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The Top Reasons Men Go Bald (and How to Deal With It)

The Top Reasons Men Go Bald (and How to Deal With It)

Have you ever run your hand through your hair, only to notice that a few too many strands have fallen out and ended up in your palm?

If so, you’re not alone. Data from the American Academy of Family Practice shows that approximately two thirds of American men will experience some degree of hair loss by the age of 35, with more than 80% dealing with hair loss by age 50.

Hair loss happens for a variety of reasons. Sometimes, stress from your work or personal life is all it takes for your hair to begin to thin. In other cases, medicines and drugs can cause your hair to shed prematurely, worsening the effects of male pattern baldness.

Most of the time, male hair loss is caused as a result of genetic and hormonal factors. You can read more about this in our guide to DHT and hair loss.

Below, we’ve listed the top reasons men go bald. We’ve also listed the most effective ways that you can deal with each cause of hair loss. If you’ve noticed your hairline beginning to recede or your hair beginning to thin, there’s a good chance you can find the root cause listed below.

Genetics

The vast majority of male baldness is caused by genetic factors, primarily the amount of male hormones your body produces and your hair’s susceptibility to them.

This type of hair loss is known as male pattern baldness (or androgenic alopecia), and it’s something that the majority of men will experience at some point in life.

Some hair loss is also the result of post-pubertal hairline recession. This usually happens in the early to mid 20s, and isn’t the same as male pattern baldness. Post-pubertal recession usually only affects the hairline and, for most men, isn’t something to worry about.

Male pattern baldness is both a genetic and a hormonal phenomenon. Certain people have hair follicles that are more sensitive to the male hormone dihydrotestosterone (or "DHT," a naturally occurring male steroid hormone) than others.

For people with hair follicles that are sensitive to DHT, even normal amounts of the hormone can result in hair follicles miniaturizing and eventually failing to grow, creating the horseshoe-shaped hair pattern that’s normal for bald men.

Not all people that are genetically predisposed to male pattern baldness will go totally bald. Male genetic hair loss can present itself as a slightly receded hairline, as diffuse thinning, or just as a small amount of hair loss around the temples.

Luckily, genetic male pattern baldness is easy and affordable to treat. Our guide to DHT and its role in hair loss explains how you can block dihydrotestosterone both topically and at its source using options like finasteride, minoxidil and topical shampoos to prevent further hair loss.

Stress

Far from being just an annoyance, stress is a serious health problem that can affect everything from your immune system to the thickness of your hair.

If you’ve been working long hours, rushing to meet deadlines or dealing with other aspects of a stressful work environment, there’s a possibility that stress from your job could have a negative impact on your hairline.

Stress-related hair loss can also be caused by stress in your personal life, whether from friends and family members or a problematic relationship.

Medical data shows that stress can lead to three different types of hair loss. The first, telogen effluvium, results in hair follicles entering into a resting phase as a result of your body’s stress hormone levels.

These hairs don’t fall out right away, but they can begin to fall out within weeks of the increase in stress hormones, often from everyday things like brushing your hair or washing with shampoo.

The second type of stress-related hair loss is alopecia areata. This is an immune condition that causes your body’s immune system to attack your hair follicles, resulting in extremely rapid hair loss that usually (but not always) grows back in time.

Alopecia areata is rare, and it’s usually a result of severe stress. While a few difficult days at the office aren’t likely to cause alopecia areata, month after month of exposure to a stressful work or home environment could trigger this condition in some people.

Interestingly, because alopecia areata is an immune system condition, it can even cause hair at the back of your head (which isn’t affected by male pattern baldness) to thin and fall out.

The third stress-related hair condition is trichotillomania. This is a serious disorder that’s also known as hair pulling disorder. People with trichotillomania have an extreme urge to pull out their own hair, resulting in patches of hair loss on the scalp and/or body.

Since stress-related hair loss isn’t hormonal or genetic, there’s no single solution. Most of the time, the best solution is to reduce stress levels, either through lifestyle changes, psychiatric help or the use of medications to treat the stress.

Diet

If you’re not genetically predisposed to hair loss or overly stressed but still have thinning hair or a receding hairline, your diet could be the cause.

Certain diets, particularly those with low amounts of vitamins and minerals, can cause your hair to shed prematurely. For example, study data shows that iron deficiency can contribute to a low rate of hair growth in mice -- a trait that researchers believe is shared by humans.

While research has yet to reveal a perfect diet for hair growth, most people agree that a diet rich in protein, iron, omega-3 fatty acids, zinc and selenium plays a major role in helping you grow a full head of strong, healthy hair. Several vitamins also play a major role in hair health.

If you’re a vegetarian or vegan, it’s important that you make consuming iron a priority. Medical studies show that vegetarians and vegans need to consume about 1.8 times as much iron as meat eaters in order to avoid iron deficiency and its potential effects on hair growth.

Drugs

Drugs, especially those that increase the levels of stress hormones or androgens in your body, can occasionally cause hair loss.

