Genetics

The AR gene makes the receptor on hair follicles that interact with testosterone and DHT. If your receptors are particularly sensitive, they are more easily triggered by even small amounts of DHT and hair loss inevitably occurs more easily as a result. Other genes may also play a part.

Age, stress, and other factors can influence whether you experience hair loss or not. But genes play a significant role, and men who have close male relatives with MPB have a much higher risk of developing MPB themselves.

Testosterone

Testosterone exists in your body in different forms. There is “free” testosterone that is not bound to proteins in your body. This is the form of testosterone most available to act within your body.

Testosterone can also be bound to albumin, a protein in your blood. Most testosterone is bound to sex hormone-binding globulin (SHBG) protein and is not active. If you have a low level of SHBG, you may have a high level of free testosterone in your bloodstream.

Dihydrotestosterone (DHT) is made from testosterone by an enzyme which is called 5-alpha reductase. DHT is five times more potent than testosterone. It is found in your skin, hair follicles, and prostate.  The actions of DHT and the sensitivity of your hair follicles to it is what causes hair loss. It is not the amount of testosterone or DHT that causes baldness; it is the sensitivity of your hair follicles. That sensitivity is determined by genetics.

DHT also acts on your prostate. Without DHT, your prostate does not develop normally. With too much DHT, you can develop benign prostatic hypertrophy (BPH) which is an enlargement of your prostate.  

5-Alpha reductase

Even if your circulating levels of testosterone is low, if you have high level of 5-alpha reductase, then very likely, you will have high level of DHT which could  effect baldness.

Severe stress

Stress-induced hair problems

Stress can definitely cause men’s hair loss. It can cause conditions that will lead to hair loss. These are:

1.   Alopecia areata – sudden loss of large clumps of hair in areas around your scalp.

Alopecia areata is an acquired skin disease that can affect all hair-bearing skin and it is characterized by localized areas of non-scarring hair loss. It is occasionally associated with some  medical problems—with stress as one of the possible triggering factors. Most often these bald areas regrow their hair spontaneously. It is rare before the age of 3 years, and there are indications that the tendency to have the disease is genetically inherited. Thus, if you are afflicted with this, it is very likely that some of your relatives and ancestors had been afflicted with it in the past.

Existing evidences suggest that alopecia areata is caused by an abnormality in your immune system. This particular abnormality leads to autoimmunity wherein your own immune system attacks your own body. That is, it attacks some and selected tissues of your body. In alopecia areata, for unknown reasons, your immune system attacks your hair follicles and disrupts normal hair formation. This has been supported by results of biopsies taken from afflicted skin that immune lymphocytes had been observed to penetrate the hair bulbs of the hair follicles.

Alopecia areata can cause different types of hair loss. Each of these types has a different name:

Alopecia areata (hair loss in patches)

Alopecia totalis (hair loss on the scalp)

Alopecia universalis (hair loss all over the body)

2.   Telogen effluvium – more hairs than normal prepare to fall out.

Telogen effluvium is one of the hair loss conditions that can be triggered by stress, be it a particular event that is traumatic or by prolonged stress. During this time more of your hair follicles enter the resting or telogen stage and thus slowing the production  of your hairs. Hair loss is not immediately noticed because it actually happens a number of months after the event which provoked your stress. When it does, you will notice that your hairs are shed and no new hairs sprout to replace them! Since this is a temporary condition, after your stress is successfully resolved, your hair will re-grow in time. Re-growth can be facilitated by instituting the proper and necessary treatment. However, telofen effuvium can spark or exacerbate MPB in men if they have an existing predisposition to this genetic condition.     

3.   Trichotillomania – a habitual condition caused by stress and anxiety where you pull out your hairs without realizing it.

If you are suffering from trichotillomania, you have an irresistible urge to pull out your hair, usually from your scalp, eyelashes, and eyebrows. It is a type of impulse control disorder wherein you know that you can damage something by acting on your impulses. However, you cannot stop yourself.  You pull out your hair when you are stressed in order to soothe yourself.

