Baldness is something that nearly every man is familiar with it can often come in the form of thinning hair or a receding hairline. The cause of baldness is mostly male pattern baldness which is caused by genetics and hormones (like DHT) that cause hair follicles to shrink over time. Other factors can worsen hair loss, including age, lifestyle factors like stress, poor diet, and some medical conditions. There are several superstitions to overcome. Some believe that wearing a helmet brings on baldness or that oiling your hair brings on baldness. However, the truth is baldness is mostly genetic. Thank goodness baldness can be managed. With modern treatments and lifestyle changes, even surgery, baldness can be managed. Men who accept baldness can come to a place within themselves to manage baldness confidently.
What is Male Pattern Baldness?
Male pattern baldness, or androgenetic alopecia, is the most widespread type of hair loss in men. Typically, male pattern baldness begins with either a receding hair line or thinning at the crown (top of the head), and it will eventually arrive at partial or complete baldness levels.
Male pattern baldness is a long-term and progressive type of baldness that is different from temporary hair fall caused by stress or illness. The most prevalent cause of male pattern baldness is simply the follicles that go from producing normal hair to periods of producing then wasting away hair over time as well as becoming more sensitive to a hormone, dihydrotestosterone (also known as DHT). Hair follicles are small “pockets” in your skin that hair grows from. Follicles that are sensitive to DHT will shrink and produce less hair until that follicle will no longer produce hair again.
Main Causes of Baldness in Male
Genetics
Heredity is the strongest cause of baldness in men. If baldness is a trait in your family (on either your mother’s or father’s side), the likelihood that you’ll also have baldness is higher. Baldness that is genetically determined is called androgenetic alopecia (male pattern baldness). You are given genes that determine how sensitive your hair follicles are to DHT (dihydrotestosterone, a hormone that diminishes the hair follicles). The sensitivity to DHT decreases the hair growth cycle over time, leading to thinner hair that can lead to bald spots.
Hormones
Testosterone, the male sex hormone, turns into a more potent form called DHT. In men with a genetic predisposition, DHT attaches to receptors at the hair follicles and causes the follicles to get smaller. As the follicles continue to get smaller, they produce weaker, shorter strands of hair until they stop producing hair altogether. This is why hormones are one of the biggest triggers of male baldness.
Age
The possibility of male (or androgenic) pattern baldness increases with age. About 25% of men show early signs of male pattern baldness before the age of 21. Early signs are as simple as a receding hair line or thinning crown; by age 50, about half of men have some significant loss of hair and about age 70, 70% of men have male pattern baldness. The hair growth cycle slows as we age, producing finer hair strands, and the most common signs of baldness show up.
Lifestyle & Environmental Factors
Your habits and environment can accelerate hair loss. The most common lifestyle factors affecting hair loss are:
Stress & Anxiety: Stress in your life may lead to telogen effluvium, where hair follicles stop producing hair and enter the resting phase. This process can lead to sudden shedding.
Poor Diet: Either due to a poor diet or some other deficiency (a lack of protein, vitamins [especially Vitamin D, B12, or Biotin], iron, and minerals), hairroots are weakened.
Smoking and Alcohol: Smoking is known to reduce blood flow to the hair follicles, while alcohol is linked to nutrient deficiencies if excessive.
Poor Sleep: Not having 7-8 hours of sleep can neutralize hormone balances which can even indirectly reduce hair loss!
Medical Conditions & Medications
Certain medical problems and treatments can play a main role in male baldness. Thyroid disorders, whether overactive or underactive, can lead to thinning hair on the scalp. Autoimmune diseases such as alopecia areata activate the immune system to attack hair cavities resulting in patchy bald spots. Infections such as scalp ringworm can weaken or kill the root of hair and result in shedding. Additionally, numerous medications or treatments, such as chemotherapy, drugs used for heart disease, high blood pressure, or depression, or extended use of steroids; are also noted as the cause of temporary or even permanent hair loss problems. These health-related factors may exacerbate baldness beyond genetics or age
Stages of Male Baldness
Stage 1: No Significant Hair Loss
At this stage, there is no visible hair loss. The hairline looks full and natural, although some men may start to notice a hint of thinning at temples.
Stage 2: Mature Hairline
The hairline has receded slightly, usually around the temple area, giving it a slight “M” shape. This is sometimes referred to as a “mature hairline.” This is a form of normal aging, and would not be classified as true baldness.
Stage 3: Early Baldness
The receding hairline is now more noticeable, showing more depth of the “M” or “U” shape on the temples. Some men may also notice their hair thinning in the crown (top of head area).
Stage 3: Vertex
This is an example of a stage 3 presentation where you can see thinning of hair loss occurring in the crown (vertex) area while the front hairline still appears full.
