Not Just a Bad Hair Day: Unmasking Male Pattern Baldness

Rohan was still a student at university when he first noticed bald patches on his scalp. “It was embarrassing, and I felt self-conscious about my thinning hair. In fact, I still feel the same way,” he says. Given that 58% of Indian men aged 30–50 years experience male hair thinning, cases of baldness are not isolated. While hair fall is normal, progressive hair loss leading to bald patches on the head is a condition known as male pattern baldness.

The psychological burden of male pattern baldness is high. “I think I subscribe to the stereotype of balding making men less attractive. This also explains my self-consciousness about my own balding,” says Rohan.

Male pattern baldness happens when the scalp loses hair that doesn't regrow naturally. Hallmark signs include a receding hairline and hair thinning at the top of your scalp and near your temples.

According to Dr Divya Sharma, a Bengaluru-based cosmetic dermatologist and hair specialist, balding in males is multifactorial. Male baldness may be triggered by genetic, hormonal, and environmental factors. In fact, a 2022 study conducted in China revealed a significant association between sugary beverage consumption and increased incidence of male pattern baldness.

Baldness is often hereditary.  Although scientists have not yet fully understood the genetic basis, research shows it can be polygenic — more than one gene is responsible for passing it on. Additionally, genes can pass from either the maternal or paternal side.

Dihydrotestosterone (DHT), a sex hormone created from testosterone, has a special connection with balding. If your hair follicle — the tubelike structure from which each strand of hair grows — is particularly sensitive to DHT, it can gradually shrink over time. Consequently, your hair strands can get thinner, leading to a receding hairline.

The risk of hair loss in men increases with age, with some experiencing thinning hair as early as in their 20s.

Poor diet and stress worsen male pattern baldness in genetically predisposed men. “Vitamin B12 and D deficiencies may increase the odds,” adds Dr Deepali Bhardwaj, dermatologist.

The treatments for male pattern baldness involve medications — oral and topical — that a doctor may prescribe. However, side effects of such treatments may include itching, scaling, and irritant contact dermatitis for topical medications and reduced sex drive, erectile dysfunction, and premature ejaculation with penile shrinkage for oral medications, as was reported in one study.

There are also surgical and non-surgical treatments that a doctor may recommend depending on the patient’s unique condition. 

There are no scientifically proven methods that can completely prevent male pattern baldness. According to Dr Sharma, timely treatment can delay the onset to an extent. 

Dr Bhardwaj adds that removing triggers like harsh shampoos, styling gels, and hard water and increasing blood vasculature through massage can also delay baldness in those with a genetic predisposition.

Don’t dismiss hair loss as a mere ‘cosmetic issue’. Consult a dermatologist if you notice the signs.

Around 25% of individuals experience hair loss before turning 21. “Premature male pattern baldness before the age of 35 is also becoming common in India,” adds Dr Sharma.

Since male pattern baldness is a genetic condition, it is not completely preventable.

Home remedies alone may not reverse male pattern baldness, given its multifactorial nature.

“When performed correctly by skilled professionals, hair transplant is a safe procedure,” notes Dr Sharma. Common side effects include itching, facial swelling, and pain. Hiccups are an unusual but not uncommon side effect.