It’s normal to lose some hair from your scalp each day. But if your hair is thinning or shedding faster than usual, you may be balding.
You’re not alone, though. Most people experience hair loss as they get older. Often, it’s related to genetics and the natural process of aging. In other cases, balding may be due to an underlying medical condition.
In this article, we’ll explore the possible causes and symptoms of balding. We’ll also discuss options for treatment and prevention in both men and women.
What exactly is balding?
Balding is due to excessive hair loss from the head. The term “balding” is most commonly used to refer to androgenetic alopecia, or male or female pattern hair loss.
The hair growth cycle typically includes three phases:
- Anagen phase. The anagen phase of hair on the scalp, or growing phase, lasts about 2 to 4 years. Approximately 90 percent of the hair on your scalp is in this phase.
- Catagen phase. During the catagen phase, the hair follicles shrink over 2 to 3 weeks. It’s also called the transition phase.
- Telogen phase. In the telogen phase, or resting phase, the hair sheds after 3 to 4 months.
When hair falls out at the end of the telogen phase, new hairs grow in. But when there’s more hair loss than growth, balding occurs.
What are the symptoms?
Since the term “balding” is almost exclusively used to describe androgenetic alopecia, the typical symptoms include:
- thinning on top of the head
- receding hairline (in men)
- widening hair part (in women)
What causes balding?
Androgenetic alopecia is what typically causes balding. In men, it’s more commonly known as male pattern baldness. In women, it’s known as female pattern baldness. It’s responsible for 95 percent of the cases of permanent hair loss, states the American Hair Loss Council.
This type of balding isn’t necessarily a disease. It’s a condition related to:
- genetics, which means it’s inherited
- normal aging process
- male hormones called androgens
Genetics play a role in the predisposing factors for androgenetic alopecia, possibly affecting key enzymes like 5-alpha reductase, which converts testosterone to dihydrotestosterone (DHT). Both hormones are androgens.
When DHT increases, or when the hair follicle becomes more sensitive to DHT, the hair follicle shrinks. The anagen phase also shortens and, as a result, hairs falls out earlier than normal.
In both men and women, androgenetic alopecia typically happens gradually. In men, it causes a receding hairline and thinning at the top of the head. These are typical characteristics of male pattern baldness.
Women don’t typically develop a receding hairline. Instead, they predominantly experience thinning throughout the top of the scalp, which manifests as a widening hair part. This is typical of female pattern baldness.
Other possible causes of hair loss or bald spots
Although androgenetic alopecia is by far the most common cause of balding, there are other conditions that can cause you to lose hair or develop bald spots on your scalp.
However, unlike alopecia, these conditions usually don’t follow a predictable progression with hair loss. This means they don’t cause your hair to recede in a pattern that’s typical of balding.
The following conditions can produce varying degrees of hair loss, some of which can be permanent and others that are reversible:
- Traction alopecia. Some hairstyles, like tight ponytails, braids, corn rows, or extensions, can pull and provide stress on the hair follicles. This can cause traction alopecia, or hair loss due to repeated tension. The hair loss may be reversible early on, but it’s permanent if prolonged.
- Alopecia areata. An autoimmune disease where the body attacks its own hair follicles, alopecia areata can damage the hair roots, resulting in hair loss. The hair may or may not regrow by itself.
- Anagen effluvium. With this condition, a toxic substance impairs the hair follicle during the anagen phase. This often causes sudden but typically reversible balding. It’s most often associated with chemotherapy, but radiation therapy and other drugs can also cause it.
- Telogen effluvium. Hair loss with this condition results from major stress or shock. It usually develops 2 to 3 months after an event like surgery, physical trauma, illness, or severe weight loss. In most cases, the hair grows back within 2 to 6 months.
- Tinea capitis. Tinea capitis is ringworm of the scalp. It happens when fungi infect the scalp and hair shaft, causing a localized scaly patch. This can cause scarring and, therefore, permanent hair loss if not treated early.
Sometimes balding is a side effect of an underlying medical condition. It may be associated with:
- hypothyroidism
- hyperthyroidism
- nutritional deficiencies
- iron deficiency anemia
- a diet low in protein
What won’t cause hair loss
Contrary to popular belief, the following aren’t responsible for balding:
- wearing hats
- wearing wigs
- frequent shampooing
- dandruff
What are the treatment options?
The most common treatments for male or female pattern baldness include the following options:
Medications
- Minoxidil. Topical minoxidil, or Rogaine, is an over-the-counter prescription medication that both men and women can use. It can take at least 6 months for this treatment to promote hair regrowth.
- Finasteride. This prescription drug (brand names Propecia or Proscar) treats hair loss in men. In most individuals, it results in hair regrowth or slower balding.
- Spironolactone. Also known under the brand name Aldactone, doctors prescribe spironolactone off-label to treat female pattern baldness. It reduces androgen production and blocks the effects of DHT, the hormone that can increase hair loss.
- Hormone therapy. During menopause, estrogen and progesterone therapy may help slow down hair loss in women.
Other options
- Laser therapy. Laser therapy can treat male or female pattern baldness. It uses low energy pulses of light to stimulate hair follicles.
- Protein-rich plasma (PRP) injections. PRP treatment uses platelets from your own blood. It’s concentrated and injected into locations of hair loss, which may contribute to hair growth. This is an off-label treatment for androgenetic alopecia.
- Hair transplant. During a hair transplant, the surgeon removes existing hair and reinserts the hair into bald spots on the scalp.
- Nutrition. According to one studyTrusted Source, hair growth may increase for women who up their intake of omega-3 and omega-6 fatty acids and antioxidants.
Can you prevent hair loss?
Balding due to genetics isn’t preventable. However, you can reduce the risk of other types of hair loss with these tips:
- Loosen your hairstyle. Tight hairstyles, like ponytails or braids, can damage your hair follicles.
- Limit heat damage. Styling tools like straighteners and curling irons may contribute to root damage.
- Massage your scalp. Some recent research has shown that regular scalp massages may help promote hair growth. However, don’t overdo it. Constant rubbing and stress to your follicles may cause damage.
- Eat a healthy diet. A diet that lacks a variety of nutrients may lead to hair loss.
- Quit smoking. Some older researchTrusted Source suggests a link between smoking and hair loss.
- Cooling cap. If you’re getting chemotherapy, a cooling cap may help reduce hair loss after treatment.
- Switch medication. If your current medication causes balding, ask your doctor about alternatives.
The bottom line
The vast majority of the time, androgenetic alopecia causes baldness. In men, it’s more commonly known as male pattern baldness. In women, it’s known as female pattern baldness. With this type of balding, hair loss follows a fairly predictable pattern.
If you’re concerned about balding, talk to your doctor or dermatologist. Depending on the cause, they might be able to recommend medication or procedures to treat or slow down your hair loss.
