Male body hair loss with age

If the hair on your head and the hair on your back seem to be advancing on each other like warring armies, you might find it comforting to know that you’re not alone. You’re likely middle-aged and in need of some grooming products, but you’re also just one of the many balding men with an increasing excess of body hair. This phenomenon is triggered by the hormone dihydrotestosterone, or DHT, a derivative of testosterone that causes hair follicles on the scalp to shrink and die, but does not affect hair follicles on the neck or back.

“This is why even the baldest men are never total bald,” explains dermatologist Susan Bard, M.D. “DHT is a much more potent androgen than testosterone and is responsible for many secondary male characteristics like dark terminal hairs on the face and body. DHT acts on the scalp follicles with the opposite effect.”

Because roughly 10% of the body’s testosterone is converted into DHT by an enzyme called 5-alpha reductase, men with high testosterone are more prone to baldness and, for the same reason, proliferating body hair. The more T a guy has, the more DHT he’s likely to have. And because of the nature of the follicles, men are more likely to end up with a “power donut” than with a totally hairless pate.

For most hairy men suffering from this condition (or enjoying it, no judgment), hormonally driven body hair doesn’t just show up when guys go bald. It tends to arrive when boys hit puberty. And as men’s hair follicles are exposed to more hormones over time, they grow more rather than less sensitive. DHT becomes, in essence, a more effective fertilizer. This phenomenon explains why older men tend to have long and unruly ear, nose, and neck hairs.

All that said, baldness is still ultimately determined by DNA, not T. If men are genetically predisposed to growing weak follicles, they’ll likely go bald. If they’re not genetically predisposed to growing weak follicles, they can have relatively high levels of testosterone and full heads of hair.

For the others, there are ways to intercede. Messing with DHT levels can cause erectile dysfunction and other problems, but men can use cosmetic interventions such as Rogaine, laser treatment, shaving, waxing, and, in extreme cases, hair transplants to cover their nakedness.

The other option is for guys to accept this as an unfortunate aspect of aging and go full Bruce Willis. There’s no shame in shaving, and there’s no shame in retreat.

This article was originally published on April 23, 2019

Name: Basil

Question: I am losing hair from my body as well as my head - my scalp hair has been thinning for a while then I started to see a couple of bald patches on top. Now I notice less hair on my arms and chest too. Male Pattern Baldness runs in my family but I don't think anyone of them has experienced body hair loss, just their heads. Does it cause body hair loss too sometimes? Can you give me advice for treatments?

Answer: Hi, Basil. We would need to assess your scalp and take a few more details in order to provide you with a confirmed diagnosis. However, we can give you the following generalised advice regarding your query.

From what you say, it is possible you may have two separate hair loss conditions.

You mention you have had on-going hair thinning for a while and this is a key sign of the hereditary condition Male Pattern Baldness, which you have already advised runs in your family. This causes thinning hair to the top of the scalp only, from the hairline to your crown, and can also present as a receding hairline. It is not known to affect body hair, nor other areas of the scalp.

Secondly, you note bald patches developing on your scalp plus further hair loss from your body. These symptoms suggest autoimmune-related shedding from a form of Alopecia Areata. This is a condition whereby the body mistakenly attacks its own hair follicles, which can be temporary or permanent, but its duration is currently impossible to predict.

The Alopecia Areata phenotype which is known to cause shedding of body hair is Alopecia Universalis. This tends to cause total baldness from head to toe, so it is extremely important you see a professional trichologist to get an accurate diagnosis, given you do not mention your scalp or body hair falling out completely.

Male Pattern Baldness is a genetic condition where hair loss appears gradually as the result of a biological sensitivity to the hormone dihydrotestosterone (DHT), whereas Alopecia Areata - and Alopecia Universalis - are autoimmune disorders which come on suddenly.

Both Male Pattern Hair Loss and Alopecia Areata can present simultaneously, and whilst Belgravia offers hairloss solutions for the former, we cannot treat Alopecia Areata when it affects the body. This generally requires hospital-based therapies, such as steroid injections orimmunotherapy, and your doctor should be able to refer you.

With regards the genetic thinning, there are two clinically-proven, MHRA-licensed and FDA-approved male pattern hair loss treatments available - one oral and one topical. These can be used individually or, as our hair loss specialists advise, together, and additional hair growth supporting products can be used alongside this pharmaceutical approach.

However, should you be diagnosed with Alopecia Universalis, it is unlikely to be worthwhile using hairloss treatment for Male Pattern Baldness as the area of your scalp affected by the genetic condition may become hairless as a result of this condition. This is not something we can diagnose or predict without a thorough consultation.

There are other causes of body hair loss which should also be considered; for example, body hair - specifically leg hair - is known to get thinner with age, and thyroid problems have been shown to lead to hairloss from the body as well as the scalp.

Hair growth can also be negatively impacted by certain skin conditions and as a side effect of some medications, too.

To determine if hair loss treatment is appropriate in your case, and - if so - the optimal selection of hair loss products for your specific condition(s), we reiterate the need for a professional consultation, ideally in-person if possible.

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