The Baldness Blog

The Baldness Blog

Genetic Testing for Male Pattern Baldness

By Joshua Baker

December 2nd, 2019

Men these days are judged ever increasingly more by their appearance; we need to be fit, handsome, well-dressed, and well-groomed. If we fail in any of these categories, we are instantly judged to be inferior. These are all important things to take care of, but perhaps no other physical characteristic exceeds the challenges posed by one’s own head of hair. Yes, it is our luscious locks that drive men to insanity about their appearance. But the insanity doesn’t set in until the hair follicles begin to fall out.

We are talking about male pattern baldness.

From thinning hair to a receding hair line, the condition can be devastating to a man’s self esteem and may even be linked to certain health conditions other than balding! With so much on the line, is there any way of predicting if you will develop male pattern baldness? And if so, is it even worth it? We will explore these questions and more in this blog.

WHAT IS MALE PATTERN BALDNESS?

Male pattern baldness is an inherited condition that results in the loss of significant amounts of head hair follicles. Symptoms include thinning hair, patchy bald spots, and a receding hair line1.

According to a 2017 study by Hagenaars and colleagues, male pattern baldness affects as much as 80% of men by the time they reach 80 years old. The dramatic and unstoppable change associated with this condition is often depressing and difficult to watch for many men, not to mention its damage to their perceived social attractiveness. The same 2017 study also found 112 autosomal genes as well as 13 genes located on the X chromosome that all are associated with male pattern baldness. Several of the autosomal genes are related to hair follicle growth while the most common X chromosome gene codes for androgen reception2. The genes linked with male pattern baldness naturally make sense. Because the condition concerns the loss of hair follicles, genes that cause male pattern baldness to develop must have some role in hair development. Furthermore, the fact that the androgen receptor gene is correlated with baldness raises the question that some hormonal process must be involved, which explains the sudden change that occurs.


Above is a man with moderate male pattern baldness. Notice the thinning hair and the bald spot1

WHY GET TESTED?

Since male pattern baldness is such a prevalent and unavoidable condition, why would one want to get genetically tested for it? If it is going to happen, then it will happen, right? For many, the emotional trauma of suddenly losing his hair is awful. But early-onset male baldness has been linked with several particularly nasty diseases, including prostate cancer and Parkinson’s disease3. As a result, getting tested early can provide relative peace-of-mind for those labeled as “low risk” and provide those labeled as “high risk” with plenty of time to prepare and start preventative measures, like prostate exams or even looking into alternatives to balding, like hair transplants.

Since there is such a massive number of genes and alleles that appear to cause male pattern baldness, it would perhaps be best to get a genome-wide sequencing test in order to detect as many of the potential variations as possible. This type of test typically runs around $1,5004.

For the most common alleles, it would be cheaper simply to test those specific genes. These tests cost approximately $220 for the entire gene, but for more than just one, it becomes more cost-effective to do the whole genome sequencing.

The previously mentioned 2017 study found a much higher frequency of certain variations of an X chromosome gene in men with early-onset balding than with late-onset. Therefore, it is possible to genetically test for the risk of developing early-onset male pattern baldness. In a 2012 study by Li and colleagues,Parkinson’s and early-onset male pattern baldness were found to be linked by one specific allele on chromosome 175.Getting tested may be worth it for both the peace-of-mind of keeping one’s hair and not developing Parkinson’s.

THINK BEFORE YOU SPIT

A genetic test, unfortunately, is not exactly a crystal ball. Simply having the genetic variations associated with male pattern baldness is not enough to declare that a subject will become bald. Only 51.9% of the variation in the human population with respect to baldness can be explained by the genetic variants found the Hagenaars et al study2. Some factors that may affect baldness outside of genes include weight, stress, chemotherapy treatment, and even simply getting older1.

Furthermore, there may be even more variations that have not been detected yet. Research on the genetics of male pattern baldness is still relatively lacking3, so the potential for more (or even fewer) variants that cause balding is possible.

