For a man, a bald head may be a sign of maturity, wisdom or even masculinity, but it might also be a sign of something else—something much worse.

According to a new study, a bald head could signal a higher risk of developing prostate cancer.


In the study, men being referred for prostate biopsies were asked to describe how bald they were by ranking their pattern of hair loss using a five-point scale. Zero meant no baldness…1 meant a minimally receding hairline…2 meant a little bald spot on the top of the head…3 meant a large bald spot on the top…and 4 meant no hair on top of the head. (For a visual scale, see the accompanying illustration.)

DHN Bald_ScaleThe researchers found that the more bald that a man was (the higher he ranked on the scale), the more likely it was that his biopsy would come back positive—showing that he had prostate cancer. In fact, men with minor baldness—a minimally receding hairline, level 1—were twice as likely to have prostate cancer as men with full heads of hair (level 0)…and men with the most severe baldness—no hair on their heads, level 4—were almost three times as likely to have prostate cancer, compared with men with full heads of hair.


To learn more, I called the lead author of the study, Neil Fleshner, MD.

Keep in mind that it’s unknown whether baldness causes prostate cancer. This study showed only an association. Why? Dr. Fleshner’s theory is that being hypersensitive to a hormone that’s partly responsible for the development of male sex organs and masculine characteristics, dihydrotestosterone, may be what both stops hair growth and prompts the development of prostate cancer, because some prior studies have hinted at a link between the hormone and baldness.


I asked Dr. Fleshner whether he thinks that men should get screened for prostate cancer the minute they start losing hair, and he said that it’s not necessary, because most men start losing hair in their 20s and prostate cancer is rare among men in that age group. When healthy men should start getting screened for prostate cancer is, of course, a controversial topic.

If you already get a regular screening, such as a PSA test that detects the level of a prostate-specific antigen in the blood or a rectal exam, during which a doctor uses a gloved finger to feel for abnormalities in the texture, shape or size of the gland, then continue getting screened, said Dr. Fleshner. A high PSA score or an abnormal rectal exam almost always requires further testing. But if your PSA score is on the borderline, assessing your level of baldness might be helpful. If you’re fully bald or balding, you may want to be extra-cautious and ask your doctor to monitor you more frequently or more intensely (doctors can also perform further tests, such as ultrasounds or biopsies of prostate tissue), he added.

Whether you get screened or not, if you’re bald or balding, be on the lookout for symptoms of prostate cancer, such as trouble urinating (difficulty starting a urine stream and/or decreased force of the urine stream) or the presence of blood in your urine or semen.