Male Pattern Baldness Health Information
Male Pattern Baldness Overview
Content Medically Reviewed by Adrian Rawlinson, MD, VP of Medical Affairs at Hims
Male pattern baldness is a genetic and hormonal condition that causes you to lose hair. It’s by far the most common cause of hair loss in men, affecting more than 50% of all men by the age of 50.
Although male pattern baldness is most common in middle-aged and older men, it can occur at any age. Many men notice the early signs of male pattern baldness, such as a receding hairline or diffuse thinning, in their 20s and 30s.
If you’ve noticed your hairline creeping backwards, your widow’s peak becoming more obvious or just a few extra hairs on your pillow or in your hairbrush, male pattern baldness could be the culprit.
Male pattern baldness is also known as androgenic alopecia. The main causes of male pattern baldness are your genetics and the presence of androgenic hormones such as testosterone and dihydrotestosterone (DHT).
Contrary to popular belief, factors like wearing a hat or using non-organic shampoos and other hair care products aren’t proven to contribute to male pattern baldness.
It’s easy to panic when you notice your hairline starting to recede. Luckily, a variety of safe and effective treatments are available today that can help you maintain your existing hair and restore some or all of the hair that you’ve lost.
Symptoms of Male Pattern Baldness
The most obvious, visible symptom of male pattern baldness is hair loss. Hair loss from male pattern baldness can occur in a variety of patterns, ranging from diffuse thinning to a receding hairline.
Hair loss from male pattern baldness can also occur gradually. You might not notice any hair loss for years at a time, then notice your scalp in the mirror when you’re in a room with bright, harsh lighting or when your hair is wet.
Most men begin to notice male pattern baldness as their hairline starts to recede. Male pattern baldness can cause you to develop the classic M-shaped hairline, with receding corners and a longer widow’s peak area (known as a forelock).
Not every hairline recedes in the same pattern. If you’re prone to male pattern baldness, there’s a chance your entire hairline could recede evenly. However, most men notice an M-shaped hair loss pattern that’s indicative of male pattern baldness.
Not all men with male pattern baldness experience hair loss around the hairline. If you’re prone to male pattern baldness but don’t have a receding hairline, you might notice the hair near your crown starting to fall out and look thinner.
Because hair loss around the crown isn’t easy to see in the mirror, it’s common for men affected by crown thinning not to notice their hair loss until it’s quite advanced. The easiest way to check for this type of hair loss is to use a handheld mirror, or to take a selfie of the back of your head.
Diffuse thinning is a form of hair loss that affects your entire scalp, thinning your hair without any obvious effects on your hairline.
Although it’s less common than a receding hairline or hair loss near the crown, diffuse thinning is often a symptom of male pattern baldness. This type of hair loss is usually easiest to notice when your hair is wet, or in bright lighting that makes your scalp more visible.
When should I see my doctor if I think I have male pattern baldness?
The best time to talk to your doctor about male pattern baldness is as soon as you notice any symptoms.
Without treatment, any hair loss you experience from male pattern baldness is permanent. By talking to your doctor as early as possible, you’ll be able to start treating your hair loss, helping you to slow down or prevent any further loss.
This is because male pattern baldness is caused by hormones. The most effective treatment is to block these hormones from being able to affect your hairline in the future.
When it comes to male pattern baldness, sooner is always better. If you’re worried about losing your hair and want to maintain a full hairline as you get older, talk to your doctor as soon as you notice any obvious signs of thinning or a receding hairline.
What Causes Male Pattern Baldness?
Male pattern baldness is caused by a combination of two factors: your production of androgenic hormones such as dihydrotestosterone (DHT) and your hair’s sensitivity to these hormones.
DHT is an androgen (male hormone) that’s produced naturally by your body. DHT is a byproduct of testosterone, meaning your body converts a small amount of the testosterone you create into DHT on a regular basis.
During pregnancy, childhood and puberty, DHT is an important hormone for helping you to form male characteristics. Things like your body hair, your genitalia, the shape of your jaw, your voice and other characteristically male features are all a result of your exposure to DHT.
DHT is produced by the 5α-Reductase enzyme. This enzyme is responsible for converting some of your circulating testosterone into DHT on an ongoing basis. You can find the 5α-Reductase enzyme in your prostate, liver, skin and hair follicles.
