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Mar 04, 2022
7 min read

8 signs of balding and how to stop it

Hair loss—in both men and women—is common. You can experience different signs of balding, the most common of which are a receding hairline, hair thinning at the crown, or overall thinning (sometimes called “invisible baldness”). Here are eight signs of balding and how to reverse it.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

We all lose dozens of hairs from our heads every day, so how do you know when it’s considered balding? Here are some of the most common early signs of balding to look for and the most important things to know—including how you can slow down, stop, and possibly even regrow lost hair.

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How to tell if your hair is thinning: 8 signs

The shift from having a full head of hair to being noticeably bald is gradual. Paying attention to the early signs of hair loss can help you slow down or reverse hair loss if that’s what you want. Here are eight early signs that it might be time to intervene.  

1. You have a receding hairline

A receding hairline is a classic early sign of balding. You’ll notice the signs of a receding hairline if your hair begins to thin at the temples, creating a more prominent widow’s peak and a hairline that resembles the letter M or a horseshoe. Or your hairline might seem to recede or thin all the way across (Murphrey, 2021).

2. You notice more hair falling out than usual

Discovering a few hairs in your comb, on your pillow, or in the shower drain isn’t necessarily a sign that you’re going bald. The scalp contains about 100,000 hairs, and we lose about 100 hairs each day. That’s part of the natural life cycle of hair—scalp follicles are continually in the process of growing hair, pausing, then shedding it (Murphrey, 2021). 

But over time, if you notice that you seem to be shedding hair at a higher rate, it could be a warning sign that your hair is permanently thinning.

3. Hair at the crown of your head is thinning

This is another one of the common early signs of male pattern balding. Hair at the crown (the back part of the top of the head) becomes sparser until the classic bald spot is evident. Because you don’t have eyes in the back of your head, you might want to use a hand mirror and the bathroom mirror to examine the area or proceed to #7 on this list.

4. Your hair seems thinner overall

Sometimes, balding doesn’t begin at the hairline or crown but develops and advances at a steady rate along a larger area of your scalp. This is sometimes called “invisible balding” because the hair loss is so gradual and balanced it may be hard to notice until nearly half the hair is lost.  

5. The photographic evidence is adding up

If you’re unsure if you’re balding and are concerned about it, a good exercise is to compare a current photo of yourself with past photos taken in similar lighting and at a similar angle. That’ll give you an objective perspective on any potential changes in your hairline or overall thickness.  

6. Hair seems to be taking longer to grow

One effect of male pattern baldness is that the hair’s growth cycle becomes shorter. The normal growth cycle lasts between two and six years, after which the hairs fall out, and the cycle starts again with new hair growth. So the maximum length your hair can grow is determined by how long your growth cycle lasts and how quickly your hair grows (Murphrey, 2021). 

If you used to produce Samson-esque locks after deciding to grow your hair out, but now you’re not getting the same results, the balding process could be responsible.

7. Your barber tips you off

Everyone’s hair is a bit different. But anyone who’s been cutting hair for a while has seen it all. If you’re unsure how you’re stacking up, ask. If you’ve been going to the same barber for years, he or she might be able to tell you if they’ve noticed changes. Even if it’s a new barber or hairdresser, they should be able to tell you if your hair is looking thin. They can also advise you on the best hairstyles and styling tips for thinning hair. 

8. Your scalp itches

An itchy scalp isn’t a typical sign of male pattern baldness, but it can be the sign of other conditions that contribute to hair loss—including a buildup of sebum (oil) on your scalp, or skin conditions such as folliculitis, psoriasis, seborrheic dermatitis or ringworm of the scalp (also called tinea capitis), a fungal infection (Phillips, 2017). 

In some cases, frequent scratching can damage hair follicles and encourage fallout. If you have a recurrent itchy scalp, consult a dermatologist. They can diagnose what’s going on and prescribe treatments to clear it up.

Why is my hair falling out?

The vast majority of the time, thinning hair results from male pattern hair loss (aka androgenic alopecia, which affects women, too, despite the name). Male pattern baldness is linked to male sex hormones (androgens), specifically DHT (dihydrotestosterone) (Ho, 2021). 

Androgens contribute to adult male characteristics, such as muscle mass and a deeper voice, though they’re essential hormones in women as well. For reasons researchers don’t entirely understand, although DHT is essential for the growth of body hair, it can attack hair follicles on the scalp and cause them to shrink, a process called follicular miniaturization. This process causes the follicle to produce shorter, thinner hairs.

In some cases, male pattern baldness can start early—some studies show that it affects up to 16% of men between 18–29. But it’s way more common in older men, with the likelihood increasing with age. White men are most affected, with 50% of men showing signs of balding by age 50 (Rhodes, 1998; Phillips, 2017)

Less common reasons for thinning hair include:

  • Breakage of the hair shaft—Damage to hair from dyeing or styling can cause the hair shaft to break off. 
  • Alopecia areata—This autoimmune condition can cause hair loss in patches throughout the body. In extreme cases, a person might lose all body hair. 
  • Vitamin deficiencies—In rare cases, a lack of nutrients such as B vitamins, vitamin D, iron, or zinc can cause hair loss. 
  • Traction alopecia—This type of hair loss occurs when hair is chronically pulled too tight, such as in a ponytail or braids.
  • Stress or an emotional shock—Some people experience a general thinning of hair several months after severe physical or emotional stress. This type of hair loss is most often temporary (Al Aboud, 2021).
  • MedicationsCertain drugs can cause hair loss, such as those used for cancer, heart problems, high blood pressure, arthritis, and depression.

