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August 29, 2016

Hair Loss Causes in Men: Learn the Facts

hair loss causesWhat Causes Hair Loss?

“I love being bald,” said no man ever. Well, maybe one or two have said it.  Hair loss causes are many and vary depending on whether we are talking about men or women. Today we will discuss causes of hair loss in men and in a future article we will discuss hair loss causes in women.

According to the American Hair Loss Association website most men with male pattern baldness are “extremely unhappy” about it. That does not mean that some men do not look attractive being bald, but they probably are not happy about it no matter how good they look without a head of hair. Hair loss affects interpersonal relationships and even careers for those who find their hair thinning slowly with each passing day.

Hair Loss Statistics

By far and away the single largest cause of hair loss in men is androgenetic alopecia also known as male pattern baldness. Androgenetic alopecia accounts for 95% of hair loss in men.

Sixty-seven percent of men experience noticeable hair loss by age 35 and that percentage approaches 85% by age 50. Apparently misery loves company. Perhaps, most startling 25% of men begin losing their hair by age 21.

What is Androgenetic Alopecia?

Androgenetic alopecia is characterized by receding of the hairline form the sides of the forehead with or without thinning of the crown or vertex. In advance cases the receding hairline on the sides and thinning of the crown meet creating the horseshoe-shape ring of remaining hair around the back.

As the word “androgenetic” implies the largest cause of hair loss in men is genetically based. And, “andro” refers to male hormones. Androgenetic alopecia occurs because the hair follicles of some men (genetically determined) are overly sensitive to the hormone dihydrotestosterone or DHT.

DHT is made from the conversion of testosterone (the “male” hormone) by the enzyme 5-alpha reductase. DHT sensitive hair follicles become smaller over time leading to smaller, weaker, finer hair, and then finally the follicle stops producing hair.

In men with androgenetic alopecia the hairs the remain around the back and sides are resistant to the effects of DHT making those follicles suitable for use in hair restoration procedures.

Will I Become Bald?

“My dad was bald. Does this mean I am going to be bald?” It was once thought that male pattern baldness was passed on from the maternal grandfather. Hair loss is more complicated than that. Actually, hair loss genes are passed down from both sides of the family, but can skip generations. And, the manifestation of hair loss in siblings can vary significantly. Basically, it is random as to whether an individual will receive hair loss genes or not.

Other Hair Loss Causes

The following are other causes of hair loss in men that also cause hair loss in women, too.

Alopecia areata

Alopecia aerate is an autoimmune disorder. It can manifest on hair loss just affecting one part of the body like the entire scalp (alopecia totalis) to hair loss over the entire body (alopecia universals). Its cause is unknown and affects 2% of the population affecting both sexes equally. Hair loss can be quite patchy. It can correct on its own.

Cicatricial alopecia

Cicatricial alopecia is rare. Hair follicles are destroyed in cicatricial alopecia and replaced with scar tissue leading to permanent hair loss. Its onset can be gradual or hair loss can proceed quite rapidly and sometime associated with itching and burning.

Drug Induced Hair Loss

There is no shortage of drugs that can cause hair loss. These include:

  • Acne medications like containing vitamin A (Accutane).
  • Antibiotics and antifungals.
  • Anticonvulsants.
  • Antidepressants including frequently prescribed Paxil, Prozac, and Zoloft as well as several others.
  • Beta blockers used to treat blood pressure and heart disease.
  • Birth control pills.
  • Blood thinners including frequently prescribed coumadin and heparin.
  • Chemotherapy agents.
  • Cholesterol lowering drug like gemfibrozil and clofibrate.
  • Diet drugs like amphetamines.
  • Estrogen and progesterone replacement.
  • Nonsteroidal anti-inflammatory drugs including naproxen and indomethacin.
  • Ulcer medications like Tagmet, Pepcid, and Zantac.
  • Testosterone by raising DHT levels.
  • Thyroid drugs

Telogen effluvium

Stress of any kind can cause temporary hair loss. Such stress can be psychological or physical and can include hair loss following major surgery or poisoning.  This type of hair loss is called telogen effluvium and is the result of the early entry of hair into telogen phase or resting phase of the hair follicle. Hair loss from chemotherapy is a form of telogen effluvium.

Traction alopecia

Hair loss can occur in individuals who wear ponytails or tight braids that pull on the hair with excessive force. The traction on the hair follicle leads to trauma. If addressed and detected early enough hair loss is temporary but can be permanent if caught later.


Trichotillomania is the loss of hair from compulsive pulling and tugging of the hairs. The constant extraction of hair can lead to permanent hair loss.

Hair loss causes in men are many. But the number one cause of hair loss in men is androgenetic alopecia or male pattern baldness. Male pattern baldness is results from hair follicles sensitive to dihydrotestosterone or DHT. In future posts we will look at proven hair loss treatments and the more causes of hair loss in women.



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Dr. Joe Jacko

Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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