Male Pattern Baldness: Treating Men's Hair Loss
Male pattern baldness, also known as androgenetic alopecia (sometimes called androgenic alopecia or AGA), is the most common type of hair loss in men. According to the National Institute for Health, male pattern baldness affects more than 50 million men (and 30 millions women) in the United States. While hair loss occurs as early as puberty in many men, it typically occurs later in life. Roughly 20% of men will experience significant hair thinning by age 35 – and by age 50, that number jumps higher than 50%!
Classic male pattern baldness typically starts with a receding hairline and thinning of the hair on the top of the head. In time, the initial hair loss can progress to complete baldness. There is no cure for male pattern baldness, but there are treatments that can help slow down or stop the progression of hair loss. Minoxidil (Rogaine) is a topical medication that is approved by the FDA for the treatment of androgenetic alopecia. It’s available over-the-counter in 2% and 5% solutions. Finasteride (Propecia) is a prescription medication that is also FDA-approved for the treatment of androgenetic alopecia. It’s taken orally in pill form.
In addition to medical treatments, there are a number of other options that can be considered for the treatment of male pattern baldness. These include hair transplantation, scalp reduction surgery, laser therapy, and PRP injections.
Causes of Male Pattern Baldness
There are many possible causes of hair loss in men, including genes, hormones, disease, trauma, and medication side effects. However, male pattern baldness is commonly attributed to a combination of genetic and hormonal factors. Male pattern baldness is often thought to be an inherited condition that is passed down from parents to children. Androgens, the male sex hormones, are thought to play a role in the development of androgenetic alopecia. These “male sex hormones” are present in both men and women, but they’re more concentrated in men.
Male Pattern Baldness Symptoms
The typical pattern of male pattern baldness begins with a receding hairline, followed by thinning at the crown. In time, the hair loss that starts with a receding hairline can progress into complete baldness. The rate of progression and the extent of hair loss associated with male pattern baldness will vary from person to person.
Diagnosing Hair Loss in Men
If you’re concerned about your hair loss or noticing a receding hairline, make an appointment with your doctor. He or she will ask questions about your medical history and perform a physical exam to check for any underlying medical conditions that may be causing your hair loss. In some cases, a blood test may be ordered to check for hormone levels or other conditions. A biopsy of the scalp may also be performed to rule out any other causes of hair loss.
Genetic Causes of Hair Loss
Genetic studies have shown that the receding hairline associated with male pattern baldness can be related to hereditary genes – meaning it can be passed from parents to children. There are hundreds of identified genes that are attributed to hair loss and genetic sequencing can help predict if a man will be more likely to experience severe hair loss during these life. However, as of now, there has not been a single identified gene that will guarantee that a man experiences hair loss, which suggest that genetics are only one of many contributing factors that can lead to male pattern baldness.
Hormonal Causes of Thinning Hair
Androgens are the male sex hormones. They’re present in both men and women, but they’re more concentrated in men. Interestingly androgens stimulate hair growth and are related to the increased facial hair that boys see while going through puberty. However, paradoxically, research suggests that androgens play a role in the development of androgenetic alopecia. So while androgens can promote facial hair growth and scalp hair growth in some situations, they are thought to cause the scalp hair follicles to miniaturize under certain conditions. This follicle miniaturization process is what leads to shorter and finer hair and eventual loss of hair.
DHT and Male Baldness
Dihydrotestosterone (DHT) is a byproduct of testosterone that’s thought to play a role in male pattern baldness. DHT is produced when testosterone comes into contact with an enzyme called 5-alpha reductase. This enzyme is found in high levels in the scalp and has been linked to hair thinning.
Once DHT is produced, it attaches to receptors on the hair follicles. This process leads to the miniaturization of the scalp hair follicles and eventually hair loss begins to occur.
Diseases Related to Male Baldness
Certain diseases and conditions can lead to hair loss. These include alopecia areata, an autoimmune disorder that causes patchy hair loss. Thyroid disorders, such as hypothyroidism and hyperthyroidism, can also cause hair loss. Medical complications related to diabetes may also cause some men to lose hair.
Hair Loss Occurs from Trauma
Any type of trauma, whether physical or emotional, can lead to hair loss. This can include surgery, a car accident, or even stress from a major life event. When hair loss occurs due to trauma, it is sometimes temporary and hair will often grow back on its own once the person has recovered from the traumatic event.
