Hair loss

Updated 20 April 2016

Why do men go bald?

Hair loss is something many men have to deal with at some stage in their life. But what exactly is it that causes millions of guys to go bald, especially as they get older?

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If you’re anything like me, you’ve been monitoring your gradually balding forehead in the mirror with some trepidation for the last 20 years or so. I’m not bald. Nowhere near it.

But for some time now there has been a very worrying upward trend in the location of my hairline and the V-shaped patches of bare scalp above my temples are on track to rendezvous on top of my head at some stage in the future.

"Are you going bald, daddy?" asks my 8-year-old with a mixture of concern and mischief and my loving wife has lots of fun pointing out to her friends that my forehead is now even shinier than it was last year. I’m not too worried about going topless, to be honest, but at the same time, I wouldn’t mind holding on to my skull-fur for just a few extra years. I’m barely middle-aged, for crying out loud.

So what is it that makes men lose their hair?

Male pattern baldness

What a horrible name for the most common type of hair loss in men, but the official medical term, androgenetic alopecia, isn’t a whole lot better. This is the common type of baldness that afflicts millions of men around the world as they get older – and some unfortunate soles before they even reach 30.

You know the drill: the initially dense and bushy cover starts thinning out gradually, the hairline heads north and soon enough all that’s left is a horseshoe-shaped ring of hair around a central helicopter landing pad. Not ideal until such time that “Franciscan monk” becomes a fashion trend...

The balding process begins at any time after puberty as blood levels of male hormones, especially dihydrotestosterone (DHT) rise. DHT interferes with the normal growth pattern of individual hairs, but for serious hair loss to occur, you also need the right (or should that be wrong) genetic make-up. Male pattern baldness is an inherited condition. The oft-repeated belief that it’s passed down via maternal lines is a myth – you can inherit it from either you father’s or your mother’s side, although research suggests that the influence of the maternal line is somewhat more important.

Your chances of developing male pattern baldness increase with age, but it’s most likely to start between your late teens and the time you hit 45. It may happen quite rapidly, or you may experience alternating periods of slow and fast hair loss punctuated by times of apparent stability.

Other common reasons for hair loss

  • Certain prescription drugs, for example some medicines for gout, high blood pressure, heart problems and arthritis, may cause hair loss, as will some medical treatments like radiation treatment and chemotherapy.
  • Fungus infections of the scalp can cause hair loss.
  • Men suffering from trichotillomania twist, pull and play with their hair obsessively and frequently cause it to fall out.
  • Problems with the pituitary or thyroid glands may result in hair loss.
  • Over-enthusiastic shampooing, blow-drying, combing, bleaching, dying, etc. may also lead to hair loss.

Alopecia

A small number of people are affected by varieties of alopecia other than androgenetic alopecia. Most commonly this involves one or more round bald spots on the scalp, but it can also spread to the entire scalp, affect a man’s beard or even, in rare instances, cause the loss of all body hair from top to toe. These forms of alopecia tend to be much more common in women than in men and are thought to involve an autoimmune disorder – an abnormality in the immune system – in which a sufferer’s body attacks its own hair follicles and suppresses hair growth.

What to do?

Loss of hair can have a major effect on a man’s self-esteem and confidence, causing anxiety, social phobias and depression. But don’t let it get you down, there are a number of things you can do:

  • Whatever you do, don’t ever go for the comb-over approach of trying to disguise a bald patch with a strand of extra-long hair. It looks daft 100% of the time!
  • Get used to it: embrace your baldness and be proud of it. Bald heads are sexy!
  • Try a wig. You’ll be surprised how authentic modern hair pieces can look. But stay away from those spray-on scalp dyes that are supposed to create the impression of fuller hair – they’re just a little too desperate.
  • Some medicines do work for some men. Minoxidil is a solution applied to the scalp to stimulate hair follicles and finasteride is an oral prescription drug that inhibits the production of DHT.
  • If you’re up for it, try hair transplants or other types of scalp surgery.
  • For the more unusual types of alopecia, the hair will usually re-grow within a year without treatment in about 50% of the patients and at a later time in nearly all of them. There is no single treatment, although some success has been reported with topical ointments and steroid injections, creams and shampoos. 

Read more: 

Triggers for hair loss 

Hair transplant caution 

Hairlessness is attractive 

     

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