Male Pattern Baldness

Male hair loss, also known as male pattern baldness, is the most common type of hair loss in men. It usually presents itself with a receding hairline or thinning of the hair on the top and crown of the head. The exact timeframe of how long it takes patients to lose their hair is unknown. While environmental factors can accelerate the process of balding, typical active hair loss can take anywhere from 10-20 years as the hair continues to thin and miniaturize before the balding process is complete.

Causes of Male Pattern Baldness

There are a number of causes for male pattern baldness and they include:

  • Gender –You have to either be a man or have a hormonal imbalance (with respect to sex hormones with elevated male hormones similar to a man). Dihydrotestosterone is a byproduct of testosterone that plays a key role in male pattered baldness in men and women.
  • Time –Baldness does not occur overnight. The right combination of factors such as gender and a genetic predisposition have to be present in order for hair loss to occur over time.
  • Genetics/Heredity –Male patterned baldness is always genetic.

Family History of Baldness

Early signs of patterned hair loss can be visible as early as the teenage years. It generally becomes more noticeable in the age range of the early 20s and spans all the way to the late 30s. Occasionally, some people don’t present hair loss until their 50s or 60s. It is important to see who else in your family is balding. If you identify someone in a prior generation who was exactly like you at your age, you can predict where you are heading in the future if you do nothing to change your course.

Although hair loss is a progressive and gradual process, the speed at which it progresses is different in each individual. Most people continue their active hair loss phase during a span of approximately 20 years. This implies if they start to lose hair in their 20’s, they may exhibit their final stage of hair loss in their early 40s.

Hair Loss Evaluation

A proper hair loss evaluation is an important first step in a successful hair restoration procedure. Key points that the doctor reviews with each patient while performing the patient consultation include:

  • Past Medical History –Patients are asked to fill out a form detailing their past medical history including medications/allergies, surgeries and past hair loss treatments.
  • Physical Exam –The doctor analyzes the current pattern of hair loss while taking into account the current/preferred hairstyle of the patient.
  • Microscopic Evaluation –A hair miniaturization study is performed to determine the degree and extent to which active hair loss is occurring on the scalp.
  • Master Plan –The master plan takes into consideration the information gathered during the exam such as the donor reserve on the scalp, current hair loss status and the lifestyle of the patient and also the desired final results of the patient. Both the doctor and patient discuss nonsurgical and surgical options including products and hairstyle choices in order to formulate a master plan designed with the future hair needs of the patient in mind. The master plan budgets or allocates scalp hair to locations that will provide the most benefits in terms of appearance and coverage over the life of the patient. It is important to set realistic expectations about what is possible given the fact that the donor hair of a patient is not a limitless resource.

Male Pattern Classifications

Men's Hair Loss Classification

The Norwood Scale is a series of images that visually represent the various stages of hair loss. The scale ranges from Type I (minimal hair loss) to Type VII (the most advanced form of hair loss). Hair loss progression and Norwood type is not based on age since the progression of hair loss is a very individual process. Your hair transplant physician will exam your scalp microscopically in order to inform you exactly where on the Norwood Scale you fall at the current time. Progression along the scale may be slowed down by the use of FDA approved hair loss medications on the market (such as minoxidil or finasteride).

Treatment Options

There are a number of options for the treatment of male pattern baldness. While a medical treatment can slow down, and even delay, the progression of hair loss, a hair transplant is the only permanent solution for male pattern baldness.

Medications for Hair Loss – Hair loss medications are an option which can be given alone or in combination with a hair restoration procedure. There are prescription medications that are approved by the FDA for hair loss. Conversely, Rogaine is a topical medication that is applied directly to the balding areas of the scalp twice a day. Both medications offer the best results when they are used during the early stages of hair loss but either medication may be used at any stage of hair loss to help maintain the hair you have.

Hair loss medications should be taken regularly in order to maintain a continued positive outcome. If these medications are not taken on a consistent basis, the results will fade over time resulting in catch-up hair loss. Typically, the choice to start these medications is a lifetime commitment.

Patient of Dr. Mohebi who had FUE Hair Transplant with 2,315 grafts

Hair Transplant – When it comes to “fixing” the issue of male pattern baldness, most doctors agree that hair transplantation is the most effective and longest lasting treatment option. Once permanent hairs are transplanted to their new location, no other treatment is necessary to maintain them. However, hair loss progression of native hair outside the permanent zone on the scalp will likely continue if medical treatment options are not commenced. Further “fixing” may be necessary to combat the appearance of additional native hair loss in the form of a second hair transplant. Other patients may request a second hair restoration procedure to “fine tune” a previously transplanted area or because of a wish to gain greater hair density to help maintain their youthful appearance. Since permanent hairs are transplanted to replace those that were lost; a second hair transplant is also a permanent change.

The hair that is transplanted from one part of the scalp to another is from the “permanent zone” so it does not behave the same as the scalp hair that was lost or is prone to hair loss. Even if the hair is taken from another area such as the beard or the chest, it still behaves as it did in its previous home. This means that the hair from the beard or chest is resistant to hormonal effects that impact hair in balding areas and the results will be long lasting.