Male Pattern Baldness: Symptoms and Causes
Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
If you’ve noticed your hairline creeping backward, your widow’s peak becoming more obvious, a new bald spot or just a few extra hairs on your pillow or in your hairbrush, male pattern baldness could be the culprit.
There are a lot of misconceptions about baldness — so many that we should probably address the facts right now:
Androgenetic alopecia is a hormonal condition that has genetic causes.
This is the most common cause of hair loss in men, affecting more than 50 percent of all men by the age of fifty.
Wearing a hat or using non-organic shampoos and hair care products isn’t proven to contribute to androgenic alopecia.
It’s easy to panic when you notice your hairline starting to recede, but what you need isn’t a brown paper bag to breathe into — it’s knowledge.
And we’re about to hit you with some. Specifically, knowledge on:
What androgenic alopecia looks like
How it happens (and why)
What to do about it with hair loss treatments
How to get your self-esteem back even if your hair count stays low.
What is Male Pattern Baldness?
As the name “androgenetic alopecia” suggests, its main causes are genetic factors and androgen hormones, or male sex hormones. These sex hormones basically attack your hair follicles when they’re converted into something called DHT.
This can be a real bummer — it can affect your self-confidence and your self-esteem. Also, have y’all seen the cost of sunscreen lately? Whew! Stuff gets expensive when your hair goes away.
And while it happens to men as they age, some men start the process much younger.
When Does Male Pattern Baldness Start?
Although androgenic alopecia is most common in middle-aged and older men, it can occur at any age. Many men notice the early signs of baldness, such as a receding hairline or diffuse thinning, at some point in their 20s and 30s (more on that later).
However, not all hair loss in younger men is male pattern baldness. Other reasons for hair loss under 25 include stress, anxiety and traumatic experiences, medical conditions, certain medications and, in some cases, nutritional deficiencies.
Male Pattern Baldness Symptoms
Some top secret news about male pattern baldness: the most noticeable symptom of it is... losing your hair. Hair loss from male pattern baldness can develop in a variety of patterns:
Receding hairline (a V- or M-shaped hairline)
These symptoms usually develop gradually over the course of several years, meaning you won’t typically wake up and suddenly notice that you’re balding.
Instead, you may notice your hairline gradually receding over the course of a decade or the hair on your scalp slowly but steadily becoming thinner and less able to cover your skin.
So, what do these symptoms actually look like? Let's dig in.
Not all men with male pattern baldness experience hair loss around the hairline. If you’re at risk of baldness but don’t have a receding hairline, you might notice the hair near your crown starting to fall out and look thinner.
In some cases, you may also notice thinning around your crown at the same time as a receding hairline.
Because hair loss around the crown of your head isn’t easy to see in the mirror, it’s common for men affected by crown thinning not to notice their hair loss until it’s gone too far.
The easiest way to check for this type of hair loss is to use a handheld mirror or take a selfie of the back of your head. Make sure to take photos in consistent lighting conditions so that you can accurately track your hair loss over time.
A receding hairline is one of the most common signs of male pattern baldness.
Most men begin to notice baldness as their hairline starts to recede. Androgenic alopecia can cause you to develop the classic M-shaped hairline, with receding corners and a longer widow’s peak area (referred to as a forelock).
Not every hairline recedes in the same pattern. You may notice that one side of your hairline is more affected by hair loss than the other or that you have more consistent hair loss that occurs evenly across your entire hairline.
Although less common than a receding hairline or hair loss near your crown, diffuse thinning is often a symptom of male pattern baldness.
Diffuse thinning is a form of hair loss that affects your entire scalp, thinning your hair without any obvious effects on your hairline or other specific areas.
This type of hair loss is generally easiest to notice when your hair is wet or in bright lighting that makes areas of the scalp more visible.
What Causes Male Pattern Baldness?
Myths and misconceptions aside, here are the facts: male pattern baldness is caused by a combination of two main factors: your production of androgenic hormones, such as dihydrotestosterone (DHT), and your genetic sensitivity to the effects of these hormones.
DHT is an androgen, or male hormone, that’s produced naturally by your body. It’s created as a byproduct of testosterone, produced by an enzyme referred to as 5-alpha reductase (5AR).
DHT plays an important role in the development of male characteristics like body hair, jawline, genitalia and voice during pregnancy, childhood and puberty.
But as you get older, that relationship can sour.
DHT causes hair loss by attaching to androgen receptors in your scalp. Once attached to these receptors, DHT causes your hair follicles to shrink and weaken through a process referred to as “miniaturization.”
As your hair follicles miniaturize, they produce finer hairs and eventually lose the ability to grow new hairs at all, resulting in visible thinning and hair loss.
