Male pattern baldness, or androgenetic alopecia, affects more than 80% of American men over the age of 50. This male pattern baldness has something to do with genes, but it's also associated with overproduction of male sex hormones - called androgens (especially dihydrotestosterone) - which help regulate hair growth. Hair loss can occur suddenly or gradually, but it usually has a pattern that makes the hair on the front of the head thin. Watching for this pattern of hair loss and several other risk factors is a good thing if you experience male pattern baldness.
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Part 1 of 2: Studying the Risk Factors
Step 1. Consider your age
Cases of male pattern baldness increase significantly with age. Age is one of the three main risk factors underlying this condition (besides gene and androgen imbalance). More than two-thirds of American men over the age of 35 have it, but this number has risen to over 80% in men older than 50. So, you have to consider age and its correlation to hair. Although male pattern baldness can begin in young adulthood, this case becomes more frequent with age. Sudden hair loss in teens or young adults usually occurs due to certain illnesses, medical treatments, or poisoning (see article section below).
- Male pattern baldness is the main type of hair loss, with a case rate of 95%.
- About 25% of men who suffer from baldness start experiencing the process before they reach the age of 21.
Step 2. Look at the condition of relatives from both sides of the family
The claim that baldness only results from the mother's side (if your mother's father is bald, you will be bald too) is a myth. Genetics accounts for 80% of all baldness cases, but you are also at risk of baldness if your father or grandfather on the other hand is also bald. So, take a look at the male grandparents, great-grandparents, uncles, and cousins (all first or second relatives) and see if their hair is still intact. If not, look at the extent of their hair loss and ask them when they first experienced it. The more of your relatives who are bald, the greater your risk of going bald.
- One of the genes that causes baldness is passed from mother to child, but the other genes are passed normally, so a bald father can have a bald son too.
- Baldness occurs when the hair follicles on the scalp shrink, resulting in shorter and finer hair. Eventually, these follicles no longer grow new hair, although they are still alive.
Step 3. Understand the effects of steroids
Sex hormones called androgens are another primary factor that causes male pattern baldness. However, the main culprits are testosterone and dihydrotestosterone (DHT). Testosterone will turn into DHT with the help of an enzyme found in the oil glands of the hair follicles. Too much DHT will shrink the follicles, making it difficult for hair to grow and survive. This problem is caused by too much testosterone and/or too much DHT on the receptors of the scalp follicles. Abnormal/sensitive binding of DHT is a gene problem, but it can also be caused by steroid use - especially in young men looking to gain muscle mass to build body or gain athletic gains. Thus, anabolic steroids increase the risk of baldness, with almost 100% certainty if you use them long term.
- You can lose 50-100 strands of hair every day, depending on your lifestyle. If more hair is falling out, you are experiencing baldness or another condition that affects the hair follicles and scalp.
- Drugs used to treat hair loss, such as finasteride (Propecia, Proscar), work by preventing the conversion of testosterone to DHT.
Step 4. Understand the correlation of baldness with prostate growth
Another indication that you are experiencing or at high risk of baldness is the growth of the prostate gland. Prostate overgrowth is a common occurrence with age. This growth is also associated with DHT levels. So if you are experiencing the signs and symptoms of an enlarged prostate and suspect you are also suffering from baldness, then it's not just your imagination: the two conditions above are interrelated because of high levels of DHT.
- Signs and symptoms of baldness include increased frequency of urination and decreased ability to hold urine, difficulty starting or stopping urination, pain when urinating, or bed-wetting.
- Other medical conditions associated with male pattern baldness include prostate cancer, coronary heart disease, diabetes, and high blood pressure.
Part 2 of 2: Recognizing the Signs of Baldness in Men
Step 1. Keep an eye on your hairline
Male pattern baldness usually starts at the front of the scalp, which is called the frontal hairline. This hairline will gradually move back and form the letter "M" in people who are bald. Their foreheads will also lean back more than the center of their scalp. Eventually, their hair will become thinner and shorter, creating a horseshoe pattern on the sides of the head. This pattern is a sign of advanced baldness, although some men may continue to be completely bald.
