Baldness: Causes, Stages and Triggers of Hair Loss

Key takeaways

• Common baldness (androgenetic alopecia) is hereditary: DHT progressively exhausts sensitive follicles.
• The Norwood (men) and Ludwig (women) scales allow you to objectively situate the progression.
• Stress, deficiencies and lifestyle factors worsen but do not create androgenetic alopecia — hence the value of a dermatological diagnosis.
• Each stage has its options: treatments to slow it down, camouflage for the visual side, and the two can be combined.

The most common baldness is androgenetic alopecia, which is hereditary: the follicles are sensitive to a hormone, DHT, that wears them down and thins the hair until it disappears. Stress, deficiencies and certain hormonal imbalances speed the process up. To map the progression, professionals use the Norwood scale (men) and the Ludwig scale (women). Only a dermatologist can give a reliable diagnosis.

Androgenetic alopecia accounts for around 80% of hair-loss cases and affects men and women alike. This often-hereditary process comes from a heightened sensitivity of the follicles to dihydrotestosterone (DHT). Understanding this mechanism and the factors that worsen it is the first step to reacting at the right time.

Understanding the mechanism of hair loss

Hair lives by a three-phase cycle: growth (anagen), transition (catagen) and rest before shedding (telogen). In a healthy person, the growth phase lasts several years.

DHT upsets this balance. By binding to genetically sensitive follicles, it gradually shortens the growth phase. The follicle then produces ever finer hairs over ever shorter cycles: this is miniaturisation. Cycle after cycle, the hair turns to down, and eventually the follicle produces nothing at all. This mechanism explains why baldness is progressive and targets specific zones, rather than causing a sudden patch.

This should not be confused with telogen effluvium, a diffuse and usually temporary shed linked to stress, a deficiency or a shock. Unlike androgenetic baldness, it does not cause the hairline to recede and resolves once the cause is addressed.

The causes and aggravating factors

The biological mechanism is known, but several factors explain why and how fast density declines.

Heredity. The number-one cause. This predisposition can be passed down from either parent and determines how sensitive your receptors are to DHT. It comes down to the combination of genes inherited, which is why some people are spared and others are not.

Stress and emotional shocks. Intense stress raises cortisol, which disrupts the follicle’s environment and can tip a share of the hair into the shedding phase. The effect often appears a few months after the trigger.

Deficiencies and lifestyle. A lack of iron (ferritin), zinc or B-group vitamins weakens the fibre, which becomes brittle and dull before falling. Smoking, by reducing scalp oxygenation, worsens thinning already under way. A balanced diet, rich in protein, zinc and iron, supports the quality of regrowth.

Assessing how far alopecia has progressed

To gauge where things stand, professionals rely on reference scales.

In men, the Norwood-Hamilton scale describes seven stages, from a slight deepening of the temporal recessions to the residual crown of hair on the sides, by way of thinning at the vertex (crown). Identifying your stage early lets you act before the loss spreads.

In women, the pattern differs: the hairline is generally preserved, and it is the centre parting that widens instead. The Ludwig scale is used here, in three grades of thinning. As female loss is often diffuse and linked to specific hormonal factors, a work-up is usually needed.

At the very first stages, the signs are subtle: our article Early baldness: recognising the signs reviews them one by one.

Myths about baldness

Plenty of beliefs circulate and stoke needless worry. No, wearing a cap does not make you bald: the pressure of an ordinary hat does not smother the follicles. No, washing your hair often does not cause loss, the hairs that fall in the shower were already at the end of their cycle. No, baldness is not passed down solely by the maternal grandfather: the genetic predisposition comes from both lines. And cutting your hair short does not increase its density: it only changes the appearance, not the number of follicles. Trusting these myths mostly wastes time; a dermatological diagnosis is better for acting on the real causes.

What to do about baldness

Understanding the cause guides the action. On the root cause, a dermatologist can confirm the diagnosis and propose a suitable plan (prescription treatments, correcting a deficiency, follow-up). On appearance, camouflage solutions restore immediate visual density while you act on the cause: we explain how in our article How to hide baldness.

Among these solutions, the Ecobell Kit is one of the simplest places to start: its densifying powder of natural microfibres grips your existing hair to instantly mask the see-through scalp, and its fixing spray ensures up to 24 hours of waterproof hold. A 99.6% natural, vegan formula, 9 shades, rated 4.7/5 from over 1,200 reviews, at €28.72 instead of €31.90. An effective way to stop dreading the mirror while the underlying treatment does its work.

Understanding the role of DHT, placing your stage on the Norwood or Ludwig scale, and seeking advice at the right moment: these are the first steps to taking back control. The rest (treating the root cause and camouflage) builds on that diagnosis.

On the treatment side, two reads complete this overview: pharmacy anti-hair-loss products like Dercos for over-the-counter solutions, and minoxidil, finasteride and powder for medical treatments and their compatibility with camouflage. At advanced stages, our article on transplants and their alternatives takes stock with no sugar-coating.