Hairloss (in men)

What is male pattern baldness?

Male pattern baldness is a type of hair loss and thinning that is common in adult men. It is also known as androgenetic alopecia. Male pattern baldness involves hair loss that starts at the hairline above the temples and leads to a receding hairline. This is followed by hair loss on the top or ‘crown’ of the head, leaving behind a horseshoe-shaped pattern of hair. While it is commonly seen in older men, male pattern baldness can affect young adult men as well.

Hair loss occurs because of changes to the normal hair growth cycle. In the normal hair-growth cycle, most hair stays in a growth phase (known as the anagen phase). This phase lasts for about 3 to 6 years before it falls out and new hair grows in its place. In male pattern balding, hair in affected areas of the scalp has a much shorter growth phase of weeks or months before it falls out. This process results in thinning and bald patches.

What are the symptoms of male pattern baldness?

Male pattern baldness usually starts after puberty and develops gradually.

You may notice your hair gradually thinning at your temples and your hairline slowly receding. The hair on your crown (the top of your head) may also get thinner and you may eventually develop a bald patch on the top of your head, which gets bigger over time. If hair loss continues, you may develop a horseshoe pattern of hair growth around the back and sides of your head.

Male pattern baldness doesn’t usually cause your eyebrows, eyelashes or the hair at the sides and back of your hair to fall out. Hair loss in these areas is usually caused by other medical conditions. If you aren’t sure, or you’re concerned about hair loss, see your doctor for information and advice.

What causes male pattern baldness?

Male pattern hair loss is an inherited (genetic) condition that affects how some of the hair on your scalp responds to certain male hormones. There is no genetic test currently available to predict whether you will experience male pattern baldness.

Male pattern baldness is very common among Caucasian men. It affects about 1 in 5 men in their 20s, 1 in 3 men in their 30s and nearly 1 in every 2 men in their 40s. Other population groups, for example, Japanese and Chinese men, are generally less affected. If affected, men in these groups may experience a milder and more general pattern of hair thinning or loss.

Other types of hair loss can be caused by:

• hormone imbalances
• autoimmune conditions
• infections
• radiation therapy
• emotional stress
• tight hairstyles

These factors don’t usually cause male pattern baldness, but if they occur together with male pattern baldness, you may lose more hair faster.

Can I prevent male pattern baldness?

Male pattern baldness is hereditary (genetic), so it can’t be prevented. However, looking after your diet and lifestyle will help maximise your general health, including the health of your hair.

Some treatments for male pattern baldness are more effective when hair loss is still mild. If you are concerned about hair loss, it is a good idea to ask your doctor for information and advice sooner rather than later.

How is male pattern baldness diagnosed?

Male pattern baldness can be diagnosed by your doctor. They will ask you questions about your general health, your hair loss and any hair loss in your family. They will then examine your head and scalp, especially areas of hair thinning or baldness.

Most of the time, you won’t need any special tests to diagnose male pattern baldness. In some cases, your doctor might refer you to a dermatologist (specialist skin doctor) for a detailed examination (dermatoscopy) or skin biopsy to rule out other conditions and confirm the diagnosis.

How is male pattern baldness treated?

Male pattern baldness is not a disease, and it is usually treated for cosmetic reasons. You may choose to embrace your new look, or to think about treatment options.

The simplest and safest solution for male pattern baldness is to wear a hairpiece, such as a wig or toupee. If wearing a hairpiece doesn’t appeal to you, there are a few medical treatments that have shown to be effective in treating male pattern baldness:

• Minoxidil is a liquid solution or foam applied 1 to 2 times a day to areas of the scalp affected by hair loss. It increases blood flow to the scalp and stimulates hair growth. You may see results after about 4 months of use, but your hair will return to its pre-treatment appearance if you decide not to continue treatment long-term.
• Finasteride is a tablet that you can take once a day. It works by reducing levels of hormones that cause male pattern baldness. You will usually notice improved hair growth after about 4 months of taking finasteride. If you stop taking finasteride, it’s very likely that any hair loss you previously experienced will return.
• Hair transplant surgery involves surgically removing hairs from the back of your head and implanting them into areas of the scalp affected by hair loss. This is usually quite effective but can be very expensive, and it may lead to complications including scarring and infection.

There are many other treatments advertised to improve hair loss, including laser treatment and plasma injections. Many of these do not have evidence to prove that they are effective, and they may be expensive.

It’s important to have realistic expectations when deciding to try a particular treatment for male pattern baldness. Although some treatments have good success rates, no treatment will completely reverse the process, and not all treatments will work for everyone. Your doctor can help you decide on which treatment might be best suited for you. They can inform you about the potential side effects of your medicines or risks associated with the different procedures.

Living with male pattern baldness

Many men accept male pattern baldness as a normal part of ageing. Some men, especially those experiencing hair loss at a younger age, may find that hair loss affects their confidence and makes them feel less attractive. If you are struggling to come to terms with male pattern baldness, you might wish to share your feelings with someone you trust, like a friend or your partner, or a professional counsellor or psychologist.

Taking a more positive view of ageing may help you embrace your new pattern of hair growth. Male pattern baldness can be viewed as a sign of maturity, masculinity and wisdom. You may also like to take this opportunity to try a new hairstyle or hat or headwear. Alternatively, you may choose to shave your remaining hair and celebrate your new look.

If you are experiencing hair loss or baldness, it’s important to make sure your scalp is protected from the sun. Apply sunscreen to your head regularly, or wear a hat, to reduce the chance of developing skin cancer.

You may also wish to wear a hat or beanie during colder months since less hair means that you will lose more heat from your head.