Hair loss can be caused by a myriad of different factors, from immune system issues to an increase in certain hormones. The most common cause of baldness is due to a condition called androgenetic alopecia (also known as male pattern hair loss). As its name implies, there is a genetic component to this progressive form of hair loss.
That being said, there’s no single male baldness gene culpable for pattern hair loss. And a number of different factors, including your hormones, racial background, and the foods you eat, can play a role in how quickly hair loss symptoms progress to baldness. So if you were hoping you could just blame your mom or dad for your hair loss, you probably can’t!
What causes male pattern hair loss?
Pattern hair loss affects most men at some point in their lives. According to a Journal of the American Academy of Dermatology article, it affects 58 percent of men over the age of 50, and 73 percent of men over the age of 80. This condition is generally thought to be caused by two main factors: genetics and hormones.
According to a study in Nature Communications, androgenic alopecia is seen as a heritable, polygenic (multi-gene) condition. While it was once thought to be inherited from your mother’s side of the family, research now shows that it can be inherited from either side of the family.
A study in Clinical and Experimental Dermatology says that androgenic alopecia is a multifactorial disorder. When it starts and its progression are due to interactions between your environment and different genes.
Male pattern baldness genetics
Hundreds of genetic loci (where genes can be found on chromosomes) have been linked to androgenic alopecia. But even now, the genetic component behind this progressive form of hair loss is poorly understood.
Most studies consider the main gene behind androgenic alopecia to be the androgen receptor (AR) gene. The AR gene, which is located on q11–q12 on the human X chromosome, is thought to play a role in regulating androgen hormones and their interactions with hair follicles.
Male pattern baldness hormones
The main hormonal component behind male pattern baldness is a hormone called dihydrotestosterone (DHT). Elevated DHT levels are the culprit behind hair follicle miniaturization, where follicles shrink and produce thinner, weaker hairs.
Hair follicle miniaturization usually progresses in a defined pattern. You usually see hairline changes, like a receding hairline and thinning hair around the temples, as the first signs of androgenic alopecia. According to a Dermatologic Clinics study, this is followed by other common symptoms, like temple hair loss, thinning hair at the top of the head, and hair loss at the crown.
If left untreated, men will eventually go bald – but only at the top of their heads. There’s usually a thin strip of hair left along the sides of the head (by the ears), and along the back of the scalp.
Other androgenic alopecia risk factors
Male pattern hair loss is often referred to as a condition that’s caused by genetics and hormones. But there are quite a few other risk factors that may increase your likelihood of developing this condition. And your genetic predisposition to going bald may determine how much of a role these additional factors play.
For example, an article in the Annals of the Russian Academy of Medical Sciences analyzed people with a high and low genetic predisposition for developing androgenic alopecia. They found that hair loss in people with a high genetic risk for androgenic alopecia had not only been affected by genetics, but also by metabolic and nutritional factors.
In contrast, people with less of a genetic predisposition to male pattern baldness still had hair loss that was caused by their genes, but was more strongly influenced by other factors, including:
- Elevated levels of DHT and other hormones, including insulin.
- Deficiencies in essential nutrients like magnesium, calcium, zinc, selenium, and vitamins B9, D, and E.
These differences highlight that the impact DHT levels have on the progression of androgenic alopecia may vary from person to person. But they also show that other aspects of daily life, like your diet and sun exposure, may also influence pattern hair loss.
Where does the bald gene come from?
Honestly, no one really knows the origin of the bald gene – or more accurately, since androgenic alopecia is considered polygenic, ‘bald genes’. But a study in the Medical Hypotheses journal proposed that it might actually be a protective mechanism that developed in order to reduce the risk of prostate cancer.
This might sound strange, but this theory is based on vitamin D and the way the human body absorbs this nutrient from ultraviolet light. Sun exposure – and consequently higher levels of vitamin D – are thought to potentially reduce the risk of advanced prostate cancer, while low levels increase your risk of other diseases, including rickets and heart problems.
But most caucasian individuals – who are the people at most risk of developing male pattern baldness – historically lived in high latitude areas and consequently had relatively little sun exposure. If you were a farmer in one of these relatively cold countries, this meant that you were likely wearing long sleeves and trousers, and the only exposed area of your body was your face, head, and hands.