Following are the symptoms of trichotillomania:

•       Repeated pulling of your hair
•       Feeling tense before pulling your hair or when trying to resist your urge to pull your hair
•       Feeling relieved, satisfied, or pleased after acting on your impulse to pull your hair
•       Distressed, with problems in work or social life, due to hair pulling
•       Bare patches  where you pulled out your hairs
•       Bizarre behavior such as inspecting the hair root, twirling the hair, pulling the hair between the teeth, chewing on hair, or eating hair.

You usually deny that you have a problem, and you may attempt to hide your hair loss by wearing hats, scarves, and false eyelashes and eyebrows.

Adverse effects of severe stress

As you continue to live in this world, you will be exposed to a lot of situations where you need to take action. In some situations, you need to take immediate action, especially if your life is threatened. When being chased by a bear for example, your body will enter a state of extreme preparedness. Your body will release a number of hormones, such as cortisol, noradrenalin, and adrenalin, into your blood stream. The brain instructs your body to release these hormones which tell you to  become alert and be able to take action quickly.

Unfortunately, in the modern world that you live in today, problems are not so simple that you can readily resolved by running away or physically fighting it out. If the situation which triggered the stress remains unresolved for some time, these hormones begin to build up in your body, transforming your stress from a handy biological advantage into an ongoing debilitating condition. High levels of these chemical can adversely affect the hair follicles on the scalp, as well as many parts of your body, and this will  lead to your hair loss

Anemia

Your blood contains three cellular components. These are: red blood cells, white blood cells, and platelets. The platelets are responsible for plugging any cut or incision wound that is inflicted on your skin and tissues, thus preventing severe bleeding. The white blood cells (WBC) are responsible for providing defense for your body against the onslaught of bacteria or viruses, thus protecting your body from overwhelming infections. Your red blood cells (RBC), on the other hand, are responsible for carrying and transferring the gases such as oxygen and carbon dioxide, that are needed and produced in your body.

RBCs contain a reddish substance known as haemoglobin, which is responsible for bringing oxygen to different tissues in your body and for collecting carbon dioxide molecules which are produced in various parts of your body. In the production of haemoglobin, three important substances are needed. These are iron, cyanocobalamine or B12, and folic acid. In the absence of one or two of the needed substances, your haemoglobin will not be produced and you will suffer from anemia.

If you lack iron, then you will suffer from iron deficiency anemia (IDA). This usually takes place if you don’t consume enough iron-rich foods or you are not adequately absorbing the iron. When you are suffering from IDA, it is highly possible that you will also suffer from hair loss because iron  is needed for the good maintenance of your hairs’ health.

Ferritin is a stored  iron that helps to produce hair cell protein. It is found in every cell in your body and is essential for healthy hair. To prevent anemia, you need to have adequate ferritin stored in your body. Correct and adequate amount of ferritin in your body will maximize your hair’s “anagen” or “growing” phase and encourage your hairs to grow to their full length. If you are not taking adequate amount of iron from your diet, your body takes ferritin stored in non-essential tissue, like your hair bulb and gives it to essential tissue, such as your heart. When your hair bulb is depleted with ferritin, you will shed your hair before reaching its maximum length. This can occur even if your haemoglobin level is normal.

Medical and dietary problems, drug intake

Drug intake

Every drug that you has dual sets of effects: the  beneficial and the adverse effects. There are occasions when you feel that you don’t want to take a certain medication because of its side effects. However, you have no choice but to take it because it is the only drug that could cure your illness. Hence, you will be forced to take it, experiencing both the beneficial and adverse effects. Chemotherapeutic drugs for example cannot be avoided because they are needed to treat your medical condition, but they cause hair loss. Thus, taking certain drugs are a two-edged sword, experiencing both the pros and cons of taking it.

