast majority of men who go bald do so because of a hereditary condition known as androgenetic alopecia, more commonly known as male pattern baldness.

According to the American Hair Loss Association, 95 percent of hair loss in men is caused by androgenetic alopecia.

This inherited trait that tends to give guys a receding hairline and a thinning crown is caused by genetic sensitivity to a byproduct of testosterone called dihydrotestosterone (DHT).

So, how exactly does this hormonal byproduct cause hair loss?

Well, hair follicles that are sensitive to DHT have a tendency to shrink over time. As the affected hair follicles get smaller, the life span of each hair becomes shorter. Eventually, the affected follicles stop producing hair, or at least the type of hair you’re used to.

With male pattern baldness, hair loss typically follows a predictable pattern. The two most common patterns of hair loss include the following:

• Hair starts to thin on top of the head and around the temples. This pattern may eventually leave a “horseshoe” of hair around the sides and back of the head.
• Hair starts to recede from the front of the hairline, pushing the hairline further back on the head.

The degree and progression of balding in men is assessed by the Norwood classification system. It has seven stages that measure the severity and pattern of hair loss and balding.

If you find that your hair is thinner than it used to be, you can draw some comfort from the fact that you’re not alone. Male pattern baldness affects the majority of men at some stage in their lives.

According to the American Hair Loss Association:

• Approximately 25 percent of men who have hereditary male pattern baldness start losing their hair before the age of 21.
• By the age of 35, approximately 66 percent of men will have experienced some degree of hair loss.
• By the age of 50, approximately 85 percent of men will have significantly thinner hair.

Although male pattern baldness is the leading cause of balding, it isn’t the only condition that can trigger hair loss.

With male pattern baldness, you typically don’t have other symptoms aside from thinning hair. But with other hair loss causes, you may notice you have other symptoms, too.

Also, with most other causes, there isn’t always a predictable hair loss pattern like there is with male pattern baldness. Instead, hair loss is more likely to happen all over, or in a few spots.

The following conditions can cause varying degrees of hair loss. Some types of hair loss may be permanent, while others may be reversible:

• Alopecia areata. This condition causes your body’s immune system to mistakenly attack healthy hair follicles, which leads to hair loss. Hair typically falls out in small patches on your head, but it can also affect other parts of your body. For instance, you may find a bald spot in your beard or in your eyelashes or eyebrows, too. The hair may or may not grow back.
• Telogen effluvium. Excessive shedding of hair can sometimes happen about 2 to 3 months after some sort of shock to the system or stressful event. Hair loss may be triggered by an accident, surgery, illness, drastic weight loss, or some kind of psychological stress. Hair usually grows back within about 2 to 6 months.
• Nutritional deficiency. Optimal levels of iron and other nutrients are essential for good overall health, as well as healthy hair growth. Protein, vitamin D, as well as adequate intake of other vitamins from your diet are also important to maintain healthy hair. A deficiency in one or more of these nutrients may cause you to lose more hair than normal.

Hair loss from certain medications is usually temporary and once you stop taking the medication, hair growth will likely resume. Some of the known drugs associated with hair loss include:

• chemotherapy drugs
• acne medications such as isotretinoin (Accutane)
• antifungal drugs, in particular voriconazole
• anticoagulants such as heparin and warfarin
• immunosuppressants
• blood pressure medications such as beta blockers and ACE inhibitors
• cholesterol-lowering drugs such as simvastatin (Zocor) and atorvastatin (Lipitor)
• antidepressants such as sertraline (Zoloft) and fluoxetine (Prozac)

Hair loss treatments, for male pattern baldness in particular, range from products you rub into your scalp to more invasive treatments aimed at restoring hair growth or replacing lost hair.

Here are some of the more popular and effective treatment options for balding.

Medications

There are both prescription and over-the-counter drugs approved for the treatment of male pattern baldness.

The two medications proven to treat or stave off further male pattern hair loss are finasteride (Propecia, Proscar) and minoxidil (Rogaine, Ioniten). Finasteride comes in a pill form and is only available by prescription. Minoxidil is a topical treatment that’s available over the counter.

It can take at least 6 months for either treatment to start showing results.

Laser treatment

Low-level laser therapy can be used to help invigorate circulation in the scalp and to stimulate hair follicles. Although this is a fairly new treatment option, it has been deemed safe and tolerable. It is also a less invasive option compared to hair transplant surgery.

Although research is limited for laser therapy and hair growth, some studies have shown encouraging results.

For instance, a 2013 study that included 41 men between the ages of 18 and 48 found a 39 percent increase in hair growth for participants who had laser hair surgery.

Hair transplant surgery

The two most common hair transplant procedures are follicular unit transplantation (FUT) and follicular unit extraction (FUE).

FUT involves the removal of a section of skin from the back of the scalp where hair is still growing. This section of skin is then divided into hundreds of tiny pieces called grafts. These grafts are then inserted into parts of the scalp where hair currently isn’t growing.

With FUE, the surgeon takes individual healthy hair follicles out of the scalp and then makes small holes, where hair isn’t growing, and puts the healthy follicles into these holes.

Male pattern baldness is commonly an inherited condition. It’s very difficult to nonsurgically reverse any of the hair loss that’s seen with this condition.

However, preventing further hair loss at the first sign of thinning is possible. Finasteride and Rogaine are two known treatments that might prevent further hair loss seen with androgenetic alopecia.

Once you discontinue use of these medications, the hair loss may resume. Talk to your doctor about if these medications may be right for you.

To keep your hair healthy and to prevent hair loss from other causes, try the following:

• Try doing regular scalp massages, which may help stimulate hair growth.
• Quit smoking. Older research suggests that smoking may be associated with hair loss.
• Manage stress through exercise, mediation, or deep breathing exercises.
• Eat a well-balanced diet rich in protein, iron, and vitamins.
• Switch medication. If you think your medication may be causing hair loss, talk with your doctor about other options that may work better for you.

If you have a bald spot or a receding hairline, it’s likely due to your genes.

In 95 percent of cases, balding is due to androgenetic alopecia, more commonly known as male pattern baldness, which is a hereditary condition. It can affect men of all ages, and may even start before the age of 21.

Although you can’t prevent male pattern baldness, there are ways to slow down hair loss. Some options include medications such as Finasteride (Propecia, Proscar) and minoxidil (Rogaine, Ioniten), laser therapy, and hair transplant surgery.

If you’re concerned about going bald, be sure to speak to your doctor or dermatologist. They can work with you to figure out the treatment options that are right for you.