How to Tell If You Will Go Bald?

If you’ve noticed your hairline slowly receding or your hair thinning in certain areas, you may be wondering if you’re on the path to baldness. The reality is, about 85% of men will experience some form of hair thinning by the age of 50.

However, hair loss can begin much earlier, sometimes in your teens or early 20s. So, how can you tell if you will go bald? The answer lies in a combination of genetic factors, hormones (especially DHT), aging, and other lifestyle factors.

This guide will walk you through the early signs of balding, how to track your progress, and what you can do to manage it.

What Are The Main Causes of Premature Baldness?

1. Genetic Factors: The Most Significant Contributor

Genetics play a dominant role in determining the likelihood of premature baldness. Research suggests that around 80% of the predisposition to male and female pattern baldness is genetic.

This form of hair loss, medically known as androgenetic alopecia, is inherited and typically follows a polygenic pattern, meaning multiple genes contribute to the risk.

Key genetic markers have been identified, particularly within the androgen receptor (AR) gene, which resides on the X chromosome. Polymorphisms in this gene are strongly associated with hair loss, with studies showing that nearly 98% of young men with early baldness carry certain variations of the AR gene.

These genetic variations increase sensitivity to dihydrotestosterone (DHT), a hormone that causes hair follicles to shrink and gradually lose their ability to produce healthy hair. If your family members, especially those on your mother’s side, have experienced early hair loss, your risk is likely higher.

Additionally, research has identified other genetic loci, such as on chromosomes 3q26, 20p11, and 7p21.1, that contribute to early onset hair loss. The strong genetic influence makes premature baldness largely unavoidable for those with a genetic predisposition.

2. Hormonal Imbalances: The Role of DHT

One of the most significant hormonal contributors to premature baldness is dihydrotestosterone (DHT). This hormone is derived from testosterone, and it attaches to hair follicle receptors, causing miniaturization of the follicles. As a result, hair produced from these follicles becomes thinner, shorter, and weaker over time, eventually ceasing to grow altogether.

Elevated DHT levels are often found in the scalps of individuals experiencing premature baldness. The enzyme 5-alpha-reductase, which converts testosterone into DHT, plays a critical role in this process. Hormonal fluctuations during puberty, pregnancy, menopause, or andropause can exacerbate hair loss by increasing the activity of DHT.

Furthermore, anabolic steroid use, which artificially elevates testosterone levels, can significantly accelerate hair thinning and balding, particularly in individuals with a genetic predisposition. Thyroid disorders (such as hypothyroidism or hyperthyroidism) can also disrupt hormonal balance and cause substantial hair loss, which is often reversible with treatment.

3. Stress and Psychological Factors

Stress is a well-known contributor to hair loss, and it plays a particularly crucial role in premature baldness. When the body experiences chronic stress, it releases cytokines, which can cause inflammation and damage hair follicles. This may lead to conditions like telogen effluvium, in which a large number of hairs prematurely enter the shedding phase, resulting in noticeable hair loss.

Additionally, the psychological impact of premature baldness can create a feedback loop: the stress of losing hair can trigger further stress, which in turn may worsen the hair loss. Young individuals, especially those in their teens and early twenties, may face significant emotional distress from hair thinning, exacerbating the cycle of hair loss.

4. Nutritional Deficiencies

A poor diet lacking essential vitamins and minerals is another leading cause of premature baldness. Hair growth is a complex process that relies on various nutrients to function properly. Zinc, iron, B vitamins, and especially vitamin D are crucial for maintaining healthy hair follicles. Deficiencies in these nutrients can weaken the hair growth cycle, leading to early hair loss.

For instance, a lack of vitamin D has been linked to telogen effluvium and accelerated hair shedding. Iron deficiency anemia can also cause hair loss due to insufficient oxygen supply to the hair follicles. Ensuring a well-balanced diet rich in these nutrients can help maintain healthy hair growth and potentially reduce the risk of premature baldness.

5. Medical Conditions and Autoimmune Disorders

Certain medical conditions can cause or accelerate premature baldness. Alopecia areata, an autoimmune disorder, often affects young adults and leads to patchy hair loss. The condition occurs when the body’s immune system mistakenly attacks hair follicles, resulting in hair loss on the scalp and other parts of the body. It can happen at any age but is particularly prevalent in those under 30.

Other autoimmune diseases, such as lupus, can also cause hair loss due to inflammation in the skin, which may affect the scalp’s ability to maintain healthy hair follicles. Additionally, trichotillomania, a mental health condition involving the compulsive pulling out of hair, can lead to patchy bald spots if left untreated.

6. Medications and External Factors

Certain medications and lifestyle factors can contribute to premature baldness. Drugs prescribed for cancer, arthritis, depression, or high blood pressure can have side effects that include hair thinning. Chemotherapy, for example, is well-known for causing complete hair loss.

Additionally, external factors like excessive use of heating tools, tight hairstyles (leading to traction alopecia), and chemical treatments (such as perms and dyes) can damage the hair follicles, causing breakage and thinning. Smoking and a poor diet can also exacerbate hair loss, although their impact is generally secondary to genetics and hormones.

