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When you’ve started to experience male pattern balding, it’s not always easy to identify. (And let’s be honest — many of us are afraid to look too hard.) Here are some of the most common early signs to look for, and the most important things to know — including how you can slow down, stop and possibly even regrow lost hair.
- Male pattern balding is common: By age 35, almost two-thirds of American men will experience it.
- Male pattern baldness tends to develop in three ways: A receding hairline, spareness at the crown, or overall thinning (sometimes called “invisible baldness”).
- Hair falling out is normal — we each lose about 100 hairs a day.
- But a more rapid rate of fallout could signify male pattern hair loss.
When does male pattern baldness start?
If you’re genetically destined to go bald, there’s no specific age when it becomes noticeable. Traditionally, it has been stated that baldness comes from the mother’s father, since male pattern baldness genes have been identified on the X chromosome (which males inherit from their mothers). However, hair loss can be more complicated than a single gene and involves other factors as well, possibly including some genes inherited from dad. All of this is to say that your hair loss might happen at a different rate than what your other male relatives experience.
Just know that it’s extremely common (AHLA, n.d.). By age 35, almost two-thirds of American men have lost hair because of male pattern baldness. After age 50, more than 85% of men experience it. And about 25% of men begin losing hair before the age of 21.
Hair loss can occur for several reasons. But 95% of the time in men, it’s due to male pattern balding (a.k.a. androgenetic alopecia). Some men are totally fine with that and embrace the smooth look. If you’re not, there are things you can do to slow down and potentially reverse hair loss — and the sooner in the process you start, the greater chance you have of success.
But first, it’s important to know how to identify hair loss. Here are some of the most common signs of balding.
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8 ways to know if you’re balding
1. You have a receding hairline
This is a classic early sign of male pattern balding. Your hair might begin to thin at the temples, creating a more prominent widow’s peak and a hairline that resembles the letter M or a horseshoe. Or your hairline might seem to recede or thin all the way across.
2. You notice more hair falling out than usual
Discovering a few hairs in your comb, on your pillow or in the shower drain isn’t necessarily a sign that you’re going bald. The scalp contains about 100,000 hairs, and we lose about 100 hairs each day. That’s part of the natural life cycle of hair — scalp follicles are continually in the process of growing hair, pausing, then shedding it. (Read more about the hair growth cycle here.)
But over time, if you notice that you seem to be shedding hair at a higher rate, it could be a warning sign that your hair is permanently thinning.
3. Hair at the crown of your head is thinning
This is another one of the common early signs of male pattern balding. Hair at the crown (or back top) of the head becomes sparser until the classic bald spot is evident. Because you don’t have eyes in the back of your head, you might want to use a hand mirror and the bathroom mirror to examine the area, or proceed to #7 on this list.
4. Your hair seems thinner overall
Sometimes, balding doesn’t begin at the hairline or crown but develops and advances at a steady rate along a larger area of your scalp. This is sometimes called “invisible balding,” because the hair loss is so gradual and balanced it may be hard to notice until nearly half the hair is lost.
5. The photographic evidence is adding up
If you’re unsure if you’re balding and are concerned about it, a good exercise is to compare a current photo of yourself with past photos taken in similar lighting and at a similar angle. That’ll give you an objective perspective on any potential changes in your hairline or overall thickness.
6. Hair seems to be taking longer to grow
One effect of male pattern baldness is that the hair’s growth cycle becomes shorter. The normal growth cycle lasts between two and six years, after which the follicle goes dormant and the hair is shed. So the maximum length your hair can get is determined by how long your growth cycle lasts and how quickly your hair grows. If you used to be able to produce Samson-esque locks after deciding to grow your hair out, but now you’re not getting the same results, the balding process could be responsible.
7. Your barber tips you off
Everyone’s hair is a bit different. But anyone who’s been cutting men’s hair for a while has seen it all. If you’re unsure how you’re stacking up, ask. If you’ve been going to the same cutter for years, he or she might be able to tell you if they’ve noticed changes and have been taking any strategic steps, so to speak; but any professional is familiar with the signs and will be able to tell you if you’re looking spare, as well as advise you on the best hairstyles and styling tips for thinning hair.
8. Your scalp itches
An itchy scalp isn’t a typical sign of male pattern baldness, but it can be the sign of other conditions that contribute to hair loss — including a buildup of sebum (oil) on your scalp, or skin conditions such as folliculitis, psoriasis or seborrheic dermatitis. In some cases, frequent scratching can damage hair follicles and encourage fallout. If you have a recurrent itchy scalp, consult a dermatologist. They can diagnose what’s going on and prescribe treatments to clear it up.
