Just a Cowlick, or an Early Sign of Balding?

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When you notice a change in your hairline – no matter how small – it may lead you to believe that it’s a sign of worse things (i.e. baldness) to come. But fortunately for those with cowlicks, this isn’t usually the case.

In this post, I’ll explain how you can tell the difference between a cowlick or pattern balding. This will include an in-depth look at the earliest signs of hair loss so you know what to look out for.

If pattern hair loss is your problem, I’ll also offer up treatment options for you to consider.

But before we begin, it’s first important to understand what exactly pattern hair loss is.

An Introduction to Pattern Hair Loss

Pattern hair loss, also known as Androgenetic Alopecia (AGA) and Male-Pattern Baldness (MPB), is the most common cause of hair loss in men (and the second most common in women) (1).

There are many factors that contribute to the development (and progression) of AGA but, overall, the condition is genetic.

Androgenetic alopecia differs from other types of hair loss in many ways, though the most prominent is in its presentation. This is due to the underlying cause of the condition which is sensitivity to the androgen hormone Dihydrotestosterone (DHT).

DHT is a by-product of teststerone (a sex hormone) and 5-alpha-reductase (an enzyme). It is a necessary hormone as it contributes to sexual function and fertility (2). But it’s also one that can wreak havoc in those who are sensitive.

In men and women with AGA, the sensitivity is found on the scalp. When the hormone attaches to the androgen receptor located at the base of the follicle, it triggers an inflammatory response.

The chronic inflammation that results leads to miniaturization which eventually causes the hair to shorten and, eventually, not grow at all.

But what does this have to do with the presentation of AGA?

In men, this sensitivity is concentrated around the hairline. The initial thinning and hair fall that occurs, then, is most often at the forehead and temples.

This is easily seen in the Hamilton-Norwood scale of hair loss that’s used to “grade” the severity of balding in men:

The Norwood-Hamilton scale

In women, however, the sensitivity is more pronounced in follicles at the crown. Women will often notice thinning here first, but it can also occur throughout the scalp.

Cowlicks: An Anomaly, or a Sign of Future Hair Loss?

You may be wondering if your cowlick is just an anomaly, or if it signifies a future of hair thinning and balding.

But before we answer that, it’s good to get a clear definition of “cowlick.”

Cowlicks are sections of hair – often seen at the hairline or crown – that grow in the opposite direction of the surrounding hair. This causes a “swirl” pattern and, in some cases, the appearance of thinning in the immediate area.

These develop in utero and are, therefore, unable to be “fixed.”

The occurrence itself is actually quite common and, in general, nothing to worry about. If it’s combined with the most common signs of early balding, though, then you may want to consider how you can treat it before it’s too late.

The Early Signs of Balding

If you’ve noticed a change in your hairline, you may be wondering if a genetic condition is to blame (as opposed to a cowlick). Here are just a few signs to look out for so you can rule out, or confirm, your suspicions.

Increase in Shedding

The first thing you’re likely to notice, whether male or female, is an increase in the number of hairs you shed on a daily basis.

It’s natural to shed anywhere between 50 to 150 hairs per day. This occurs as a result of telogen phase shedding, which is a normal part of the hair growth cycle (3).

Minoxidil shedding

But when the amount of shed hair increases, it’s often a sign of a larger issue.

How can you tell if your hair is shedding more? The best places to look are in the drain of your shower, and on your pillow.

Activities such as showering and sleeping can dislodge the hairs most easily from your scalp. If you have an excess number of follicles in telogen phase (which tends to happen in those with AGA), then this will lead to more hairs lost during those activities than usual.

If the condition has continued for long enough, you’ll also begin to notice the shedding at the hairline and crown.

Receding Hairline

Perhaps the first time that many men even begin to notice a problem is when their hairline begins to noticeably recede.

The hairline is a line of follicles that are found at the forehead and temples. Over time, the hairline will naturally recede (a process known as maturation), but it should do so evenly and without a noticeable loss in volume.

When your hairline continues to recede past the point of maturation, though, is when you should consider pattern baldness as a cause.

The easiest way to determine whether your hairline is mature or receding is the pattern in which it’s moved back. If it’s done so evenly, it’s very likely just matured. If it’s done so unevenly, though, then it’s time to consider your treatment options.

