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The reason some men go bald, according to a dermatologist

Graham Flanagan   

The reason some men go bald, according to a dermatologist
  • We asked a dermatologist to explain why some men lose their hair, and why male pattern baldness can strike early in life.
  • According to Dr. Jennifer Chwalek, genetics will likely determine whether or not you lose your hair, and how soon it will happen.
  • Testosterone is converted to dihydrotestosterone in the hair follicle by an enzyme called 5-alpha-reductase.
  • When the enzyme attaches to the androgen receptor in the hair follicle in susceptible individuals, it causes the follicle to produce a smaller hair.
  • According to Chwalek, about 40% of the population has some degree of thinning.
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Following is a transcript of the video.

Graham Flanagan: Look at that beautiful bald man. He's oozing swagger and confidence. He owns it. But it wasn't always like this. This is Rob. He's 33. This is also Rob. He started to lose his hair when he was about 20. So, what happened? Why did Rob go bald, and what does it mean? There's something about being bald and owning it. I mean, look at all these bald icons. Michael Jordan, Jason Statham, his sidekick, The Rock. But losing your hair is not something you aspire to.

Commercial: If you're concerned about your thinning hair, call Hair Club for Men and receive our free brochure.

Flanagan: In fact, there's an entire industry built around fighting it.

Man: And remember: I'm not only the Hair Club president, but I'm also a client.

Flanagan: I asked a dermatologist about why some men lose their hair and if going bald is my destiny as well.

Jennifer Chwalek: So, when we say "baldness," we're usually referring to male-pattern baldness, or androgenetic alopecia. The hair follicle is slowly, over time, becoming smaller and smaller, to the point when it stops producing a full hair. Testosterone is becoming converted to dihydrotestosterone in the hair follicle by an enzyme called 5-alpha-reductase, and when it attaches to the androgen receptor in the hair follicle, it causes the follicle to produce a smaller hair.

Flanagan: So, I want to show you my friend Rob here. Rob started losing his hair in his early 20s, and, as you can see, there's little to...well, there's none left. So what is going on with Rob?

Chwalek: Well, Rob has what we call androgenetic alopecia, or male-pattern baldness. This is due to several genes. And some of the genes are early expressing, and some susceptible individuals, they start to lose their hair very young, usually by age 30.

Flanagan: The fact that Rob is bald, does that make him any less virile?

Chwalek: No. So, it's a myth that hair loss or balding is associated with virility in men. Men who go bald don't have abnormal levels of testosterone. It's really that the hair follicle becomes sensitized to the effects of testosterone or androgens, and it starts to create a smaller hair, and eventually it stops producing hair.

Flanagan: So, what role do genetics play, and is it true that baldness is inherited from your mom's side?

Chwalek: The genetics of male-pattern thinning and baldness is complicated. We know that the androgen receptor gene is on the X chromosome, which is inherited from your maternal side, typically. So, there are some studies showing that having a brother who expresses male-pattern baldness might be more predictive than if your father has male-pattern thinning.

Flanagan: Let's talk about me.

Chwalek: Mm-hmm.

Flanagan: I'm 37. I've still got some hair.

Chwalek: Yeah.

Flanagan: But can you tell me what's going on? Am I gonna go bald?

Chwalek: Well, do you have a family history of any thinning?

Flanagan: Yes, I do, on my dad's side. My dad, pretty much bald, his brother is bald. I have a brother who has a very thick head of hair.

Chwalek: Do you think your hair has been thinning?

Flanagan: I think it might be, like, in the front a little bit. I don't really know what's going up top there.

Chwalek: Yeah, maybe a little.

Flanagan: Really?

Chwalek: Maybe a little. So, androgenetic alopecia is actually not an uncommon trait. About 40% of the population has some degree of thinning, usually between the ages of, like, 20 to 40.

Flanagan: My wife, Janet, she really likes my blond hair, and if it were to go, that could be a problem. So, how long do you think I've got to keep some semblance of this?

Chwalek: I think you probably have a while to go. I think you're gonna be OK. The men who tend to go bald-bald tend to do so by age 30, usually.

Flanagan: Based on what you see, my age, what I've described about my family, you don't expect my hair to just fall out in the next, like, five years?

Chwalek: No, it would be unusual, but you may notice, you know, as you get a little bit older, it may continue to thin slightly.

Flanagan: OK, that's a relief. Fantastic. That's great!

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