Heredity doesn't just determine the color of our eyes. It can also be a cause of hair loss. In this article, we’ll look at what genetic hair loss is in men and women and how it differs between them. We’ll also discuss supportive care approaches.
What Is Genetic Hair Loss?
Androgenetic alopecia is associated with an inherited increased sensitivity of the hair follicles to androgens. In this context, the focus is primarily on DHT, which the body produces from testosterone. Female pattern hair loss is also strongly influenced by genetics, although the role of androgens is less clearly defined.
Is Genetic Hair Loss the Same as Androgenetic Alopecia?
Androgenetic alopecia (or androgenic alopecia) and genetic hair loss are often used as synonyms. However, androgenetic alopecia is a medical term. It refers to hair loss with genetic causes, including hair follicles' sensitivity to androgens. Both terms are appropriate for everyday use, but in medical literature, you are more likely to see “androgenetic alopecia.”
Why Does Genetic Hair Loss Happen?
The tendency toward hair thinning is passed down from parents to children. A person can inherit a greater or lower susceptibility to hair loss from either parent. Of course, this is a simplified picture - many genes are involved, and how they combine is far more complex than any one family pattern.
The androgen receptor gene (AR) is one of the best-studied genetic factors associated with male pattern hair loss. It is not the only gene involved, but it plays an important role in androgen signaling.
Androgens, DHT, and Hair Follicle Miniaturization
In follicles that are sensitive to DHT, this hormone can gradually shorten the active growth phase of hair, called anagen. Over time, this causes the follicle to shrink, or “miniaturize.” This doesn't happen overnight - it's a very slow process, and early changes may be too subtle to notice without a special scalp examination called trichoscopy.
One of the main changes in genetic hair loss is this gradual miniaturization, or shrinking, of susceptible follicles. Each growth cycle, the follicle comes back a little smaller, and the hair it produces is a touch shorter and thinner than last time. Eventually, in the more advanced cases, some follicles stop producing hair you can actually see.
Does Hair Loss Come From Your Mother or Your Father?
There's no fixed rule that hair loss always comes from one side of the family. Actually, it’s possible for you to inherit genetic susceptibility to pattern hair loss from your mother, your father, or both. The process is more complicated, since it involves many genes rather than a single “baldness gene.”
How to Know If Hair Loss Is Genetic
The pattern of hair loss can provide important clues, but it cannot confirm androgenetic alopecia on its own. Family history can strengthen the suspicion, while a dermatologist can distinguish pattern hair loss from other causes of thinning or shedding. In both men and women, miniaturized hairs gradually become finer and shorter. However, the distribution of thinning often differs between the sexes, even in the earlier stages.
Genetic Hair Loss in Men and Women
Genetic hair loss in men and women occurs according to different patterns. Since there is no single pattern, genetic hair loss should be considered separately for both sexes.
Male Pattern Baldness (Male Pattern Hair Loss)
Male pattern hair loss begins with gradual recession of the hairline at the temples and forehead. It can also involve thinning at the crown. The Hamilton-Norwood scale describes this in detail, outlining seven stages of androgenetic alopecia in men. Each has its own typical pattern.
Stages of Male Pattern Baldness
In men, it often begins with barely noticeable recession at the temples and along the hairline. Gradually, it expands, and the hairline shifts further back. As the alopecia progresses, thinning at the crown may develop as well, and eventually these areas can merge together - which is what the later stages of the Hamilton-Norwood scale describe.
One thing worth noting: the speed of progression varies from person to person and depends on genetic, hormonal, biological, and other individual factors. That's why in two men with hereditary hair loss, the process can unfold at very different speeds and intensities, showing up earlier for one and much later for the other.
Female Pattern Hair Loss (Female Pattern Baldness)
Female pattern hair loss differs from male pattern hair loss. Women rarely develop the extensive baldness typically seen in advanced male pattern hair loss. More often, you'll see thinning along the parting line, with hair also becoming thinner at the crown. The female pattern is commonly described using the Ludwig scale, which has three main stages.
In women, hereditary hair loss can also involve hormonal factors, though the exact influence of androgens is less clearly defined than in men. The pattern is usually distinct as well: thinning typically appears gradually and more evenly across the crown and along the parting line. In most cases, the front hairline remains relatively preserved.