Could your style choices lead to hair loss?

Aging is a fact of life — albeit one that people may not readily embrace. Even signs of aging that a majority of people experience can still be hard to accept.

Balding, for instance, is exceedingly common. Male pattern hair loss, the most common cause of hair loss in men, impacts more than half of white men by the time they reach 50, according to the American Academy of Dermatology (AAD).1

Nevertheless, “hair loss can be extremely distressing,” says Dr. Shoshana Marmon, Assistant Professor of Dermatology at New York Medical College. “For many people, hair is not just a cosmetic issue but is also intertwined with self-image and confidence.”

Men may notice they're experiencing pattern hair loss — technically androgenic alopecia — if their hair starts thinning, they develop a bald spot, or their hairline starts receding. Some people with androgenic alopecia can start losing their hair as early as their late teens or early 20s.1 According to Dr. Marmon, the onset, type, and prognosis of hair loss, along with factors like age, gender, and cultural importance of hair, will impact the way in which each individual handles this diagnosis.

The stress of hair loss often prompts people to speculate and wonder how to stop or slow down the process. Scores of message boards are filled with questions about whether using certain products or styling techniques — or even wearing a hat — can exacerbate hair loss. We checked in with dermatology experts to find out more about baldness and what you can do about it.

Genetics is the leading cause of baldness by far. "Genetics plays a crucial role," in the emergence of androgenic alopecia, says Dr. Marmon — and multiple genes have been implicated in this condition.2 Both men and women are affected, but it primarily impacts men.

Male pattern hair loss also occurs when your body converts testosterone into dihydrotestosterone or “DHT,” a type of androgen (a hormone that stimulates the development of male characteristics). Higher levels of DHT will shrink your hair follicles and shorten your hair growth cycle, leading to hair loss.3

Given that androgenic alopecia is largely a genetic condition, there's really not much you can do to stop it. The idea that you could stave off hair loss with specific styling techniques is "really an old wive's tale," says Dr. Bruce Katz, a dermatologist and clinical professor at the Icahn School of Medicine at Mount Sinai.

That being said, other causes of hair loss could call for different styling habits. Traction alopecia, for instance, is a type of hair loss often resulting from chronic mechanical stress on the hair follicle. Traction alopecia, if caught and remedied early, can be reversed, but chronic traction alopecia can lead to permanent hair loss due to scarring.4

"Traction alopecia can happen from tight hairstyles like braids," says Dr. Carolyn Goh, Associate Clinical Professor in Dermatology at the UCLA David Geffen School of Medicine. "Tight headgear could also cause this or a pressure-induced alopecia. It is basically due to trauma to the hair which over time weakens the hair follicle and can cause the hair to fall out and sometimes cause scarring of the hair follicle."

Dr. Katz notes that other causes of hair loss include side effects of medications or medical conditions like alopecia areata, an autoimmune disease. With this condition, your immune system mistakenly attacks your hair follicles.5

To find the root cause of your hair loss, "you really need to see a dermatologist," Dr. Katz explains. A dermatologist can examine your hair to observe the distribution of hair loss, determine if there’s any scarring, and take a biopsy if necessary.

Dr. Marmon adds, "It is always a good idea to be gentle with your hair and scalp in the presence of a hair loss condition. Dermatologists commonly suggest avoiding styles that pull or tug at the hair and using a mild shampoo. However, there is really no concrete evidence that changing your brushing, washing, or hair care habits will have a significant effect on the amount or rate of hair loss."

As the dermatologists we spoke with said, there's very little evidence to suggest that wearing a hat will make you more likely to lose your hair. In fact, one study published in 2013 suggested the opposite. Researchers recruited 92 identical male twins to investigate the potential contribution of different factors on male alopecia, and daily hat use actually correlated with decreased temporal hair loss.6

Still, there are some scenarios where headwear could lead to hair loss. One case report from 2011 highlighted two adolescent Sikh brothers who wore turbans since early childhood. They both developed band-like scarring traction alopecia at the frontal hairline. "Awareness of this condition may help in preventing irreversible hair loss by early modification of the daily hair care routine," researchers note.7

For men who frequently wear hats and are concerned about hair loss, Dr. Marmon offers some advice, "Choose loose-fitting hats to avoid constant pressure on the same areas of the scalp. Ensure that the hat is clean to prevent scalp irritation and allow the scalp to breathe by taking periodic breaks from hat-wearing. It's also important to maintain a healthy scalp through proper hygiene and nutrition."

Like headwear, certain hairstyles worn tightly over prolonged periods could contribute to traction alopecia.

Traction alopecia is more commonly associated with women than men. However, doctors have more specifically correlated the problem with factors like hairstyles. As written by dermatologists from the University of Miami School of Medicine, "The frequent use of tight buns or ponytails, the attachment of weaves or hair extensions, and tight braids (such as cornrows and dreadlocks) are believed to be the highest risk hairstyles."8

As for grooming techniques, Dr. Goh says, "Ultimately, washing or brushing your hair differently will not change whether or not you will get male pattern hair loss. However, I generally encourage everyone to wash their scalp more often to make sure they are keeping their scalp clean and healthy. An unhealthy scalp can contribute to more hair loss."

According to Dr. Marmon, men concerned about hair loss should consider using gentle, sulfate-free shampoos to minimize scalp irritation. She adds that they should also avoid products with harsh chemicals, such as certain hair dyes, which can damage hair. Additionally, minimizing the use of any heat-styling tools can help prevent hair damage.

Dr. Goh adds that some types of hair gel can cause microtraction. For that reason, she says, "I encourage people to wash their hair frequently if they are using hair gels."

Additionally, The American Academy of Dermatology recommends adding conditioner to your hair care routine after every shampoo to prevent hair damage — and letting your hair air dry whenever possible.9

At the end of the day, several factors could contribute to hair loss. But your choice of headwear, hairstyle, or hair products is less likely to be the culprit than your genetics are. However, no matter the root cause, speaking with a doctor is vital to get ahead of your hair loss.

"It's important to consult a dermatologist to identify the specific cause of your hair loss," Dr. Marmon says. "There are extremely effective in-office and at-home treatments available, and early intervention typically yields better outcomes. A dermatologist can recommend the most suitable treatment options for your condition."