How to stop thinning hair

If you’re experiencing male pattern hair loss, there are several ways you can stem the loss and increase hair growth. The only FDA-approved medications are minoxidil and finasteride (Propecia; see Important Safety Information), but other treatments have been shown to be effective in some cases (Nazarian, 2019)

Finasteride (brand name Propecia)

This oral prescription medication is FDA-approved to help slow hair loss and stimulate hair regrowth in men with androgenic alopecia. It blocks the conversion of testosterone to DHT, which can prevent further hair loss. It is the most effective drug for treating male pattern baldness, preventing hair loss in 83% of men treated for two years (Shapiro, 2003).  

It shouldn’t be used by anyone who could become pregnant since it can cause abnormalities in the fetus (Ho, 2021).

Minoxidil (brand name Rogaine)

This liquid or foam is rubbed onto the scalp. Patience is needed because it can take about four months of continuous use to see results with minoxidil. It is most effective when used with finasteride (Adil, 2017). We don’t know exactly how minoxidil stops hair loss, but it is believed to increase blood flow to the hair follicles. 

Low-level laser therapy

Low-level laser therapy (LLLT) is an FDA-cleared way to treat hair loss. How it works is not well understood, but LLLT may trigger the hair follicle stem cells to stimulate new hair growth. One review of studies showed it to effectively promote hair growth in men with male pattern hair loss (Adil, 2017).

DHT-blocking shampoo

Several varieties of shampoo claim to block DHT’s effect on miniaturizing follicles. They’re considered less effective than minoxidil or finasteride. Some contain zinc, vitamin B12, or ketoconazole (the active ingredient in the dandruff shampoo Nizoral). Ketoconazole, in combination with finasteride, may disrupt DHT’s effects on the scalp has been shown to be  more effective at reducing hair loss than finasteride alone, but scientific evidence doesn’t show that other common ingredients in DHT blocker shampoos cause hair regrowth (Khandpur, 2002).

PRP (platelet-rich plasma) treatments

Several dermatologists and hair-replacement specialists offer this treatment, in which a patient’s own blood is drawn and placed in a centrifuge to extract the plasma, which is then injected into the scalp. The theory is that the growth factors in platelets can spur hair growth. Studies have shown varying results, and PRP is not FDA-approved for hair loss at this time.

Hair transplants

Hair transplantation is a surgical procedure that moves hair from one place on the scalp to another. The most dramatic results are seen when trying to correct a receding hairline. This makes it a good choice for improving androgenetic alopecia (Zito, 2021).

References

  1. Adil, A. & Godwin, M. (2017). The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. Journal of the American Academy of Dermatology, 77(1), 136–141. doi:10.1016/j.jaad.2017.02.054. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28396101
  2. Gentile, P., Cole, J., Cole, M., et al. (2017). Evaluation of not-activated and activated PRP in hair loss treatment: role of growth factor and cytokine concentrations obtained by different collection systems. International Journal of Molecular Sciences, 18(2), 408. doi:10.3390/ijms18020408. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28216604
  3. Ho, C., Sood, T., & Zito, P. (2021). Androgenetic alopecia. [Updated Nov 15, 2021]. In: StatPearls [Internet]. Retrieved on Mar. 1, 2022 on from https://pubmed.ncbi.nlm.nih.gov/28613674/
  4. Hugo Perez, B. S. (2004). Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men. Medical Hypotheses, 62(1), 112–115. doi:10.1016/s0306-9877(03)00264-0. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0306987703002640
  5. Kaufman, K. D., Rotonda, J., Shah, A., & Meehan, A. G. (2008). Long-term treatment with finasteride 1 mg decreases the likelihood of developing further visible hair loss in men with androgenetic alopecia (male pattern hair loss). European Journal of Dermatology, 18(4), 400–406. doi:10.1684/ejd.2008.0436. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18573712
  6. Murphrey, M. B., Agarwal, S., & Zito, P. M. (2021). Anatomy, hair. [Updated Aug 11, 2021]. In: StatPearls [Internet]. Retrieved on Mar. 1, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK513312/ 
  7. Phillips, T. G., Slomiany, W. P., & Allison, R. (2017). Hair loss: common causes and treatment. American Family Physician, 96(6), 371–378. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28925637/
  8. Rhodes, T., Girman, C. J., Savin, R. C., et al. (1998). Prevalence of male pattern hair loss in 18-49 year old men. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery, 24(12), 1330–1332. doi:10.1111/j.1524-4725.1998.tb00009.x. Retrieved from https://journals.lww.com/dermatologicsurgery/Abstract/1998/12000/Prevalence_of_Male_Pattern_Hair_Loss_in_18_49_Year.9.aspx 
  9. Sato, A. & Takeda, A. (2012). Evaluation of efficacy and safety of finasteride 1 mg in 3177 Japanese men with androgenetic alopecia. The Journal of Dermatology, 39(1), 27–32. doi:10.1111/j.1346-8138.2011.01378.x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21980923/ 
  10. ​​Shapiro, J. & Kaufman, K. D. (2003). Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). The Journal of Investigative Dermatology. Symposium Proceedings, 8(1), 20–23. doi:10.1046/j.1523-1747.2003.12167.x. Retrieved from https://www.sciencedirect.com/science/article/pii/S0022202X15529357 
  11. Zito, P. M. & Raggio, B. S. (2021). Hair transplantation. [Updated Nov 15, 2021]. In: StatPearls [Internet]. Retrieved on Mar. 1, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK547740/