Signs of Balding

Balding is one of the biggest anxiety men are faced with in their late 30s and 40s. 

The unfortunate truth is that most men will experience symptoms of male pattern baldness at some point in their life. Nearly 50 percent of men over the age of 50 are affected by hair loss. 

So how can I tell if I’m starting to bald? What are the early warning signs? 

In this article, you’ll learn four ways to find out if you’re starting to go bald, and what you can do about it. 

Early Signs of Balding: 4 Signs to Look Out For

1. Your Hairline is Receding

A receding hairline may be difficult to notice at first. Over time you may find the hair around your temples starting to thin, or your hairstyle doesn’t quite fall into place like it used to. 

As the hairline recedes, it creates a more pronounced “M” shape. 

You can compare your hairline to old pictures to see if there’s any difference in the shape of your hairline. 

If you want to slow the progression of hair loss, it’s important to act quickly. As soon as you notice your hairline receding is a good time to act. 

2. You’re Finding More Hair On Your Pillow Each Morning

The average human will lose about 100 hairs per day. This is a completely normal part of the hair growth cycle. 

Hair follicles are created, hair grows for a set amount of time (different for everybody), and eventually falls out to renew the process. 

This hair loss happens naturally throughout the course of the day, but a good way to measure the rate of hair loss is to look at the number of hairs that fall out and remain on your pillow while you move around during the night. Using a lint brush each morning, you can collect the hairs from your pillow to see how many you’ve lost. 

It’s not worth counting the hairs, but over time you may notice a trend. If the concentration of hairs you’re collecting is increasing over time, it could be a sign of balding. 

Alternatively, you can observe the number of hairs you’re collecting from a comb or brush.

3. You’re Developing a Bald Spot On Your Head

The progression of balding is different for each man individually. Some men will begin balding from the front with a receding hairline, others will start to lose hair eventjoy throughout the top of the head. Some men will begin balding outwardly from bald spots usually on the top of the back of the head. 

Balding that originates from spots could be due to a condition called telogen effluvium hair loss. This type of hair loss is usually caused by stress after a particularly traumatic event — which could be either physical or psychological. 

4. You Can See Your Scalp Through Your Hair

Being able to see your scalp through your hair is one of the main signs of balding. If you’re losing hair faster than you’re growing new ones, the hair will begin to thin out. The thick forest of hair you once had to cover the skin on your scalp becomes sparse, exposing the top of your head. 

This process usually takes a long time, worsening over the course of several years. The process is so slow you may not even notice until you look back at old pictures of yourself from a time when your hair was much thicker. 

What Causes Balding? 

Balding has many causes [3], some are related to stress or past trauma, others are caused by changes in male androgens that accompany age. 

Here are five different causes for balding in men: 

1. Androgen Dysfunction

Androgens are a group of male hormones which includes several different types of testosterone, as well as dehydroepiandrosterone (DHEA), androstenedione (A4), androstenediol (A5), and dihydrotestosterone (DHT). 

The main culprit behind “male pattern baldness” is DHT. 

Free testosterone is converted into DHT in the hair, skin, and prostate. This form of testosterone is roughly five times more potent than testosterone. 

As men age, the rate of conversion from testosterone (and DHEA) to DHT increases. This potent androgen can interfere with the growth phase of hair, leading to hair loss over time. 

The main treatment for this cause of hair loss involves blocking the enzyme responsible for converting testosterone to DHT — called 5-alpha-reductase (more on how this works in the treatment section). 

2. Nutritional Deficiencies

The body requires specific nutrients in order to maintain the hair follicles, and manufacture the hair itself. The bulk of hair is made from a substance called keratin, which is also the basis for skin and nails.

In order to make keratin (a protein), we need to have a steady supply of amino acids, various trace minerals, and vitamins. If any of these raw materials aren’t available in the diet, it can lead to hair loss. 

