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.
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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.