The Top Reason For Hair Loss In Men

Whether it fuels bathroom mirror scalp inspections or masquerades as one-liners about becoming “Baldilocks”, hair loss and balding are common sources of anxiety amongst men. In fact, one news report suggests that more men are worried about going bald (94 percent) than becoming impotent (89 percent). 

The prevalence of this common anxiety is understandable, since balding (medically dubbed peladophobia) is prevalent: The vast majority of men will experience hair loss at some point in their lifetime, says board-certified dermatologist and hair-loss specialist Peter Young M.D., the medical director of Nurx Dermatology. About a quarter start losing hair by the age of 21, and half of men are affected by the time they hit middle age. 

So, what causes baldness in the first place? And is there anything you can do to ward off thinning hair? Ahead, doctors answer frequently asked questions and pinpoint the top reason for retreating hair lines.  

• ABOUT OUR EXPERTS: Peter Young M.D., is a board-certified dermatologist, hair-loss specialist, and the medical director of Nurx Dermatology. Ross Kopelman, M.D., is a hair transplant surgeon at Kopelman Hair Restoration in New York and New Jersey. Shendy Engelina, M.D., is a board-certified dermatologist with Dermatica and ZipHealth in London. Hardik Doshi, M.D., F.A.C.S., is a double board-certified plastic surgeon and lead surgeon and hair restoration specialist with Ample Hair hair restoration clinic in New York City.

The Most Common Cause Of Hair Loss in Men 

The most prevalent type of hair loss occurring in men is male pattern baldness, according to Ross Kopelman, M.D., a hair transplant surgeon at Kopelman Hair Restoration in New York and New Jersey. Also known as androgenic alopecia, male pattern baldness is thought to affect upwards of 50 million men in the United States. Usually, this kind of baldness is marked by hair gradually receding away from the temples in an M shape, as well as the thinning of the hair at the apex of the head, per Mount Sinai Hospital. 

“Male pattern baldness is primarily caused by genetics,” says Kopelman In fact, the researchers behind one 2023 review published in the European Journal of Human Genetics called the condition “highly inheritable”. Considered a polygenic condition, which means that several inheritable genes play a role, research suggests there may be as many as 125 genes involved in baldness. In short, “if a man has close relatives with male pattern baldness on either side of the family, he is more likely to experience it as well,” says Young. That’s right, you can go ahead and blame your family.

How Do Genes Cause Male Pattern Baldness? 

The so-called baldness genes are thought to impact how sensitive the body is to an androgen called dihydrotestosterone (DHT), according to Shendy Engelina, M.D., a board-certified dermatologist with Dermatica and ZipHealth in London. 

DHT, which the body synthesizes from circulating testosterone, supports the growth and development of secondary male sex characteristics like pubic, facial, and body hair during puberty, she explains. After puberty, some DHT in the hair follicle is needed to support continued hair growth. Too much DHT in the scalp, however, can lead to hair loss. 

Read More: 7 Signs You Should Have Your Testosterone Levels Checked

You see, an increased amount of DHT in the hair follicles significantly alters the hair growth cycle, essentially speeding it up. The shorter the hair growth cycle, the less time the strands have to incubate in the hair follicle, which ultimately leads to finer hairs and then eventually hair loss, says Engelina. 

Can Lifestyle Changes Help Stop or Slow Male Pattern Baldness? 

Several holistic and lifestyle changes can benefit men and potentially slow the speed with which male pattern baldness takes your hairline, according to Engelina. 

To start, she recommends prioritizing an overall healthy lifestyle. “Eating a balanced diet and implementing stress management techniques can help,” she says. Indeed, one study published in the Journal of Preventive Medicine and Hygiene in 2022 reports that poor diet, stress, and depression can all exacerbate the symptoms of male pattern baldness. 

Eating a nutritious diet helps ensure that you’re getting all the essential vitamins and minerals that are key to your overall hair health, says Young. The researchers behind that 2022 study recommend the plant-forward Mediterranean diet as a great way to meet your nutrient needs. 

Beyond that, adequate iron and vitamin D consumption, in particular, have been found to support hair health in those with male pattern baldness. If you don’t consume ample amounts through your diet, consider supplementing with these key nutrients.

