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Are bald men more

virile?
MEDIC AL MY THS HUMAN BODY

Testosterone increases sex drive at the

cost of a thinning head, so the story
goes. The truth is a little more
complex.

By Claudia Hammond
11th December 2012

hink of Bruce Willis, Andre Agassi or

T Michael Jordan, and you’ve got three

famously strong, masculine men with
plenty of female fans. They also have
something else in common: they’re bald.

It’s oGen said that bald men are more virile. The
popular theory is that they have higher levels of
the male hormone testosterone, which makes
them more masculine and increases their sex
drive, but they lose their hair at a younger age
than average as a result. The truth, though, is a
little more complex.

It is true that balding is dependent on

testosterone. Back in 1960 a Yale doctor called
James B. Hamilton studied twenty-one boys who
were undergoing castration. Shockingly this was
sometimes done to boys diagnosed with
behavioural or mental problems. He followed
them up, some of them for as long as 18 years,
and found that they showed no signs of
developing male pattern baldness as they aged.
On the other hand, men of the same age who
were still intact, and therefore producing
testosterone, already had receding hairlines.

Hamilton wasn’t the first to discover a link

between testosterone and baldness, both
Hippocrates and Aristotle had made the same
observation centuries earlier. Hamilton’s finding
suggested that high levels of testosterone might
lead to baldness, but in fact the level is irrelevant,
providing there are some quantities of the
hormone present. Castrated men, who have
almost no testosterone, may retain their hair, but
men with low testosterone levels can still go
bald.

That’s because it is not the amount of

testosterone circulating in the bloodstream that
dictates baldness, it’s down to genetics. Several
genes are thought to be involved, all resulting in
hair follicles becoming particularly sensitive to
tiny amounts of circulating testosterone.

The process still isn’t fully understood, but it

involves an enzyme that converts testosterone
into a substance called dihydrotesterone, which
causes the hair follicles to shrink in some people,
possibly by choking off their supply of blood and
nutrients. As the follicle shrinks, the growing
cycle gets shorter and new hairs become finer
and finer until only the finest so-called vellous
hairs remain on the scalp. Eventually the follicle
becomes dormant and no more hair is produced.
This starts on the top of the scalp and then
moves down over the head in the characteristic
shape of male pattern baldness. Bald men are
genetically more predisposed to be more
sensitive to dihydrotestosterone, but the follicles
on the chin are unaffected by the hormone,
which is why beards continue to grow.

As theories about the influence of testosterone

have developed, so have various avenues of
treatment. In the 1960s there were curious
attempts to treat baldness by adding more
testosterone directly to the scalp. First
researchers tried an ointment, but it was so
heavy and oily that men didn’t want to stick out
the trial, so they suspended the testosterone in a
cream instead. Still most men dropped out of the
study before the ten months were up. The cream
didn’t make hair grow back, and although half
the men who took part said they thought this
might have slowed down the rate of hair loss,
this was not confirmed by the experimenters.

Some people who don’t lose their hair have low

levels of the enzyme that converts testosterone,
and so more recently researchers have been
seeking ways of blocking the enzyme in others. A
treatment called finasteride works on this
principle, but it is expensive and needs to be
used continuously or hair loss begins again.

Meanwhile, scientists are still trying to

understand the mechanism by which the hair
stops growing. In 2010, researchers examined
sections of scalp with and without hair and
found that stem cells were still present in the
follicles in both areas, but in bald regions they
weren’t progressing onto the next stage where
they would normally develop into so-called
progenitor cells. This study raises hopes that one
day hair could be grown on bald parts of the
heads, if scientists can find a way of triggering
growth or blocking whatever is preventing it, and
researchers are currently investigating particular
proteins that might provide that trigger.

Baldness seems to involve more myths than

many other conditions, possibly because its
distribution feels so arbitrary that we look for
explanations. If you have lost your hair sadly you
can’t claim to be more virile, but you can blame
your parents. They passed on the genes aGer all.

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You can hear more Medical Myths on Health

Check on the BBC World Service.

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