Hereditary hair loss is a typical sign of aging in many men. First the hair on the temples and on the forehead thins out, then the hair on the back of the head becomes thinner. More and more hair roots die off until balding occurs. Eight out of ten men suffer from hormonal hair loss, and in every second man the hair roots begin to die off at an early age between 20 and 25 years.
Women are less likely to experience hair loss. Only one in ten loses a noticeable amount of hair before the menopause for hormonal-hereditary reasons, two to three out of ten women lose more hair after the menopause - mostly in the area of the middle parting. Even if hair loss caused by hormones is not an illness, many of those affected feel their self-esteem is impaired.
Hair Loss Causes
The cause of hereditary hair loss in men is an increased sensitivity of the hair follicles to a certain form of the male sex hormone testosterone (dihydrotestosterone, DHT) and the increased production of a certain enzyme. The increased sensitivity to DHT and the amount of converting enzyme in follicles and hair roots are genetically determined. DHT in the hair follicles shortens the growth phase of the hair. They fall out more and become shorter and finer. Since male hormones are also called androgens, hereditary hair loss is also called androgenetic alopecia.
Recent research has also discovered a messenger substance (prostaglandin D2, PGD2) that was found in increased amounts in the scalp of men with hair loss and is now suspected of slowing down hair growth. Research is currently being carried out into suitable antidotes.
The male sex hormone testosterone also plays a crucial role in women with hereditary hair loss. The fact that many women suffer from increased hair loss after menopause has less to do with rising testosterone levels than with a decrease in female sex hormones, which can no longer counteract testosterone.
It is therefore a misconception that women with hair loss have too much testosterone in their blood. Also, in the realm of myth, all bald men are overly masculine due to high doses of male hormones. The testosterone responsible for hair loss is local to the hair roots.
Although hereditary hair loss - as the name suggests - is already a predisposition in the genes, it is by no means certain that a father with a bald head will also have sons whose hair falls out just as much. Likewise, the daughter's hair can thin after the menopause, while the mother has thick hair into old age.
Eight out of ten men are affected by hereditary hair loss, most of them show the typical receding hairline-baldness pattern. Only 20% suffer from a female failure pattern with a center parting.
Half of all women suffer from hereditary hair loss during their lifetime, mostly after the menopause. Only around every tenth person affected already shows clearly visible hair loss at the age of 20 to 30.
Hair Loss Symptoms
Are you losing more hair on your forehead and temples?
Is your hair thinning along the middle parting?
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| Hair loss causes and symptoms |
Hereditary hair loss begins gradually. The hair is thinning more and more in certain parts of the head, while at the same time the hair density decreases. Doctors distinguish between increased hair loss (effluvium) and visible bald spots (alopecia). How much hair a person loses and how quickly this happens varies from person to person. Above all, the patterns differ in men and women.
- In men, the forehead and temples are the first to be affected by hair loss, so-called receding hairline forms. This is often followed by a receding hairline. Next, many men lose their hair on the top of the back of the head (tonsure at the spine or vertex region). As the hereditary hair loss progresses, the bald spots can get closer and closer together until only a fringe of hair remains. When a man develops a receding hairline, it doesn't mean he's going bald. There are young men in their mid-20s with completely unkempt hair and men in their 70s whose full head of hair is gray at best. Only a fifth of men lose their hair on the center parting, while the temples and back of the head retain their normal hair density.
- In the case of hereditary hair loss, women usually lose the hair in the middle parting area. They rarely develop bald patches - rather, the hair thins out more and more until the scalp becomes visible. A few women show a similar course of hair loss as men with a receding hairline and tonsure, although it is not nearly as pronounced.
Physicians divide the progression of hereditary hair loss in men into seven stages, with Stage I corresponding to the normal state and Stage VII corresponding to complete baldness (Hamilton-Norwood classification). In women, doctors distinguish only three stages of hereditary hair loss.
Although hereditary hair loss is a normal process and not a disease, many sufferers suffer when their hair falls out. Thick hair is socially associated with attractiveness and health. As a result, those affected by hair loss feel less attractive and healthy. This does not only apply to women, men also often find their dwindling scalp hair a psychological burden and would like to stop the process.