A Detailed Guide to Male Pattern Baldness and the Treatments

 by Matt Weik, BS, CSCS, CPT, CSN

Male pattern baldness is the most common type of hair loss. It starts with a receding hairline or temples, which eventually leads to a shiny scalp on the top of your head that begins to be the start of the “do you polish your head” jokes.

Well, male pattern baldness is no laughing matter, and for many men, it can destroy their confidence.

Male pattern baldness is estimated to affect 50 million men in the US and half of all men by the age of around 50. Although hair loss is a natural part of the aging process for millions of men (even though no one wants to hear that), it can still be psychologically distressing.

It is also important to note that unexpected or sudden hair loss can sometimes be linked to more severe health problems that may require medical attention — so pay attention to the signs.

What Are the Causes of Male Pattern Baldness?

The leading cause of male pattern baldness is Dihydrotestosterone (DHT). DHT is an androgen (male sex hormone) that can be found in both men and women. In men, it causes hair follicles to shrink and gradually stop producing new hair fibers.

In order to understand how DHT affects hair growth, it is important to know how the body produces new hair fibers.

Each strand of hair grows from a tiny hole on your scalp called a follicle. The follicle contains a bulb-like structure known as the matrix, which produces cells called keratinocytes (keratin is the protein that makes up your hair). These keratinocytes then travel up through the shaft of the follicle until they reach the surface of your scalp, where they produce new hair fibers.

For this process to occur properly, your body needs certain nutrients such as zinc, vitamin A, and copper. Being deficient in these nutrients can cause problems with your hormonal balance, potentially leading to an increase in DHT levels.

Many genes are involved, which accounts for differing ages of progression, onset, severity, and pattern of hair loss in family members. The susceptibility genes can be inherited from both father and mother.

At the time of writing this article, genetic testing to predict balding is unreliable.

What Treatments Are Available for Male Pattern Baldness?

Male pattern baldness is the most common type of hair loss, affecting approximately 50 percent of men by the age of 35. There are many treatments available for male pattern hair loss.

Treatments for male pattern baldness:

1.      Hair Transplant

Hair transplant is the most popular treatment for male pattern baldness. It’s a surgical procedure to transplant donor hair follicles from the back of your scalp to balding areas. This can be done using strip harvesting (a strip of scalp tissue containing hair follicles is removed from the back of your head and dissected into individual grafts) or follicular unit extraction (a single hair follicle and some surrounding tissue is removed from the back of your head).

The transplanted grafts can either be placed immediately at the recipient site or stored for later use. Transplanted hairs will fall out within six months but will then regrow normally over time.

2.      Minoxidil

This is a medication approved by the Food and Drug Administration (FDA) for the treatment of male pattern baldness. Minoxidil is applied once daily to the scalp, usually at night. It works by promoting blood flow to the hair follicles, which in turn allows more nourishing oxygen and nutrients to reach them. This helps slow down or stop further progression of hair loss and encourages new growth, although it will not regrow lost hair.

3.      Finasteride and Dutasteride

Finasteride (often sold as Propecia) and dutasteride (often sold as Avodart) are prescription drugs that can be used to treat male pattern baldness. These drugs work by inhibiting the formation of a natural sex hormone called dihydrotestosterone (DHT). DHT is thought to cause male pattern baldness because it shrinks the hair follicles on your scalp, which causes them to produce thinner and shorter hairs.

4.      Cosmetics

You may be able to conceal your hair loss with styling products, like gels or pomades, which cover up thinning areas. These products don’t provide permanent results but can be useful for men who are self-conscious about their appearance.

5.      Shampoo Therapy

Shampoos containing ketoconazole 2 percent, also known as Nizoral, or pyrithione zinc 1 percent, or Head and Shoulders, are FDA-approved for treating androgenetic alopecia in men. These shampoos have been shown to be effective in patients with mild to moderate hair loss.

6.      Micropigmentation (Tattoo) to Resemble Shaven Scalp

Micropigmentation (tattoo) can be used to resemble a shaved scalp and cover up patches of baldness. It’s a cosmetic procedure that requires multiple sessions over several months to achieve the desired effect.