As well as helping you form male genitalia and secondary sex characteristics in puberty, DHT is the main hormone responsible for male pattern baldness.
DHT causes hair loss by binding to your hair follicles. Once it’s bound to your hair follicles, DHT causes the follicle to shrink and weaken, slowing down hair growth and eventually stopping the follicle from producing new hairs.
For some men, DHT isn’t a big deal. It circulates freely in their bodies without affecting their hair in any noticeable way. However, some men are highly sensitive to DHT and notice hair loss that starts in their early-to-mid 20s, or even in their late teens.
The more sensitive your hair follicles are to DHT, the quicker you’ll notice your hair thinning and falling out.
Risk Factors for Male Pattern Baldness
- Family history of hair loss. If one or both of your parent’s families have a history of hair loss, you might be more likely to experience male pattern baldness at some point in your life.
Contrary to popular belief, hair loss in either of your parents’ families can signal a higher risk of you experiencing hair loss
- Age. The longer your hair is exposed to DHT, the more likely you are to notice significant hair loss. This is the main reason why male pattern baldness is most common in men as they enter their 40s, 50s and 60s.
- Medications. Medications that increase your production of testosterone and/or DHT can speed up and worsen male pattern baldness. If you use testosterone-based medications to treat low testosterone or andropause, this could contribute to faster hair loss.
Diagnosis of Male Pattern Baldness
To diagnose male pattern baldness, your doctor will usually examine your scalp to determine if you’ve lost a significant amount of hair. They might use a device called a densitometer to view miniaturized hair follicles and look at the space between each hair follicle.
There’s usually no need to perform a biopsy to diagnose male pattern baldness -- this type of procedure is usually only necessary to determine if your hair loss is caused by a chemical or other external factor.
Most doctors classify male pattern baldness using a system called the Norwood scale. This scale features reference diagrams for a variety of hair loss patterns, ranging from a receding hairline to almost complete hair loss.
Want to stop your hair loss and thicken up thinning patches? The Complete Hair Kit contains everything you need to maintain your hair, prevent further hair loss and look your best without having to worry about your hairline.
Male Pattern Baldness Treatment and Prevention
The earlier you treat male pattern baldness, the easier you’ll find it to stop further hair loss and maintain your hair.
Right now, the most effective treatments for male pattern baldness are medications such as finasteride, which block DHT, and topical medications such as minoxidil, which help to stimulate hair growth.
These treatments work best if you start using them as soon as you notice your hair thinning or falling out. If your hair loss is advanced, you might also be able to restore it via hair transplant surgery.
Currently, the FDA has approved two different medications for treating hair loss in men. They are finasteride (an oral medication that stops your body from producing DHT) and minoxidil (a topical medication that helps your hair follicles produce new hairs).
- Finasteride is a medication that prevents male pattern baldness on a hormonal level. It works by inhibiting production of 5α-Reductase, the enzyme that converts testosterone into DHT within your body.
Studies show that finasteride can lower your DHT levels by 71.4% when taken at a hair loss prevention dose. As well as stopping hair loss, studies also show that daily use of finasteride can cause some of your “lost” hair to gradually regrow over time.
- Minoxidil is a topical medication that promotes hair growth. It works by stimulating your hair follicles to enter the growth phase, increasing blood flow to your hair and helping to transport essential nutrients to your hair follicles.
Unlike finasteride, minoxidil doesn’t affect DHT and has no effects on your production of hormones. Like finasteride, it’s backed up by a huge amount of scientific evidence, with studies showing a significant increase in hair growth after several months of use.
Supplements and Products
Numerous supplements and non-pharmaceutical products are available to help slow down and treat hair loss. While these supplements aren’t as effective as FDA-approved medications like finasteride and minoxidil, they can be a helpful part of your baldness prevention routine.
- Saw palmetto. While it’s not as effective as finasteride, studies show that saw palmetto can help to reduce DHT levels by a modest amount, helping to slow down male pattern baldness in men sensitive to DHT.
- Biotin. While biotin doesn’t directly prevent hair loss, it’s linked to improvements in hair growth in scientific studies. Biotin is available as an oral supplement, or as an ingredient in hair loss prevention shampoos.
