Most elderly people experience hair thinning as one expression of aging. Among males, however, gradual baldness may start any time after puberty by recession at the temple hairline and crown thinning. The action of the male hormone, testosterone, on genetically predisposed follicles causes a degenerative change in their hair production capability. Bald patches on the heads of men or women may be due to localized follicle disease such as ring worm and acne (Acne vulgaris), or to other conditions affecting the general health.
Male pattern baldness, or androgenetic alopecia, is an inherited trait. It results in too high a concentration of the hormone dihydrotestosterone (DHT) in the blood. The DHT builds up in the scalp and damages the hair-producing follicles, which eventually die. DHT is produced when a chemical in the body converts androgen to DHT.
Around 40 million men in the USA suffer from baldness. Collectively, they spend more than $1 billion a year on shampoos, hair pieces, lotions, pills and follicle transplants (hair transplants: $800 million, with each transplant costing from $3,000 to $20,000; hair systems, also known as toupees and hairpieces: $250 million annually; medical therapies: $225 million; vitamins and nutritional supplements: $60 million.
Baldness, complete or partial, causes acute embarrassment in some people and a feeling of social inferiority which inhibits the development and expression of the personality. The stigma of hair loss, and attempts to disguise this with toupÃ©es, is a source of vulnerability to some men. Disclosure of their baldness has been used to embarrass or threaten them. To expunge discriminatory thinking and speech, it is argued that "bald" should be replaced by the term "follically challenged".
It is ironic that baldness should be associated with inferiority, or "lack of manliness". The male hormone which causes hair loss is equally the source of male libido. Baldness and "degree of masculinity" show no relationship by any objective measure, just in the minds of certain people.