BALDNESS. causes (evolutionary & genetically) and control

pattern baldness affects over half of

men to some extent over the age of 50 and

most men at some stage in their lives. Most

affected men do not wish to have any

treatment. If required, there are some

treatments which can prevent further hair

loss and may help hair regrow.

What causes male pattern

baldness?

Hair is made in hair follicles which are like

tiny pouches just under the skin surface. A

hair normally grows from each follicle for

about three years. It is then shed and a

new hair grows from the follicle. This cycle

of hair growth, shedding and new growth

goes on throughout life. The following is

thought to occur in men as they gradually

become bald:

Affected hair follicles on the scalp

gradually become smaller than normal.

As the follicle shrinks, each new hair is

thinner than the previous one.

Before falling out, each new hair grows

for much less time than the normal

three years or so.

Eventually, all that remains is a much

smaller hair follicle and a thin stump

of hair that does not grow out to the

skin surface.

Male hormones are involved in causing these

changes. The level of the main male

hormone, testosterone, is normal in men

with baldness. Cells in the skin of the scalp

convert testosterone into another hormone

called dihydrotestosterone. For reasons

that are not clear, affected hair follicles

become more sensitive to

dihydrotestosterone, which causes the hair

follicles to shrink. It is also not clear why

different hair follicles are affected at

different times to make the balding process

gradual. It is also not clear why only scalp

hairs are affected and not other areas

such as the beard or armpits.

The condition is hereditary (genetic).

Various different genes have been shown to

be involved.

Are there any complications

from male pattern baldness?

Although male pattern baldness is a

common and harmless condition, it can

occasionally be linked to metabolic

syndrome. This is a combination of obesity,

diabetes, raised blood pressure and raised

cholesterol. People with this syndrome have

an increased risk of heart disease. This link

is most often seen in men who develop

baldness at a relatively young age.

Men can feel less good about their own

appearance when they lose hair. This can

sometimes affect their mood and well-

being.

There is more risk of sunburn and sun-

related skin damage when the skin is not

protected by hair. This can be avoided by

the use of suntan lotions and hats.

Women with male pattern baldness should

be checked for causes of raised male

hormone levels. For example, conditions

such as polycystic ovary syndrome – a

condition in which cysts develop in the

ovaries.

What are the treatment

options for male pattern

baldness?

No treatment

To become gradually bald is a normal part

of the ageing process for most men. No

treatment is wanted or needed by most

affected men. For some men, baldness can

be distressing, particularly if it is excessive

or occurs early in life. Treatment may then

help.

Medication

Currently there are two medicines that help

– finasteride (Propecia®) and minoxidil

(Regaine®) . Neither is available on the NHS,

so you need to pay the full price for them.

Finasteride was launched in the UK in

2002, although it has been available in the

USA since 1997. It works by blocking the

conversion of testosterone to

dihydrotestosterone. The hair follicles are

then not affected by this hormone and can

enlarge back to normal.

In around 1 in 3 to 6 men taking

finasteride, enough hair regrowth occurs

for them to consider treatment helpful.

Some points about finasteride include the

following:

It takes about four months for any

effect to be noticed and up to 1-2

years for full hair growth.

The balding process returns if

treatment is stopped. Therefore, if

successful, you need to carry on

treatment to maintain the effect.

Side-effects are uncommon. The most

common is that about 2 in 100 treated

men report loss of sex drive (libido).

It does not work in women with male

pattern baldness.

You need a private prescription to get

it from a pharmacy.

CHECK THE QUESTION ASK AND SEVERAL ANSWERS PROVIDE

What exactly is the evolutionary reason

behind male baldness? It happened to me

about 10 years ago and its advantages are

not immediately apparent.

Keith Stael, Brighton England

There isn’t an evolutionary advantage or

disadvantage in male pattern baldness, it’s

just one of those things. Nothing that

happens after the usual age of reproduction

can act much on evolution, and many things

are neutral or disadvantageous. I’m afraid

nature has little or no interest in the

individual after they have reproduced.

Although since male pattern baldness is

connected with hormone levels, it may be

that being prone to it is advatageous in

earlier life since higher levels of testosterone

may be linked both to reproductive success

and to male pattern baldness. You can’t

have it both ways!

Susan Deal, Sheffield, UK

In evolutionary terms, when ‘man’ became

the hairless ape it coincided with the

discovery of fire which selected the less

hairy cavemen as they were less flammable.

So, it could be construed that as ‘man’

became older and generally slower in his

reactions that his hair disappeared in order

to prevent any hirsute horrors. Therefore

balding men have a genetic advantage that

may now be redundant. Also, baldness may

confer an aerodynamic advantage when

swimming, chasing prey or potential mates.

C Jackson, Tseung Kwan O Hong Kong

A well-polished bald male head was often

used by tribes of cavemen to blind

predators. As a result every cavemen

hunting group of 8 had one bald member,

and thus thousands of years later 1 in 8

men experience early on set of baldness.

