Why Do Men Lose Their Hair?

Why is it that so many men seem to lose their hair and often at such an early age? If you are a man experiencing hair loss there are probably a number of factors, and the stress of modern life may be one of them. We know that acute stress, as for example that caused by a serious operation or from witnessing a traumatic or tragic event, can cause loss of hair, so isn’t it possible that chronic stress over a period of time could also have an adverse effect on our hair? Certainly it is known that stress affects our hormones, causing a rise in cortisol levels that has a knock-on effect, making physiological changes for the body to meet subconsciously perceived threats or challenges. Long term high levels of stress are not good for us and have been linked to heart and artery disease amongst others.

The main cause of hair loss in men however is still reckoned to a genetic predisposition to the effect of a male hormone on the hair follicles. It seems that follicles can have an inherited tendency to be sensitive to the adverse effect of DHT, and this can be inherited from either father or mother. DHT, or dihydrotestosterone, is a male hormone formed by the action of 5-alpha reductase on testosterone, a process that goes on naturally throughout life. As general levels of DHT rise due to gradual accumulation, hair follicles that are susceptible begin to shrink and become less productive, causing gradual loss of hair. This process can begin as early as the twenties, but is more commonly seen amongst high flying thirty year olds. The condition is called male pattern baldness and is said to affect over 40% of men once they are past fifty. Hair loss follows a characteristic pattern where the hairline at the front, together with any widow’s peak, gradually thins and recedes, along with loss of hair on the crown of the head. Hair loss is progressive and eventually leads to the horseshoe pattern of hair around the head that is often seen.

Many men do not find their gradual loss of hair at all disturbing. They accept it as part of ageing and do not feel their self image or virility is threatened. Other men do find the creeping hair loss upsetting, feeling that it ages them prematurely. In this case some will resort to shaving the whole head to give a more macho appearance. Many others however will strive to halt the hair loss and restore some hair growth.

Fortunately, this can be achieved in many cases. The first line of defence for many men losing their hair is to take a drug that helps to block the production of, or the effects of, DHT. The drug widely used is finasteride (Propecia), taken as a tablet just once a day it helps to reduce DHT levels and allow the hair follicles to resume production. It can take a few months for results to be seen as hair grows only slowly but it seems to halt hair loss in the majority of cases and help new hair to grow in a significant number of men who take it. It can have side effects such as reduced libido and/or erectile dysfunction, but these are rare.

The other major treatment for male pattern baldness is the application of minoxidil to the scalp. It is usually applied twice a day as a solution, foam, or gel, and left on for a while. It may work by increasing blood flow to the scalp, and, whilst not working in every case, does seem to encourage hair re-growth for many. Again, though the process takes time.

Why men should have developed this inherited tendency toward baldness seems a mystery, but perhaps it’s caused by a gene linked in some way to another trait of more value and has thus persisted throughout our evolution. Genetics is a complicated science, and we have a way to go yet before properly understanding it.