Other drugs, aside from cancer medications, that could cause hair loss are the following:   

•       Acne medications containing vitamin A (retinoids)
•       Antibiotics and antifungal drugs
•       Antidepressants
•       Birth control pills
•       Anticlotting drugs
•       Cholesterol-lowering drugs
•       Drugs that suppress the immune system
•       Epilepsy drugs (anticonvulsants)
•       High blood pressure medications (anti-hypertensives), such as beta-blockers, ACE inhibitors, and diuretics
•       Drugs used for hormonal replacement therapy
•       Mood stabilizers
•       Non-steroidal anti-inflammatory drugs (NSAIDs)
•       Drugs for Parkinson’s disease
•       Steroids
•       Thyroid medications
•       Weight loss drugs

Medical and dietary problems

Aside from drug intake, existing medical and dietary  problems and some forms of lifestyle could lead to nutrient deficiency which will, in turn lead to hair loss.

Low vitamin and micronutrient levels

Some vitamins, minerals, and micronutrients are incriminated as possible cause of hair loss if they are not adequately taken. These are zinc, niacin, selenium, folic acid, biotin, antioxidants; vitamins D, E or A. Right now, there is no question that these substances have possible role in the prevention of hair loss. As such, intake of some supplements may be needed.  However, the notion that adequate levels of these substances in your body will help prevent hair loss has not been scientifically established.

Bad hair care techniques

Hot showers

In addition to being bad for your skin, washing with hot water is a poor choice for your hair. It rinses away your natural protective oils and accelerates the fading process for  your colored hair. It is a myth that a final rinse with cool water will close the hair’s cuticle, but using tepid water in general is much gentler on hair.

Hot water shower could damage your hair in different ways:

•       It can make your hair easy to break. When exposed to hot water, your hair can become much more resilient than it actually should be. If you comb it or brush it right after applying hot water then be aware that it is really easy to break some hair by doing so in these circumstances.
•       It can weaken your hair roots. If you use very hot water when washing hair then you can do serious damage to your hair roots and let me tell you, it can sure cause a lot of problems later on. Because if your roots are weakened, then your hair starts to curl, becomes more frizzy and can be in danger of premature graying.

While it is true that hot water shower could damage your hair, it has some uses. As mentioned in the preceding, hot water opens up your hair cuticle and this change can make cleaning the hair more effective. When your cuticle opens up, you can easily remove any dirt, build-up, and unnecessary oil from your hair.

While hot water can be quite harmful at times, you should not only use cold water for washing your hair. The best  strategy would probably be to use warm water instead of hot when shampooing and conditioning your hair. Do not use cold water when doing these processes because you want the pores in your scalp  and your hair cuticle to open up. If you feel like there is more grease and oil in your hair than usual, then you may turn the water from warm to hot in order to really open up everything and get that dirt out. Remember, however, that frequent use of very hot water is damaging to your hair and you need  to be very careful and conservative in using it. Use cold water only for your final rinse with the purpose of sealing everything that you have done. Remember that it does not have to be ice-cold – choose a temperature that you can very well tolerate.

Brushing when wet

When hair is wet, it is significantly weaker and thus brushing it in this vulnerable condition leads to increased breakage. Water weakens the weakest bonds within strands of hair, removing 1/3 of its strength. The individual strands cannot handle the tugging and tension, so they stretch until they snap. To detangle wet hair during or after the shower, gently use a wide-toothed comb, working from the ends upward. Better yet, use your fingers.

Brushing is one of the roughest actions you can do to your hair, especially if it is long and in tangles. Brushing wet hair will lead to significantly more broken strands than if you allowed the hair to dry before brushing it. If you worry about hair growth, you should also brush you hair often because it stimulates the roots. However, do it when it is dry.

If you absolutely cannot wait to brush your hair, use an absorbent towel to remove as much moisture as possible before proceeding. Allowing your hair to air dry for only 5 to 10 minutes will help reduce damage. As your hair dries, weak bonds are re-established and your hair gains strength rapidly. Allowing these bonds to form before brushing the hair is key in preventing breakage.

