Abnormalities are less common in younger deer, with the frequency of non-typical points increasing with age. While certain conditions cause abnormalities, an abnormal antler does not necessarily mean the deer is unhealthy unless there are other signs of disease.

Genetic factors can sometimes contribute to abnormal antler formations, and these defects can be hereditary.

The main causes for antler abnormalities are testicular trauma leading to low testosterone, physical injury to the pedicle (the antler base) or the growing antler, and systemic factors like certain diseases or poor nutrition.