“Avoiding smoking and limiting alcohol consumption can also support overall hair health,” according to Kopelman. One 2022 review published in the International Journal of Trichology found that smoking may lead to earlier onset age of male pattern baldness, as well as worsen its severity. Meanwhile, excessive drinking alcohol may decrease overall well-being, which is thought to indirectly lead to exaggerated hair loss, he says. 

Since stress has been proven to contribute to hair loss, too—likely due to the impact the stress hormone (cortisol) has on the entire endocrine system and therefore on DRT derivation—Young suggests implementing stress-reduction techniques. “By reducing overall stress, yoga or meditation can also be helpful to combat hair loss,” he says. For additional support, you might consider supplements like ashwagandha and lemon balm, which support the body’s ability to adapt to stress.

Lastly, it’s also important to practice good overall hair and scalp care, says Young. This includes keeping your scalp clean and healthy and avoiding excessive heat styling and harsh chemicals. “Staying away from hairstyles that tug on the hair can also be helpful,” adds Engelina. So if you tend to rock a tight man-bun or Noah Kahan-style milk braids, you might want to reconsider.

Is There Medical Treatment For Male Pattern Hair Loss? 

If you’re experiencing symptoms of male pattern baldness or are nervous about its potential future impact, Engelina recommends seeking the counsel of a dermatologist, trichologist, or other hair loss specialist. 

Depending on how far along your hair loss is, as well as your specific aesthetic goals and budget, you might try a prescription intervention, she says. Currently, there are two medications prescribed: finasteride and minoxidil. 

1. Minoxidil

Minoxidil—sold under the brand name Rogaine—is a popular over-the-counter topical that extends the length of the hair growth cycle and stimulates the hair follicle, explains Kopelman. One year-long, 900-person study on the medication published in Journal of the American Academy of Dermatology found that the medication was effective at reducing hair shedding and/or increasing hair growth in 84 percent of participants. 

Available in foam or liquid form, as well as two different strength levels, Young says it takes at least three to four months to start seeing results from topical minoxidil and one to two years to see optimal results. Notably, “you also need to continue using the medicine indefinitely to maintain the benefits,” he adds. 

The most common side effects of topical minoxidil include scalp irritation, itching, and redness, he says. 

2. Finasteride

Finasteride is an oral prescription option that works on male pattern baldness by reducing DHT levels in the body. Sold under the brand names Propecia and Proscar, this medication works by inhibiting the conversion of testosterone to dihydrotestosterone. 

While it might take several months to figure out if this medication is working for you, research has shown that 88 percent of individuals experience new hair growth or slowing of their existing hair loss. As with minoxidil, “you need to keep taking finasteride to sustain the benefits,” notes Young. 

Side effects are rare but include low mood, decreased sexual desire, erectile dysfunction, and other ejaculatory changes. 

Other Treatments Options

Notably, there are a few additional medical interventions for male pattern hair loss, according to double board-certified plastic surgeon Hardik Doshi, M.D., F.A.C.S., a lead surgeon and hair restoration specialist with Ample Hair hair restoration clinic in New York City. These options include lower-level laser therapy (LLLT), platelet-rich plasma (PRP) therapy, and hair transplantation. 

• • Lower-level laser therapy (LLLT): Also known as red-light therapy, LLLT is a laser-based therapy that involves shooting photons into the scalp to stimulate the hair follicle, Doshi explains. “Some studies suggest that LLLT devices can promote hair growth, but additional research is required,” he says. 
  • Platelet-rich plasma (PRP) therapy: PRP therapy involves injecting a significant amount of a patient’s own platelets, obtained from their blood, into their scalp to promote hair growth, says Doshi. “Current research is promising, but additional research is required to properly demonstrate its efficacy,” he says. 
  • Hair transplantation: While it cannot prevent future baldness, hair transplantation is a type of surgery that can restore hair to balding regions by “transplanting” hair follicles where hair is currently growing to the bald spots, he explains. 

The Bottom Line

Hair loss caused by male pattern baldness cannot be fully prevented in those predisposed to the gene. However, there are a number of lifestyle edits that may help slow the speed at which hair is lost, as well as a handful of medical interventions that may even reverse balding. Of course, given that stress is one of the factors that can speed up male pattern baldness, one of the most cost-effective ways to preserve your hair may be to embrace the ethos that bald is, in fact, beautiful.