As people get older, they’re increasingly on the lookout for signs and symptoms of balding. If you think you might be balding, chances are that you’ve noticed hair loss around your temples or crown. You may have also noticed a receding hairline or thinning hair. For other people, the first sign is identifying areas where hair isn’t growing back the way it usually would.
The trouble is that some of these symptoms are signs of balding, while others are indicative of other hair loss disorders. In order to determine whether or not you’re going bald, you first need to determine the cause of your hair loss.
Hair loss disorders that cause balding
Various hair loss disorders have the potential to cause balding. The most common cause is known as androgenic alopecia (often referred to as pattern hair loss), a condition caused by both genetics and hormones. Other hair loss disorders that can cause baldness include alopecia areata and scarring alopecias.
Whether or not you’re seeing actual signs of balding will depend on the symptoms you’ve been experiencing, and which type of hair loss they’re indicative of. Certain types of hair loss are progressive and cause eventual baldness. Others are temporary, which means your hair will grow back.
All that being said, some of these temporary types of hair loss can occur multiple times in your life. They may also have the potential to turn into more permanent hair loss.
Identifying the first signs of androgenic alopecia: The most common cause of balding
Although pattern hair loss is most often associated with older men, it can actually occur to adults of all ages. Since this type of hair loss is progressive, it will always eventually result in baldness… unless it’s treated.
Androgenic alopecia is known for causing hair loss at the temples and top of the head. But these symptoms are often more indicative of mid or late stage pattern hair loss. Early signs of balding tend to be much more subtle. You’re more likely to see hairline changes or thinner, weaker hair. And if your hair seems weaker, there’s a good chance that it’s falling out in larger amounts than usual.
Hairline changes and receding hairlines
A receding hairline is a quintessential sign of androgenic alopecia. But actually determining whether or not your hairline is receding can be challenging for most people. This is because everyone’s hairlines naturally shift and recede a bit as they age. It’s perfectly normal to not have the same hairline that you did when you were a teenager or child.
People with androgenic alopecia will often notice that their hairline is changing shape. They might start to develop an uneven hairline, or simply feel like their foreheads are larger than usual. In some cases, they might also notice an excessive amount of thinning hairs or smaller hairs framing their face. This is a sign of miniaturization, where hairs get smaller and thinner before they stop growing back completely.
The easiest way to tell if your hairline is receding is by measuring it. According to a study in the Facial Plastic Surgery Clinics Of North America Journal, most men’s hairlines recede about 1.5 to 2 centimeters. A little variation beyond this amount can still be normal, but much more is likely to be indicative of a receding hairline.
To determine how much your hairline has receded, simply find the highest wrinkle on your forehead. The wrinkle that forms at the very top of your head can help you identify the location where your childhood hairline once was. You can then measure the distance between this wrinkle and the point where your hairline starts. If the distance is much more than 2 centimeters, there’s a good chance you’re seeing a receding hairline.
Thinning hair and widening partitions
A widening part is also a sign of thinning hair or hair loss. Like the initial signs of a receding hairline, this symptom of hair loss starts out subtle and increases over time.
Rather than seeing hair loss in a specific spot, like the temples or crown, a widening part is indicative of both generalized hair loss and hair thinning. It’s most common in women with androgenic alopecia, but men with thinning hair will also see it — particularly if they tend to part their hair to one side, near one of their temples.
Thinning hair and hair shedding
Thinning hair implies that your hair strands are literally getting thinner in diameter. And the thinner these strands get, the weaker they’re likely to be, too.
It’s normal to lose a little bit of hair when you brush it or wash it. But if you start seeing more hair loss than average when going through your daily routine, it could be a sign of hair loss. Thinner hair is more likely to break and fall off, so keep an eye out for thin, short hairs — particularly framing your face or at the top of your head.
Later signs of balding in androgenic alopecia
Many people struggle to recognize the initial signs of androgenic alopecia. As it progresses, hair loss symptoms become increasingly more and more obvious. People with pattern hair loss start to see hair loss in distinct areas, like the temples or crown of their heads. At this stage, their hairlines will be much more obviously affected.
Temple hair loss
Temple hair loss refers to hair loss at the sides of your head. People with this hair loss symptom lose hair directly above their temples, affecting their hairlines as it gives them the appearance of an exaggerated widow’s peak. If allowed to progress to mid-stage androgenic alopecia, it’s common for the hairline to form a distinct ‘M’ shape.
A widow’s peak, or heart-shaped hairline, should not be confused with temple hair loss.
Distinctly receding hairline
When pattern hair loss is allowed to progress past a certain point, people can lose most of the hair framing their face. While they might still have a substantial amount of hair growth on their head, these receding hairlines often make people’s foreheads look very large. At this stage, it becomes very obvious that people are going bald.
Hair loss at the crown
Hair loss at the crown refers to hair loss at the very top of your head. Imagine where you’d place a crown if you were a king or queen. That’s exactly where hair loss is likely to occur. This type of hair loss starts out slow, usually in the form of thinning hair, and increases over time. It can be hard to notice at first because it’s at the back of your head, though.
Eventually, all of the above symptoms start to occur in tandem. Since hair stops growing back, it becomes increasingly hard to not notice that this type of hair loss is occurring. When left untreated, the combination of all of these hair loss symptoms will result in eventual baldness.
Signs of balding caused by other hair loss disorders
Hair loss disorders generally cause patchy, diffuse, or temporary hair loss. Only a handful of conditions are likely to cause permanent hair loss and complete baldness.
