Male Pattern Baldness: Stages, Early signs, Causes, Prevention, and Treatment
“Women in my focus groups, they tell a bald man is trustworthy. He has nothing to hide.”
Kellyanne Conway
But the fact is most of us don’t think this way.
For most men, baldness is a disaster.
Hair plays a significant role in building self-esteem, self-confidence, and men’s attractiveness,
On the other hand, baldness works as a reduction factor of the same feelings.
For most people, baldness causes stress and becomes the downgrading matrix to their personality.
Baldness has been encountered as one of the common reasons behind inferiority and social fear, which ultimately leads to in lack of confidence.
To tell you how much hair is important to us, I put a couple of stats for you.
More than $35 Billion is being spent every year on hair loss treatments in the United States alone.
UK and Ireland combined Spends £182,000,000 per year on hair loss treatments.
This data is more than enough to understand what hair means to us.
In this article, I’m going to tell you about male pattern baldness it’s early signs, stages, causes and treatment.
Through this article my objective
is to educate and aware all of you about male pattern baldness.
So, let’s start….
What is Male Pattern Baldness?
Male pattern baldness, also known as Androgenetic alopecia, is an inherited condition referred to as-
“A slow or gradual disappearance of hairline and hair loss on the front (temple) and top (crown) of the head.”
According to the American Hair Loss Association:
- Male pattern baldness accounts for more than 95% of hair loss in men.
- Two-thirds of American men will experience some degree of appreciable hair loss by the age of 35 years.
- Around 85% of men have significantly thinning hair by the age of 50 years.
- Around 25% of men who suffer from male pattern baldness, the condition arises before they reach the age of 21.
Male pattern baldness genetics
Unfortunately, the genetics of male pattern baldness isn’t rather well understood. The more complex the biology behind a phenomenon is, the harder goes to be to seek out all the genetic factors.
Regulation of hair growth in mammals is extremely complicated and poorly understood, in spite of this subject being a really active area of research.
Hair is extremely important to mammalian thermoregulation thus it is sensible for its biology to be very complex.
It is very well known that the male pattern baldness is a greatly inherited condition, although there is also some evidence for the involvement of epigenetic factors
There are a few genes involved in male pattern baldness from different studies.
Unsurprisingly, the androgen receptor (AR) gene is one of them, as it is well known that the condition is dependent on testosterone ( an androgen).
The Androgen receptor is on the X chromosome, that’s why some people say that male pattern baldness comes from the mother’s side of the family ( a male inherits the X chromosome from the mother and the Y from father).
But, It is not the mere gene or even the primary gene involved.
There are genes in basically all chromosomes that are involved in male pattern baldness, and this is what makes it so difficult to unravel, as we’d need to check out the overall contribution that each gene variant (single nucleotide polymorphism, or SNP) play in hair loss, and also how these genes interact with each other and thus the environment to result in the phenotype.
Some of these genes code for transcription factors or histone deacetylases.
The Wnt pathway seems to be involved even though we know a fair amount about transcription factors, the Wnt pathway, etc.
However, this does not tell us much about what’s happening in male pattern baldness and why the hair follicles shrink and die.
The hope is that identifying these genes will provide targets for therapeutic intervention.
But so far, we are still far from a definitive cure for male pattern baldness.
Hair Thinning At Crown in Male
The male pattern baldness didn’t happen overnight, it took many years to develop.
The hair loss in male pattern baldness progresses gradually, beginning with a gradual disappearance of hairline at the front of the head or thinning hair at crown.
Hair thinning at crown means-
“Thinner bald spots on the top (crown) of the head.”
There are various reasons for it, One of the most common reasons is Iron deficiency anemia.
Iron deficiency makes hair follicle cells sensitive, and therefore, these cells lose their ability to grow new hair on the scalp.