Medication Causing Thinning Hair
Certain medications can cause hair loss as a side effect. These include medications used to treat cancer (chemotherapy), high blood pressure (beta blockers), and depression (antidepressants). If you’re taking any type of medication and notice that hair loss occurs, be sure to talk to your doctor about the possibility that the medication is causing the problem.
Prostate Health and Male Pattern Baldness
There is some evidence to suggest that there may be a link between prostate health and male pattern baldness. One study found that men with androgenetic alopecia were more likely to have an enlarged prostate. This study also found that men with androgenetic alopecia were more likely to develop prostate cancer. However, it’s important to note that the exact link between prostate health and male baldness still poorly understood.
If you’re concerned about your risk of developing prostate cancer, talk to your doctor about the possibility of undergoing regular screenings, such as a digital rectal exam or prostate-specific antigen test.
Dermal Papilla Cells and Hair Loss
The dermal papilla is a small, cone-shaped cell at the base of the hair follicle. These cells are responsible for the growth of the hair follicle. Research suggests that dermal papilla cells play a role in the development of androgenetic alopecia.
One theory is that dermal papilla cells may be sensitive to male sex hormones like testosterone. This sensitivity means that a hair follicle may be more likely to miniaturize in response to high levels of these hormones, which is when new hair loss begins. Another theory is that dermal papilla cells may be genetically predisposed to androgenetic alopecia. This means that certain genes may make these cells more susceptible to the effects of androgens, leading to hair diseases such as a balding scalp.
Hair Follicle Health and Male Pattern Baldness
The health of the hair follicle is also thought to play a role in male pattern baldness. One theory is that androgenetic alopecia may be caused by an inflammation of the hair follicle. This inflammation is thought to damage the cells responsible for new hair growth. Another theory is that androgenetic alopecia may be caused by a build-up of fatty acids around the hair follicle. This build-up is thought to interfere with the normal function of the hair follicle and lead to hair loss.
Nutritional Deficiencies Related to Hair Loss
Certain nutritional deficiencies can lead to hair loss. Iron deficiency is one of the most common deficiencies associated with hair loss. This is because iron is necessary for the production of hemoglobin, which transports oxygen to the cells. Without enough oxygen, the cells can’t function properly, which can lead to hair loss.
Other nutrients that are important for hair health include zinc, biotin, and vitamin D. If you think you may be deficient in any of these nutrients, talk to your doctor about taking supplements or increasing your intake of foods that are rich in these nutrients.
Smoking and Hair Loss
Smoking has been linked to hair loss in both men and women. In men, smoking is thought to contribute to male pattern baldness by damaging the hair follicles and causing inflammation. Smoking is thought to cause diffuse hair loss by damaging the blood vessels that supply the hair follicle with nutrients.
If you smoke, quitting is one of the best things you can do for your overall health, including your hair health. If you’re struggling to quit, talk to your doctor about ways to make quitting easier, such as nicotine replacement therapy or prescription medications.
Senescent Alopecia: Hair Loss Due to Aging
As we age, our bodies produce less of the hormones that stimulate hair follicles to promote new hair growth. This decrease in hormone production can lead to a type of hair loss called senescent alopecia. Senescent alopecia is a natural part of aging and is not thought to be due to any underlying health condition.
While there’s no way to prevent senescent alopecia, there are things you can do to keep your hair healthy as you age to prevent losing hair. These include eating a healthy diet, avoiding smoking, and managing stress. If you’re concerned about your hair loss, talk to your doctor about ways to keep your hair healthy and prevent further hair loss.
Stress and Male Pattern Baldness
It’s well known that stress can contribute to hair loss. This is because when we’re stressed, our bodies produce more of the hormones that are responsible for hair loss.
If you’re experiencing stress-related hair loss, there are things you can do to manage your stress and stimulate hair growth. These include exercise, relaxation techniques, and counseling. If you’re struggling to manage your stress on your own, talk to your doctor about ways to get help.
Exercise and Hair Follicle Health
Exercise is important for overall health, but it may also be beneficial for hair follicle health. One study found that men who exercised regularly had a lower risk of androgenetic alopecia. Another study found that women who exercised regularly had thicker hair and less hair loss than women who didn’t exercise.
