Ask Otto: Baldness

 

A question from Byter Nando:

Why do men go bald from the top of their heads but the hair around the head usually is there till the end?

As a chrome dome, a cue ball, a bowling ball, a skinhead or simply follically challenged, myself, I can relate to the above question.  Those interested in having a look at your writer’s pate can visit a past post and see a portrait which made it to the finals of the Moran portraiture prize:

http://bytesdaily.blogspot.com/2010/03/art-archibald-and-dobell.html

Back when I was a lad, going bald was commonly a source of regret, humility, even embarrassment.  It was a time when crew cuts had given way to long hair, primarily inspired by pop stars (The Beatles, The Rolling Stones et al) and youth movements (Hippies, Mods, Surfies); when  hair was associated with youth, with being cool.

Give me a head with hair, long beautiful hair
Shining, gleaming, streaming, flaxen, waxen
Give me down to there, hair, shoulder length or longer
Here baby, there, momma, everywhere, daddy, daddy

Hair, flow it, show it
Long as God can grow, my hair

- Lyrics to "Hair", from the musical Hair

Today it is no longer as big a deal, even people with full heads of hair shave their heads. No one seems to care as much. Kate Middleton doesn’t seem to mind too much that hubby is thinning on top.  Bruce Willis is still dying hard. 

Some facts on baldness:

More than 95% of thinning hair in men comprises male pattern baldness (MBP), also known as androgenetic alopecia.  This is characterised by receding hairlines and by hair loss from the crown of the head, known as the vertex.  (In medical terms, a baby born head first is known as a vertex birth; buttocks first is a breech birth).  When the receding hairline and the loss of hair from the vertex meet, it leaves a horseshoe ring of hair on the sides and the back.

MBP is usually genetically determined.  Previously it was thought that the gene was inherited from the maternal grandfather, current thinking is that both parents contribute to baldness in their children.

The sex hormone which determines baldness or otherwise is commonly known as DHT (the full name is too long and complicate to quote here).  DHT causes hair follicles to atrophy so that hair produced is progressively smaller until it disappears. 

Baldness can also be caused by certain illnesses (including disorders of the immune system), stress as a result of major surgery, chemotherapy, radiotherapy, hormonal problems, fungal infections, and as a side-effect of some medications. Scarring from burns can also cause permanent hair loss.

Female baldness is increasing and women are experiencing baldness at earlier ages.  Causes can be female pattern baldness (which causes hair to thin, rather than recede and thin at the vertex, as in males) and the effects of hormones (pregnancy, menopause, the presence of ovarian cysts, birth control pills with a high androgen index and polycystic ovary syndrome).  As with men, thyroid disorders, anemia, chronic illness and some medications can also cause female hair loss.

As regards the connection between baldness and testosterone, I have come across two popular viewpoints:

1.      Baldness is caused when hair follicles become exposed to too much dihydrotestosterone (DHT). This is a chemical produced by the male hormone testosterone. Men with high levels of testosterone are more likely to lose their hair, especially if baldness runs in the family.

2.      With or without testosterone, the incidence of baldness in men ranges from about 23 percent to 87 percent, and baldness may develop any time after puberty. Castration after the onset of puberty halts the progression of human balding, indicating that hormones must play a significant role.  Therapeutic injections of testosterone do not result in the loss of hair in adult males treated because of a deficiency in testosterone, and there is no noticeable change in the scalp hair of normal men who receive testosterone. Perhaps low testosterone is a greater risk factor for increased balding than high or increased testosterone. Male pattern baldness, with balding limited to the top of the head, also seems to be related more to hormone deficiencies than to excess testosterone.

 

To answer Nando’s question, why do men go bald on top first, the answer is that that is how we are genetically programmed.  We have eyebrows, hair under our arms, pubic hair, and so on.  That is how we have evolved. 

Why then have we evolved so as to lose hair on the top of our head first?

Most theories regard it as a result of sexual selection. Some other primate species – chimpanzees, stump-tailed macaques and South American uakari, lose their hair on the scalp after adolescence.  For some species, such as gorillas, an enlarged forehead, created anatomically and through frontal balding, confers increased status and maturity.  Baldness in humans has also been equated with wisdom and social maturity. Some studies have shown that men with facial hair and those with bald or receding hair were rated by other men and women as older, more mature and more nurturing than men with full heads of hair and who were clean shaven.  Some have theorised that this dichotomy has caused females to be excited by hairy, aggressive, irresponsible young males but to have selected balding, stable, mature and nurturing males to partner and mate with for offspring.  Accordingly prominent baldness was perpetuated in the evolutionary process.

“A man can be short and dumpy and getting bald but if he has fire, women will like him.”

-  Mae West

 Trivia Item #1:

Some years ago when I was part of an ace trivia team that played a couple of times a week, there was another regular team that called themselves Merkin.  (Our team was named 4Q; after a break of a couple of years we formed again and called ourselves Pizzle [look it up on Google]; now we have reformed again, the team now being named Lazarus). 

The word “merkin” refers to a pubic wig, originating from the 1450’s when women shaved their pubic hair and wear a merkin  to combat pubic lice.  Prostitutes also wore them to cover up signs of disease, such as syphilis.  Further, male actors playing female roles in plays, as was also common in Shakespeare’s day, wore merkins to hide their male genitals so that they would appear as women in nude scenes.

Merkins are today used by actors and actresses in films to prevent inadvertent display of genitals.

Trivia Item #2:

Those who are young and have full heads of hair should be careful about mocking us baldies, lest they be smited.  Witness the following quotations from the King James Version of the Bible and the Good News version at 2 Kings 2:23-24:

²³And he went up from thence unto Bethel: and as he was going up by the way, there came forth little children out of the city, and mocked him, and said unto him, Go up, thou bald head; go up, thou bald head.

²⁴And he turned back, and looked on them, and cursed them in the name of the LORD. And there came forth two she bears out of the wood, and tare forty and two children of them.

²³ From there Elisha went up to Bethel. As he was walking along the road, some boys came out of the town and jeered at him. “Get out of here, baldy!” they said. “Get out of here, baldy!”

²⁴ He turned around, looked at them and called down a curse on them in the name of the LORD. Then two bears came out of the woods and mauled forty-two of the boys.

“We're all born bald, baby.”

- Telly Savalas