Alopecia areata
Alopecia areata is an autoimmune form of hair loss that can (but doesn’t always) cause balding. This condition is a bit peculiar since it can go away for some people, but may be permanent for others.
Alopecia areata most often presents as round patches of hair loss. These patchy spots of hair loss typically appear on the scalp, but the condition isn’t restricted to this part of the body. It can affect multiple parts of the body beyond the scalp, like the eyebrows or even your body hair.
Alopecia areata can occur to people just once or may be recurrent. Whether or not this condition will result in permanent hair loss depends on your body’s immune system.
Scarring alopecias
Like alopecia areata, scarring alopecias are a type of hair loss caused by autoimmune issues. A study in the Skin Appendage Disorders journal says that in these conditions, the body attacks either the skin or the hair follicles, preventing hair from growing back.
Scarring alopecias are very likely to lead to permanent hair loss and baldness. This is because, as their name implies, they cause scarring that prevents hair regrowth. And like with other autoimmune conditions, scarring alopecias can be hard to treat and prevent the progression of — hence why hair loss is consequently often permanent.
When people think of scarring, they often imagine a huge, visible scar like an injury or burn. But with scarring alopecias, scarring can simply mean that the hair follicle or skin around it has been permanently damaged and is now incapable of producing hair. These scars could be completely imperceptible to the naked eye.
Telogen effluvium (Stress related hair loss)
Stress has the potential to cause excessive hair shedding and hair loss. This condition, known as telogen effluvium, can occur following both physiological and psychological stress. In this condition, people experience hair loss that occurs shortly after a stressful event or situation.
When you hear the word stress, you might immediately think psychological stress – like someone robbing your house, a death in the family, or losing your job. But according to a study in The Journal of Medicine and Life, stress can mean a lot more than that. Stress can also be physical, like an injury or illness that has affected your body. It can also be a combination of these things, like the COVID-19 pandemic has been for many people.
The extent that telogen effluvium affects your hair can vary widely. You might notice some symptoms similar to androgenic alopecia, like thinning hair or a widening part. Or, you might see sudden bursts of hair loss that might remind you of alopecia areata. It’s also possible to lose a huge amount of hair — though in telogen effluvium, this typically presents as diffuse hair loss.
The good news is that despite the similarity in symptoms to other conditions, stress-related hair loss isn’t permanent. In most cases, your hair will naturally start to grow back a few months later.
Of course, if you’ve gone through a serious physical illness, your body might struggle to recuperate and hair regrowth can be slower. In these cases, your doctor might recommend that you use a hair loss treatment like minoxidil to help restart hair growth.
How to prevent balding: Treatments for androgenic alopecia
If you have androgenic alopecia, the good news is that you have a myriad of hair loss treatments at your disposal. The Food and Drug Administration recommends three different types:
- Minoxidil, which is available as a topical serum or foam in concentrations of 2 and 5 percent
- Finasteride, which is available as a pill you need to take each day
- LLLT (low level laser therapy), which is sold as a device you can use at home or a treatment administered in clinics
All three of these treatments are effective at stopping the progression of pattern hair loss. They can also counteract hair loss symptoms and help you regrow hair.
But of course, these treatments work best when they are started early. You’re likely to see the best effects if you start as soon as you identify the first symptoms of hair loss.
If you don’t start a hair loss treatment early, it will be much harder to get your hair to grow back. People who wait a long time to deal with androgenic alopecia often end up needing a hair loss transplant in addition to these treatments. Although hair loss surgeries tend to be very successful, they come at a high premium.
Hair loss treatments for other hair loss disorders
Telogen effluvium generally doesn’t require any treatment as it’s a temporary form of hair loss. But in certain cases, doctors may recommend use of minoxidil. Although this treatment is only FDA-recommended for androgenic alopecia, it works by increasing blood flow to the scalp to promote hair growth. This means that it has the potential to help in this and certain other hair loss disorders.
Autoimmune conditions like alopecia areata and scarring alopecias are often hard to treat. Generally, you’ll want to talk to your doctor about specific medications, like steroids, that may be able to help combat these conditions. When these medications do work, doctors sometimes recommend minoxidil to help boost hair regrowth.
However, keep in mind that these treatments aren’t always permanent. If your condition returns, it’s likely that you’ll need to restart these treatments at a later date. And if you’ve been experiencing repeated bouts of scarring alopecia, treatments like minoxidil will have no effect as your hair follicles won’t be able to produce new hairs.
Takeaway: Balding is usually treatable
Various types of hair loss disorders can cause balding. The most common cause of hair loss, androgenic alopecia, is progressive and guaranteed to result in baldness if left untreated. Since this condition is partially due to genetics, you might already be on the lookout for any signs of going bald.
The main signs of male pattern baldness are pretty obvious, presenting as distinct hair loss around the hairline, temples, and crown. But the very first signs of balding are more likely to feature an array of subtle symptoms, like hairline changes, a widening part, and hair thinning at the crown and temples.
It’s easiest to combat male pattern baldness when treating it early on. FDA-approved medications like minoxidil and finasteride, as well as FDA-recommended LLLT devices are all good ways to fight patterned hair loss and regrow hair.
While rare, it’s also possible for autoimmune conditions like alopecia areata and scarring alopecias to cause baldness. If an autoimmune condition is causing you to lose hair, talk to your doctor immediately. Although minoxidil can sometimes help regrow hair, these hair loss disorders often require specific medications, like steroids, to stop their progression.