Family History of Baldness

Genetics aren’t the only factor in the development of AGA, but they are a strong one.

Men and women who have a history of baldness in their family should know that they are at an increased risk of developing the condition (4).

There are many genes linked to AGA, and some of them (such as the Androgen Receptor (AR) gene) have even been identified (5). But unfortunately, there is no telling who will present with the condition and who won’t.

Your best bet, then, is to take a proactive approach.

This means taking care of your hair and lowering your environmental risks.

Just a few of the risks that may increase the chances of balding include smoking, drinking, and poor diet.

You may also want to consider adding in some scalp exercises on a regular basis to ensure the blood flow is optimal.

How To Tell If It’s Just a Cowlick

So, is the curious patch of hair on your scalp just a cowlick or a sign of worse things to come?

The best indication is how long the hair has been like that.

Cowlicks are often present at birth. If your hair has always gone in an opposite direction in that area, then the chances are it’s not an early sign of balding.

If the change in your hair is more recent, however, then it may be time to worry.

You can also look at other areas of your scalp, and the area immediately surrounding the “cowlick” to gain further insight into its true cause.

If the rest of your hair is otherwise healthy and no visible thinning is present, you are likely in the clear.

Of course, even if the area is a cowlick that doesn’t mean you still can’t develop balding patterns in the future. So it’s good to keep an eye on the situation to be sure it doesn’t progress.

How to Address Early Hair Loss

If you’ve determined that your cowlick is just that – a cowlick – then you should worry no further. But for those with other signs of hair loss, here are some treatment options.

Medical Intervention

The first place that people go when they notice thinning and balding is a dermatologist.

A dermatologist is a doctor who specializes in skin and hair conditions. There are those who take a more general approach to their practice, while there are others (known as trichologists) who focus on hair issues only.

If you’re currently dealing with thinning, it doesn’t hurt to get the opinion of a doctor before you proceed with treatment.

Your dermatologist will likely perform a physical examination, and they will also take your family history and perhaps even draw some blood. Based off of these things, they can steer you in the right direction.

If you’re diagnosed with pattern baldness, there are two medications your doctor is likely to suggest or prescribe: minoxidil and finasteride.

Minoxidil, also known as Rogaine, works by increasing blood flow to the scalp and upregulating growth factors (6, 7).

Finasteride, also known as Propecia, takes a more direct approach and lowers DHT levels within the body (8).

And while these drugs may be helpful, they also aren’t the only treatment options available.

In severe cases, your doctor may also recommend more complex procedures including Platelet-Rich Plasma (PRP) or even hair transplantation. Only you and your doctor can determine if these are good options for you.

Scalp Stimulation

Scalp stimulation is a catch-all term that refers to techniques which stimulate the scalp either manually, or with a specialized tool.

You can perform many of these techniques – including massage, scalp exercises, and microneedling – at home. Best of all, there is scientific research to back their success claims.

Massage, for example, has been shown to increase hair thickness (9). And microneedling – a procedure that uses tiny needles to penetrate the scalp – has been shown to increase hair counts in men with AGA (10).

Microneedling the scalp
The dermaroller – pictured above – is the most popular microneedling tool for use at home.

The theory behind scalp stimulation for hair growth is simple. By stimulating the scalp, you increase blood flow which helps to deliver oxygen and vital nutrients. These techniques also break down any calcification and reduce scalp tension (11, 12).

They can also be combined with the above-mentioned medications, or with more ‘natural’ solutions.

Essential oils and other such ingredients (like hyaluronic acid) are commonly used in cosmetics and hygiene products.

You can add these into your hair care routine by combining the essential oil (e.g. peppermint or rosemary) with a carrier oil (e.g. coconut or almond). Though, you should always perform a quick test on a small area to ensure there is no allergic reaction.

And while there is still much research that needs to be done on natural ingredients and their effects on hair growth, they are often not harmful and they even provide other benefits (such as anti-inflammatory and antifungal).

Conclusion

A cowlick is a natural phenomenon and it, in and of itself, is not a sign of early balding.

But if you notice any other signs of balding, including increased shedding or hairline recession, then you’ll need to take a proactive approach to ensure that further hair loss does not occur.

Do you have questions about any of the information covered above? Please be sure to leave a comment below.

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