The most common nutrient deficiencies involved with hair loss include [1]: 

• Iron deficiency
• Zinc deficiency
• Niacin (Vitamin B3) Deficiency
• Omega-6 or Omega-3 fatty acid deficiency
• Selenium deficiency
• Vitamin D deficiency
• Vitamin A deficiency
• Vitamin E deficiency
• Folic acid deficiency
• Biotin deficiency
• Protein deficiency

3. Thyroid Disease

The thyroid gland is an important endocrine organ in the body. It’s involved with regulating metabolism and energy production. Both an underfunctioning thyroid, and over functioning thyroid can lead to hair loss — usually marked by a thinning of the hair on the top of the head. 

Thyroid disease has other symptoms as well that should be checked out by a doctor. 

Common symptoms of hypothyroid (underfunctioning thyroid) include: 

• Fatigue and lethargy
• Sensitivity to cold
• Constipation
• Increased weight gain
• Muscle cramps and weakness
• Brain fog and depression

Common symptoms of hyperthyroid (overfunctioning thyroid) includes:

• Unintentional weight loss
• Rapid heartbeat
• Heart palpitations
• Increased appetite
• Anxiety and nervousness

4. Traumatic Event or Chronic Stress

This type of balding or hair loss is referred to as telogen effluvium. Traumatic experiences, such as physical injury, hospitalization, or severe psychological stress can alter the growth cycle of the hair follicles. With this condition, less hair follicles are able to transition from the telogen phase (resting period), to the anagen phase (regrowth period). This results in a net loss of hair over time, without regrowth filling in the place of the old hairs. 

This type of hair loss is usually completely reversible. 

5. Fungal Infection

There are several species of fungi that can infect the skin on the scalp and lead to hair loss.

Fungal infections on the scalp and skin are usually accompanied by dandruff or flaky skin, redness and inflammation, itching of the scalp, or a white residue forming on the surface of the scalp. 

This form of balding is treatable using oral or topical antifungals. 

How to Prevent or Delay Hair Loss

Now onto the biggest question of them all — can hair loss be treated or prevented? 

The answer is yes, but with some caveats. 

The ability to treat hair loss depends on the cause — so it’s important to visit your local GP or a dermatologist to identify the root cause. The faster a cause is determined, the quicker you’;; be able to find effective treatment. 

With degenerative causes, like male pattern baldness resulting from androgen dysfunction, it’s important to begin treatment as quickly as possible. The more advanced the condition becomes, the harder it is to treat. 

Most men who begin treatment at the first sign of trouble achieve complete regeneration of hair within just a few weeks or months. Men who start treatment later may experience some regrowth of hair, but it’s unlikely the hair will return completely. 

Here are some of the most common treatment options men pursue to manage balding. 

1. Prescription & OTC Medications

There are dozens of prescription medications available for managing hair loss. Some work by blocking the enzyme responsible for converting testosterone into DHT, others work by stimulating blood flow to the hair follicles. 

Here are the most popular hair loss medications:

A) Minoxidil (Rogaine)

This medication is available over the counter without a prescription. It’s applied topically to the scalp, and is converted to the active ingredient by an enzyme found in the hair follicles. Some men lack this enzyme, which is why Rogaine doesn’t work for all men. 

Once converted to the active ingredient, Rogaine stimulates blood flow to the hair follicles, often providing enough of a kick to initiate the growth phase in dormant follicles [6]. 

Rogaine is a great option for men with early to mid grade hair loss. It can take several weeks or months to produce effects and won’t work for everybody. 

B) Finasteride (Proscar & Propecia)

This is a prescription-only medication used for treating male pattern baldness [7]. It works by blocking 5-alpha-reductase, which converts testosterone into DHT in the skin and prostate gland. Over several weeks or months, finasteride helps reduce the accumulation of DHT in the scalp that’s interfering with hair growth. 

This medication only works if the cause of hair loss involves DHT. 

C) Dutasteride (Avodart)

Dutasteride works through the same mechanism as finasteride (5-alpha-reductase inhibitor). This medication is prescribed for treating benign prostatic hyperplasia (BPH), but is often used off-label for managing male pattern baldness [8].

2. Wigs or Hair Pieces

One of the easiest ways to manage balding is to use a wig or hair piece. This treatment allows you to choose any hairstyle you like, and doesn’t bring any of the added risk of taking prescription medications or undergoing surgery. 

