Male Pattern Baldness: Why It Happens and What You Can Do

Male Pattern Baldness: Why It Happens and What You Can Do

Table of Contents

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I. What is Male Pattern Baldness?

II. Stages of Male Pattern Baldness

III. Causes of Male Pattern Baldness

IV. Hair Loss Treatment for Men

V. Conclusion

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For many men, watching their hairline recede is a rite of passage into middle age and beyond. If the men in your family are any indication, male pattern baldness seems to be inevitable.

But while your dad and grandfather may have embraced their bald spots, you don't have to follow suit. Understanding what causes male pattern baldness can help you find ways to slow down hair loss before it's too late.

In this article, we will define male pattern baldness, explore its various stages, uncover its root causes, and discuss the available treatment options. 

What is Male Pattern Baldness?

Male pattern baldness, also known as androgenetic alopecia, is a common condition that affects up to 50% of men by the age of 50. It's characterized by hair loss that typically begins at the temples and progresses across the crown and mid-scalp. ¹

Unlike female pattern hair loss, which tends to spread evenly across the scalp, ² male pattern baldness is more selective. It affects only the hair follicles at the front and top of the scalp while leaving the hair around the sides and back of the head intact. ¹

The key is to start treatment early before you lose too much hair. ¹ So, if you notice your hairline creeping back or your scalp becoming more visible, see your doctor about hair loss treatment options.

Stages of Male Pattern Baldness

The progression of male pattern baldness can be classified using the Norwood scale, developed by Dr. James Hamilton Norwood in 1975. ³ This classification system categorizes hair loss into seven stages based on the location and extent of thinning:

• Stage 1: Minimal or no receding of the hairline.
• Stage 2: The first signs of hair loss become visible as triangular regions of thinning appear at the temples.
• Stage 3: This marks the first clinically significant stage of balding. The hairline recedes into an M, V, or U shape with deeper recessions at both temples. For many men, this is when they first notice their hair thinning.
• Stage 4: The recession at the temples is more pronounced. Hair at the top of the scalp also becomes sparse or absent altogether. The thinning areas are separated by a band of hair across the top of the head that connects the hair remaining at the sides.
• Stage 5: The thinning patches at the temples and crown expand, and the connecting band of hair across the top becomes narrower and sparser.
• Stage 6: The receding front hairline merges with the thinning crown area. The band across the top of the scalp is very narrow or completely absent.
• Stage 7: This stage represents the most extensive hair loss. Only a horseshoe-shaped band of hair remains around the back and sides of the head. The top of the scalp is completely bald. ³

Causes of Male Pattern Baldness

Male pattern baldness can be caused by many factors. Your hormones, genetics, and age all play a role:

• Hormones: Dihydrotestosterone (DHT) binds to receptors in your hair follicles, causing them to shrink over time. And when those follicles shrink, they stop producing hair. Now, all men make DHT naturally. But some men's follicles are more sensitive to it than others - and those tend to be the guys that start losing their hair. Genetics determine how much DHT you produce and how sensitive your follicles are to it.
• Genetics: Male pattern baldness runs in families and is linked to genes on your autosomal chromosomes - that is, all chromosomes except X and Y. However, researchers have also discovered some baldness genes on the X chromosome that you inherit from your mother.
• Age: As you get older, your DHT levels decrease. However, male pattern baldness still tends to worsen with age. That's because it's a progressive condition that causes increasing hair loss over time if left untreated. The good news is that by seeking treatment early on, you can slow down hair loss. ⁴

Hair Loss Treatment for Men

The first step to an effective hair loss treatment plan is an accurate diagnosis. Seeking a professional opinion from a dermatologist is crucial to figuring out the root cause of your hair loss. ⁵

During your appointment, your doctor will:

• Ask questions about the duration and suddenness of your hair loss
• Conduct a thorough examination of your scalp and areas of hair loss
• Perform a gentle hair pull test to assess the health and growth of your hair ⁵

Once your dermatologist determines the underlying cause of your hair loss, they will recommend treatment options to stimulate hair regrowth and prevent further loss.

Topical Minoxidil

Minoxidil is a topical medication that is applied to the scalp twice a day. While scientists aren’t exactly sure how minoxidil works its magic, ⁶ clinical studies have shown that minoxidil can:

• Reduce hair loss
• Promote hair growth
• Strengthen existing hair ¹

Although minoxidil is available as an over-the-counter treatment, you may get the best results by using it under the guidance of a dermatologist. They can determine if the 2% or 5% formula is better suited to your needs. A dermatologist can also teach you the proper way to apply the medication for maximum effect. ⁶

When you first start using minoxidil, you may experience increased shedding for a few weeks. Don’t worry—this is normal and temporary. ⁶

While minoxidil does not work for everyone, many men see noticeable improvements in six to twelve months. To maintain results, you need to keep using minoxidil consistently. If you stop, hair loss is likely to start again. ¹

Oral Finasteride

Finasteride is a prescription medication used for male pattern baldness. This hair loss treatment comes as a tablet that is taken once daily. It works by inhibiting the production of DHT, a hormone that contributes to hair loss in men. ⁶

Clinical studies have demonstrated that oral finasteride is successful in:

• Slowing down hair loss in 80 to 90% of men.
• Stimulating new hair growth, especially in men who start taking it at the first signs of balding. ¹

While it may take around four months for finasteride to start showing visible results, significant hair growth may not be noticeable until a year into treatment. Your dermatologist will monitor your progress after six months to determine the effectiveness of the treatment. ⁶

If finasteride is successful, continuing treatment is recommended for as long as you wish to maintain the new hair growth, as discontinuing the medication can lead to a recurrence of hair loss. ⁶

While finasteride can be very effective, some men experience side effects such as:

• Decreased desire to have sex
• Erectile dysfunction
• Depression
• Swollen or tender breasts ¹

Because of these potentially serious side effects, your dermatologist will discuss the risks of finasteride with you before prescribing it. If you experience side effects, be sure to tell your doctor right away.

Conclusion

Losing your hair does not have to be an inevitable part of aging. While male pattern baldness is a common affliction for many men, there are effective treatment options available to help keep a full head of hair. The key is to start hair loss treatment early, as the sooner you take action, the better your chances of success.