Why is my hair thinning?
Remember, the vast majority of time — about 95% — thinning hair is the result of male pattern hair loss. That’s caused by DHT (dihydrotestosterone), a sex hormone known as an androgen.
Androgens contribute to adult male characteristics, such as muscle mass and a deeper voice. But for reasons researchers don’t entirely understand, although DHT is essential for the growth of body hair, it can attack hair follicles on the scalp and cause them to shrink.
Hair follicle shrinkage is called follicular miniaturization. This process causes the follicle to produce shorter, thinner hairs known as vellus hairs instead of the more robust terminal hairs that you’re used to on top of your head.
Less common reasons for thinning hair include:
- Breakage of the hair shaft. Damage to hair from dyeing or styling can cause the hair shaft to break off. This isn’t the same as male pattern hair loss.
- Alopecia areata. This autoimmune condition can cause hair loss in patches throughout the body. In extreme cases, all body hair might be lost. It’s not the same as male pattern baldness.
- Vitamin deficiencies. In rare cases, a lack of nutrients such as B vitamins, vitamin D, iron or zinc can cause hair loss.
- Traction alopecia. This type of hair loss occurs when hair is chronically pulled too tight, such as in a ponytail or braids.
- Stress or an emotional shock. According to the Mayo Clinic, some people experience a general thinning of hair several months after severe physical or emotional stress. This type of hair loss is most often temporary.
- Medications. Certain drugs, such as those used for cancer, heart problems, high blood pressure, arthritis and depression, can have the side effect of hair loss.
How to stop thinning hair
If you’re experiencing male pattern hair loss, there are several ways you can stem the loss and increase hair growth. They include:
- Finasteride (brand name Propecia). This oral medication is known as a 5-alpha-reductase inhibitor. 5-alpha-reductase converts testosterone into DHT. DHT is the hormone responsible for hair loss in men who are genetically predisposed to lose their hair. By blocking the conversion of testosterone to DHT, finasteride can prevent further hair loss and may even regrow hair. In one European study, men treated with 1 mg of finasteride over five years saw a 93% decrease in further hair loss compared to men who took a placebo (Kaufman, 2008). Finasteride also regrows hair for some men: A different study found that 61% on men experienced mild to moderate hair regrowth. Of note, finasteride should not be taken by women or children.
- Minoxidil (brand name Rogaine). This liquid or foam is rubbed onto the scalp twice a day. About 60% of men who use minoxidil see hair regrowth. The exact mechanism of how minoxidil stops hair loss is unclear although it is believed to increase blood flow to the hair follicles. However, minoxidil and finasteride work better together than either one alone.
- A red light therapy device. Low-level laser therapy (LLLT) is an FDA-cleared way to treat hair loss. These devices come in the form of a wand you point at the scalp or a cap you can wear. They emit a constant red LED light that is believed to reduce inflammation and increase blood flow to the hair follicles. According to a 2017 meta-analysis of studies published in the Journal of the American Academy of Dermatology, minoxidil, finasteride and LLLT were found to be superior to placebo in regrowing hair, and the researchers concluded they’re all effective for promoting hair growth in men with male pattern hair loss (Adil, 2017).
- DHT-blocking shampoo. Several varieties of shampoo claim to block DHT’s effect on miniaturizing follicles. They’re considered less effective than minoxidil or finasteride. Some contain zinc, vitamin B12, or ketoconazole (the active ingredient in the dandruff shampoo Nizoral). It is hypothesized that ketoconazole, in combination with finasteride, can disrupt DHT’s effects on the scalp (Hugo Perez, 2004).
- PRP (platelet-rich plasma) treatments. Several dermatologists and hair-replacement specialists offer this treatment, in which a patient’s own blood is drawn and placed in a centrifuge to extract the plasma, which is then injected into the scalp. The theory is that the growth factors in platelets can spur hair growth. A 2017 study published in the International Journal of Molecular Sciences found that PRP treatment increased number of hairs and overall hair density versus areas treated with a placebo (Gentile, 2017).
- Hair transplants. Hair transplantation is a surgical procedure that moves hair from one place on the scalp to another. The hairs on the back and side of the head are more resistant to DHT, even into old age, than hairs on the top of the head. So when hair is moved from the sides of the scalp into areas of male pattern baldness, it can provide a long-lasting solution.