You know that blow drying your hair can cause damage that may be difficult to correct. In an effort to thwart this damage, you should let your hair air dry whenever possible. However, you should also resist the urge to brush your hair when it is wet.

If you have thin hair, you need to be especially cautious. Thin hair can be damaged easier than thicker hair because each strand is made of less polypeptides with less bonds. Less bonds means weaker hair. Having less total bonds  also means that a greater percentage of the bonds will be broken when the hair is wet, leading to even more damage if you brush it.

Fortunately, thin hair dries faster than thick hair, so the amount of time you must wait before brushing it is lessened. Towel drying thin hair is also more effective, helping to reduce the need for a hair dryer, which can also cause damage. If you cannot really wait to brush your hair, you should use a wide-toothed comb. This will cause less damage than a regular brush, though some breakage is inevitable. If your hair is curly, you will need an even wider comb.

Demi-permanent color

Non-permanent Level 2 color, a popular at-home option, is generally safe for hair, but it is not 100 percent gentle and damage-free substance. Demi-permanent dyes  contain no ammonia, but they still have a small amount of peroxide to open the hair cuticle and deposit the color molecules. Even though demi-permanent color cannot lighten hair, it still causes a small amount of damage, especially when compounded by other harsh styling practices.

Perms

The principal chemical used in permanent waves, ammonium thioglycolate, actually loosens the bonds between the molecules of the hair shaft and allows the hair to take whatever shape it’s set in—in the case of perms, on rollers. While any chemical process causes some amount of damage, perms are considered one of the more reliable treatments, as long as the hair is healthy beforehand.

Permanent hair color

Since permanent hair color involves significant amount of peroxide and ammonia, it can cause a significant amount of damage including dryness, breakage, and dullness. The most potentially damaging color change is in lightening dark hair, which requires two separate processes. The removal of the original color and the deposition of the new color. After this much chemical meddling, hair is in a significantly weaker state than when it was started. All bottle blonds should take care to condition their hair regularly and treat it gently.

Blow drying/Flat ironing/Curling ironing

The occasional blast from a hair dryer will not harm hair too much, but the heat from daily use of a blow dryer or flatiron causes hair to become extremely dry and brittle. Hair in this weakened condition is more susceptible to damage from other stressors, causing it to lose elasticity and inflict breakage. For daily dryers, stylists recommend allowing hair to partially air-dry before blow-drying, or blow-drying it until it is only about 80  percent dry and then allowing it to air-dry the rest of the way.

It is an undeniable fact that heat causes damage. Blow drying causes a “flash drying” effect that not only removes the surface moisture but also removes water that is bound to your hair, which is called hydrating water.  The effect of this flash drying is that your cuticles become dry, rigid, and brittle. When your hair flexes, the pressure causes the cuticles to crack. Combing your hair with this degree of cuticle cracking aggravates the situation and   causes significant breakage.

Flat ironing and curling ironing can damage your hair in different ways than blow drying.  Ironing hair can cause two different types of damage, depending on whether the hair is ironed dry or wet.  Ironing dry hair causes cracking along the edges of the cuticles, which can lead to chipping. Ironing wet hair causes the moisture to burst out in little steam explosions. This causes a bubbling and buckling of the cuticle that appear as tiny hair blisters under magnification. Both types of damage can lead to breakage and split ends.

Tight hairstyles

Sporting the occasional ponytail is harmless, but the tension of constantly wearing extremely tight hairstyles can trigger a condition called traction alopecia, which can actually cause individual strands of hair to break off. Even if you are not wearing severe hairstyles every day, repeated use of elastics, combs, or other implements can still cause hair to break. Signs of traction alopecia include pain in your scalp, thinning hair (especially in the front and back), and breakage near the hairline. African American women, who are more likely to wear extensions, weaves, or braids, are more susceptible to this condition. Luckily, if caught in time, traction alopecia is highly reversible

Chemical relaxers

These curl-easing products use extremely harsh chemicals, including sodium hydroxide, a product found in drain cleaners. Relaxers work by penetrating the hair shaft and literally rearranging the structure of the molecules. While this technique may loosen curls, it also affects hair’s elasticity and strength. Let only a trained technician apply a relaxer; even if it is done properly, hair is still left fragile and susceptible to damage.