Medications for Men's Hair Loss
While there is no cure for male pattern baldness, there are treatments that can help slow down or stop the progression of hair loss. Minoxidil (Rogaine) is a topical medication that is approved by the FDA for the treatment of male pattern baldness. It’s available over-the-counter in 2% and 5% solutions. Finasteride (Propecia) is a prescription oral medication that is also FDA-approved for the treatment of androgenic alopecia.
Minoxidil for Male Pattern Baldness
Minoxidil (Rogaine) is a topical medication that is approved by the FDA for the treatment of androgenetic alopecia. It’s available over-the-counter in 2% and 5% solutions. Minoxidil is thought to work by increasing blood flow to the hair and by promoting the growth of new hair.
To use minoxidil, apply the solution to your scalp twice a day. You should see results within four months, although it may take up to a year to see the full effects. Minoxidil is most effective when used in combination with finasteride (Propecia).
Topical Minoxidil vs. Oral Minoxidil
Oral minoxidil was originally prescribed to patients with high blood pressure in the 1970s. After physicians started noticing that their patients were starting to regrow hair, a topical minoxidil solution was developed to treat hair loss. To this day, both oral and topical minoxidil are regularly prescribed to patients experiencing hair loss. Both oral and topical types of treatment are effective, yet there are some key differences between the two:
Topical Minoxidil for Male Pattern Baldness
Minoxidil topical solutions can be applied to the scalp by massaging it in twice per day. These solutions come in different forms, including minoxidil foam, as offered by Rogaine. Even though most patients tolerate this medication well, there is a risk that it might cause allergic contact dermatitis on the scalp along with a skin rash. In some cases, the bad side effects of minoxidil might even lead to reactions like increased hair loss!
Although there are potential side effects to using Minoxidil topical solution, it has become one of the most popular treatments for male pattern hair loss and female pattern hair loss. Originally, doctors prescribed a 2% concentration of Minoxidil to patients; however, recent studies conclude that a 5% concentration is more effective.
Oral Minoxidil for Thinning Men's Hair
Although oral minoxidil dosages can be as low as 0.25mg per day, the potential side effects are more severe than those from using a topical solution. These side effects include low blood pressure, fast heart rate, and dizziness, among others such as insomnia and breast tenderness.
Topical Minoxidil for Men with High Blood Pressure
Oral Minoxidil is commonly prescribed to treat high blood pressure by dilating vessels. For this reason, it’s still worth considering the potential dangerous interactions of topical minoxidil drugs like Rogaine. If you’re already taking medication for hypertension, be sure to speak with a medical professional before using any additional treatments.
Minoxidil for Men with Heart Disease
Minoxidil use can result in serious side effects like irregular heartbeat and difficulty breathing. These symptoms could be life-threatening for patients with heart conditions. Minoxidil might also interact dangerously with drugs taken for heart disease. If you suffer from any kind of cardiovascular ailment, it’s essential that you consult a physician before using Rogaine or any other medication containing minoxidil.
Finasteride for Male Pattern Baldness
Finasteride (Propecia) is a prescription medication that is also FDA-approved for the treatment of androgenetic alopecia. It’s taken orally in pill form. Finasteride is thought to work by decreasing the production of DHT, which slows hair loss.
Prevention of Male Pattern Baldness
There is no known way to prevent male pattern baldness. However, there are things you can do to keep your hair healthy and prevent rapid hair loss. These include eating a healthy diet, avoiding smoking, and managing stress. If you’re concerned about your hair loss, talk to your doctor about ways to keep your hair healthy and prevent rapid hair loss.
Wigs and Hairpieces for Male Baldness
Wigs and hairpiece are artificial replacements for natural hair. They are usually made from human or synthetic hair and attached to the scalp with an adhesive.
Wigs and hairpieces are usually worn to cover up balding areas of the scalp. They can be used temporarily or permanently, depending on the type of hairpiece. They are available in a variety of styles and colors, and can be custom made to match the person’s natural hair color and texture.
PRP Injections for Male Pattern Baldness
PRP injections are a new treatment for hair loss. PRP stands for platelet-rich plasma. Platelets are cells in the blood that are involved in clotting and plasma is the liquid part of the blood.
PRP injections are thought to work by releasing growth factors that stimulate hair follicles to promote the growth of new hair. PRP injections are considered a safe and effective treatment for hair loss. You can learn more about PRP for hair loss here.