For some men, DHT circulates freely in their bodies without affecting their hair in any noticeable way. Some men, however, are highly sensitive to the effects of DHT.
These men may notice hair loss that begins in their early-to-mid 20s — maybe even their late teens. The more sensitive your hair follicles are to DHT, the earlier you could notice your hair thinning and falling out.
Not all of the hair follicles on your scalp are equally sensitive to the effects of DHT. Even in men with a genetic predisposition to hair loss, it’s common for a rim of hair to remain at the back and sides of your scalp.
Our detailed guide to DHT and hair loss explains more about how this form of hair loss can develop, as well as the role that androgen hormones can have in balding.
Other Causes of Hair Loss That Aren’t Male Pattern Baldness
While male pattern baldness is the most common type of hair loss in men, we're sure you'll all be thrilled to know that it isn't the only type of hair loss you have to worry about.
From medical conditions to stress, a variety of issues can cause you to lose hair, either in the short term or permanently. We’ve discussed these below and explained how each issue could affect your hairline in the future.
Hair loss can often occur as a symptom of certain diseases and medical conditions, or as a side effect of some medications:
Thyroid issues. Because the thyroid regulates so many hormones, including those that can impact hair growth, conditions like hypothyroidism (an underactive thyroid) or hyperthyroidism (an overactive thyroid) could lead to hair loss.
High blood pressure medication. While high blood pressure isn’t typically a cause for hair loss, certain medicines used to reduce blood pressure and treat this condition may contribute to hair shedding.
Alopecia areata. This immune condition attacks the follicles that produce hair, causing hair to fall out. It typically causes patchy bald spots that can develop around your scalp and in your facial hair.
Other factors — like eating a diet lacking in certain nutrients or feeling overly stressed — can also take a toll on your hair growth.
Anxiety and stress. In some cases, you may develop temporary thinning of your scalp hair after a stressful event. This is known as telogen effluvium — a type of hair loss that isn’t considered male pattern baldness.
Nutritional deficiencies. Certain diets lack nutrients that your hair needs to grow to its full potential. For example, iron deficiency and a lack of protein are both associated with temporary hair shedding.
Rapid weight loss. While losing weight can be healthy when done steadily through a healthy diet and exercise, rapid weight loss can put a lot of strain on your body, including your hair follicles. In some cases, this can cause temporary hair loss .
Use of hard water when you shower. Although hard water (water that’s high in certain dissolved minerals) doesn’t appear to cause hair loss by itself, some research suggests that it may decrease the strength of your hair and contribute to breakage.
Risk Factors for Male Pattern Baldness
Male pattern baldness can affect all men, but certain factors can put you more at risk of dealing with it. Many of these risk factors can also affect the severity of hair loss you experience, from a mild receding hairline to full baldness.
Risk factors for male pattern baldness include:
Let’s take a deeper look at them.
Family History of Hair Loss
Male and female pattern hair loss is at least partly genetic, meaning you could be more at risk of losing your hair if you have a parent with noticeable baldness.
Contrary to popular belief, there’s no high-quality scientific evidence to suggest that baldness is passed down only from your mother’s father. In fact, experts aren’t yet aware of the exact genes that cause male pattern baldness to develop.
The effects of DHT can accumulate over the course of your lifetime, meaning you’re more likely to notice significant hair loss as you get older. This is the main reason why pattern hair loss can often develop in your 40s, 50s, 60s or later.
Remember that thing we said above about DHT sensitivity? Well, that's a thing regardless of your age. If you have a high level of sensitivity to DHT, you may notice the early signs of baldness developing as early as your late teens.
Medications that increase your production of testosterone and/or DHT may cause you to notice male pattern baldness earlier.
Should I See My Healthcare Provider If I See Signs of Male Pattern Baldness?
Easy question; easy answer: Yup.
You should seek medical advice when you see any signs — and the sooner, the better. Without active treatment, any hair loss you experience from male pattern balding can quickly become permanent, depending on the type of hair loss it is.
By talking to your healthcare provider as early as you can, you’ll be able to get started and treat your hair loss, helping you slow down or prevent any recession or balding.
Diagnosis of Male Pattern Baldness
Diagnosing male pattern baldness isn't rocket science. Your doctor won't need to run any blood work or schedule an MRI. Usually, all they'll have to do is take a quick peek at your scalp.
In some cases, your healthcare provider or dermatology professional may use a dermatoscope to examine your scalp more closely.
This process, called dermoscopy, can determine whether or not you’ve lost a significant amount of hair, if your hair follicles have significant miniaturization and the distance between your active hair follicles.
Your healthcare provider may also ask about your habits, lifestyle and your family history of hair loss.
Most healthcare providers determine the severity of male pattern baldness using a system that’s referred to as the Norwood scale.
