EXPERT GUIDE

Male Pattern Baldness

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Medically reviewed by Dr. Sternberg Written by Alex Rode on 1 Feb 2021

Male pattern baldness, or androgenetic alopecia, is a genetic condition which causes hair loss in men. It is the most common cause for balding, it affects over 50% of all men by the age of 50. While the symptoms of male pattern baldness are most common in middle-age to older men, hair loss can begin in the early 20s. It is important you recognize the signs early, if you begin treatment as early as possible it will be much more effective.

In a Nutshellsvg

Symptoms Receding hairline svg
Causes DHT svg
Treatments Hair Transplant svg

What are the symptoms of male pattern baldness?

The hair loss associated with male pattern baldness can take a variety of different courses which are unique to the patient. It begins gradually in most cases, often starting with a receding hairline or thinning of the hair.

The first sign of male pattern baldness for many men are the receding corners of the hairline. This will cause an exaggerated widow’s peak to form, also known as a forelock. Some men will find their entire hairline receding evenly, however this is not as common.

Hair loss symptoms

Another symptom of male pattern baldness is a thinning of hair in the crown area. This can happen in addition to a receding hairline or by itself. The whorl in the crown region at the back of the head will begin to thin and start balding. This is a less noticeable symptom and many men will fail to notice the bald spot until it is quite advanced.

Diffuse hair loss is the gradual thinning of the hair, it is less common than balding in the crown or a receding hairline. It affects the entire top of the head in most cases without a noticeable change in the hairline.

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Causes of male pattern baldness

Testosterone is converted into dihydrotestosterone by the enzyme 5α-reductase, higher levels of this hormone DHT are associated with male pattern baldness. DHT attaches to the hair follicle and begins to weaken the hair and shrink it. It will slow down the growth of hair from the follicle until it eventually stops new growth from the follicle altogether.

DHT is a naturally occurring hormone, this alone will not always cause the hair to fall out. A man’s sensitivity to DHT is determined by their genetics. The more sensitive an individual’s hair follicles are to the hormone, the more likely they will suffer from hair loss and the more extensive their balding will become.

Ironically, while DHT causes hair on the top of the head to weaken and fall out, it has the opposite effect on hair below the eyebrows. This is why many men who have a bald head will continue to have thick, full beards and lots of body hair.

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Hamilton-Norwood scale for the pattern of hair loss

The hair loss pattern associated with male androgenetic alopecia is illustrated by the Hamilton-Norwood scale. According to this scale, androgenetic hair loss is divided into seven stages. Prior to most hair transplants, the patient’s degree of hair loss is identified using this scale.

This scale is then used to determine the number of grafts needed for the transplant and to make a prediction about the cost of hair restoration. The scale can also be used to predict the further course of hair loss.

Typical male pattern hair loss: The norwood scale.

There is not a specific stage of the Hamilton-Norwood scale when a patient should decide to seek treatment. An individual should take action to combat hair loss as soon as they notice signs of a receding hairline or thinning hair. The earlier preventative measures are taken, the more effective they are in stopping hair loss. You will be able to retain more of your natural hair by starting medicinal treatment early on. The more extensive the hair loss is, the more difficult it becomes to treat.

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Most effective treatments for male pattern baldness

One of the most effective treatments to combat male pattern baldness is finasteride. Originally used as a remedy for prostate enlargement, today it helps many individuals who suffer from hair loss. 1mg of finasteride is taken daily with a glass of fluid to prevent hair loss.

The drug finasteride inhibits the enzyme reductase of 5α- DHT, blocking the conversion of testosterone to DHT. If the hair loss is already advanced (Norwood scale 5 to 7), taking finasteride is not really helpful, as the drug primarily stops hair loss. Various studies show that finasteride can stop hair loss, particularly on the crown of the head. In many cases, however, the spread of a receding hairline can also be prevented.

Most common prescribed hair loss treatments

Another effective treatment for androgenetic alopecia is minoxidil. Minoxidil is an antihypertensive drug that was originally used to treat high blood pressure. The effect of minoxidil as a hair loss remedy was discovered by chance.

For hereditary hair loss, it is applied to the scalp in the form of a solution or foam called Regaine twice a day, morning and evening. When it is applied, it dilates the blood vessels under the scalp, optimizing the supply of blood and nutrients to the hair. It is advised to start the medication as soon as the thinning of hair is noticed. According to the manufacturer, minoxidil can stop hair loss in 70-80% of cases, and in 30% of cases new hair growth is even stimulated and the hair shaft diameters increase.

Unfortunately, neither of these treatments will regrow the lost hair. The only solution to grow hair in bald spots is to have a hair transplant.

With hair transplantation, the patient’s own hair is taken from a donor area and reinserted at the desired location. The transplanted hair is resistant to DHT. As a result, the transplanted hair does not fall out, making hair transplantation a permanent solution for hair loss.

Number of hair transplants worldwide

Even though hair transplants have become more affordable in recent years, the cost of the operation is still quite high and can act as a deterrent at first. However, hair transplantation is often still worthwhile in the long run, because hair transplantation has a lasting effect. Many hair loss remedies only promise improvements while the treatment is continued, leading to a higher cost than hair transplantation over time.

According to our hair transplant study, the most common hair transplant methods are FUE and FUT. While during a FUE surgery the grafts are harvested separately from the donor area with the FUT method a skin strip is extracted from the donor.

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Ways to hide hair loss

Some individuals choose to attempt to hide their hair loss with the use of a wig, toupee, extensions, or a comb-over. Celebrities like Donald Trump and Nicholas Cage style their hair with a comb-over to hide their hair loss. These methods are only successful for a short time and as hair loss increases, they become less effective.

A more permanent solution to hide hair loss is micro hair pigmentation. Micro hair pigmentation has become increasingly popular in recent years. With this method, hair growth is not stimulated, but small pigmentations are applied to the scalp. This creates the optical illusion of greater hair density. This method has several advantages including, no surgical intervention being necessary and the pigmentation is cheaper than hair transplantation. Of course, micro hair pigmentation also has disadvantages e.g., the method is only suitable for dark hair and the effect fades after a few years. This method generally costs between 1,200 and 6,000 USD depending on the clinic and amount of pigmentation needed.

Another alternative is to embrace the hair loss, this is often done by shaving one’s head. This method is more popular amongst men as hair is often seen as a symbol of femineity. Celebrities like Michael Jordan, Dwayne Johnson, and Ben Kingsley have all shaved their heads as a way of embracing their hair loss.

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Wouldn’t you prefer to regrow your hair though?

Hair transplantation offers are a dime a dozen. Furthermore, the regional price differences are high. Therefore, get an overview of the offer and compare the hair surgeons in United Kingdom, US or Turkey based on experiences of real patients, costs and treatment methods:

Is your preferred city or country not included? No problem, you can easily request an overview of all suitable offers. Would you like to learn more about hair transplantation? Then inform yourself now in our guide!

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Frequently Asked Questions

What is the cause of male pattern baldness?

Can you stop male pattern baldness?

How can you hide your hair loss?

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