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Male pattern baldness, also called androgenetic alopecia, is the most common type of hair loss in men. At some point in their lives, up to 50 percent of all men will be affected by male pattern baldness to some extent.
Male pattern baldness is both genetic, and associated with the male sex hormones called androgens. Androgens have many functions, one of which is to regulate hair growth.
Each strand of your hair grows out of a little hole in your skin called a follicle. Normally, an individual strand of hair grows for two to six years, goes through a resting stage for several months, falls out, and is replaced by a new hair strand. With male pattern baldness, the hair follicle becomes smaller. It grows shorter and finer strands, and eventually stops growing hair altogether.
The common cause of male pattern baldness—heredity—is usually harmless. However, sometimes it has more serious causes, such as certain cancers, medications, thyroid conditions, and anabolic steroids. See your doctor if hair loss occurs after taking new medications or when it is accompanied by other health complaints.
Male pattern baldness is diagnosed by the pattern of hair loss. A medical history and exam may be performed to rule out health conditions, fungal conditions of the scalp, or nutritional disorders that may be responsible. Health conditions are suspected when the hair loss is accompanied by a rash, redness, pain, peeling of the scalp, hair breakage, patchy hair loss, or an unusual pattern of hair loss. A skin biopsy and blood tests also may be used to diagnose disorders responsible for the hair loss.
Male pattern baldness can begin in your teenage years, but it more commonly occurs in adult men with the likelihood increasing with age. Genetics play a big role. Men who have close relatives—particularly on the maternal side—with male pattern baldness are at a higher risk.
Male pattern baldness is identified by the pattern of hair loss. The hair loss typically begins at the temples or the crown of the head. Some men will get a single bald spot, while for others their hairline will recede to form a “M” shape. In some men, the hairline will continue to recede until all or most of the hair is gone.
Medical treatment isn’t necessary if other health conditions have been ruled out. However, for men who are unhappy with the way they look, treatment options are available. The goal is to give the appearance of a fuller head of hair. Common treatment options include:
Men with limited hair loss can sometimes hide hair loss with the right haircut or hairstyle. Ask your hairstylist for a creative cut that will make a thinning hair look fuller.
Wig or Hairpiece
Wigs can cover thinning hair, receding hairlines, and complete baldness. They come in a variety of styles, colors, and textures. For a natural look, choose wig colors, styles, and textures that look similar to your original hair. Professional wig stylists can help style and fit wigs for an even more natural look.
Hair weaves are wigs that are sewn into your natural hair. You must have enough hair to sew the weave into. The advantage to weaves is they always stay on, even during activities such as swimming, showering, and sleeping. The disadvantages are they must be re-sewn regularly, whenever new hair growth occurs, and that the sewing process can damage your natural hair.
Minoxidil is a topical medication applied to the scalp. In some men, minoxidil slows hair loss and stimulates the hair follicles to grow new hair. Minoxidil takes four months to one year to begin working. Hair loss reoccurs when you stop taking the medication.
Possible side effects associated with minoxidil include dryness, irritation, burning, and scaling of the scalp. Serious side effects that warrant an immediate doctor visit include:
Finasteride (Propecia, Proscar)
Finasteride is an oral medication that slows hair loss in some men. It works by blocking the production of the male hormone responsible for hair loss. Finasteride has a higher success rate than minoxidil. When finasteride use is discontinued, your hair loss returns.
Finasteride must be taken for three months to one year before results will be seen. If no hair growth occurs after one year, the medication should be discontinued. Side effects of finasteride include:
Finasteride can cause breast cancer, although it is rare, so any breast pain or lumps should be evaluated immediately. Finasteride may affect Prostate-Specific Antigen (PSA) tests used to screen for prostate cancer. The medication lowers PSA levels, which causes lower than normal readings. Any rise in PSA levels when taking finasteride should be evaluated for prostate cancer.
A hair transplant is the most invasive and expensive treatment for hair loss. Hair transplants work by removing hair from areas of the scalp that have active hair growth and transplanting them to areas of your scalp that are thinning or bald. Multiple treatments are often needed and the procedure carries the risk of scalp scarring and infections. The advantages of a hair transplant are that it looks more natural and is permanent.
Going bald can be a big change. You may have trouble accepting your appearance. You should seek counseling if you experience anxiety, low self-esteem, depression, or other emotional problems because of male pattern baldness..
There is no known way to prevent male pattern baldness. An unproven theory is that stress may cause hair loss by increasing the production levels of sex hormones in the body. You can reduce stress by participating in relaxing activities, such as walking, listening to calming music, and spending more quiet time.
Written by: Rose Kivi and Matthew Solan
Medically reviewed by George Krucik, MD
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