Other reason that causes hair thinning at the crown in male:
- Radiation therapy
- Stress and Anxiety
- Scalp infections
- Over hair styling such as Coloring, curling & straightening
- Some medications such as Antihypertensive medicines, Cholesterol-lowering drugs, high dose of vitamin A, antifungal medicines and acne medicines
- Male pattern baldness; itself
Male Pattern Baldness Early Signs
Male pattern baldness doesn’t happen overnight, it is a gradual process and contains many stages. This is why, It’s not always easy to identify it’s progression.
However, Here are some early signs of male pattern baldness whereby you can identify and tackle it in time.
A Noticeable Change in Your Hairline
This is the most unambiguous early sign of male pattern baldness that you can observe.
Male with male pattern baldness observes their hair begin to thin at the temples, creating a more prominent widow’s peak and a hairline that resembles the letter M or a horseshoe.
Or your hairline might seem to recede or thin all the way across.
If you want to check out these changes, compare your old ( almost several years) photographs with current photographs or can directly check out in the mirror.
Thinning of your hair
Baldness does not always begin from the hairline. Some people experience their hair begin to thin either across the entire scalp or in specific areas like the crown.
The easiest way to check out thinning hair is to compare photos from different periods.
If you find that your hair looks thinner now in recent photos compared to photos which have been taken many years ago, then you may have male pattern baldness.
Excessive hair loss after shampooing, brushing or on your pillow when you wake up
People lose at least 100 hair each day, and it is normal.
However, if you start to notice an excessive amount of hair falling after hair washing, brushing, or on your pillow every morning when you wake up, this is indicating that you are suffering from male pattern baldness.
But hold on, it is essential to know that it may be the result of temporary hair loss.
Temporary hair loss can occur due to various reasons, such as nutritional deficiencies, use of certain drugs, psychological stress.
Temporary hair loss usually lasts one or two weeks.
But, if it persists over a long period, you should seek medical help to figure it out.
Male Pattern Baldness Stages
Male pattern baldness typically follows different stages.
In initial stages, Male pattern baldness usually affects the frontal hairline and vertex (top or crown) of the head.
In advanced stages, when it spreads over time, a rim of average hair growth at sides and the occipital (back of the head) scalp remains.
Male pattern baldness is a continuous process instead of a series of separate stages and has widely different features for each individual.
However, Hairs within the balding areas may become gradually shorter and thinner, in the end, disappear completely.
For the measurement of different stages of male pattern baldness, the Norwood-Hamilton classification system is used.
The Norwood-Hamilton scale has seven stages. Each stage measures the severity and pattern of male pattern baldness.
The seven stages are as follows:
Stage 1
No hair loss or receding hairline. The head is full of hair. No treatment required.
If you don’t have a family history of baldness, there is no need to worry.
On the other hand, If you have a family history of baldness, you should monitor your hairs closely so that you can get treated in time.
Stage 2
Triangular and typically symmetrical areas of recession are observed at the front temporal area.
Hair loss remains at a line of several centimeters in front of the ears. Hair falls and may become thinner in the central front part of the scalp.
The initial signs of hair loss are demonstrating.
Stage 3
Hair loss is strong enough to be categorized as “baldness” by the Norwood scale at this stage.
Hairline has receded further back on the head.
Deep, symmetrical recession on the temples observed that are bare or have very little hair.
Stage 3 Vertex
This stage confirms that you’re experiencing male pattern baldness.
The hairline stays at stage 2, but there is significant hair loss around the vertex ( the top of the scalp).
Stage 4
Severe stage of hair loss.
The hair loss becomes more severe, resulting in bare or sparse hair on the vertex.
The hairline may start forming a horseshoe shape, resembling the letter U.
Stage 5
Hair loss at the top of the scalp is yet separated from the front temporal region but the division is a lot less distinct.
The band of hair across the crown becomes narrower and thinner.
At this stage, Hair loss at the front temporal and crown becomes more substantial.
Stage 6
The two bald regions frontotemporal and vertex now join together, without the band of hair to separate them.
Hair loss on the sides is increased further.
The man with male pattern baldness at stage 6 is now mostly bald on the front temporal and vertex regions.