Wigs are very common, and the technology behind them has come a long way in recent years. A high-quality wig or hairpiece installed by a barber will last up to 6 months before it needs to be replaced. They’re resistant to water, exercise, and other normal activities, and provide a healthy, youthful look.

3. Hair Transplants

A hair transplant is a procedure involving the removal of live follicles from the back of the neck or behind the ears — which are then transplanted onto the top of the head [4]. 

The new follicles will integrate with the tissue and start to produce new hairs within a few months. 

It’s common for the hair in a hair transplant to fall out after the surgery, but will start to grow-back naturally after 3 to 6 months. 

Transplants are a long-term treatment option as the follicles need to become established in their new location before they can begin growing hair normally. It’s also important to treat any underlying causes for the hair loss to avoid the same problem from affecting the new hairs. 

4. Platelet-Rich Plasma (PRP)

Platelet rich plasma (PRP) is obtained from the blood and injected into the scalp to promote hair growth [5]. 

The blood is first removed, and spun at high speeds in a centrifuge to separate the different densities of fluid in the blood. The largest portion is the plasma, separated by layers of red blood cells and white blood cells. 

PRP is exceptionally nutritional and provides growth factors that can stimulate dormant hair follicles. This treatment is often used in combination with hair transplantation to increase the success rate of the transplanted follicles. 

5. Hair Styles for Bald Men

Many men choose to embrace their hair loss and simply adapt their hair styles to fit. This is the easiest method, which can be highly effective for a lot of men. There are no side effects and it’s the cheapest solution, by far. 

A few hairstyles that work well with balding include: 

1. Buzz cut
2. Clean shaven
3. Ivy league
4. Comb-over
5. Regulation cut
6. Skin fade
7. Crew cut
8. Slick back

Key Takeaways: Four Signs of Hair Loss In Men

Hair loss is a normal part of the aging process for men. Most men in their 50s will experience hair loss in one form or another, and many men in their early thirties or forties will experience some degree of hair loss as well. 

Understanding the cause for your hair loss is the first step towards treating it. Knowing the signs of hair loss can be helpful for understanding what the cause is, and how best to manage it. 

The main signs of balding include the formation of bald spots, receding hairline, and a visible scalp (thinning hair on the top of the head). One of the early warning signs to watch out for is an increase in hair left on your pillow each morning, or in your comb or brush. 

The sooner you start paying attention to your hair patterns, the easier it is to treat. Catching balding early can make a big difference in the ability to treat, or slow the progression of hair loss using medications, nutritional supplements, and lifestyle changes. 

References

1. Guo, E. L., & Katta, R. (2017). Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatology practical & conceptual, 7(1), 1.
2. Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2019). The role of vitamins and minerals in hair loss: a review. Dermatology and therapy, 9(1), 51-70.
3. Rushton, D. H., Norris, M. J., Dover, R., & Busuttil, N. (2002). Causes of hair loss and the developments in hair rejuvenation. International journal of cosmetic science, 24(1), 17-23.
4. Dua, A., & Dua, K. (2010). Follicular unit extraction hair transplant. Journal of cutaneous and aesthetic surgery, 3(2), 76.
5. Li, Z. J., Choi, H. I., Choi, D. K., Sohn, K. C., Im, M., Seo, Y. J., … & Lee, Y. (2012). Autologous platelet‐rich plasma: a potential therapeutic tool for promoting hair growth. Dermatologic Surgery, 38(7pt1), 1040-1046.
6. Messenger, A. G., & Rundegren, J. (2004). Minoxidil: mechanisms of action on hair growth. British journal of dermatology, 150(2), 186-194.
7. Kaufman, K. D., Olsen, E. A., Whiting, D., Savin, R., DeVillez, R., Bergfeld, W., … & Shapiro, J. (1998). Finasteride in the treatment of men with androgenetic alopecia. Journal of the American Academy of Dermatology, 39(4), 578-589.
8. Olszewska, M., & Rudnicka, L. (2005). Effective treatment of female androgenic alopecia with dutasteride. Journal of drugs in dermatology: JDD, 4(5), 637.