This scale features reference diagrams for a range of different hair loss patterns, ranging from a mild receding hairline to almost complete hair loss.
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Male Pattern Baldness Treatment Options
Male pattern baldness is treatable. This treatment might include prescription medications or over-the-counter ones, hairpieces or transplants.
Hair Loss Medication
Currently, the most effective treatments for male pattern baldness are two FDA-approved medications: finasteride and minoxidil.
Minoxidil is an over-the-counter medication believed to stimulate hair growth by moving hairs into the anagen phase of the hair growth cycle. It also improves blood circulation in your scalp, which may promote more consistent hair growth.
Research shows that both finasteride and minoxidil are effective at stopping the progression of hair loss, with most men who use either medication reporting improvements in hair growth.
Research also suggests that minoxidil and finasteride get even better when combined, which is why providers often recommend using them together.
In one study published in the journal Dermatologic Therapy, more than 94 percent of balding men reported improvements after using both finasteride and minoxidil for one year.
We offer finasteride online, following a consultation with a healthcare provider. We also offer minoxidil solution and minoxidil foam, with minoxidil and finasteride available with a selection of other hair loss products in our Hair Power Pack.
Over-the-Counter Hair Loss Supplements and Products
Numerous supplements and non-pharmaceutical products are available to help slow down and treat hair loss.
While these supplements aren’t as effective as FDA-approved medications like finasteride and minoxidil, they can be a helpful part of your baldness prevention routine.
Popular supplements and products for hair loss include:
Saw palmetto. While it’s not as effective as finasteride, studies show that saw palmetto reduces DHT levels by a modest amount, which may slow down male pattern baldness in men with alopecia. It’s with noting that this study involved prostate tissue and not scalp tissue.
Biotin. While biotin doesn’t directly prevent hair loss, it’s linked to improvements in hair growth in some studies. However, most research on biotin as a supplement for stopping hair loss has focused on hair loss in women. Biotin is one of several ingredients in our Biotin Gummy Vitamins, which are formulated to support healthy hair, nails and skin.
Hair thickening shampoo. Shampoos that contain ketoconazole or saw palmetto may help to prevent hair loss at the scalp level. Our Thick Fix Thickening Shampoo is made with thicker, fuller-looking hair and better scalp health in mind.
Other Hair Loss Treatments
In addition to medication and supplements, other treatments can help to improve the health of your scalp hair follicles, promote hair growth and/or make hair loss less visible.
Common cosmetic procedures, products and other options for hair loss include:
Hair transplantation surgery. Hair transplant surgery is a procedure that involves removing hair follicles from the back and sides of your head and then using them to create extra hair density in your hairline, crown or other areas with noticeable hair loss. A hair transplant can improve your hairline and almost completely eliminate signs of hair loss. Like other cosmetic surgeries, a hair transplant can be highly effective but is costly and rarely covered by insurance.
Scalp micropigmentation. Scalp micropigmentation is a cosmetic procedure that can change the pigment of your scalp, creating the appearance of small, short hairs and a fuller head of hair. Simply, it's a cosmetic tattoo that conceals hair loss. Just remember: it doesn't treat anything and, like all tattoos, will fade over time.
Hairpieces. While they won’t help you grow back any real hair, hairpieces and weaves can produce surprisingly good results if you need to fill in thin areas and cover up your hair loss for an important event. Our guide to the pros and cons of toupees goes into more detail about the advantages and disadvantages of “treating” hair loss with a hairpiece.
And if none of that sounds good to you or you're not that concerned about hair loss, there's always the acceptance route.
For some men, hairstyles are a waste of time. Bald is beautiful and there's nothing wrong with that.
Shop by treatment options
No matter the treatment plan, the best place to start is somewhere. Early action is the best hair loss prevention.
Ready to Treat Your Male Pattern Baldness?
If you’ve recently noticed your hairline receding or counted some extra hairs on your pillowcase, take action. Hair loss is usually easy to treat when caught early, with medications and medical treatments available to preserve your hairline and stimulate growth.
Seeking those treatments can feel nebulous, so just remember these key takeaways:
Follow the DHT. Baldness is caused by hormones — specifically the hormone DHT, which can kill your hair follicles over time.
Baldness is stopped at the source. Treating androgenic alopecia is first and foremost about managing those DHT levels, which is something that the medication finasteride can do.
Hair loss is a whole-body problem. You can also promote better hair growth with a healthy lifestyle and medications like minoxidil.
We offer several hair loss medications online that you can use to shield your hair from damage and promote more consistent hair growth.
By taking action early and not feeling overwhelmed, you can prevent male baldness from getting worse and enjoy a fuller head of hair throughout your life.