Stage 4: Moderate Hair Loss
The receding hairline and thinning crown area are more obvious to the observer. At this stage there are still two bald spots on the head, with a strip of hair across the scalp still uninvaded by the baldness area.
Stage 5: Significant Hair Loss
The hairline and crown bald spots have diffused into larger areas, and the strip of hair separating the two bald spots is narrowing. The bald areas are close to merging.
Hairline recession and a bald spot at the crown become fully connected (only some sparse hair exists across the top of the flow). There remains hair on the sides and back of the scalp.
Stage 7: Severe Baldness
This is the most advanced case of male pattern baldness. There is only a thin band left of hair along the sides and back of the scalp. The majority of the top o the head is bald.
Myths About Baldness
1. Myth: Baldness comes from the mother.
Fact: Baldness comes from both sides of your family.
2. Myth: Wearing hats can cause hair loss.
Fact: Hats do not suffocate hair follicles or make you bald – hair follicles use blood to obtain oxygen. Only dirty hats can promote scalp infections that contribute to hair loss, so washing your hats is essential!
3. Myth: Oiling your hair will prevent baldness.
Fact: Oils can nurture your scalp and improve the texture of your hair, but oils have no impact in preventing genetic baldness.
4. Myth: Baldness occurs only in older men.
Fact: Although it is true that age is often correlated with baldness, hair loss can occur in younger people due to a number of reasons including stress, medical conditions or extreme hair styles.
5. Myth: Baldness is caused by dirty hair.
Fact: Dirty hair or lack of regular shampoo does not cause baldness. Baldness occurs due to genetics, hormones, and aging – not because of your hygiene.
6. Myth: Poor circulation causes hair loss.
Fact: Poor circulation is not the cause of baldness, just a by-product of follicles shrinking and hair loss turning into bald areas.
7. Myth: If you shave your head, it will come back thicker.
Fact: Shaving your head will only be thicker when you start to grow your hair back because the coarseness of the hair follicle gives the illusion of thickness. The actual structure of the follicles remains unchanged, and the process of baldness continues.
8. Myth: Frequent shampooing can make you lose your hair.
Fact: Shampooing your hair regularly does not make you lose your hair, but some harsh products can cause damage to your hair.
9. Myth: Baldness means the person has too much testosterone.
Fact: Baldness is not really about having “too much” testosterone; it is more concerned with the hair follicles’ sensitivity to DHT (a byproduct of testosterone).
10. Myth: Natural and home remedies can fix baldness.
Fact: Remedies like onion juice, aloe vera, or oils may improve scalp health, but they cannot reverse male pattern baldness. Only medically proven treatments (Minoxidil, Finasteride, or surgery) have done anything for baldness.
Prevention & Treatment Options for Male Baldness
Medical Treatments
One of the most common approaches to slowing or treating male baldness is the use of clinically approved medications.
Minoxidil (Rogaine)
- It is a topical solution or foam that is applied directly to the scalp.Â
- Minoxidil increases blood circulation to the hair follicles, and as a result, helps deliver oxygen and nutrients.Â
- Minoxidil prolongs the growth (anagen) phase of the hair cycle, which allows for thicker strands of hair and healthier strands of hair.Â
- Minoxidil is generally best used for early to moderate hair loss stages.Â
- Minoxidil requires consistent use to see results, and when the treatment is stopped, hair loss resumes.Â
- The common side effects include scalp irritation, itching, or dryness.
Finasteride (Propecia)
- An oral prescription drug taken daily as a pill
- Finasteride inhibits the conversion of testosterone to DHT (dihydrotestosterone), the hormone that causes follicle shrinkage and baldness,
- Finasteride slows hair loss, and in many cases can promote regrowth in thinning areas.
- Doesn’t distinguish between different areas of the scalp, with it being more efficacious for crown and mid-scalp hair loss.
- Once started, it can only be stopped after a specific period of time; if you discontinue before that time limit you will lose any gains you made in the treatment, typically within a few months.
- Propecia side effects may include decreased libido, erectile dysfunction, or hormonal imbalance, sometimes referred to as “post finasteride syndrome”, although it’s rare.
Surgical Treatment
Hair Transplant
This is a surgical process where normal hair follicles form from the back of either side of the scalp (donor area) and grafted into thinning or bald areas.
Most popular methods:
- FUT (Follicular Unit Transplantation) – A strip of scalp is cut out and those follicles are removed and transplanted.
- FUE (Follicular Unit Extraction) – Individual follicles are taken directly, leaving behind tiny scars.
• DHI / MHI (Direct Hair Implantation / Modified Hair Implantation) – Advanced variations of FUE where follicles are directly implanted into the scalp using specialized implanters. MHI, VPlant’s patented technique, further refines DHI with higher graft survival, virtually bloodless implantation, and natural-looking density by design.
