Male-pattern baldness, also known as male-pattern hair loss (MPHL), affects about 50% of men over 40. Balding usually begins at the forehead and the hairline recedes towards the back of the head. Male pattern hair loss is also referred to as male androgenetic alopecia (MAGA). This term explains that the hair loss (alopecia) is caused by high levels of male androgens (male hormones i.e. testosterone, dihydrotestosterone (DHT)). Medications such as Finasteride and Propecia can help to prevent future hair loss and encourage new growth.
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Written by Dr Kimberly Langdon, MD
Information last reviewed 06/21/19
Hair loss or baldness is extremely common and affects roughly 50% of men over the age of 40. White males have the highest incidence of hair loss with Asians and African Americans second, followed by Eskimos and Native Americans. Balding generally begins at the forehead and progresses towards the back of the head. The earlier in life that it begins, the more severe the degree of baldness.
Male-pattern baldness is genetic, but it is passed from a mother to her son. Therefore, men often do not show the same hair loss pattern as their father. High levels of androgens (male hormones such as testosterone) can lead to hair loss.
It is thought that other factors may be involved in hair loss besides high levels of androgens. Hair loss can also be caused by:
The pattern of balding can vary from person to person, but the signs of male pattern baldness include:
You may experience male pattern baldness in any of the following patterns. If you are experiencing hair loss in other patterns, patches or clumps, it may be caused by another condition and it is a good idea to speak to your doctor about this.
Male pattern baldness is generally diagnosed by asking the patient about the development and progression of their hair loss and by looking at the pattern of hair loss itself. Some lab tests can also be done to identify or rule-out any underlying causes of the hair loss. The tests can involve measuring the following:
Trichograms may also be carried out to assess the rate of progression of your hair loss. This involves 50-100 hairs being plucked from the scalp and examined under a microscope to measure different types of hair roots and their shapes on the scalp.
There are a number of conditions and diseases that can cause hair loss:
Hair loss can also predispose you to other conditions such as:
Therefore, if you do experience baldness, it is a good idea to be aware of the symptoms of these conditions and to be monitored to prevent the conditions as much as possible.
There are two FDA approved medications for male-pattern baldness: Minoxidil and Finasteride.
Finasteride or Propecia is taken orally and can only be used by men. It helps to slow the progression of hair loss and can also cause new growth. Results are usually better towards the back of the head, rather than in the forehead area. It works by reducing the levels of the androgen, dihydrotestosterone (DHT), which is implicated in male pattern baldness. To prevent further hair loss, Finasteride must be continued indefinitely, because stopping it will cause the DHT to rise and hair loss to resume.
Minoxidil or Rogaine is a topical lotion that stimulates and prolongs hair growth. It is thought to do this by increasing the blood flow to the hair follicles and increasing the size of the follicle and the thickness of individual hairs . Regrowth is better in the back of the head than the forehead and may take up to 4 months to show an effect. To prevent hair loss returning, it is essential to continue the topical treatment indefinitely because stopping it will cause the baldness to return rapidly.
Non-Medicinal Hair Loss Treatments
No, but if it is done, it may demonstrate inflammation, which is thought to contribute to male-pattern baldness.
There are 2, one located on the X- chromosome and thus must come from the maternal side, the other is on chromosome 20 which could come from paternal or maternal genes.
Propecia™ is the only FDA-approved prescription grade treatment indicated for the treatment of androgenetic alopecia also known as male pattern hair loss in men. However, it is a branded product and more expensive than the generic Finasteride which contains the same active ingredients and is a lot cheaper. You can order Finasteride or Propecia using our online doctor’s service and have it delivered to your door.
Yes, hair loss has many types with varying causes and symptoms and stress can be one of them.
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