PRP vs. Minoxidil for Androgenetic Alopecia
An article published in the International Journal of Molecular Medicine in 2020 showed that PRP injections were more effective than Minoxidil therapy in treating men suffering from male pattern baldness. In this study, 69 men were divided into 3 groups who received either minoxidil therapy, PRP injections, or both minoxidil therapy and PRP injections.
This study measured the density of each subject’s scalp hairs as well as the number of scalp hairs demonstrating a healthy hair growth cycle. For the male androgenetic alopecia patients in this study, it was shown that PRP injections were a more effective hair loss treatment than topical minoxidil alone. Additionally, the patients that received both topical minoxidil therapy and PRP injections had the greatest success in reducing hair loss and hair breakage.
PRP treatments have very few severe side effects when done correctly. Allergic reactions to PRP are rare because the patient’s own blood is used. Minoxidil, on the other hand, can cause skin irritation and allergic reactions that may even lead to accelerated hair loss! Additionally, while Minoxidil provides temporary results for some patients, often times the new hair growth will fade within a couple months after treatment has stopped.
Laser Therapy for Male Pattern Hair Loss
Laser therapy is a new treatment for hair loss. It’s thought to work by increasing blood flow and cellular metabolism around the hair follicles, thus promoting the growth of new hair. Laser therapy is typically fast and painless. There are plenty of published studies showing that laser and LED lights are an effective option for treating hair loss. Specific wavelengths of light have been shown to stimulate hair regrowth – although the results often seem less dramatic or noticeable than some other hair restoration therapies.
Hair Transplant Surgery for Male Pattern Baldness
A hair transplantation is a surgical procedure that moves hair from one part of the body to another. It’s commonly used to treat male pattern baldness. In this procedure, grafts containing hair follicles that are resistant to DHT are transplanted to the balding areas of the scalp.
Scalp Reduction Surgery for Male Pattern Baldness
Scalp reduction surgery is a surgical procedure that removes balding areas of the scalp. This can help to reduce the size of the balding area and make it less noticeable.
Scalp reduction surgery is considered a permanent solution to hair loss. The removed tissue will not grow back, so the person will not experience further hair loss in that area.
Follicular Unit Extraction (FUE) for Men
Follicular unit extraction (FUE) is a hair transplantation surgery that removes individual follicles from the donor area and transplants them to the recipient site. This technique is often used as a solution to male pattern baldness and male pattern hair loss.
Follicular unit extraction is a less intrusive alternative to other procedures. The surgeon makes shallow cuts in the skin and uses a specific instrument to remove the follicles before transplanting them to the desired area.
Follicular Unit Transplant (FUT) for Men
Follicular Unit transplant surgery is a method of hair restoration, where hair is transplanted from one area of the scalp to another to restore lost hair.
FUT surgery entails taking a strip of skin from the back of your head. This strip is then cut into small pieces, called follicular units, which are transplanted to areas of your scalp where you want more hair growth.
Men's Hair Surgery: FUE vs. FUT
Notable differences between FUE and FUT hair transplant surgery include the extraction process. With FUE, individual hair follicles are extracted from the donor area for transplantation to the recipient area. The strip method is utilized with FUT, which involves extracting a strip of scalp from the donor area before it’s divided into grafts for placement in the balding or thinning areas (recipient site).
Furthermore, FUT leaves a linear scar in the donor area while FUE does not leave any scars. The lack of scarring with FUE is due to the handheld device that extracts the donor hair follicles one at a time. For this reason, FUE is typically the preferred procedure for people who want to avoid visible scarring. However, FUE is often more costly and time-consuming than FUT. Additionally, some hair transplantation surgeons may only have experience performing one of these types of procedures.
Is Men's Hair Surgery Painful?
Although hair transplantation surgery is not commonly seen as a painful medical treatment, some patients may feel discomfort during and after the surgery.
The pain management methods a hair transplantation surgeon uses varies depending on the type of surgery being performed. FUE procedures may use a local anesthetic to numb both the donor and recipient areas while FUT procedures might utilize general anesthesia or just a local anesthetic for numbing the donor area. For a more in-depth overview of hair transplantation surgery, check out this article.
Do Transplanted Hair Fall Out?
Hair transplant surgery comes with the possibility of post-operative hair breakage and hair loss. This happens when transplanted hair doesn’t take root or grow properly. Sometimes, people may lose transplanted hair a few weeks or months after the surgery.