While most over-the-counter drugs are unlikely to trigger hair loss, many common prescription drugs can have a negative effect on hair health and, in some cases, can result in temporary or permanent loss of hair:

  • Retinoids, which are used to treat acne and other skin issues, can occasionally cause hair loss. Commonly prescribed retinoids include isotretinoin, which is widely known as Accutane and tretinoin, which is sold as Retin-A.
  • Antidepressants, which can cause stress-induced telogen effluvium, or hair shedding.
  • Thyroid medications, which can in rare cases cause diffuse hair loss due to thyroid overactivity.
  • Steroids, including testosterone and steroids derived from testosterone, which can convert to dihydrotestosterone and cause permanent male pattern baldness.

If you’re prescribed a medicine that you think is having an effect on your hair, it’s best to speak to your doctor to find out if it could be responsible and if any alternative treatment options are available.

Lifestyle

If you drink, party and barely get any sleep, there’s a risk that your hairline could suffer. Because sleep plays an important role in every almost aspect of your health, staying up late and failing to get enough sleep may have a negative effect on your hair health.

Research data shows that lack of sleep can contribute to stress, which in turn can often lead to diffuse hair loss and telogen effluvium. Low quality sleep also results in lower production of essential hormones, many of which play a major role in promoting hair growth.

While there’s no need to live like a Zen monk, reducing your consumption of alcohol, eliminating tobacco and going to bed earlier can help you avoid the negative lifestyle effects that could lead to hair loss.

Just remember that hair loss is still mostly hormonal and genetic. While improving your lifestyle is a great way to avoid stress-induced hair loss, it won’t do anything to stop genetic male pattern baldness -- that requires a different solution.

In closing

From hormones and genetics to diet, lifestyle and pharmaceuticals, a variety of factors all play a role in hair loss.

If you want to minimize your hair loss and preserve as much of your hair as possible, it’s vital to understand how these factors affect you. If you’re stressed, take action to eliminate stress from your life and fix the problem at its cause.

If you’re genetically predisposed to hair loss, learn about the role hormones and genetics play in hair loss and what you can do about it.

Finally, if your diet and lifestyle aren’t ideal for hair health, take steps to fix bad habits and make the switch to a healthier diet.

Not sure where to start? We specialize in helping people of all ages (including guys in their 20's and 30's who’ve only just started paying attention to their hairlines) deal with hair loss using real, proven solutions.

This content was reviewed by Brendan Levy, MD.

Important Safety Information

IMPORTANT SAFETY INFORMATION

Finasteride is for use by MEN ONLY and should NOT be used by women or children.

Read this Patient Information before you start taking Finasteride and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment.

What is Finasteride?

Finasteride is a prescription medicine used for the treatment of male pattern hair loss (androgenetic alopecia).

It is not known if Finasteride works for a receding hairline on either side of and above your forehead (temporal area).

Finasteride is not for use by women and children.

Who should not take Finasteride?

Do not take Finasteride if you:

  • are pregnant or may become pregnant. Finasteride may harm your unborn baby.
    • Finasteride tablets are coated and will prevent contact with the medicine during handling, as long as the tablets are not broken or crushed. Females who are pregnant or who may become pregnant should not come in contact with broken or crushed Finasteride tablets.
    • If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
  • are allergic to any of the ingredients in Finasteride. See the end of this leaflet for a complete list of ingredients in Finasteride.

    What should I tell my healthcare provider before taking Finasteride? Before taking Finasteride, tell your healthcare provider if you:

  • have any other medical conditions, including problems with your prostate or liver

    Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.

    Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

    How should I take Finasteride?

  • Take Finasteride exactly as your healthcare provider tells you to take it.
  • You may take Finasteride with or without food.
  • If you forget to take Finasteride, do not take an extra tablet. Just take the next tablet as usual.

    Finasteride will not work faster or better if you take it more than once a day.

    What are the possible side effects of Finasteride?

  • decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.

  • There may be an increased risk of a more serious form of prostate cancer in men taking finasteride at 5 times the dose of Finasteride.

    The most common side effects of Finasteride include:

  • decrease in sex drive
  • trouble getting or keeping an erection
  • a decrease in the amount of semen

    The following have been reported in general use with Finasteride:

  • breast tenderness and enlargement. Tell your healthcare provider about any changes in your breasts such as lumps, pain or nipple discharge.
  • depression;
  • decrease in sex drive that continued after stopping the medication;
  • allergic reactions including rash, itching, hives and swelling of the lips, tongue, throat, and face;
  • problems with ejaculation that continued after stopping medication;
  • testicular pain;
  • difficulty in achieving an erection that continued after stopping the medication;
  • male infertility and/or poor quality of semen.
  • in rare cases, male breast cancer.

    Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

    These are not all the possible side effects of Finasteride. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA1088.

    How should I store Finasteride?

  • Store Finasteride at room temperature between 59˚F to 86˚F (15˚C to 30˚C).
  • Keep Finasteride in a closed container and keep Finasteride tablets dry (protect from moisture).

    Keep Finasteride and all medicines out of the reach of children.

    General information about the safe and effective use of Finasteride.

    Medicines are sometimes prescribed for purposes other than those listed in this Patient Information. Do not use Finasteride for a condition for which it was not prescribed. Do not give Finasteride to other people, even if they have the same symptoms you have. It may harm them.