Taz Boonsberg, London UK

Males tend to lose their hair because it was

never in their Top Ten Attributes. So as their

bodies deteriorate due to age, disease and

wear and tear, hair is jettisoned in favour

of more important attributes, eg sexual

potency and physical strength. Females, by

contrast, rate their hair highly because it is

a way of attracting the attention of a

potential mate. Therefore baldness is much

rarer in females than in males. It all comes

down to how much energy the body is

prepared to invest in any particular

attribute. You may wish that it would invest

more in your hair, but unfortunately the

investment decisions were taken millenia ago

and programmed into our DNA. All you can

do now is grin and bare it. Or wear a wig.

Les Reid, Belfast UK

Why worry about the evolutionary reason?

But the advantages are obvious. You’re

saving a small fortune that would otherwise

be lavished on your hairdresser and don’t

have to answer inane questions about what

you did on your holiday to someone who

really isn’t interested anyway.

Sheila Kirby, Esbjerg Denmark

My late father used to say that men who go

bald from the front of their heads are great

thinkers. Men who go bald from the backs of

their heads are ‘sexy’. Yet, men who go bald

all over think they are sexy.

Johnathan Wilkinson, Surabaya, Indonesia

It has no advantages. To give an

evolutionary advantage, a trait must lead to

differential reproduction. This means that a

trait has to help you make more or fewer

babies to be selected for or against.

Baldness happens, but it doesn’t keep you

from making babies or make you more able

to make them.

Amanda, Raleigh, North Carolina, USA

Its obvious. Going bald saves you a fortune

on hair care products which means you have

more cash to spend, more liquid cash means

more socialising thus leading to greater

opportunity to meet the right partner etc,

etc.

Kevan , Lucca, Italy

One theory put foward by researchers

Muscarella and Cunningham susgests

baldness may have evolved in males through

sexual selection as an indicator of aging and

social maturity when males become less

aggressive and more nurturing. I good thing

for fatherhood I would say. Less threat of

infanticide and another source of resources

for fragile infants. Would these males be

more faithful as well?

Rachel Steen, Great Falls, USA

Humans are very tribal and sometimes

warlike creatures. I wonder if hair patterns

provided a method of recognizing blood

relatives. The teamwork and shared

resources improved the odds of survival for

genetic lines that were able to recognize and

cooperate with kin. Sort of like the uniforms

used by sports teams.

Don Ringwald, New Lenox, IL USA

Loss of hair creates more skin area, which

means more vitamin D can be absorbed from

sunlight. This would provide a survival

benefit for men, which would explain this

trait being passed on.

Joe Dokes, Chicago, USA

Baldness is a gift from nature. Once you

begin to lose hair, you realize you are ageing

and that nothing about you is forever. You

are not here for admiring yourself in the

mirror but for changing this world.

Therefore you’ll become wiser and death

won’t make you worry.

Tim Owen, Suffolk

Once all that clubbing them over the head

stuff stopped, it became necessary to

actually attract females, in order to

reproduce. Nature quickly discovered that it

was better for the human race (survival,

etc.) to stay together in family units. Men

go bald to render them less attractive to

other women who might otherwise steal them

from their families (who would potentially

die without them). Evolution is all about

survival of the alivest…

John Kulin, Purgatory, USA

Because chicks dig it.

Patrick, California, USA

So predators can identify them as the oldest

and weakest. Easy prey.

Albert,

I wonder if it can be linked to the time in

evolution when Europeans lived in Central

Asia before moving west to Europe. Vitamin

D was a scarce necessity. I like to think of

my bald head as sun ray receiver. I have

noticed that women 30+ are a lot more

likely to be attracted to me partially due to

my baldness, sometimes very much so 😉

Richard, Tacoma USA

It is partly a cultural and partly a social /

evolutional mechanism. It’s interesting to

take notice that baldness separates men in

two groups clearly. It should have some

evolutional advantage in some way,

otherwise the genes for male pattern

baldness would not be so wide spread (sexual

selection). In our western culture being

young and healthy has become a second

religion. Getting wrinkles, gray hair and

balding are associated with aging. A young

guy looks significant old when balding

natural (without shaving). What I

experienced with balding was the deep

painful sense that I couldn’t be the curly

haired ‘nice guy’ anymore. Most girls I

hooked up with liked my curly hair. I lost

something that made it more easy for me to

be treated as the ‘curly haired sweet

guy’…After I shaved my head, I

experienced that more girls where less

friendly to me and sometimes even ignored

me. That hurts, because I am the same guy.

But I think we all have to live with it, it’s

something in our culture. You have to work

harder to get that one sweet girl until she

accepts you for who you are. My theory is

that balding is a mechanism to ‘force’ men

to focus, mature and don’t waste time on

short term ‘pleasures’..like one night

stands. Maybe balding is a phase in life to

‘trigger’ certain behavior in humans. Some

doors are closed with balding and other are

opened…maybe it’s a gift of nature 😉

Bart, San Diego USA, CA

Have you ever noticed high ranking male

gorillas or chimps being groomed by

females? The more higher in status the more

they are groomed. What happens with

excessive grooming? They look as if they are

going bald because the hair keeps being

pulled out. So the more bald you loovideoplaybackk the

more attractive you are to females who

think you must be of a high status to have

achieved such baldness, therefore genetic

baldness would mimic groomed baldness and

would be evolutionary advantageous. So you

would have bald apes going around conning

females into thinking they were some local

stud.