Male pattern baldness, also called androgenetic alopecia, affects more than 80% of the male population over the age of 50. This disorder is associated with genetic factors, but it is also caused by an overproduction of male sex hormones, androgens (especially dihydrotestosterone), which help regulate hair growth. Hair loss can be sudden or gradual, but usually follows a thinning pattern that starts at the forehead and progresses towards the crown of the head. If you know the process of the development of baldness and some risk factors, you can understand more precisely if you suffer from this disorder.
Steps
Part 1 of 2: Understanding the Risk Factors
Step 1. Consider your age
The incidence of baldness increases significantly over the years. Age is one of the three main factors affecting this disorder (besides the hereditary factor and hormonal imbalance). In the Western world, up to two-thirds of men around age 35 start to show signs of baldness, but this percentage rises to over 80% among men over the age of 50. Therefore, you need to take your age into account and relate it to hair loss. Although androgenetic alopecia can begin in the early years of adulthood (albeit rarely), in reality in most cases it develops over the years. Sudden hair loss at a young age or during adolescence is usually associated with some disease, medical treatment, or even toxicity (as described below).
- Although alopecia can begin to manifest in early adulthood (albeit rarely), it becomes a much more common problem later in life. Sudden hair loss in adolescence or early adulthood is usually related to some disease, certain medical treatment, or intoxication.
- Androgenetic alopecia is the most common type of hair loss in men and accounts for 95% of total baldness cases.
- About 25% of men with this disorder begin the process before age 21.
Step 2. Observe the male relatives of both of your parents
It is a popular misconception that baldness is inherited from the mother and that if the maternal grandfather was bald, so will the grandson. In this disorder, the genetic factor has an 80% incidence, but you are equally likely to lose your hair if your father or paternal grandfather is bald. For this reason, also check your father, your grandfather, uncles and cousins (first and second degree) on your father's side, to see if they still have thick hair. If not, take note of the degree of hair loss and ask them when they noticed the first signs of baldness. The greater the number of hairless relatives, the more likely you are to be affected by this disorder.
- Research from 2001 suggests that young adult children of a parent with alopecia are 5 times more likely to lose hair than those with a parent who does not.
- A gene that triggers different types of baldness is passed from mother to child, but others have a hereditary transmission that meets generic criteria; for this reason, a bald father can have a son with the same problem.
- Androgenetic alopecia occurs when the hair follicles on the scalp shrink over time, resulting in shorter, thinner hair. Eventually, the atrophied follicle no longer produces new hair, although it typically remains alive.
Step 3. Understand the impact of taking steroids
Male hormones called androgens are another factor in male pattern baldness. The main culprits are testosterone and dihydrotestosterone (DHT). Testosterone converts to DHT with the help of an enzyme found in the sebaceous glands of the hair follicles. When DHT is present in excessive amounts, it shrinks the follicles, making healthy growth of resistant hair impossible. This problem is caused both by the excessive amount of testosterone in circulation, and by a too strong bond of DHT with the receptors of the follicles present on the scalp. Excessive binding or sensitivity to DHT is primarily a genetic factor, but another cause of high levels of this hormone is the use of steroids, particularly among young men who want to gain muscle mass for athletic or bodybuilding purposes.. Therefore, a considerable and prolonged intake of anabolic steroids increases the risk of baldness by almost 100%.
- There are no huge differences between the testosterone levels of men with alopecia or not. However, men with baldness tend to have higher DHT production rates.
- It is completely normal to lose around 50-100 hairs each day, depending on your lifestyle, but if you do fall a lot more, it is a sign of male pattern baldness or other ailments affecting the hair follicles or scalp.
- Drugs that are used to treat androgenetic alopecia, such as finasteride (Propecia, Proscar), work by preventing the conversion of testosterone to DHT.
Step 4. Understand the correlation with prostate growth
Another factor that indicates the presence of this disorder or the risk of being affected is the growth of the prostate gland. Benign prostate growth is a very common feature over the years and is related to DHT levels. Therefore, if you notice the signs or symptoms of an enlarged prostate and suspect that you are suffering from baldness, you are probably seeing a fact, because both are caused by a high level of DHT.
- Symptoms that indicate an enlarged prostate are an increase in the frequency and urgency to urinate, difficulty in starting or stopping the flow of urine, pain when urinating, incontinence.
- Other medical ailments related or associated with male pattern baldness are prostate cancer, coronary heart disease, diabetes and chronic high blood pressure (hypertension).
Part 2 of 2: Recognizing the Signs of Male Pattern Baldness
Step 1. Monitor your hairline
Male pattern baldness usually begins in the frontal area of the scalp, called the front hairline. This gradually begins to recede and almost all people with this disorder get their hair in the shape of an "M", with hair starting to disappear from the temples to beyond the central part of the head. In addition, the hair also begins to get thinner, shorter and takes on a horseshoe-shaped arrangement around the sides of the head. This is a sign of late stage androgenetic alopecia, but in some men it progresses until the head becomes completely bald.
