Most people associate hair loss and balding with old men. The unfortunate truth is that men can start losing hair at almost any age. For most people, hair loss is caused by androgenic alopecia. This condition is progressive — which means it will keep getting worse, and is unlikely to stop unless you start a treatment.
Of course, not all men go bald. But the percentage of men who go bald is surprisingly high. Around 50 percent of men have major hair loss by the time they’re 50 years old, and nearly 75 percent see signs of balding by age 80.
Why do men go bald?
Not all hair loss is the same. There are different types, with conditions and causes that vary from person to person. Hair loss can be related to your immune system, genetics, and even involve external factors, like medications or your diet.
That being said, the American Hair Loss Association says that 95 percent of cases in American men are due to a condition called androgenetic alopecia (commonly called male pattern hair loss). This condition is primarily caused by a mixture of hormones and genetic factors.
If you’re losing your hair due to male pattern baldness, you’re probably seen a few common symptoms, like thinning at the temples or a bald patch developing around the crown of your head. You’ll also see a receding hairline, which will become more pronounced over time.
What causes baldness?
As the “genetic” in androgenetic alopecia suggests, this hair loss condition is passed on through your family. Initially, it was believed that if you inherited a recessive ‘baldness’ gene from your mother, you were more likely to develop male pattern baldness.
Recent research suggests that this is a little more complicated. A variety of genetic markers are actually thought to be involved. And your father’s genes are now thought to play a significant role, too.
Male pattern baldness also involves a hormonal component. It specifically involves a reaction to an androgen called dihydrotestosterone (DHT). DHT is derived from the main male sex hormone, testosterone.
When hair follicles are exposed to DHT, they start to shrink. This process is known as miniaturization. Eventually, once they get small enough, the follicles stop growing altogether.
Do bald men have more testosterone, then?
Both testosterone and DHT are normal hormones that are important for human health. Bald (or balding) men with androgenic alopecia don’t have more testosterone circulating in their bodies. They don’t have more DHT in their bloodstreams, either. This is actually a common misconception.
What changes, then? It’s actually your hair follicles, and their ability to bind DHT. People with androgenic alopecia have hair follicles that have receptors capable of being affected by DHT. This is the reason that DHT-blocking drugs and nutraceuticals can be used to counteract androgenic alopecia’s progression. But not all of them work in the same way. Some of them remove some of the DHT from your body — while others simply prevent it from binding to your follicles and exacerbating hair loss.
So, when does male pattern baldness start?
You might think it’s uncommon to start experiencing symptoms of hair loss in your thirties, twenties, or even teens. The unfortunate truth is that it’s probably more common than you’d expect.
Research in the South Medical Journal by experts on male pattern baldness, Drs. O’Tar Norwood and James Hamilton, studied the progression of hair loss with age. They developed the Norwood-Hamilton scale, which is used to measure and classify the different stages of hair loss.
The study indicated that:
- Around 20 percent of men younger than 25 years old will notice the first signs of balding.
- By the age of 35, roughly 40 percent of men will experience some hair loss.
- More than 50 percent of men will have significant hair loss by the time they reach 50 years of age.
Another study in the Journal of Investigative Dermatology Symposium Proceedings also showed that balding increases with age. Taking a sample of 68 males, the study found that 73.5 percent of men aged 80 or more had significant hair loss on their crown and hairline.
Rates of balding vary by country and heritage
America is known for being a multiracial society. But the demographics of this country are still skewed. Studies don’t always look at a perfectly diverse racial distribution representative of the country’s population. In fact, the Norwood scale was designed looking at only white men.
What does this mean? Well, if you’re a first or second generation American, your likelihood of going bald could be less (or more) likely than the percentages listed above. You might also start to see hair loss symptoms at a completely different age.
For example, a study in the journal Expert Opinion on Drug Safety reported that Caucasians are more likely to have androgenic alopecia compared to people of Asian or African American descent. The age at which you go bald can also be different based on your specific racial heritage. The same study reported that Japanese people are likely to start experiencing androgenic alopecia hair loss symptoms a decade later than Caucasians.
Similarly, a study of Korean men from the British Journal of Dermatology noted that male pattern baldness increased significantly with age, but at a much lower prevalence than in Caucasian males. Only 2.3 percent saw any signs of balding in their twenties, 4 percent in their thirties, and 24.5 percent in their fifties. A significant portion of participants had a family history of baldness (48.5 percent).
What to do once you start seeing hair loss
Even if you’re young and healthy, hair loss can still be a problem. It might feel like you’re the only one going through it, but research shows that it’s pretty likely you have friends or acquaintances who are starting to see similar changes to their hair.
Like any unwanted change to your appearance, hair loss can affect your personal life and self-esteem. The good news? It’s often easy to grow your hair back if you identify the problem early on. Even if you think you’ve left it too late to act, there are still options. However, the treatments available for those with more extensive hair loss are likely to be more complicated, expensive, and time-consuming.
Have scientists developed a baldness cure yet?
Unfortunately, there is currently no male pattern baldness cure. However, there are a myriad of different treatments you can choose from.
