Health & Wellness

What Causes Male Pattern Baldness?

Sometimes it’s due to hormones, but for the most part, it comes down to genetics. Thanks, Mom & Dad.
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Colleen Travers

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Colleen Travers,   

Jan 24, 2020 • 3 min read

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Guys generally don’t spend a ton of time thinking about their hair — until they start losing it. Approximately two-thirds of American men will deal with some hair loss by the time they hit age 35, according to the American Hair Loss Association. By the age of 50, roughly 85 percent of men will experience some type of hair loss or thinning. But unlike female hair loss, which can be caused by a myriad of hormonal and environmental reasons, 95 percent of male hair loss is caused by a condition called androgenetic alopecia. “As the name implies, androgenetic alopecia is typically due to a combination of genetic and hormonal factors, specifically androgen hormones,” says Douglas Buethe, MD, a dermatologist at Mercy Medical Center in Baltimore, MD. “Studies have consistently shown a genetic basis for the condition, and individuals with a family history of androgenetic alopecia are much more likely to have it.”  

While several genes are associated with a link to male pattern baldness, it’s more likely the combination of multiple genes that leads to an increased risk. “Androgens (male sex hormones) also play a critical role by promoting the thinning of hair follicles,” says Dr. Buethe. Here’s how it breaks down: Hair follicles go through a constant cycle of growth, regression, and rest. The hair eventually sheds, and the cycle starts all over again. Hair spends most of its time in the growth phase and shorter amounts of time in the regression and rest phases. But when male pattern baldness starts to happen, the androgen hormone dihydrotestosterone (referred to as DHT, a form of testosterone) significantly shortens the growing phase of hair follicles. “Since hair is in the growth phase for a shorter period of time, it becomes shorter, finer, and thinner,” says Dr. Buethe. “This process is called miniaturization. Over time, as more and more hair undergoes miniaturization, it creates the physical appearance of hair thinning and balding.”

Most male pattern baldness happens after puberty, when androgen production increases. And since hair follicles on the front and top part of the scalp are more androgen sensitive, they are the first to start thinning once androgenetic alopecia starts. Genetic factors and family history aside, if you use anabolic steroids, you may also be at risk for developing this condition due to the excess of sex hormones being produced as a result of the medication, says Dr. Buethe.

To help determine if your hair loss is more than normal, Dr. Buethe has a point person you can get initial feedback from. “I recommend having a good relationship with your barber, as they may be the first to notice that your hair is thinning (particularly if your hair loss begins around the crown),” he says. However, if your hair loss is accompanied by itching, pain, flaking, scaling, or crusting, these are signs the problem may be the result of a separate medical condition, which you should talk to your doctor or dermatologist about. 

If you do suspect you’re dealing with hair loss, make an appointment with your dermatologist for early intervention. “With male pattern baldness it’s much easier to keep the hair you have than it is to regrow lost hair, so starting treatment early is of critical importance,” says Dr. Buethe. Medication options include finasteride and minoxidil. Once you and your healthcare provider establish a treatment plan, check to see if your prescription is available for less with Blink Health.

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This article is not medical advice. It is intended for general informational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.

Blink Health is not insurance. The discount prescription drug provider is Blink Health Administration, LLC, 1407 Broadway, Suite 2100, New York, NY 10018, 1 (844) 265-6444, www.blinkhealth.com.

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