- To make it easier for you to check your hairline, look in the mirror and compare the image with the photos from when you were younger.
- The "M" shaped hairline is a typical feature of male pattern baldness, because hair at the temples (and crown) is the most sensitive to DHT levels.
- However, some men do not have this arrangement, but rather show a crescent, where the entire front hairline retracts evenly and does not leave the "widow's peak".
Step 2. Check the central area of the head
In addition to a thinning and withdrawal of hair from the front hairline, the same process can occur on the top (crown) of the skull. In some cases, baldness in this area precedes that on the hairline, other times it occurs later, while in other people it occurs at the same time as the frontal recession. As previously described, the hair follicles of the central area of the head appear to be more sensitive to DHT levels - much more so than those above the ears or on the back of the head.
- To check this area of the head, you need to grab a manual mirror and bring it over your head while looking at the reflected image in a wall mirror. Alternatively, ask a friend or partner to take a photo of the crown of the hair. Compare the photos over time and try to figure out if the baldness has spread.
- A sign in the front that may indicate hair thinning and loss at the crown is an enlargement of the space at the temples or a "higher" forehead in the center.
Step 3. Notice if there is hair on the pillow or brush or comb you usually use
As already indicated before, it is normal to lose hair every day, which in fact grows back, but when androgenetic alopecia is severe, the fall is abundant and definitive. Keep the pillowcase clean and pay attention to how much hair you lose while you sleep (take a photo to document it). If it's more than 10-15 a night, there might be some problem. If you use a brush, make sure it is clean and hair-free before using it so that you can examine it carefully when finished. Using the brush tends to make more hair fall out naturally (especially if it's long), but if you lose more than a few dozen it is not normal and is indicative of male pattern baldness.
- If you have dark hair, use a light colored pillowcase to clearly see the fallen hair. Conversely, wear a dark colored pillowcase if you are blond.
- Apply a conditioner when you wash your hair; This creates fewer knots and tangles, which in turn can cause more hair loss when you try to untangle it with a brush and comb.
- If you have a ponytail habit, you should consider loosening it up when you sleep. Holding your hair tight in a rubber band can induce more loss when you turn from side to side at night.
- Remember that in the first stage of baldness you may notice that your hair becomes shorter and thinner, not necessarily falling out.
Step 4. Identify other possible causes
Although androgenetic alopecia is undoubtedly the predominant factor of baldness in men, there are other causes that can cause it and that you should know, including: disorders of the endocrine glands (pituitary, thyroid), malnutrition (especially protein deficiency), fungal infections, iron deficiency, excessive intake of vitamin A or selenium, drug abuse (especially retinoids and anticoagulants), cancer treatments (chemotherapy, radiation).
- If you experience severe hair loss all over your scalp within a short period, it is not androgenic alopecia. The cause is much more likely to be due to a level of environmental toxicity (such as lead poisoning), drug abuse, high doses of radiation, or extremely intense emotional trauma (shock or fear).
- If your hair falls out in clumps, the skin looks scaly, and these spots spread all over your head, you probably have ringworm, a scalp infection. Other symptoms are breaking hair, swelling of the skin, redness and oozing of fluids.
- Rapid hair loss or any type of hair loss that occurs along with symptoms such as itchy, burning or aching scalp is likely due to underlying disease rather than (or in addition to) alopecia.
- Some hair treatments, such as applying hot oil, dyes, or chemicals used to straighten the hair, can cause scalp damage and permanent hair loss.
Step 5. See a specialist
To be absolutely certain that androgenetic alopecia is your problem, make an appointment with a hair specialist, such as a dermatologist or doctor who is trained and educated in this area. Typically, the disorder is diagnosed based on the appearance of baldness and the distribution of areas of alopecia. However, the specialist may ask you for information about your family (especially the maternal one) and will carefully examine the scalp under a microscope (with a device called a densitometer), to assess the degree of miniaturization of the hair follicles.
- It is not necessary to perform a hair analysis or a scalp biopsy to correctly diagnose baldness.
- Your doctor will inform you about all possible treatments for this problem, not just medications or hair transplant surgery.
Advice
- When baldness is detected early and treated promptly, it is possible to slow hair loss in many people, but keep in mind that drugs cause side effects and do not cure the problem.
- Men with light to moderate baldness often manage to hide the hairless areas with a proper hairstyle or hairdo. Ask your hairdresser for advice on making your thinning hair appear more voluminous (just avoid the "carryover" effect!).
- When androgenetic alopecia is at an advanced stage, you can consider having a hair transplant, laser treatments, partial toupees, extensions or full wigs.
- Some men prefer to shave their heads completely rather than have a "horseshoe" hair style. Fortunately, baldness today no longer has a negative connotation as it once did.