They provide some of the most natural and permanent results available since the transplanted follicles will resist DHT.
The most ideal candidates are males with stable baldness and available donor supply.
Advantage – Provides permanent, natural-looking hair, boosts confidence, requires low maintenance, and is cost-effective long-term.
Drawbacks – High costs, a recovery period and potential surgically-related complications such as; infections or scarring.
Scalp Micropigmentation (SMP)
- A non-surgical cosmetic tattooing procedure, where little dots of pigment are placed on the scalp.
- It creates the appearance of a close shaved head or adds density in an area of thinning.
- SMP is ideal for men looking for a low-maintenance shaved head look or men who don’t have the available donor hair.
- Results are semi-permanent and typically last 4-8 years before touch-ups are required.
Advantages- Results are visible immediately; there is no surgery and the advanced procedures are cheaper than some transplants.
Drawbacks- Tan -provoking hair density, but does nothing to change the actual number or locations of existing hair follicles.
Lifestyle Improvements
Lifestyle choices can also affect the impact of baldness and the quality of existing hair. A protein heavy diet of eggs, fish, and nuts along with leafy vegetables can help produce nails and new hair. Finding ways to reduce stress, such as yoga, mediation or exercise, can regulate hormones and may limit hairs loss due to stress. In conjunction with stress management, quitting smoking, and cutting back on alcohol, are equally helpful. Both smoking and alcohol can diminish the hair follicle and expedite hair thinning. Finding ways to sleep 7–8 hours of good quality sleep will allow your body to self repair and for hormonal balance to be maintained, allowing for healthier hair.
Natural/Home Remedies
While some natural remedies may be beneficial to scalp health, there is little evidence they are effective for genetic baldness. Aloe vera is used to soothe the scalp, treat dandruff, and add moisture, improving scalp health and making the environment healthier for hair. Onion juice is thought to promote circulation when massaged into the scalp, and rosemary oil may produce some degree of hair growth when massaged into the scalp on a regular basis. Overall, these products may help to improve the condition of the scalp and provide some temporary improvements in hair strength and thickness to a very small degree, but cannot undo genetic or hormonal male pattern baldness. Natural remedies should be included as part of supportive care with medical options or lifestyle changes.
When Should You See a doctor?
It’s best to consult a physician if you feel anxious or concern over the persistent hair loss in yourself or your child and wish to discuss treatment alternatives. It is important that women with a receding hairline and/or unusually thinning hair are evaluated promptly, since early diagnosis and intervention can help avoid permanent hair loss.
You should also proceed to see a physician if you are observing abnormal hair loss or unexpected hair shedding, i.e. clumps of hair while combing or washing your hair. Changes in your hair, scalp, or hair loss behaviours could be indicative of an underlying health concern that may warrant medical intervention (e.g. hormonal issues, autoimmune disorders, or infections of the scalp).
Conclusion
For men, baldness is a common condition that is mostly caused by genetics, hormones, and ageing, but factors such as lifestyle and other medical conditions may also affect balding in men. While there are many misconceptions concerning hair loss, the reality of male pattern baldness is that it is most often genetic and related to the sensitivity of your hair follicles to DHT. For some balding occurs as young as the age of 20, while in others it gradually accelerates as they age.
The encouraging thing is that there is treatment. Minoxidil and finasteride, can help to slow or stop hair loss. Surgical treatments such as a hair transplant can restore hair permanently for those that desire that outcome. The effectiveness of each of these treatments depends on factors including the extent of baldness, your health, and when the treatment begins. Stress management, nutrition, and healthy choices can be supportive to your hair health and may slow further loss.
Simultaneously, it’s vital to note baldness does not define who you are. Many gentlemen confidently own it as part of their identity, whilst others wish to use medical help to have fuller coverage of hair. Whatever decision you make to embrace or treat it, you have to feel comfortable, confident, and true in your identity.
FAQs
1. What is the real reason men go bald?
Male pattern baldness is related to genes and male sex hormone
2. Can bald men really regrow hair?
It is possible, but it depends on the cause, the extent of hair loss, and how soon you act.
3. Is baldness reversible?
Not completely, but medications such as Minoxidil, Finasteride, and hair transplantation can be effective treatments if you want to see improved coverage.
4. Does stress cause baldness?
Stress can cause temporary hair loss in the form of telogen effluvium, but does not usually cause permanent baldness.
5. Is baldness caused by high testosterone?
It’s not the amount of testosterone or DHT that causes baldness. It’s the sensitivity of your hair follicles. That sensitivity is determined by genetics. The AR gene makes the receptor on hair follicles that interact with testosterone and DHT.
