At what age will I start losing my hair?

Why do men lose their hair?

Male pattern baldness (MPB) is the most common form of hair loss, with more than half of all men experiencing it to some degree in their lifetime. It's thought that more than 50% of men over 50 have some degree of hair loss.

There are many names for male pattern baldness. These include androgenetic alopecia, hereditary hair loss and male pattern hair loss. MPB tends to start with a receding hairline as hair thins at the temples. Thinning hair on the crown of your head is also common, resulting in a bald spot. Eventually, some men will be completely bald. Male pattern baldness is hereditary, and is linked to levels of testosterone in the body which converts to DHT, a hormone which causes hair follicles to shrink. Hair loss can start at any age.

Why do women lose their hair?

Although women can also suffer from androgenetic alopecia, it is less common and rarely leads to total baldness. In women, hair loss is more commonly experienced as a thinning all over, which may lead to a bald patch on the top of the head, but the hairline does not typically recede and hair loss rarely results in total baldness. The causes of female baldness are not as clear, and it's not thought to be hereditary. Hair loss is most common after the menopause which means it may be linked to hormone levels.

How does balding affect men?

For some people, baldness is a normal and acceptable part of ageing. For others, it's highly distressing.

If you are not upset by losing your hair, great! There is no medical need to do anything about male pattern baldness, and with 50% or more of men having the same experience, a receding hairline is unlikely to raise any eyebrows.

Still, many men find hair loss a very difficult experience, having a significant effect on our self-esteem. Hair is often tied up with our sense of identity and how attractive we feel to potential partners, and losing it can understandably knock our confidence.

Hair loss can be more difficult still for women, young people and any other groups for whom going bald is less common and therefore more othering.

What causes male pattern hair loss?

It is likely that a variety of causes come into play, both genetic and environmental, though it is considered a hereditary condition. Some scientists believe that certain genes are responsible for androgenetic alopecia, but more research needs to be done.

Researchers have found a link between male pattern baldness and hormones called androgens, which aid male sexual development as well as affecting how hair grows. If levels of these male sex hormones are too high, it can damage your hair follicles.

However, we are not yet sure exactly how these factors come into play.

At what age do men go bald?

MPB affects all men differently, starting at different ages and progressing at different rates.

On average it takes 15-25 years for men to go completely bald. This process can begin at any age. About two thirds of men are either bald or have a balding pattern by the age of 60. However many will start losing their hair much earlier, and others not until later.

In a nutshell, there is no particular age when you can expect to see hair loss.

How do I know if I'm starting to go bald?

To gain an idea of when you are likely to go bald, it is important to note the time significant hair loss begins.

Usually, each strand of hair survives for around four years. Once this cycle is over, the hair follicle falls out and within six months is replaced by a new one.

In the case of MPB, hair follicles thin and fall but do not re-grow. Thinning and hair loss usually begins at the temple and the crown of the head - resulting in a bald spot. Often hair elsewhere continues to grow at the same rate as ever.

The extent to which your scalp is affected by this process (i.e. the speed at which you will go bald) is hereditary. For some men, the process goes from start to complete baldness in five years. Others will retain their hair for much longer.

How do I know it's definitely hereditary hair loss?

It is important to note that hair shedding is not always an indication of male pattern baldness.

On average the average scalp contains about 100,000 hairs, and each of us will lose between 50 to 100 hairs per day. This figure is useful to remember when hair styling or perhaps noticing the odd strand of hair on your pillow.

In contrast, if you are losing patches of hair in an apparently random manner you may have alopecia. In this circumstance, hair loss can occur from any part of the scalp or body.

Also, remember that male pattern baldness is a gradual process, so in circumstances when hair loss is rapid, it is recommended that you seek medical advice to determine whether there are any underlying health issues.

Certain lifestyle factors can also encourage hair loss. Poor diet and stress can both lead contribute, as can certain medications. In these instances, hair loss is rarely permanent. It may well slow or even reverse once the underlying causes are addressed.

If your hair loss does not seem to fit the pattern of male pattern baldness, speak to your doctor. They'll help with the diagnosis or treatment of any underlying causes.

Can you stop male pattern baldness?

Unfortunately, there is no guaranteed baldness cure. There are available treatments, but there is no one-size-fits-all cure for male pattern hair loss.

