From Samson to Homer Simpson, men and hair loss seems always to have been a losing combination. Although male pattern hair loss is extremely common—two out of three men will experience it—and is rarely associated with serious health risks, it’s hard to imagine a common condition that is met with more trepidation. But much of the stigma surrounding male hair loss is due to half-truths and exaggerations. So if you start noticing there’s not as much hair up there, don’t pull out the rest of it in worry—take our quiz below and learn what’s going on with your body and how you can slow the follicle fallout.

If you’re losing hair, it’s male pattern baldness.
False. It’s true that for 95 percent of men who lose their hair, male pattern baldness, or androgenetic alopecia, is the culprit. With this condition, an enzyme called 5-alpha reductase converts testosterone to dihydrotestosterone, a hormone that causes hair follicles to shut down hair production. Male pattern baldness can begin appearing in men in their 20s and usually progresses slowly from the front or apex of the scalp, or both.

But male pattern baldness is not the only cause of male hair loss—and it’s important to talk to your physician or dermatologist to determine the cause, because it can indicate certain health problems. For example, if your hair is falling out quickly and in small patches, it may be a sign of alopecia areata, an autoimmune disease in which the body attacks the hair. Stress can also lead to rapid hair loss. In these cases, the hair usually regrows after several months. Other causes include a severe ailment or major surgery; protein, vitamin B, or iron deficiencies; medication complications; or thyroid disease.

It’s your mother’s fault.
False. Male pattern baldness is a largely genetic characteristic that can be inherited from either your mother or your father. It’s even possible to acquire the hair-loss gene from both parents. In fact, the same gene also causes hair loss in women, although because of hormonal differences, women tend to lose their hair in small amounts all over their scalp.

There’s hope.
True. Here’s the good news: In many cases, male pattern baldness can be treated. In the early stages, many conventional physicians prescribe either minoxidil lotion, applied topically, or finasteride, taken orally. These medications have been shown to slow hair loss in many patients and, in some cases, cause hair to grow back. According to Robert Brodell, MD, professor of internal medicine in the dermatology section at Northeastern Ohio Universities College of Medicine, complications associated with both drugs are minimal, but there are downsides. Not only are the medications expensive, but they only work for as long as you take them. “I tell my patients that they are going to be on one of those medicines for 5 years or 10 years or 15 years, until they are married and have kids and don’t care anymore,” says Brodell. “And then when they stop their medicine, we fully expect them to start losing their hair again.” Great strides are being made in the field of hair transplants, but like any invasive therapy, these procedures are expensive and time-consuming and should not be undertaken lightly.

Saw palmetto, stinging nettle root, and beta-sitosterol appear to work similarly to conventional medicines.

If surgery or drug therapies aren’t for you, a number of naturopathic remedies might offer similar results—without the high cost. Keith F. Zeitlin, ND, a naturopathic physician with a private practice in Connecticut, recommends the herbs saw palmetto (Serenoa repens) and stinging nettle root (Urtica dioica), and the supplement beta-sitosterol, which all appear to work similarly to conventional medicines by shutting down the enzyme 5-alpha reductase’s creation of dihydrotestosterone, the hormone that ceases hair production. “If we can inhibit that enzyme, we can actually inhibit hair loss,” says Zeitlin. (For more information, see “Herbs and Supplements for Hair Loss,” below.)

Another option is mesotherapy, a treatment in which very short needles are used to inject homeopathic remedies; vitamins such as biotin; or conventional medicines such as minoxidil just underneath the surface of the scalp. “The skin is used as a natural time-release system,” says practitioner Harry Adelson, ND, a Utah-based pain-medicine specialist. “Whatever it is you are injecting remains in the area for up to a week and continually penetrates down into the deeper tissue.”

You can live a hair-healthy lifestyle.
True. Although there’s no apparent validity to the old wives’ tales that sexual activity or excessive hat-wearing can cause hair loss, other lifestyle choices may indeed hurt your hair. In fact, it might make more sense to keep that hat on; a study conducted at the University Hospital of Zurich in Switzerland proposed that ultraviolet rays from the sun might injure hair follicles (Dermatology, 2003, vol. 207, no. 4). How you clean and care for your hair may also be a factor in hair loss. According to the American Academy of Dermatology, too many chemical treatments such as dying, straightening, and bleaching, as well as excessive washing, towel drying, and brushing, may weaken or damage your hair, causing it to break or fall out.

Replace saturated fats and vitamin A-rich foods, which may encourage hair loss, with green vegetables, whole grains, and essential fatty acids.

Those worried about hair loss should also reevaluate their diets. Zeitlin warns that very large doses of vitamin A can lead to vitamin A toxicity and eventual hair loss. He recommends his patients replace vitamin A-rich foods and saturated fats, which may also encourage hair loss, with green vegetables, whole grains, essential fatty acids, and other foods rich in hair-healthy vitamins and minerals such as zinc. What you drink may also play a role: According to a 2003 study, alcohol consumption may aggravate hair loss (British Journal of Dermatology, 2003, vol. 149, no. 6).

Resources

American Academy of Dermatology
www.aad.org
202.842.3555
Includes detailed information on hair loss and hair health and connects patients with local dermatologists.

The American Association of Naturopathic Physicians
www.naturopathic.org
866.538.2267
The easiest way to find a naturopathic physician in your area who can talk to you about alternative treatments for hair loss.

Hair loss is a bad thing.
False. Let’s not forget the cheapest, easiest, and safest treatment for male pattern hair loss: doing nothing at all. After all, hair loss is not usually a health concern and, despite what our culture may sometimes suggest, there’s nothing wrong with showing a little skin—on your head, that is. After all, look at Patrick Stewart, Bruce Willis, and Sean Connery. “I certainly wouldn’t recommend that anybody have their male pattern baldness treated who isn’t bothered by it,” says Brodell. “I’m losing my hair, and I’m not using any of these treatments.”Joel Warner, a Boulder, Colorado-based writer, still has his hair but wouldn’t have a problem with looking like Yul Brynner.