With more men choosing to shave their heads these days, it's clear that bald is beautiful. Still, watching your hairline recede is by no means a pastime you care to cultivate.
Though you may think a sparsely covered crown is a sign that you're a stud, "it's an old wives' tale that guys who have premature balding have great libidos," says urologist Steve Kaplan, MD, director of the Iris Cantor Men's Health Center at NewYork-Presbyterian/Weill Cornell Medical Center. The connection between testosterone levels and hair loss known as male pattern baldness are more complicated than that.
What Causes Baldness?
Male pattern hair loss is caused by three things: genes, hormones, and age. Roughly one-third of the male population starts to lose hair by the age of 45. By the time retirement rolls around, nearly all men have some degree of hair loss.
Men graced with male pattern baldness genes inherit hair follicles that are oversensitive to the male hormone dihydrotestosterone (DHT). When testosterone is converted into DHT, it shrinks the hair follicles, resulting in shorter and finer hair until, eventually, hair growth stops altogether. The good news is, the hair follicles don't die off, so hair growth may still be possible.
The role of testosterone in premature balding has led to the myth that going bald is a sign of virility. However, men with male pattern baldness aren't any more well-endowed with testosterone than other guys. Their hair follicles are simply more sensitive to the hormones.
Treatments for Hair Loss
If your family tree is missing a fair amount of foliage, there's little you can do to prevent your own leaves from falling out. Hair loss treatments can slow down the balding process, but there's no cure for male pattern baldness. The two treatments approved for male pattern baldness are minoxidil and finasteride. Hair loss returns when you stop using either medication.
Minoxidil is a topical solution or foam that you apply directly to the scalp to stimulate the hair follicles. For many men, minoxidil slows hair loss. For some, it may even reverse hair loss, allowing new hair growth. Minoxidil generally takes about two weeks to start working. If hair growth doesn't seem to increase after four months of use, tell your doctor.
Finasteride is a pill that blocks the conversion of testosterone to DHT to slow hair loss. Because DHT contributes to prostate growth, finasteride is also used to treat enlarged prostate (also called benign prostatic hyperplasia, or BPH). For hair loss, it can take at least three months to see new hair growth.
Other remedies for hair loss include hairpieces, hair transplants, and plastic surgery procedures, such as scalp reduction.
It probably goes without saying that if you're not distressed by hair loss, there's no reason to treat it. As a general rule, though, it's easier to maintain hair than it is to regrow it, so if you think you may be bothered by hair loss as it progresses, treat your thinning hair as soon as possible.