Study Supports Evidence of Link Between Balding and Skin Cancer

A new genetic study has examined the relationship between male pattern baldness and skin cancer, suggesting that increased sun exposure may be at least partly responsible for this link – not dysregulated testosterone levels. The research is published in Nature Communications.

Exploring the risks underlying cancer

Hair loss has already been established as being linked to an increased risk of skin cancer. But how straightforward is this association?

The two prevailing theories are that this relationship is caused by either dysregulated testosterone levels or increased sun exposure. Previous studies have shown that patients with male pattern baldness – also known as androgenic alopecia – have higher levels of testosterone compared to controls, and that male pattern baldness is in turn linked to higher rates of skin cancer on the scalp.

“Testosterone levels are a major driver of male pattern baldness, and some studies suggest they may also contribute to this increased skin cancer risk in people with hair loss,” explained Dr. Jue-Sheng Ong, lead author of the study and research officer at Queensland Institute of Medical Research (QIMR) Berghofer. “The more obvious explanation would be that people with hair loss receive greater sun exposure to their head and neck.”

Researchers from QIMR Berghofer have investigated further to find out what could be underpinning these links and determine if any of the long-held assumptions surrounding testosterone levels or sun exposure may indeed be false.

Combing through the data

“It’s important that we investigate and prove causality to inform the best evidence-based prevention for deadly skin cancers – even if the answers seem obvious,” said Dr. Matthew Law, senior author of the study and associate professor in statistical genetics at QIMR Berghofer.

The researchers ran extensive genetic analyses to reveal the relationship between balding and skin cancer. They used genetic data from almost 30,000 cases of 2 types of skin cancer – melanoma and keratinocyte cancer – while incorporating data on genes predisposing people to high testosterone or hair loss.

Strong links were identified between male pattern baldness and keratinocyte cancers, but there was no link to high testosterone. Male pattern baldness was also strongly associated with head and neck squamous cell carcinoma and melanoma. Together, this suggests that skin cancer is linked to increased sun exposure as a result of hair loss, rather than to testosterone levels.

“We sought to find clear answers and unsurprisingly, it appears the more common-sense explanation is the correct one. Balding men are more susceptible to sun damage and skin cancer because they have less hair protection,” explained Ong. “We found no evidence that testosterone levels play any meaningful role in the relationship between balding and skin cancer.”

“Interestingly, we did find an overlap between genes that cause hair loss and genes that affect skin color or pigmentation. Skin color is a known risk factor for skin cancer, and these results suggest pigmentation may also contribute to this increased risk in people with hair loss,” he added. “However, the majority of this relationship between balding and skin cancer is still explained by increased sun exposure.”

The researchers emphasize that irrespective of people’s individual risk levels, protecting our skin from sun exposure and UV radiation is critical to prevent melanoma and other skin cancers, and that further research into genetic factors that promote skin cancer development is vital.

Reference: Ong JS, Seviiri M, Dusingize JC, et al. Uncovering the complex relationship between balding, testosterone and skin cancers in men. Nat. Commun. 2023;14(1):5962. doi: 10.1038/s41467-023-41231-8

This article is a rework of a press release issued by QIMR Berghofer. Material has been edited for length and content.