The easiest way to increase sun exposure is consequently via the head – particularly a head that’s not covered by hair. Hair loss meant that this essential nutrient could be easily absorbed by balding people’s exposed scalp, even in places where sunlight is limited.
Although this theory might seem a bit far-fetched, other studies have also linked androgenic alopecia to prostate cancer. For example, another study in Medical Hypotheses proposed that androgenic alopecia helps protect against prostate cancer by increasing levels of DHT. The increase in DHT levels also increases levels of a different hormone, prostaglandin D2. Increased prostaglandin D2 can decrease the risk of prostate cancer and limit the proliferation of prostate cancer cells.
Male pattern baldness inheritance
Male pattern hair loss is known to be inherited, with heredity linked to about 80 percent of cases. But your racial background also plays a huge role in whether or not you’ll go bald and at what point you’ll start seeing symptoms.
According to the National Center for Biotechnology Information publication Endotext, 50 percent of people with caucasian ancestry are affected by pattern hair loss. This progressive form of hair loss is also thought to be most severe in white men, affecting them at an earlier age and causing more substantial hair loss symptoms.
While people of Asian, African, and Native American descent may experience androgenic alopecia, they generally experience less severe hair loss symptoms. For example, one of the main signs of androgenic alopecia is a receding hairline. But androgenic alopecia may affect people with these ancestries differently, allowing them to retain some or all of the hair along their hairline. If and when hair loss symptoms do progress to baldness, they’re more likely to do so once folks reach a much older age.
How to tell if baldness is in your genes
Male pattern baldness is largely seen as a complex condition since it’s polygenetic. But despite this, there are genetic tests that can test for this condition.
According to a study in the International Journal of Molecular Biology: Open Access, the most accurate way to tell if pattern baldness is in your genes is to look at the AR gene. Molecular genetic tests will look for mutations on this gene to determine your likelihood of going bald.
Hereditary hair loss treatments
The FDA has approved three treatments for androgenic alopecia. These treatments, which can help stop the progression of pattern hair loss and promote hair regrowth, are most effective for people with mild to moderate hair loss. People with more advanced hair loss can use these treatments, but may also need to consider another option, like a hair transplant.
Minoxidil was the first hair loss treatment to ever be approved by the FDA. This topical treatment works as a vasodilator, increasing blood flow to the scalp. Minoxidil is currently sold as a liquid and foam in concentrations of 2 and 5 percent. Minoxidil 5 percent is thought to be the most effective solution.
Finasteride was the second hair loss treatment to be approved for androgenic alopecia. This oral medication is meant to be taken once per day in the form of 1-milligram pills. Finasteride works as a DHT blocker, targeting the hormonal component of androgenic alopecia. You’ll need a doctor’s prescription to be able to obtain this medication.
Low-level laser therapy
Low-level laser therapy, commonly known as laser hair therapy or LLLT, is a light therapy treatment for androgenic alopecia. This hair loss treatment is pretty new, and according to an article published in the Dermatology Online Journal, was given FDA clearance in 2007. LLLT uses a variety of different tools, including combs, brushes, caps, headbands, and hoods, to deliver biostimulatory light therapy to the scalp. You can buy your own device or go into a clinic a few times a week for treatments.
There are two main types of hair transplants currently performed: FUE and FUT. FUE refers to follicular unit extraction, the removal and transplantation of individual hair follicles. FUT refers to follicular unit transplantation. In this procedure, a strip of skin is surgically removed from the back of a person’s scalp, and individual follicles are then removed and transplanted back onto the head.
FUT – or both FUT and FUE – are generally reserved for people with very advanced hair loss. FUE, on the other hand, can be used for hairline restoration and less extensive hair loss procedures.
Is baldness hereditary?
Male pattern baldness is a progressive form of hair loss that’s mainly caused by a mixture of genetic and hormonal factors. It has a strong hereditary component that accounts for about 80 percent of cases. But there are also a number of other factors that affect the development of this condition, including racial background, metabolic differences, diet, and sun exposure.
Fortunately, there are a number of FDA-approved treatments to stop androgenic alopecia from progressing to baldness. If you’re seeing mild to moderate hair loss symptoms, you can use minoxidil, finasteride, or laser hair therapy.
If you’re already balding, you can still use these treatments. But if you already have late-stage hair loss, you may also need to consider a surgical procedure, like a FUE or FUT hair transplant. The earlier you start using hair loss treatment, the better your chance of getting good hair regrowth results.