Hair loss in men can be devastating to self-esteem, confidence, and body image. Consequently, hair replacement is a huge industry. However, hair loss can also be a sign of a medical problem.
Significant baldness strikes about half of men aged 50 years. By age 70, the majority of men have the characteristic monk hairline—bald on top with hair only around the temples and back of head.
Most men feel some attachment to their hair, so when it starts coming out it is not uncommon to feel a loss attractiveness. Hair is an important component of one's looks, health, and sexuality. How someone feels about themselves can affect their interactions with others. However, all is not lost. In today's world, a completely shaven head—like that of Bruce Willis, Vin Diesel, Patrick Stewart, or Michael Stipe of REM—can be the picture of manly virility.
For most men, the dreaded loss of hair starts with a receding hairline and, with time, results in hair that covers only the back of the neck and just over the ears. If balding starts in the teen years, it is usually extensive. Some balding men only call attention to their condition by growing the hair above their ears long and then combing the scant strands across their heads. Others may wear hairpieces.
So, what causes hair loss? The male hormone androgen interrupts the natural growth cycle of hair in the front and crown regions of the scalp, but it does not happen without genetic predisposition. All you need to do is check your family tree. The most dominant part of your hair inheritance comes from your mother. If you want a view into your future, look to your mother's father and brothers.
Be careful not to assume that you have male pattern baldness because you are losing some hair. That hair loss could also be a sign of low serum iron, an early indication of a blood condition. Think about the medications you are taking. Losing your hair may be a side effect from taking certain medications, such as those that treat high blood pressure. Other medications include beta-blockers or anticancer preparations.
Hair loss may be a sign of a medical condition, such as hypothyroidism. If you want to talk with a doctor, dermatologists may be best suited to evaluate hair loss.
You can also lose a lot of hair during times of intense stress. Being shipped off to a war, losing a job, being hospitalized, or the rigors of divorce court can cause a type of balding.
For reasons doctors do not fully understand, the hair at the back of the head is genetically hardier. And that observation led to a major industry—hair transplanting. Doctors remove a patch of hair-bearing skin from the back of the head and sew the scalp shut. Using either a scalpel or a laser, practitioners make holes for the grafts in the scalp and then plunk in micrografts, containing 1 or 2 hairs, or minigrafts—plugs of skin with 3 or 4 hairs.
As technology advances, hair transplants appear more natural than they have been in the past. Most men who undergo hair transplants can attain the look they want over the course of 6 months. Be aware that it is normal to experience hair loss after transplantation because hair loss increases over time. Some men need repeated procedures to maintain their desired amount of hair.
What if you do not want to undergo surgery? Another option is to use minoxidil, a topical solution that is rubbed into the scalp. While it is not clear exactly how minoxidil works, the medication may be able to extend the hair's growth cycle. It is recommended that you continue to use it to maintain hair growth. If you stop using minoxidal, your hair will eventually return to the condition it was in before.
Another medication used as a treatment for baldness is finasteride, taken as an oral tablet. The drug works by reducing the hormone which interferes with hair growth. It can take about 3 months to see the full effect.
Of course, if a bald head makes no difference at all to your self-esteem, you can always join the ranks of men like actor Sean Connery and basketball player Michael Jordan, who show that baldness can be an attractive trait.
American Academy of Dermatology
Family Doctor—American Academy of Family Physicians
Canadian Dermatology Association
Androgenetic alopecia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 9, 2014. Accessed July 6, 2015.
Finasteride. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 18, 2013. Accessed July 6, 2015.
Hair transplant FAQs. Hair Loss Learning Center website. Available at: http://www.hairlosslearningcenter.org/content/treatments/hair-transplant-faqs.asp. Accessed July 6, 2015.
Ross EK, Shapiro J. Management of hair loss. Dermatol Clin. 2005;23:227-243.
Stough D, Stenn K, Haber R, Parsley WM, Vogel JE, Whiting DA, Washenik K. Psychological effect, pathophysiology, and management of androgenetic alopecia in men [review]. Mayo Clin Proc. 2005;80:1316-1322.
Wells PA, Wilmoth T, Russell RJ. Does fortune favour the bald? Psychological correlates of hair loss in males. British Journal of Psychology. 1995;86(Pt 3):337-344.
Last reviewed June 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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