Stage 7
This is the most advanced or severe stage of male pattern baldness. Only a band of hair in horseshoe shape remains at the sides of the head.
The remaining hair may be fine and less dense than before.
Very difficult to treat. Hair restoration is almost impossible at this stage of male pattern baldness.
Male Pattern Baldness Symptoms
Men typically become conscious of hair loss or a receding hairline, beginning at any time after puberty.
The most common symptoms of male pattern baldness are as follows:
- Excessive hair loss
- Hairline receding at the front (temple) of the head
- Whole Hair thinning
- Decrease hair density
- Bald patch at the top (crown) of the head
- Partial baldness and complete baldness at an advanced stage.
Male Pattern Baldness Causes
Before discussing Causes of male pattern baldness, it’s important to understand hairs in depth.
Hair is a modified sort of Keratin, a protein that forms a protective shield around your hair shaft in order that hair remains elastic & youthful, which is equal to the epidermis ( the outermost layer of three layers that structure the skin).
Each hairs have two different parts: the shaft, which is visible above the skin, and the follicle, which lies within the upper layers of the skin.
The shaft comprises dead cells containing the keratin and and melanin ( a pigment ), furthermore; the shaft contains between 10% and 15% water, which helps maintain its appearance.
There are three phases of hair growth.
- Anagen: The active phase of hair growth. The longest phase, which usually lasts 1000 days relying on predetermined genetic factors ( except body hair, which lasts 1 to 6 months).
- Catagen: The short growth arrest phase, lasts approximately 10 days.
- Telogen: The resting phase of hair growth lasts approximately 100 days anywhere in the body.
I hope you’ll get some general knowledge about hair.
Now take a look at its causes-
Genetic or having a family history of baldness plays a huge role in male pattern baldness.
Men with male pattern baldness actually, inheriting their hair follicles with a genetic sensitivity to dihydrotestosterone (DHT)- a byproduct of testosterone.
If you’re genetically susceptible to hair loss, DHT binds to receptors in your follicles, causing them to miniaturize.
The hair follicles that have been miniaturized, produces weaker, shorter, finer, and thinner hair.
Eventually, stopping your hair follicles from producing new hairs. Thus, the male pattern baldness takes place.
Know more about DHT
Dihydrotestosterone (DHT) is a derivative or by-product of
testosterone.
Your body converts some amount (up to 10%) of testosterone into the DHT with the assistance of 5-alpha-reductase –an enzyme that converts a small amount (up to 10%) of testosterone into the DHT.
5-alpha-reductase enzyme is found in your liver, prostate, skin and hair follicles.
DHT is a sex hormone that is important to develop male characteristics during pregnancy, childhood and puberty.
Some male characteristics include:
- A deep Voice
- The shape of your jaw
- Increased muscle mass and strength
- Increased body hair
- The growth of male genitals like, testicles, penis and scrotum
Male Pattern Baldness Risk factors
Here are some factors which will increase your chances of developing male pattern baldness:
- Genetics or family history of baldness: you’re at very high risk of developing male pattern baldness if you have close relatives with pattern baldness.
- Age: As you grow old, your chance of developing male pattern baldness also increases, because your hair is also exposed to Dihydrotestosterone (DHT) for so long.
Male Pattern Baldness: Prevention
As we all know very well that the male pattern baldness is a highly heritable condition, so, there is no known way to prevent it.
You can’t stop male pattern baldness but you can delay the progression of male pattern baldness through various tactics:
- Have a diet that rich in biotin, ,selenium, iron, zinc, protein, omega-3 fatty acids, amino acid, and Vitamin A, B,E
- Don’t do over hair styling; stay at one hair style for long period of time
- Try some exercise such as, scalp massage exercise, Jogging, upside down exercise, side to side hops
- Try some yoga such as; Balayam ( rubbing your nails), Vajrasana (diamond pose), Uttanasana (standing forward fold pose), Ushtrasana ( camel pose),
- Don’t rub, twist or pull your hairs
- Quit smoking; cigarette smoking is related to male pattern baldness, research has shown that
Male Pattern baldness: Treatment
Most men go through baldness as they get older and it’s normal. But it can be distressing if it occurs excessively or occurs at an early age.
