Definition and Overview
Male pattern alopecia is a medical condition that causes hair loss among men. It is also known as male pattern hair loss and is the most common cause of male hair loss. The condition, which commonly affects the hairline and the crown, is believed to be caused by genetic factors and hormones. Thankfully, there are now many treatment options available for patients who suffer from this condition.
Causes of Condition
Male pattern alopecia is believed to be caused mainly by genetics and hormones, particularly the male hormone dihydrotestosterone.
Studies also showed that there is a direct correlation between male pattern baldness and the values of certain hormones that a person has. To be more specific, many patients with alopecia showed low values of FSH (follicle stimulating hormone), SHBG (sex hormone-binding globulin), and epitestosterone.
According to studies, patients with alopecia still have the stem cell progenitor cells where hair follicles originate from. This means that although they still have their hair follicles intact, they are most likely dormant and unable to trigger hair growth. Dormant follicles, on the other hand, are associated with the activity of the ICF (insulin-like growth factor). This growth factor is responsible for stimulating the male sexual development that occurs both after birth and during puberty. In men with alopecia, the ICF triggers hair growth on the face but, as a consequence, suppresses hair growth on the scalp.
Age is also believed to be a factor. Since age can cause a number of hormonal changes in the body, people over the age of 50 are more prone to experiencing these changes. Most of these changes have several effects on a person’s body. For example, aging can cause a person’s testosterone levels, serum DHT, and 5-alpha reductase levels to decrease. The same is true for 3AAG, which is a peripheral marker of the DHT metabolism. As the balance of hormones in the body is disrupted, they either trigger or accelerate hair loss.
Moreover, a large percentage of patients who suffer from male pattern alopecia also have close relatives who experienced male pattern baldness as well. The connection seems more prevalent among maternal relatives.
However, not all hair loss is caused by alopecia. Male pattern alopecia tends to follow a common pattern, so hair loss that does not follow the same pattern may be caused by other factors. To diagnose male pattern alopecia, hair loss specialists usually check for other symptoms that may indicate another problem.
If the hair loss is accompanied by redness, scaling, pain, or a pus discharge from any part of the head, then it is most likely caused by other factors. Also, if the hair loss occurs suddenly and in big patches instead of receding slowly towards the crown of the head, or if it is accompanied or caused by hair breakage, then other potential causes need to be explored.
To do so, a series of tests will be performed, including a skin biopsy on the scalp as well as a hair analysis test where the patient’s hair is analyzed to check for nutritional deficiencies and other disorders.
The primary symptom of male pattern alopecia is hair loss that starts with a receding hairline and progresses toward the crown. This means that most patients still have some hair on the sides and on the rear of the head. The condition, which can occur in different grades, do not often lead to total baldness. The severity of the condition is measured using the Hamilton-Norwood scale.
Who to See and Types of Treatments Available
While male pattern alopecia is not a dangerous or life-threatening condition, it does cause some psychological and emotional distress for patients who are affected. This is due to the low self-esteem that they experience due to their appearance. Thus, many choose to seek hair loss treatment for men despite the expenses they will incur during treatment.
For this reason, cures for baldness are now widely offered by clinics that specialize in hair loss treatments. These include:
Minoxidil. This is a special solution used to slow down hair loss among men who are showing the first signs of alopecia. This is also effective in encouraging new hair to grow. However, this is not a total hair regrowth solution, as hair loss will resume once the patient stops taking the medication.
Finasteride. This is a medication that slows down hair loss by interfering with the production of the active form of testosterone that is believed to be responsible for baldness. It is believed to be more effective than minoxidil. However, like minoxidil, finasteride is not a hair loss cure as well, as hair loss will also resume if the patient stops using the medicine.
Hair transplant surgery. Hair transplant is currently the most advanced and one of the most effective hair loss treatments available today. It offers a long-term hair loss cure for patients with male pattern alopecia. During a hair transplant, the specialist will take tiny plugs of hair from other areas of the scalp where hair growth is abundant, then transfer it surgically to areas where hair loss occurs. The hair taken from the donor site is called the hair graft, which is retrieved during a follicular unit transplantation (FUT) or follicular unit extraction (FUE). Once obtained, the hair graft is implanted into the recipient sites using very small incisions.
Of all the treatment methods that are available, having hair transplants is the most expensive option. Patients typically need to attend multiple sessions for the treatment to be completed. The procedure is also associated with a few risks, such as scarring and infection, which occur very rarely.
For those who opt not to take medications or undergo a procedure to resolve their male pattern alopecia, they can use hairpieces such as wigs or weaves to cover up the thinning hair on their heads. Some also simply change their hairstyles to cover up the specific part of their head affected by alopecia.
Cranwell W, Sinclair R. “Male androgenetic alopecia.” https://www.ncbi.nlm.nih.gov/books/NBK278957/
Hagenaars SP, Hill WD, Harris SE, Ritchie SJ, Davies GD, Liewald DC, Gale CR, Porteous DJ, Deary IJ, Marioni RE. “Genetic prediction of male pattern baldness.” 2017. http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1006594
Bonnici M. “Treatments for male pattern hair loss.” https://www.prime-journal.com/treatments-for-male-pattern-hair-loss/
Keum N, Cao Y, Lee DH, Park SM, Rosner B, Fuchs CS, Wu K, Giovannucci EL. “Male pattern baldness and risk of colorectal neoplasia.” British Journal of Cancer (2016). 114:110-117. http://www.nature.com/bjc/journal/v114/n1/full/bjc2015438a.html