Some, like minoxidil, finasteride, and low level laser therapy, are extensively tested and approved by the Food and Drug Administration. Others, like FUE and FUT (Follicular Unit Extraction and Follicular Unit Transplantation, respectively) are surgical procedures that are particularly popular among celebrities. And of course, there are various natural options, like DHT-blocking supplements and hair loss shampoos.
In order for scientists to develop a baldness cure, they’d have to be able to isolate the exact cause of baldness and be able to either prevent it or reverse it. Right now, that’s pretty complicated — particularly because of the genetic component of this condition.
A recent study in Nature Communications identified 71 different genetic regions across various chromosomes that are associated with androgenic alopecia. But those regions were only responsible for 38 percent of the chance of this condition. As research progresses, we’ll undoubtedly find more genetic components associated with pattern baldness — but for now, with so much left unknown, a cure is in the distant future.
Other causes of hair loss
While male pattern baldness is undoubtedly the most common cause of hair loss, it’s not the only cause. The good news is that most other forms of hair loss are temporary, which means they’re also resolvable.
Stress-related hair loss: Telogen effluvium
Stress, whether it’s physical or emotional, has the ability to cause hair loss. If you’re under a considerable amount of stress, it’s possible you may be suffering from a condition called telogen effluvium. The good news is that this condition can often resolve without treatment once the source of the issue is managed.
Stress can disrupt the hair growth cycle. It essentially causes your hair to shed more rapidly than it would normally. If you’re experiencing telogen effluvium, you might see excessive hair shedding. You might also notice that your hair seems less voluminous as it’s growing back more slowly.
It’s technically possible to experience telogen effluvium in conjunction with other types of hair loss, including androgenic alopecia. However, there hasn’t been any conclusive research on whether stress further speeds up the rate of male pattern baldness.
Medication-related hair loss
Some medications can cause significant and sometimes sudden hair loss. If you have been prescribed medications for acne that contain isotretinoin, the Journal of Cosmetic Dermatology says that hair loss could be a side effect. Keep in mind that this is only likely to occur if you’ve been taking the medication for a while or in high doses. However, if you suspect a medication is affecting your hair, it’s worth talking to your doctor or dermatologist about alternatives.
According to studies in the journal Haematologica and the British Journal of Haematology, antibiotics can lower your levels of B-complex vitamins and hemoglobin, which can cause anemia and prevent optimal blood supply to tissues. This is usually a temporary issue, however, and any hair loss as a result of taking antibiotics should cease once you stop taking them.
A study in the Dermatologic Clinics journal reported that blood thinners and drugs that regulate your blood pressure can also cause hair loss. Other medications that can induce alopecia include chemotherapy drugs and certain contraceptives and antimicrobials. Antidepressants and mood stabilizers have also been identified as medications that may cause hair loss as a side effect of treatment.
If you have concerns about your hair thinning or excessive hair shedding, check with your doctor about any prescription or over-the-counter drugs you’re taking. You might find that your concerns are put to bed by simply changing to a different medication.
Autoimmune types of hair loss
The American Academy of Dermatology describes alopecia areata as an autoimmune disorder where the body attacks hair follicles to stop them from growing. In this condition, hair loss occurs in patches and may fall out suddenly.
Unlike androgenetic alopecia, which only affects hair on your scalp, alopecia areata can also affect all hair on your body, from eyelashes and eyebrows to your beard and sideburns. It can even affect the hairs inside your nose and ears. However, this form of total hair loss is generally quite rare.
Most people only experience alopecia areata symptoms during childhood or their teenage years. In many instances, their hair even grows back without any treatment. This means that people with alopecia areata could go bald as infants or toddlers, but in this case, baldness isn’t necessarily permanent.
If this condition doesn’t go away on its own, it can be pretty hard to treat. Since alopecia areata is an autoimmune issue, a doctor will need to prescribe steroids and other medications to try prevent further hair loss.
Like alopecia areata, scarring alopecias are an autoimmune form of hair loss. According to an article in Current Problems in Dermatology, scarring alopecias can either directly affect hair follicles, or they can affect the skin and consequently destroy hair follicles as a result.
Regardless of how they happen, scarring alopecias involve the replacement of hair follicles with scar tissue or collagen. A study in the journal Actas Dermo-Sifiliográficas says that this process destroys the hair follicle’s ability to produce hair, resulting in permanent hair loss. Scarring alopecias go by a variety of names, and include conditions like:
- Chronic cutaneous lupus erythematosus
- Lichen planopilaris
- Central centrifugal cicatricial alopecia
- Alopecia mucinosa
- Keratosis follicularis spinulosa decalvans
- Folliculitis decalvans
- Dissecting cellulitis
- Acne keloidalis nuchae
- Acne necrotica varioliformis
- Erosive pustular dermatosis
Out of all these other types of hair loss, scarring alopecias are the hardest type to treat. They are the most likely to cause permanent bald patches or baldness.
So, at what age do men start balding?
Theoretically, balding can happen at any age. It really depends on what kind of hair loss condition you have, your lifestyle, medication, stress, and other factors.
If you’re fairly sure you have male pattern baldness, though, you can learn more about hair loss, treatments, and other ways to prevent further hair loss or increase hair growth.