Remember, MPB is not anything to worry about. It is very common and poses no threat to your health unless it is caused by an underlying problem. Most men go bald, it's a fact of life. If you don't feel the need to do anything about it, just don't.

Still, many men struggle mentally and emotionally with losing their hair. If this is the case, there are various options available that may help.

Treatments for male hair loss

While there is no treatment guaranteed to reverse or even put a stop to your thinning hair, there are many options available that are worth trying if you feel the need.

1. Wigs and toupees

Wigs or weaves are an age-old solution for covering bald spots, if a little out of favour these days.

2. Medication

Finasteride and minoxidil are the main medications available in the UK for male pattern baldness. Both can potentially slow down hair loss as well as encouraging hair growth.

However, they won't work for everyone, and they won't regrow all of your hair. Also, the effects normally stop if you stop taking the medication.

Finasteride

Finasteride is a treatment for male pattern baldness that you take once a day in tablet form. It works by preventing testosterone from being converted into dihydrotestosterone (DHT). DHT causes hair follicles to shrink, which is what causes the hair loss. By preventing its production, finasteride helps to stop baldness and even promote hair regrowth.

It can take up to six months before the results of finasteride become visible, and the balding process starts again within a year if you stop taking it. It's therefore recommended to begin taking the tablets as soon as your hair loss starts.

Potential side effects include a loss of sex drive and an inability to get or maintain an erection, although they are uncommon, with less than one in 100 men experiencing side effects.

Minoxidil

Minoxidil is used to treat both male and female pattern baldness. It comes as a lotion which you rub into your scalp once a day, and it's available without a prescription. It's not clear how it works, but it has been shown to stop or slow hair loss in some people and promote hair regrowth in others. Women tend to see better results with minoxidil than men do; around one in four women report hair regrowth.

As with finasteride, it takes several months of using minoxidil to see any effect. Any new hair will fall out if you stop using it, and the balding process will resume. There are two strengths available: 2% and 5%. Although it's not clear if the 5% lotion is more effective, it is more likely to cause side effects such as a dry or itchy scalp.

3. Hair transplant

This is a cosmetic procedure that involves grafting hair from another part of your head onto the bald spot. This can either be done by grafting a strip of skin or by grafting hair one follicle at a time. Hair transplant procedures have come a long way in the last decade and as such have grown in popularity.

It is a serious operation that should be considered at length. Be sure to speak to a qualified and experienced surgeon and ask them questions about their track record with the procedure.

4. A good haircut

These days it's become acceptable and even stylish to have a shaved head. Many balding men choose to brave the shave once their hair loss becomes noticeable.

If you don't want to embrace a smooth scalp, speak to your barber or hairdresser and ask for their advice on the best haircut for you. Sometimes a new style can make what seemed like drastic hair loss look insignificant.

Are we getting closer to curing baldness? New research and potential cures

Despite decades of research, we still don't have a cure for baldness. But just how close are we to an effective definitive treatment?

The existing treatments aren't effective on everyone and they have to be used consistently otherwise hair loss resumes. However, there are many researchers still striving for a cure for baldness.

Several recent discoveries have been made, which may in time lead to promising new treatments for male and female pattern baldness. Examples include:

KROX20 protein, SCF gene

This protein was identified by researchers at the University of Texas as the one which 'switches on' skin cells and gives them the signal to grow hair. It also produces SCF (stem cell factor) which plays a crucial role in hair colour. Still, much more research needs to be done before this knowledge has practical applications.

Genetics of male pattern baldness

A recent study by researchers at the University of Edinburgh has identified 287 genetic signals involved in male pattern baldness.

Faulty immune cells

University of California-San Francisco researchers have found that defects in an immune cell called Tregs play a role in male pattern baldness.

JAK inhibitors

A Columbia University Medical Centre study has found that hair growth can be restored by inhibiting the Janus Kinase (JAK) family of enzymes located in hair follicles.

Stem cells

Researchers at the Sanford-Burnham Medical Research Institute have developed a way to create new hair using stem cells.

What can I do to stop my hair loss?

If you are living with male pattern baldness or experiencing hair loss for any other reason, it's up to you whether you would like to get treatment or not. Many people simply embrace it as a fact of life, while others struggle emotionally with the change.

If you would like to see whether any of the treatments above can work for you, book an appointment with one of our experienced consultant dermatologists, who can help you to find the right solution for you.