Bald is Beautiful, But Beware

Prostate cancer in black men may be associated with early frontal baldness

March 26, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Baldness affects about 60 percent of men at some time in their lives.  Researchers now think baldness and prostate cancer may be linked in African American men.

Baldness of any type increased an African American man’s risk of developing prostate cancer, according to a new study. The type of baldness and the man’s age increased these risks.

Early onset (before age 60) and frontal (receding hairline) only baldness were associated with more advanced and more aggressive prostate cancers in black men.

"Research options for treating hair loss."

Charnita Zeigler-Johnson, PhD, research assistant professor at the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania in Philadelphia, led a study to look at the relationship between early onset baldness and prostate cancer in black men.

Research has established that African American men are more likely to develop prostate cancer and die from the disease than men of other races.

For the study, investigators identified 318 black men with prostate cancer between the ages of 39 and 86. Another group of 219 men without prostate cancer between the ages of 33 and 93 served as the control group.

All of the men were enrolled in the Study of Clinical Outcomes, Risk and Ethnicity (SCORE) between 1998 and 2010, and all had varying degrees of baldness – none, frontal or vertex baldness that starts at the crown of the head.

In addition to looking at baldness, the researchers also considered other prostate risk factors, including family history, smoking and alcohol history and prostate-specific antigen (PSA) levels.

The researchers noted that baldness and prostate cancer are linked by their relationship to the metabolism of male hormones – androgens. In particular, high levels of one hormone called dihydrotestosterone (DHT) have been associated with both prostate cancer biology, early baldness and increased PSA levels.

Here’s what the study found about baldness and prostate cancer in African American men:

  • Any type of baldness increased the risk of developing prostate cancer by 69 percent.
  • Men with frontal – but not vertex – baldness had more than twice the risk of being diagnosed with advanced prostate cancer than men with no hair loss.
  • Early onset baldness that appeared before the age of 60 showed a six-fold increased risk of advanced disease and a four-fold increased risk of aggressive disease.

Prostate cancer specialist E. David Crawford, MD, told dailyRx News, “Drugs like finasteride [Proscar and Propecia] and dutasteride [Avodart] do block the natural enzyme that produces the culprit hormone dihydrotestosterone.—DHT. It is too bad that men on finasteride were excluded since this may have been preventative,” said Dr. Crawford, professor of surgery, urology, and radiation oncology, and head of the Section of Urologic Oncology at the University of Colorado Health Sciences Center in Denver.

Dr. Crawford continued, “So what is the association if any of early baldness in African American men and prostate cancer? Perhaps higher DHT levels. And finally, there may not be an association, just a statistical fluke when you do subset analysis.”

Dr. Zeigler-Johnson concluded, “Pending future studies to confirm our results, there is a potential to use early onset baldness as a clinical indicator of increased risk for prostate cancer in some populations of men.”

This study was published March 26 in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. This work was supported by grants from the Department of Defense and the Public Health Service. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
March 25, 2013
Last Updated:
March 26, 2013