Why do men go bald?

Hair loss is a common concern for men.

Sometimes, it can be a symptom of a more serious underlying disease, but it is usually only an aesthetic issue.

There are several potential causes. However, genetics is by far the most common one.

Hereditary baldness is not reversible with non-surgical means, and hair transplant surgery remains the best treatment option.

Although, some medications can help slow down hairline recession.

If you are experiencing hair loss, you should seek medical guidance as soon as possible.

Visit your doctor or dermatologists to find suitable treatment.

The Causes of Hair Loss in Men

The leading cause of male hair loss is androgenetic alopecia, also known as male pattern baldness.

According to the American Hair Loss Association, the condition accounts for ninety-five percent of all male hair loss cases.

Androgenetic alopecia is hereditary. It is a genetic sensitivity to dihydrotestosterone or DHT, a byproduct of a male hormone, testosterone.

How DHT affects hair loss?

Some hair follicles are sensitive to DHT. Under the influence of this hormone (androgen sex steroid), hair follicles tend to shrink over time.

As they shrink, they also decrease the life span and the development potential of the hair they produce.

Finally, the follicles stop growing hair. When that happens, these follicles are considered dead. The process is irreversible.

It is essential to understand that not all hair follicles are DHT-sensitive.

Hence the other name for the condition is male pattern baldness. There is a blueprint for androgenetic alopecia-caused hair loss in men.

Hair loss usually follows two basic patterns:

1. The hairline begins to recede from the front and steadily continues further back.

2. The hair starts to fall off on the top of the head and the temples (horseshoe pattern).

When do men start to lose hair?

Hair loss affects most men at some point in their lives. That's regardless of the hereditary factor.

With age, however, it becomes more common. Still, a number of men experience hair loss before the age of twenty-one. Here's what the statistics show:

· Approximately one-in-four men with a genetic predisposition for male pattern baldness will start losing hair before they are twenty-one.

· The number increases to two-out-of-three men by the age of thirty-five.

· By the age of fifty, around eighty-five percent of men have visibly thinner hair.

These numbers do not mean that all men lose hair equally.

Some only experience minor hair thinning.

However, this shows that hair loss is fairly common in men and that taking action on time is an invaluable advantage.

What are the other causes of hair loss in men?

Androgenetic alopecia is the leading cause of baldness in men, but it is not the only one.

Other conditions, dietary factors, and some medications can also provoke hair loss.

Male pattern baldness has only cosmetic consequences. With other causes, that is not the case.

Hair loss is usually just one of the symptoms and may be temporary or permanent.

Predictability is another issue. The hair loss pattern is usually irregular and asymmetric with non-hereditary hair loss causes and can also affect hair in other body parts.

Alopecia areata is an autoimmune condition that causes your immune system to target healthy hair follicles as foreign bodies.

The destruction of hair follicles causes hair loss. The hairline does not recede evenly.

Instead, the hair usually falls off in small patches that can be anywhere on the scalp, eyebrows, eyelashes, etc. In some cases, the hair grows back, but the outcomes of alopecia areata are generally uncertain.

Telogen effluvium is temporary hair shedding that happens due to a traumatic or highly-stressful event, such as surgery, accident, illness, radical weight loss, or psychological stress.

It usually manifests two to three months after the triggering shock. In most cases, the hair grows back after two to six months.

An unhealthy diet resulting in nutritional deficiency can also cause hair loss.

All organs and tissues require a balance of essential nutrients and vitamins to maintain proper function.

When this balance is not present for a while, general health (and hair health) deteriorates.

Healthy hair requires an adequate intake of proteins, iron, and vitamins, such as vitamin D.

The presence of these nutrients creates a favorable environment for hair growth.

Hair loss that occurs due to nutritional deficiency is usually reversible with the establishment of nutritional balance inside the body.

Certain medications can also cause hair loss.

When this happens, it is usually temporary. The hair grows back after you stop taking the drug.

These are some medications that may cause hair loss:

· Immunosuppressants

· Chemotherapy medications

· Some acne medications (isotretinoin)

· Antifungal drugs (Voriconazole)

· Blood pressure medications (beta blockers and ACE inhibitors)

· Anticoagulants (heparin, warfarin)

· Antidepressants (Prozac, Zoloft)

· Cholesterol-lowering medications (Lipitor, Zocor)

The Final Word

The most likely cause of a receding hairline in men is genetics.

Androgenetic alopecia, or male pattern baldness, is by far the most common reason with over ninety-five percent of all cases attributed to this condition.

Androgenetic alopecia is hereditary. It runs in families and affects men of all ages.

It is not possible to prevent the development of the disease, but there are ways to slow it down. The most popular methods include:

· Oral finasteride (Propecia, Proscar)

· Topical minoxidil (Rogaine, Ioniten)

· Laser therapy, and

· Hair transplant surgery

If you notice that your hairline is receding or that you have bold spots on your head, seek professional help without delay.

A dermatology specialist can help you choose the treatment that best fits your specific needs.

The sooner you start therapy, the better results you can expect.

References:

· Clarke P. Male baldness. Aust Fam Physician. 2016;45(4):186-188.

· Lolli F, Pallotti F, Rossi A, et al. Androgenetic alopecia: a review. Endocrine. 2017;57(1):9-17. doi:10.1007/s12020-017-1280-y

· Gjersvik PJ. Mannlig skallethet [Male baldness]. Tidsskr Nor Laegeforen. 2000;120(10):1120.

· Kash N, Leavitt M, Leavitt A, Hawkins SD, Roopani RB. Clinical Patterns of Hair Loss in Men: Is Dihydrotestosterone the Only Culprit?. Dermatol Clin. 2021;39(3):361-370. doi:10.1016/j.det.2021.03.001