7. Age and Prevalence

While premature baldness is officially defined as hair loss that begins before age 30, age still plays a role in the overall prevalence of hair loss. Studies show that 24% of men aged 18-49 experience some form of hair thinning, with the prevalence increasing as men age.

In Singapore, 63% of males report hair loss, with 32% of men aged 17-26 already experiencing early signs of baldness.

There are also racial variations in the incidence of premature baldness. Caucasian men tend to experience earlier and more pronounced baldness compared to men of other racial groups. For example, Japanese men typically experience hair loss later than Caucasians.

How to Spot The Early Signs of Balding?

Recognizing the early signs of balding can be challenging, as hair loss often occurs gradually. The earlier you catch it, the more options you have to slow or manage the process.

1. Receding Hairline

One of the first signs of male pattern baldness is a receding hairline. This typically starts at the temples or sides of your hairline and gradually forms an “M” shape. Initially, it may be subtle and resemble a “maturing” hairline, which is a natural aging process.

However, a maturing hairline is different from balding because it doesn’t significantly change over time, whereas a receding hairline will continue to recede, signaling the onset of male pattern baldness.

2. Thinning Crown

The crown (the area at the back of your head) is another common site where balding starts. You may notice a small patch of thinning hair at the crown, which, if left unchecked, may gradually spread. This area may not be as immediately noticeable as a receding hairline, but thinning at the crown can be a clear indicator that you’re on the road to balding.

3. Diffuse Thinning

Unlike a receding hairline or crown thinning, diffuse thinning occurs when hair loss is spread evenly across the top of the head. In this type of thinning, you won’t notice a distinct receding hairline, but the overall volume of your hair will decrease.

This type of balding can be particularly subtle, and it may not be until you see a noticeable difference in fullness that you realize your hair is thinning.

4. Increased Hair Shedding

A certain amount of hair shedding (100-120 hair a day) is normal. However, if you notice an increase in hair fall, especially in the shower or while brushing your hair, this could be a sign that you’re losing hair more rapidly than usual. Pay attention if you see more than just a few hairs falling out at once, or if you notice hair clumps in your hands during regular activities.

5. Slow or Weak Hair Growth

If you notice that the hair on your head is growing more slowly, or the new hair is weak and thinner than it used to be, this could be a sign of miniaturization. When DHT affects the hair follicles, they shrink, making the hair they produce thinner and weaker.

If you’re noticing that your hair isn’t growing as fast or thick as it used to, it’s important to pay attention, as this could be an early sign of balding.

What Are The Important Tools and Methods to Assess Your Risk

1. Genetic Testing

If you’re serious about understanding your risk for baldness, genetic testing can provide insights. Companies like 23andMe and AncestryDNA offer genetic testing that looks for markers related to male pattern baldness, specifically the AR gene.

While these tests can give you an idea of your genetic predisposition, they can’t guarantee whether or not you will go bald, as environmental factors and lifestyle choices can still play a role.

2. Alpecin Baldness Calculator

For a quick self-assessment, tools like the Alpecin Baldness Calculator can help estimate your risk based on your family history, age, and other factors. Though not diagnostic, such tools can provide an early indication of your likelihood of developing baldness.

3. The Norwood Scale

The Norwood Scale is a tool used to classify the stages of male pattern baldness. It helps you track the progression of your hair loss, from a slight recession at the temples (Stage 1) to more advanced stages of baldness (Stage 7).

By comparing your current hairline and thickness to the stages on the Norwood Scale, you can gauge the extent of hair loss over time.

4. Regular Monitoring

It’s important to monitor your hair regularly. Use a mirror to check your hairline in various lighting conditions, as this will give you a more accurate view of any changes. You can also compare photos from previous years to track how your hair has changed over time.

If you notice significant changes in a short period, it may be worth considering treatments or seeing a dermatologist.

What You Can Do to Manage Balding

1. Minoxidil (Rogaine)

Minoxidil is an over-the-counter topical solution that can help slow hair loss and promote hair growth. It works by stimulating hair follicles and increasing blood flow to the scalp. If you catch hair loss early, Minoxidil can help preserve your existing hair and even regrow some lost hair.

2. Finasteride (Propecia)

Finasteride is an oral medication that works by inhibiting the production of DHT, the hormone responsible for shrinking hair follicles. By reducing DHT levels, Finasteride can help slow or stop the progression of male pattern baldness.

However, it’s important to consult a doctor before starting this medication, as it can have side effects.

3. Hair Transplants

For more severe cases of hair loss, hair transplants may be an option. During a hair transplant, healthy hair follicles are moved from one area of the scalp to the thinning or bald areas. While this is a more permanent solution, it can be costly and requires careful consideration.

4. Healthy Lifestyle

Maintaining a balanced diet, reducing stress, and avoiding smoking can all help maintain healthy hair. While lifestyle changes won’t prevent genetic hair loss, they can reduce the impact of environmental factors that may accelerate thinning.