- Hair loss prevention shampoo. There are countless hair loss prevention shampoos on the market. Look for shampoos that contain proven ingredients like biotin, ketoconazole and saw palmetto, all of which have real benefits for your hair.
- Hair transplant surgery. Hair transplant surgery involves transplanting hairs from the back and sides of your head (areas that aren’t affected by male pattern baldness) onto your crown, hairline or other areas with hair loss.
Performed by a skilled surgeon, a hair transplant can restore your hairline and almost completely eliminate any visible signs of hair loss. Like other cosmetic surgeries, hair transplant surgery is highly effective but very costly and rarely covered by insurance.
- Scalp micropigmentation. Scalp micropigmentation is a cosmetic procedure that can change the pigment of your scalp, creating the appearance of small, short hairs and a fuller head of hair.
Although scalp micropigmentation can make it look like you have a thicker head of hair, it’s not a treatment for male pattern baldness and does not restore any real hair follicles.
- Hairpieces. While they won’t help you grow back any real hair, hairpieces and weaves can produce surprisingly good results if you need to fill in thin spots and cover up your hair loss for an important event.
- Acceptance. If your hair loss is severe and you’re not interested in treating it, you can simply accept it. Whether you choose to shave your head or keep your remaining hair cut short, rocking the bald look can be a great option if you’ve got the confidence.
Read More About Male Pattern Baldness
Want to learn more about male pattern baldness? Our guides to DHT and male hair loss, what you should know about using finasteride and how minoxidil and finasteride can work together to stop hair loss cover the treatment aspects of male pattern baldness in more detail.
Important Safety Information
IMPORTANT SAFETY INFORMATION
Finasteride is for use by MEN ONLY and should NOT be used by women or children.
Read this Patient Information before you start taking Finasteride and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment.
What is Finasteride?
Finasteride is a prescription medicine used for the treatment of male pattern hair loss (androgenetic alopecia).
It is not known if Finasteride works for a receding hairline on either side of and above your forehead (temporal area).
Finasteride is not for use by women and children.
Who should not take Finasteride?
Do not take Finasteride if you:
- are pregnant or may become pregnant. Finasteride may harm your unborn baby.
- Finasteride tablets are coated and will prevent contact with the medicine during handling, as long as the tablets are not broken or crushed. Females who are pregnant or who may become pregnant should not come in contact with broken or crushed Finasteride tablets.
- If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
are allergic to any of the ingredients in Finasteride. See the end of this leaflet for a complete list of ingredients in Finasteride.
What should I tell my healthcare provider before taking Finasteride? Before taking Finasteride, tell your healthcare provider if you:
have any other medical conditions, including problems with your prostate or liver
Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements.
Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
How should I take Finasteride?
- Take Finasteride exactly as your healthcare provider tells you to take it.
- You may take Finasteride with or without food.
If you forget to take Finasteride, do not take an extra tablet. Just take the next tablet as usual.
Finasteride will not work faster or better if you take it more than once a day.
What are the possible side effects of Finasteride?
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
There may be an increased risk of a more serious form of prostate cancer in men taking finasteride at 5 times the dose of Finasteride.
The most common side effects of Finasteride include:
- decrease in sex drive
- trouble getting or keeping an erection
a decrease in the amount of semen
The following have been reported in general use with Finasteride:
- breast tenderness and enlargement. Tell your healthcare provider about any changes in your breasts such as lumps, pain or nipple discharge.
- decrease in sex drive that continued after stopping the medication;
- allergic reactions including rash, itching, hives and swelling of the lips, tongue, throat, and face;
- problems with ejaculation that continued after stopping medication;
- testicular pain;
- difficulty in achieving an erection that continued after stopping the medication;
- male infertility and/or poor quality of semen.
in rare cases, male breast cancer.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of Finasteride. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA1088.
How should I store Finasteride?
- Store Finasteride at room temperature between 59˚F to 86˚F (15˚C to 30˚C).
Keep Finasteride in a closed container and keep Finasteride tablets dry (protect from moisture).
Keep Finasteride and all medicines out of the reach of children.
General information about the safe and effective use of Finasteride.
Medicines are sometimes prescribed for purposes other than those listed in this Patient Information. Do not use Finasteride for a condition for which it was not prescribed. Do not give Finasteride to other people, even if they have the same symptoms you have. It may harm them.