However, there are two types of men with pattern baldness.
One, who is happy with his look.
And for others, baldness can be disastrous because it is directly associated with men’s self esteem, confidence and attractiveness.
In addition, it is better to treat male pattern baldness in early stages as soon as you start to notice your hair thinning or falling out.
If Your male pattern baldness is in an advanced stage, it becomes very difficult to treat.
Treatments available for male pattern baldness.
Medication
The U.S. Food and Drug Administration (FDA) has approved two types of drug for the treatment of male pattern baldness.
Minoxidil (Rogaine)
A topical solution applied to the scalp. Minoxidil slows hair loss and stimulates the hair follicles to grow new hair.
Minoxidil comes as liquid or foam. The liquid /foam should be applied on the affected scalp area with the dropper or pump spray. Spread the liquid /foam over the affected scalp area gently with your fingertips.
Minoxidil takes four month to one year to produce visible results.
It has often been seen that hair fall stops as long as you keep using it. Once you stop using it, hair loss starts again.
Possible side effects include:
- Skin dryness
- Irritation
- Swelling
- Widening of the blood vessels.
Rare side effects (When too much minoxidil absorbed into the scalp) include:
- Blurred vision
- Chest pain
- Fast or irregular heartbeat
- Headache
- Low blood pressure
- Dizziness
- Lightheadedness
- Weight gain (Rapid)
Finasteride (propecia, proscar)
Finasteride is used alone or in combination with minoxidil.
Finasteride is an oral medicine that works by blocking the production of Dihydrotestosterone (DHT), a sex hormone accountable for hair loss.
It prevents hair loss,increases the ratio of anagen to telogen hairs, increases the growth rate and hair thickness.
Finasteride has a higher success rate than minoxidil. The benefit only remains when you keep using it, once you stop taking it, hair loss starts again.
Continuous use for 3 to 6 months is required before a result is seen.
Like other medications, finasteride also prompts side effects. Possible side effects include:
- Loss of libido (loss of interest in sex)
- Difficulty getting an orgasm
- Painful ejaculation
- Swelling in your hands or feet
- Breast swelling or tenderness
- Dizziness
- Weakness
- Skin rash
- Headache
Finasteride may also cause decrease in blood prostate specific antigen (PSA) levels, and can affect the PSA blood test.
PSA blood test performed for Prostate Cancer, a cancer in man’s prostate, a small walnut sized gland that produces seminal fluid.
Dutasteride
Dutasteride is equivalent to finasteride, but more effective.
Dutasteride has higher efficiency than finasteride. Finasteride blocks almost 70% DHT, whereas dutasteride blocks more than 90% DHT.
Surgical treatment
Hair transplant
In hair transplantation, a dermatologist or cosmetic surgeon takes a strip of skin, containing hairs, from the back or side of the scalp, and transplant it onto the bald area of the scalp.
Multiple hair transplantation is required to get the desirable results. The surgical procedure also contains risk of scarring and bleeding.
Hair transplantation is very expensive .
Laser therapy
In laser therapy, low-dose laser treatment is used in male pattern baldness.
Low-dose laser treatment enliven circulation and stimulation that promote hair follicles to grow new hair.
The results of laser therapy are inconsistent, it appears to work for some people but not for others.
So, More research is needed.
Non medical treatments/techniques to tackle male pattern baldness
Medical treatments are not required if other health conditions are not a cause and you’re happy with your look.
If you’re not happy with your look and want to disguise your hair loss, non medical treatments/techniques are there to help you.
Changing your Hairstyle
Men with male pattern baldness who didn’t lose much hair, can disguise their hair loss with appropriate hair style.
There are a variety of hairstyles and haircuts to disguise hair loss such as, crew cut, buzz cut, comb over hairstyle, high and tight haircut, ivy league hairstyle, razor shave haircut and many more.