Traditionally, chemical straightening of your hair could be achieved by alkaline disruption of the disulphide bonds in the cortex of your hair shaft. Because of the pH (9-12) in the chemicals that were used, it causes considerable damage leaving your hair dry and fragile. In the study titled “Chemical hair relaxers have adverse effects a myth or reality” published in the International Journal of Trichology in January-March 2013,   the common complaints associated with the use of chemical hair relaxers were frizzy hair (67%), dandruff (61%), hair loss (47%), thinning and breakage of hair (40%). These findings had some similarities as observed in a study done by Swee W wherein they found that 95% of their subjects had hair loss and hair breakage. The reason for this wide difference in the causation of hair loss could be due to the nature of the chemical used and the frequency of procedure done.

There are signs that a chemical relaxer has been damaging your hair. These are:

(1)   Burning

Some believe that “beauty is pain,” but that is not always true. It should not definitely apply to the burning sensation that you feel when you apply or use chemical relaxers in your hair. Never   have the misconception that pain only takes place when a relaxer is left on too long. Your scalp may be sensitive to a certain formulation, and leaving it on for even a minimum period of time on your hair could cause severe pain.

You may be one of the users of chemical relaxers who wait for the burn, believing that your hair will turn out straighter the longer the chemical stays on your hairs. In many instances, if your hairs are bone straight, they simply were over-processed.  Ignoring time frame instructions is a sure recipe for potential and permanent disaster. As soon as you feel tingling sensation from a relaxer application, rinse it out with plenty of water. Make sure that it is lukewarm water so you will not experience even more burning. To prevent more injury, do not wait for a relaxer to “tingle”. Burning is not normal.

(2)   Sores on your scalp

Along with burning, you may experience sores on your scalp soon after getting a damaging relaxer. In some cases, the sores may ooze with fluids and/or crust over. These are serious signs of damage that could lead to infection and/or permanent hair loss.

Development of sores on your scalp could be due to reaction to the chemicals, regardless of how long they were left on your head. You could be allergic to the relaxer, or the relaxer is of poor quality.  Any relaxer that causes a break in your skin is too strong—if not bad for you.

(3)   Thinning

Thin hair is sometimes unavoidable, but it usually happens as a result of genetic predisposition or natural aging. Without genetic intervention, thin hair is not normal, but some men suffer from it because of chemical relaxers. Over-processing  is a major cause of your hair thinning, and if you continue to apply chemicals to your already thin hair or damaged follicles, you may eventually go bald. Instead of trying to relax hair as straight as possible, which often leads to limp tresses that do not hold style well, cut the time that you leave relaxers on. You will have more body and volume, and lessen the chance of inflicting damage to your hairs.

(4)   Breakage

If it seems that your hairs are not growing, it is possible that they are breaking at the same rate that they are growing. Unless you have a trusted and experienced partner to help you apply a relaxer, it is difficult to do a good job at the back of your head. Overlapping of application is a common mistake, and it leads to breakage of hairs.

(5)   Dryness

Relaxers are designed to break the disulphide bonds in your hairs; hence, by their very nature, they cause damage to your hairs. Because your hair shafts undergo such drastic change, they are  weaker than healthy, and they could not hold on to moisture. This leads to dryness of your hairs.

Thermal conditioning

This straightening process uses chemicals similar to those in perms in order to rearrange hair’s molecular structure. But what makes this treatment particularly harsh is that in the second phase of the application, hair with the active chemical on it is brushed and blow-dried so that it sets in a new alignment. That is a hair-hazard trifecta: chemicals, heat, and tension. Even when a qualified technician does it for you, this process has the potential to cause serious or catastrophic breakage. Many people find the treatment effective, but even healthy-looking hair is left fragile and extremely porous, making it susceptible to damage.