Balding is something many men will experience at some point in their lives, but have you ever wondered why it happens? The reasons behind male pattern baldness are as varied as the men who experience it, but there are a few main culprits, from genetics to stress.

The good news? Whether you’re experiencing hair thinning or balding, there are various options when it comes to treatment. First, though, it pays to identify the key causes of your hair loss. Dr Bessam Farjo, Hair Transplant Surgeon at Farjo Hair Institute, reveals why men go bald – and what to do about it.

If you’re curious about whether hair loss and balding are different, you’re not alone. Dr Farjo explains that they are pretty much the same thing, but there is one small difference.

‘Hair loss refers to any form of hair shedding, thinning or reduced density, which can be temporary or permanent. This can be in terms of hair numbers and/or hair shaft diameter. Hair loss may be caused by stress, illness, hormonal changes, or medical conditions like alopecia areata,’ he says.

‘Balding, on the other hand, specifically describes progressive and often permanent hair loss, typically due to androgenetic alopecia (male or female pattern baldness). This condition follows a predictable pattern, such as a receding hairline or thinning crown.In short, all balding involves hair loss, but not all hair loss leads to balding. The terms are sometimes used interchangeably, but in a clinical context, balding usually implies a long-term, hereditary process rather than a temporary shedding phase.’

Balding in men has several causes, but the main reasons are due to the below.

1/ Genetics

‘Androgenetic alopeci is the most common reason for balding in men and it’s driven by the hormone dihydrotestosterone (DHT),’ explains Dr Farjo. ‘Since men have higher testosterone levels than women, they also produce more DHT, which gradually causes hair thinning.’

2/ Hormonal imbalances

These can include issues such as thyroid disorders, which can also contribute to balding.

3/ Medical conditions

Medical conditions such as alopecia areata, scalp infections, and chronic illnesses may trigger hair loss.

4/ Certain medications

Medications including chemotherapy, antidepressants, and steroids, can further induce hair shedding and loss.

5/ Stress

Where lifestyle is concerned, stress can cause what is known as telogen effluvium, which can push hair into a premature shedding phase.

6/ Lifestyle factors

Nutritional deficiencies such as iron, vitamin D, and protein can also weaken hair structure, while smoking, excessive alcohol, and poor diet can further impact hair health.

‘Baldness is more common in men primarily due to higher levels of DHT, a hormone derived from testosterone,’ says Dr Farjo. ‘Androgenetic alopecia (male pattern baldness) occurs when hair follicles are genetically sensitive to DHT, causing them to shrink and produce thinner hair until they stop growing altogether. Since men naturally have much higher testosterone levels than women, they also produce more DHT, making them more prone to balding.

‘In contrast, women have lower testosterone and DHT levels, and oestrogen helps protect hair follicles. When women do experience hair loss, it tends to be diffuse thinning rather than the receding hairline or bald spots typical in men. However, after menopause, oestrogen levels drop, and some women may develop a pattern of hair thinning similar to male balding.’

The age at which men start balding varies. Some notice hair thinning in their late teens or early 20s, while others experience significant loss in their 30s, 40s, or even later. Genetics plays a key role, with those predisposed to androgenetic alopecia losing hair earlier due to DHT sensitivity.

The most effective treatments for baldness depend on the severity and type of of hair loss.

‘In the case of genetic pattern hair loss, medications like finasteride (a DHT blocker) and minoxidil (a topical solution that stimulates hair growth) are widely used to slow hair loss and promote regrowth,’ says Dr Farjo. ‘Finasteride works by reducing DHT levels, preventing further follicle miniaturisation, while minoxidil increases blood flow to the scalp, extending the hair growth phase.

‘For those seeking non-surgical in-clinic treatments, additional options like Platelet-Rich Plasma (PRP) therapy and TricoPat can improve hair density. PRP involves injecting concentrated platelets from the patient’s own blood into the scalp to stimulate follicles, while TricoPat uses microstimulation techniques to rejuvenate hair growth.

‘For advanced hair loss, hair transplant surgery is the most long term solution. Techniques like Follicular Unit Excision (FUE) and Strip Follicular Unit Transplantation (FUT) involve transplanting healthy hair follicles from donor areas to thinning or bald regions, restoring a natural hairline and long-term hair growth.’

‘It depends on the individual and may not be entirely preventable,’ explains Dr Farjo. ‘However, early intervention can help slow or reduce its progression. Medications like finasteride and minoxidil can help prevent further hair loss and promote regrowth if used early. Maintaining a healthy lifestyle, managing stress, and addressing any underlying medical conditions can also support overall hair health.’

Again this is also not a straight forward answer. Dr Farjo says ‘it depends on the cause and the stage of hair loss. If the hair loss is caused by temporary factors such as stress, nutritional deficiencies, or hormonal imbalances, hair can often regrow once the underlying issue is addressed. For example, if hair loss is linked to telogen effluvium (a condition where stress or illness causes hair shedding), once the trigger is resolved, hair typically grows back within several months.’

However, in cases of androgenetic alopecia (male pattern baldness), where hair loss is genetic and linked to the effects of DHT on the hair follicles, regrowth is a lot more challenging.

‘If caught early, hair loss may be slowed down or managed and may even be reversed, but it’s less likely to fully regrow without intervention,’ Dr Farjo adds. ‘The success of regrowth also depends on how much hair loss has occurred, as follicles that have completely miniaturised may no longer be capable of regrowing hair.’