Ask your hairstylist for a better hairstyle/haircut that could disguise your hair loss and make your look better.
Wigs and hairpieces
Wigs and hairpieces are often used to disguise hair loss. Unlike changing hair style, wigs and hairpieces can be used in any hair loss condition like, complete baldness, partial baldness.
Wigs and hairpieces are safe to use.
Conclusion
In this article, I have tried to touch every aspect of male pattern baldness. However, if any important thing has missed, your suggestions are always welcomed!
Friends, as we all know, in today’s era, baldness is becoming a huge problem among men. No matter where you live, footprints of male pattern baldness are always there irrespective of demographic and region make it one of the most concerning things for men.
Though, male pattern baldness alters race, white men are more prone to pattern baldness than asian and African heritage, a study says.
Now, let’s talk about the most important aspect of male pattern baldness i.e. cure.
It is very sad to say that still there is no cure for male pattern baldness. though there are a number of treatment options available.
Two medicines, Minoxidil and finasteride, are currently used to treat male pattern baldness. But the results of these medicines are temporary, once you stop taking medicines, hair loss reverses.
Later, we can consider hair transplantation as a treatment option, it’s more durable than minoxidil and finasteride. But also there are many problems.
- Hair transplantation is very expensive, most people can’t afford.
- You can’t get satisfactory results through a single transplant, need multiple transplants for desirable results.
- It can be painful, also cause many side effects such as, bleeding, scarring, itching, infections, crust or pus drainage around the surgical sites,
scalp pain, swelling,
inflammation of hair follicles (folliculitis), bleeding.
Friends, as we can see there is no way to cure male pattern baldness, have a number of treatment options but they all temporarily work (except hair transplant) and have many shortcomings.
Now here the question arises……
What can we do to tackle male pattern baldness?
The answer is so simple, we can prevent it, not fully but partially because male pattern baldness is highly heritable.
We can slow down the rate of hair loss, receding hairline, thinning hair through some tactics (as I mentioned these tactics in the prevention section of my article).
You can try these tactics along with treatment or without treatment, I’m pretty sure that it will help you.
I hope that I have addressed all of your curiosities.
“Frequently Asked Questions”
Q.1: Why do men usually get bald at the front or top of the head? Why not on the sides or back of the head.
Answer: Because,The hair roots that are present on the sides or back of the head don’t have receptors, a protein molecule that responds to a hormone, antigen,a particular neurotransmitter and other substances.
So, DHT can’t get attached to hair roots present here, and sides and back of the head didn’t get bald.
Q.2: Will I go bald if my father is bald?
Answer: Men inherited the baldness gene from the X chromosome that they get from the mother’s side of the family.
But it is not the single or primary gene that causes baldness, there are many others. So, if your dad is bald, you may also go bald.
Q.3: How do I know if my hair loss is due to male pattern baldness?
Answer: It’s not always easy to identify because male pattern baldness is a gradual process, take several years to make complete bald.
However, there are some early signs whereby you can identify it.
- You have a receding hairline at the front (temple) of your head.
- Thinning of the hair at the top (crown) of the head.
- Overall hair thinning
- Excessive hair loss than normal limit ( we lose 100 hair each day and it’s normal)
If you experience these signs, you may have male pattern baldness.
Q.4: Is Male pattern baldness permanent?
Answer: Yes, It is. You can only fix male pattern baldness with hair transplant, other forms of hair loss such as alopecia areata, telogen effluvium are temporary.
Q.5: Is male pattern baldness curable?
Answer: There is no cure for male pattern baldness. You can slow down the progression of male pattern baldness, some men grow new hairs with the help of Minoxidil and finasteride, but once you stop taking these medicines, hair loss returns.
Q.6: Is Male pattern baldness a disease?
Answer: Generally, Male pattern baldness is not considered as a disease. But research is showing that the men with male pattern baldness have an increased risk of developing coronary heart disease, prostate cancer and high blood pressure.