ETHICAL CONSIDERATIONS

Testing as a “high risk” candidate for balding will be terribly worrying for any man placed in such a situation. Given the possible correlations with various diseases, it would be hard not to stress over the test’s findings. Ignoring the potential for disease, even losing one’s hair, a symbol of one’s male identity, fills many with dread about future social and physical decline.

Luckily, there appear to be no major or common concerns for genetic privacy. Few companies would discriminate against an employee given his genetic propensity for balding, save those of the entertainment and modeling industry. As a result, few men should worry if getting tested for male pattern baldness might damage his prospects for future employment.

There are other downsides, though, to consider.  Given the cost and potential for inaccuracy in predicting risk of developing male pattern baldness, it may not be worth the $1,500 to sequence one’s entire genome. However, there is an added bonus. Once a genome has been sequenced, it will be available in its entirety for further analysis of other potential diseases, like risks for certain cancers. Even if the balding prediction does not hold true, having the option to also check for those awful diseases might just be worth it.

ASKING THE RIGHT QUESTIONS BEFORE THE TEST

In order to determine if genetic testing is right for you, here are some important questions to consider.

  • Do you have a family history of balding, on either side?

This is important to ask because if not, then there is very little chance that the cause of any balding you might have in the future will be due to genetics.

  • What will you do if you test as a high-risk individual?

If you cannot answer what you would do after being labeled as high-risk for balding, then perhaps the genetic test is not right for you. It is too expensive to simply do it for the peace-of-mind; it is best to go into the test with a plan for either treatment (if desired) or coping with balding.

  • What will you do if you test as a low-risk individual?

Being labeled as a low-risk individual does not necessarily mean you are in the clear. You may still develop male pattern baldness in the future. On another note, you need to still continue to remain healthy as general health can also affect hair loss.

  • Consider discussing getting the test and the results of the test with a doctor or geneticist.

Not so much a question as much as advice. If you would like to explore being tested, it would be wise to discuss your risks of balding before spending all that money on the test. Furthermore, if you have been tested and would like to consider potential treatment options and/or other genetic risks, doctors and geneticists are excellent resources to find out more about such topics.

  • What are you willing to change after being identified as high-risk?

To reduce your overall chances of developing baldness even after being labeled as high-risk, it is important to try to be healthy and fit. To even further reduce risk, it may be best to consider changing your hairstyle, which can damage hair follicles, or trying to reduce stress, which can induce hair loss.

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Regardless of whether you decide it is best to get tested for male pattern baldness, it is important to maintain a healthy sense of what matters. If you are legitimately concerned about your appearance and you actively want to prevent losing your hair, then getting genetically tested is not a bad idea. But if you honestly don’t mind the prospect of balding, then that’s ok too! It is all a personal choice; no two people will have the same reasons for either decision. And regardless of that decision, above all, you need to learn to love who you are, whether that’s with a full head of hair or none at all.

Sources Cited

1Hair loss. Mayo Clinic Web site. https://www.mayoclinic.org/diseases-conditions/hair-loss/diagnosis-treatment/drc-20372932. Updated February 12, 2019. Accessed December 2, 2019.

2Hagenaars S, Hill D, Harris S, et al.Genetic prediction of male pattern baldness. PLoS Genetics. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308812/. Accessed December 2, 2017.

3The role of genetics in male pattern baldness. 23andMe Blog Web site. https://blog.23andme.com/23andme-research/the-role-of-genetics-in-male-pattern-baldness/. Updated March 8, 2017. December 2, 2019.

4The cost of sequencing a human genome. National Human Genome Research Institute Web site. https://www.genome.gov/about-genomics/fact-sheets/Sequencing-Human-Genome-cost. Updated October 30, 2019. Accessed December 2, 2019.

5Li R, Brockschmidt FF, Kiefer AK, et al.Six novel susceptibility Loci for early-onset androgenetic alopecia and their unexpected association with common diseases. PLoS Genetics. 2012. https://www.ncbi.nlm.nih.gov/pubmed/22693459/. Accessed December 2, 2017.