Male Pattern Baldness

Male pattern baldness (also known as androgenetic alopecia) is a very common genetic hair loss condition that affects over 50% of men. Genetics determines when or if a man experiences male pattern baldness, and if it does occur, it’s triggered by the release of the hormone DHT. 

The severity of male pattern baldness differs greatly, with the Norwood Scale showing 7 distinct stages of hair loss, going from slight hair loss to full baldness. In the most advanced cases, targeted hair loss treatments may be considered.

Male pattern baldness is a progressive form of hair loss that affects most men in their lifetime. It typically affects the hairline and crown, with most men affected experiencing a receding hairline and crown thinning. 

Male pattern baldness is different from temporary shedding, which is typically caused by lifestyle factors like high levels of stress or nutritional deficiencies. Instead, it happens progressively over time and can only be reversed with specific targeted treatments. 

The earliest signs of genetic hair loss in men include thinning at the temples and a progressively balding crown. 

Does Male Pattern Baldness Start at the Hairline or Crown?

It most commonly starts at the hairline, often creating an M-shaped hairline (although this can also be genetic). There are some cases where it starts at the crown of the head, though. 

What Does a Receding Hairline Look Like?

You will notice thinning at the temples. It may create an M shape. Often, this hair loss is progressive, moving further back as time goes on. 

How can You Tell if Thinning is Permanent?

Permanent hair thinning will come on more gradually and typically affect the hairline and crown. It follows a standard, predictable pattern, and you don’t experience regrowth. 

Male pattern baldness is a genetic hair loss condition caused by DHT. DHT, or dihydrotestosterone, is a male hormone that triggers hair follicle miniaturisation, which eventually leads to the follicles not growing new hairs anymore. 

How Does DHT Affect Hair Follicles?

DHT binds to the follicle receptors. When this happens, the follicular miniaturisation process begins, which is when the follicles shrink. This in turn affects the hair growth cycle, with the growth (anagen) phase being shortened and the shedding phase (telogen) being extended. 

Yes. Follicle sensitivity to DHT is inherited and can come from either your mother or father. It’s also a polygenic trait, which means it’s caused by several genes (rather than a single one). 

How Does It Affect the Hair Growth Cycle?

This hormone-related hair loss affects the hair growth cycle by shortening the anagen phase, which is when the hair actively grows. At the same time, it extends the shedding and resting phases. Over time, this causes progressive thinning. 

No, there is no direct link between high testosterone and baldness. Instead, it’s about a man’s inherited sensitivity to DHT. The more sensitive a man is to DHT, the more likely he is to experience balding. 

However, there is a link between DHT and testosterone, as DHT is an androgen derived directly from testosterone. 

For most men, male pattern baldness begins when they are in their thirties. That’s not always the case, though, so, when does male pattern baldness start?

Can Male Pattern Baldness Start in Your 20s?

Yes. While it affects most men who are 30 or older, it is possible to start balding in your 20s. This affects up to 25% of men who experience male hair loss. 

Why Do Some Men Go Bald Earlier Than Others?

It’s primarily due to genetics. If you have a father who went bald younger, it’s more likely to happen to you. However, there are some lifestyle factors at play, too. For example, a man might go bald faster if he leads a highly stressful lifestyle. 

The gold standard for measuring the stages of male pattern baldness is the Norwood Scale, which includes 7 distinct stages. These can then be broken into three stages: early, moderate, and advanced. 

What Are the Different Stages of Male Pattern Baldness?

Early: Norwood Scale 1-3. This is when there is no significant hair loss at the hairline or crown. However, there may be a slight recession noticeable, for example, an M-shaped hairline. At stage 3 of the Norwood Scale, light thinning may also be present at the crown. 

Moderate: Norwood Scale 4-5. There is definite visible hair loss at both the temples and the crown. While both these areas of hair loss are separated by hair growth in between, they grow closer together. 

Advanced: Norwood Scale 6-7. The most extensive form of hair loss. Most of the hair that grew between the temples and crown has disappeared. At the most severe stage of the Norwood Scale 7, men just have a singular band of hair around the back and sides of their heads. Often, this hair is thin. 

Yes. While there is no cure for male pattern baldness, some treatments can stop progression and even reverse the hair loss. 

A common treatment is medication. Finasteride is an oral prescription-only medication that prevents the production of DHT, the cause of hair loss to begin with. There’s also minoxidil, an effective over-the-counter medication that stimulates blood flow to the scalp. Both of these hair loss medications need to be continuously taken daily for results to be maintained. 

For advanced cases, a hair transplant can restore hair growth to the crown and temples by transplanting hair follicles into the balding sections. 

Keep in mind that these ways of how to stop male pattern baldness affect people in different ways, one treatment may be more effective for one man than another. 

Consider treatment when the hair loss is affecting your confidence. If you are still in the early stages of male pattern baldness, minoxidil or finasteride may be enough to stop the progression. If your hair loss is more advanced, seeking a FUE hair transplant procedure can transform your hair, giving you a full head once more. Keep in mind that suitability differs from person to person. 

Male pattern baldness usually begins with temple recession. It’s a slow progression that usually manifests as an M-shaped hairline at the beginning. As it progresses, men also experience crown thinning.