Know if You Have Male Pattern Baldness

Take notice of your risk factors, including your age, baldness patterns in your relatives, steroid usage, and prostate gland growth. Look for an "M" shape pattern in your hair, and check the crown of your head for missing hair. Look for hair on your pillow or brush. Consider other reasons for baldness, such as malnutrition or iron deficiency. Consult a hair loss specialist for a diagnosis.

Steps

Learning the Risk Factors

1. Consider your age. The incidence of male pattern baldness increases significantly with age. Your age is one of three main risk factors for the condition (along with heredity and androgen imbalance). Up to two thirds of American men by the age of 35 experience male pattern baldness, but that increases to over 80% for men older than 50 years. As such, consider your age and correlate it to your hair loss. Although male pattern baldness can begin in early adulthood (albeit rarely), it becomes much more common with age. Sudden hair loss in a teenager or young adult is usually related to some disease, medical treatment or toxicity (see below).
   • Male pattern baldness is the most common type of hair loss in men, accounting for about 95% of it.
   • About 25% of men who suffer with male pattern baldness begin the process before the age of 21 years.
2. Look at male relatives on both sides of the family. It is a common myth that baldness only comes from the mother's side of the family, and that if your mother's father was bald, you may be, too. Genetics account for 80% of baldness, but you are just as likely to be bald if your father or your father's father is bald, too. As such, look at your father, grandfathers, uncles, and male cousins (any first and second-degree relatives) and see if they still have a full head of hair. If they don't, take note of the degree of hair loss and ask them when they first noticed losing their hair. The more relatives you see who are bald, the greater your risk of male pattern baldness.
   • One gene of the several causing baldness is passed from mother to son, but other genes are passed in the usual way, and thus bald fathers can had bald sons.
   • Baldness occurs when the hair follicle on the scalp shrinks over time, which results in shorter and finer hair. Eventually, the atrophied follicle does not grow new hair, although it typically remains alive.
3. Understand the impact of taking steroids. Sex hormones called androgens are another primary factor of male pattern baldness. The main culprits in men are the hormones testosterone and dihydrotestosterone (DHT). Testosterone converts to DHT with the aid of an enzyme that's in the oil glands of hair follicles. Too much DHT shrinks hair follicles, making it impossible for healthy hair to grown and survive. This problem is caused by either too much circulating testosterone and/or abnormally high binding of DHT to receptors in scalp follicles. Abnormal binding or sensitivity to DHT is largely genetic, but a common cause of higher levels of DHT is the use of steroids — particularly in younger men who want to gain muscle mass for bodybuilding or athletic advantage. Thus, taking anabolic steroids greatly increases your risk of hair loss to nearly a 100% certainty if taken long enough.
   • It's normal to lose about 50-100 hairs every day, depending on your lifestyle, but much more than that is a sign of male pattern baldness or other condition that affects the hair follicle or scalp.
   • Drugs used to treat male pattern baldness, such as finasteride (Propecia, Proscar), work by preventing the conversion of testosterone to DHT.
4. Understand the correlation with prostate growth. Another indication that you're experiencing or at greater risk of male pattern balding is prostate gland growth. Benign prostate growth is very common with advancing age and also correlated to DHT levels. Thus, if you experience the signs and symptoms of prostate enlargement and suspect male pattern baldness, then it likely isn't your imagination because both conditions are caused by high DHT levels.
   • Signs and symptoms of an enlarged prostate include increased frequency and urgency of urination, difficulty initiating or stopping urination, pain with urination, incontinence.
   • Other medical conditions correlated or associated with male pattern baldness include prostate cancer, coronary heart disease, diabetes and chronic high blood pressure (hypertension).