- You can keep an eye on your hairline by looking in the mirror and comparing yourself to photos of you when you were younger.
- The letter "M" pattern is a unique feature of most cases of male pattern baldness, as hair in the forehead area (and crown of the head) appears to be very sensitive to changes in DHT levels.
- However, some people don't have an "M" pattern. They may have a crescent pattern - with the entire front hairline pointing backwards and not forming a "hilltop".
Step 2. Check the crown of the head
Apart from the thinning and diminishing frontline of hair, the same process can occur at the top (crown) of the head. Sometimes, baldness at the crown precedes a thinning hairline. In other cases, this baldness occurs after or at the same time. Hair follicles at the crown of the scalp are more sensitive to changes in DHT levels - especially when compared to hair follicles above the ears or at the back of the scalp.
- To check the crown of the head, hold a hand mirror above it while looking at the wall mirror. You can also ask a friend for help to photograph the crown of the head. Compare the photos over time to assess the extent of hair loss.
- A sign on the front that can indicate hair loss is the side/middle of the hair that is getting wider.
Step 3. Look for hair loss on your pillow and comb
Hair will fall out every day and this is normal - hair will grow back soon too. However, severe baldness will cause a high amount of hair loss. Keep your pillowcase clean and watch how much hair falls out while you sleep (take a photo to document it). If the number of hair loss is more than a dozen, this may be a cause for concern. If you're using a hairbrush, make sure it's clean and compare after you've used it. Brushing your hair is more likely to fall out naturally (especially if you have long hair). However, be aware that if you are losing more than a few dozen hairs, this is not normal and you may be going bald.
- If your hair is dark, use a light-colored pillowcase to look for loose hair. Instead, use a dark pillowcase if you have light hair.
- Use conditioner when shampooing to reduce tangles. Conditioner prevents hair loss as a result of combing or brushing.
- If you have your hair styled in a ponytail, consider breaking it down while you sleep. The strength of the pigtails can cause more hair to fall out when you change your posture at night.
- Be aware that the early stages of baldness will make your hair thinner and shorter, not necessarily falling out.
Step 4. Distinguish other causes of hair loss
Although baldness is the main cause of hair loss in men, there are other things you should also know about, for example: disorders of the endocrine glands (pituitary, thyroid), malnutrition (especially protein), fungal infections, iron deficiency, excess vitamin A or selenium, overtreatment (especially retinoids and anticoagulants), and cancer treatments (chemotherapy, radiation).
- Severe hair loss in all areas of the scalp in a very short period of time is not a problem of baldness. This may be related to toxic levels in the environment, excessive medication, high levels of radiation, or extreme emotional trauma (because of shock or fear).
- If your hair is cracked and contains dead skin all over your scalp, you may have a tapeworm infection. Other symptoms include damaged hair, swollen, reddened skin, and a rash.
- Some hair care methods, such as hot oils, hair dyes, or chemical hair straighteners, can damage the scalp and cause permanent hair loss.
Step 5. Consult a hair loss specialist
To determine if you are going bald, make an appointment with a hair loss specialist, who is usually a dermatologist or specialist. Male pattern baldness is usually diagnosed based on the appearance and pattern of hair loss. However, the doctor will also ask about your relatives (especially from the mother's side) and carefully examine the scalp with enlargement (with a device called a densitometer) to check the degree of hair follicle shrinkage.
- You don't need a hair analysis or scalp biopsy to accurately diagnose hair loss.
- Your doctor should tell you about all the potential treatment methods for baldness, not just the necessary medications or hair transplants.
Tips
- Early detection of baldness and proper treatment with medication can slow hair loss in most people, although you should also be aware of the side effects. Know that actually baldness can not really be overcome.
- Men with mild to moderate cases of baldness can usually hide the extent of their hair loss with the right haircut or hairstyle. Ask for a power cut to make your thinning hair look fuller (just make sure you avoid looking too fluffy!).
- Some options for treating advanced baldness include hair transplants, laser treatments, adding strands, and wearing wigs.
- Some men prefer to shave their entire head instead of having a "horseshoe" look. Fortunately, people who are bald don't get too bad of a stigma these days.