Many things can cause hair loss after hair restoration surgery, but one of the most common is called shock loss. Sometimes hair loss occurs when the surgical procedure traumatizes the hair follicles, causing them to shed prematurely.
If you have a hair transplants and experience any sudden or dramatic hair loss afterwards, see your doctor right away. This could be due to infection or poor wound healing.
Hair Transplant Surgery vs PRP Injections for Male Pattern Baldness
Although hair transplantation surgery is widely used to treat alopecia, it comes with certain dangers. One of the most prevalent side effects from hair transplant surgery is “shock loss”- when the newly transplanted hairs fall out soon after the operation. Shock loss can be either temporary or permanent and usually happens because of the trauma associated with the surgery.
Unlike hair transplant surgery, PRP therapy is less invasive and has a shorter recovery time period. With this type of treatment, there is also a lower risk for shock loss because the injections work to stimulate existing hair follicles rather than introducing new ones. Even though both PRP and hair transplant surgeries can be successful in treating male pattern baldness (and female pattern baldness), it’s crucial to compare the advantages and disadvantages of each option.
Diet and Nutrition for Male Pattern Baldness
There is no one-size-fits-all diet for male pattern baldness, but certain foods and nutrients can help support scalp health and prevent hair diseases.
Protein-rich foods like chicken, fish, eggs, and beans are essential for hair health because keratin, the protein that makes up hair strands, needs amino acids (the building blocks of protein) to function properly.
B vitamins are also important for hair health. Biotin, in particular, helps the body metabolize fats and carbohydrates which are necessary for cell growth- including hair cells. Foods rich in biotin include fatty fish like salmon and avocados.
Vitamin C is another nutrient that’s crucial for hair health. It helps the body produce collagen, a protein that gives hair its structure. Foods rich in vitamin C include oranges, grapefruits, and leafy greens.
Can Vitamin Deficiency Cause Male Pattern Baldness?
Vitamin deficiencies don’t just impact your overall health-they can also lead to hair loss. A study published in 2018 found that a lack of certain vitamins and minerals, including vitamin D, biotin, folate, and vitamin B12 can cause hair loss. There are countless other studies that have shown a link between vitamin deficiencies and thinning hair.
Vitamins for Male Pattern Baldness
Clinical literature on hair loss says that maintaining a healthy diet can keep hair healthy and even stimulate hair growth. It’s not uncommon for dermatologists to suggest that their patient’s with male pattern baldness consider taking hair vitamins or iron supplements depending on their blood test results.
Hair thinning can be frustrating, but it may give you a chance to look into your vitamin and mineral intake. Many times, hair loss occurs due to deficiencies that can be identified with a blood test. Once you know what’s causing the issue, you and your doctor can create a supplement plan tailored just for you.
There is no surefire way to tell if taking vitamins will prevent your hair from thinning, but it’s worth a try as part of a larger plan to tackle the issue. To learn more, check our our guide on the Best Vitamins to Stop Hair Loss.
Vitamin D Intake Related to Male Pattern Baldness
A number of studies have shown that vitamin D deficiency can be linked to male pattern baldness. A 2021 review study published in Cureus identified at least 13 peer-reviewed studies that examined the link between patient vitamin D levels and male pattern baldness. The review study concludes that a vitamin D deficiency can be directly linked to male pattern hair loss. Additionally, the study suggests that men with low vitamin D levels may be able to stimulate hair growth with proper increases in dietary vitamin D or vitamin D supplementation.
While we are not sure of the full extent to which vitamin D and hair health are linked, some experts believe that vitamin D might help protect hair follicles from damage. Additionally, a deficiency in vitamin D can lead to an general decline in health, which may then lead to hair loss.
Hair Follicle Health and Vitamin D
A lack of nutrients can cause hair follicles to enter a resting phase, which hinders new hair growth. When a hair follicle shrinks, it can be due to a vitamin deficiency, an unhealthy diet, or another health issue. When a hair follicle shrinks, it stops growing new hairs and the old ones fall out eventually leading to thinning hair or complete hair loss.
Vitamin D is essential for maintaining healthy hair follicles. A 2013 study published in the journal Skin Physiology and Pharmacology found that women with female pattern hair loss had lower levels of vitamin D than those without any hair loss. This clinical evidence suggests that vitamin D levels are also likely related to male pattern baldness.
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