Recognizing the Signs of Male Pattern Baldness

1. Monitor your hairline. Male pattern baldness usually begins at the front of your scalp, called your frontal hairline. The hairline gradually moves backward (recedes) and forms an "M" shape in most people with male pattern baldness, with the temples receding back more than the middle section of the scalp. Eventually the hair becomes thinner and shorter, and creates a horseshoe pattern around the sides of the head. The horseshoe pattern is a sign of advanced male pattern baldness, but some men can progress beyond and become completely bald.
   • Monitoring your hairline can easily be done by looking in the mirror and comparing what you see to photographs of your younger self.
   • The "M" shape pattern is a characteristic feature of male pattern baldness because hair in the temples (and crown) appear to be the most sensitive to DHT levels.
   • However, some people don't exhibit an "M" pattern, but more of a half moon pattern, where the entire front hairline recedes back in unison and does not leave a "widow's peak."
2. Check the crown of your head. In addition to thinning and receding of the frontal hairline, the same process can occur on the top (crown) of the head. Sometimes balding of the crown precedes a receding hairline, sometimes it follows after, and sometimes it happens concurrently. As noted, the hair follicles at the crown of the scalp seems to be more sensitive to DHT levels — much more so compared to the hair follicles above the ears or at the very back of the scalp.
   • To check the crown of your head, you'll need to hold a handheld mirror above your head while looking into your vanity mirror. Alternatively, get your partner or a friend to take a photo of your crown. Compare photos over time to judge the extent of your hair loss.
   • A sign from the front that may indicate thinning and hair loss at your crown is a widening side or middle part.
3. Look for hair on your pillow and hair brush / comb. Some hair loss on a daily basis is normal and it typically grows right back, but aggressive male pattern balding leads to very noticeable amounts of permanent shedding. Keep your pillowcase clean and note how much hair you lose while sleeping (take pictures to document it). If it's much more than a dozen or so hairs per night, that might be cause for some concern. If you use a brush, make sure it's free of hair before you use it and then examine it after your normal brushing routine. Brushing triggers more hair loss naturally (especially if your hair is long), but more than a few dozen hairs is not normal and a sign of male pattern balding.
   • If you have dark hair, use a light-colored pillowcase to highlight hair loss. Conversely, use a dark-colored pillowcase if your have light hair.
   • Using a hair conditioner while washing your hair might lead to less tangles, which might lead to less hair loss from brushing or combing.
   • If you wear a ponytail, consider letting it out at night while you sleep. The tightness can lead to more hair loss as you turn from side to side in the night.
   • Keep in mind that the early phases of male pattern baldness mainly involve thinning and shortening of hair, and not necessarily hair loss.
4. Distinguish between other causes of hair loss. Although male pattern baldness is the most common cause of hair loss in men (by far), there are some other causes that you should be familiar with, such as: endocrine gland (pituitary, thyroid) disorders, malnutrition (especially protein), fungal infection, iron deficiency, taking too much vitamin A or selenium, over-medicating (particularly retinoids and anticoagulants) and cancer treatments (chemotherapy, radiation).
   • Severe loss of hair from all areas of the scalp within a very short period of time is not male pattern baldness. It's likely related to environmental toxicity (such as lead poisoning), over-medication, high doses of radiation or extreme levels of emotional trauma (shock or fright).
   • If your hair loss is patchy and involves widespread scaling that spreads over your scalp, then you likely have a ringworm infection. Other symptoms include broken hair, skin swelling, redness and oozing.
   • Certain hair treatments, such as applying hot oil, dyes or chemicals meant to straighten hair, can cause scalp damage and permanent hair loss.
5. Consult with a hair loss specialist. To be completely sure if you are affected by male pattern baldness, make an appointment with a hair loss specialist, who is likely a dermatologist or physician with special training. Typical male pattern baldness is usually diagnosed based on the appearance and pattern of hair loss. However, your doctor will also ask about your extended family (particularly on your mom's side) and carefully examine your scalp under magnification (with a device called a densitometer) in order to assess the extent of miniaturization of the hair follicles.
   • Hair analysis or a scalp biopsy are not needed to properly diagnose your hair loss.
   • Your doctor should let you know about all the potential treatments for male pattern balding, not just medications or hair transplant surgery.

Tips

• Early detection of male pattern baldness and prompt treatment with medications can slow down hair loss in most people, although be aware that the drugs cause side effects, and that there is no cure.
• Men with mild-to-moderately advanced male pattern baldness can often hide the extent of their hair loss with the right haircut or hairstyle. Ask your hairstylist for some ideas to make your thinning hair look fuller (just avoid the combover look!).
• Other options for advanced male pattern baldness include hair transplants, laser treatment, hair pieces / weaves and full wigs.
• Some men prefer to shave their scalps entirely instead of having the "horseshoe" look. Fortunately, there's much less stigma of being completely bald nowadays.

Sources and Citations

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