UNDERSTANDING MALE PATTERN BALDNESS

The most common type of hair loss in men is male pattern baldness. Male pattern baldness is the loss of hair on the scalp of males. It usually begins at the hairline or on top of the head. It typically manifests as a receding hairline and crown hair thinning. Eventually, it is possible for it to progress to partial or complete baldness.¹²⁷

In detail, the male pattern baldness usually happens progressively as described below: ¹²⁸

1. The typical male baldness pattern begins at the hairline. 
2. The hairline moves backward and forms a "M" shape. 
3. Over time, a circular area on the back of the head vertex often thins and expands in size. 
4. The hair eventually becomes finer, shorter, and thinner, forming a U-shaped (or horseshoe) pattern around the sides of the head and a bald spot on the back of the head.

What Causes Male Pattern Baldness? ¹²⁹

Genetics and male sex hormones cause male pattern baldness. 

Each strand of hair is held in place by a follicle, which is a tiny hole (cavity) in the skin. Baldness occurs as a result of the hair follicle shrinking over time, resulting in shorter, finer hair. The follicle eventually ceases to produce new hair. The follicles are still active, implying that new hair can grow.

Diagnosing Male Pattern Baldness: ¹³⁰

Classic male pattern baldness is diagnosed based on the appearance and pattern of hair loss.

Remember though, a variety of conditions can cause hair loss. This is especially true if your hair loss occurs in patches, you shed a lot of hair, your hair breaks, or your hair loss is accompanied by redness, scaling, pus, or pain. Other conditions that cause hair loss may necessitate a skin biopsy, blood tests, or other procedures.

Male Pattern Baldness Treatment: ¹³¹

There is no need for treatment if you are satisfied with your appearance. Hair weaving, hairpieces, or a change in hairstyle can all aid in the concealment of hair loss.

However, if you are unsatisfied, below are some options. 

The following medications are used to treat male pattern baldness:¹³¹

• Minoxidil (Regaine®) is a topical solution used to stimulate hair follicles that is applied directly to the scalp. Many men's hair loss is slowed, and as a result, some men grow new hair. Hair loss resumes after stopping this medication. 
• Finasteride is a pill that prevents the production of a highly active form of testosterone linked to baldness. It lessens hair loss. It has a slightly higher efficacy than minoxidil.  Hair loss resumes after stopping this medication. 
• Dutasteride, like finasteride, could be more effective.

Other treatments being considered include: ¹³²

• Platelet-rich plasma (PRP) is injected into the scalp to stimulate hair growth. This entails drawing your blood, separating a portion rich in platelets, and injecting the areas of hair loss over the course of several sessions.¹³³
• Hair transplants involve removing tiny plugs of hair from areas where hair is still growing and transplanting them into balding areas. ¹³⁴
• The use of laser or light caps or helmets to stimulate hair follicles. ¹³⁵

Male pattern baldness is not a medical condition, but it can have a negative impact on self-esteem and cause anxiety since the hair lost is permanent. Nonetheless, rest assured that hair loss solutions like Regaine® for men are available and others are on their way as researchers continue to investigate and to assess new treatments. 

References: 

1. ¹²⁶ https://health.clevelandclinic.org/why-do-men-go-bald-and-is-there-anything-you-can-really-do-about-it/
2. ¹²⁷ https://www.mayoclinic.org/diseases-conditions/hair-loss/multimedia/male-pattern-baldness/img-20005838
3. ¹²⁸https://medlineplus.gov/ency/article/001177.htm#:~:text=Male%20pattern%20baldness%20is%20related,hair%20thinning%20on%20the%20crown.&text=Generally%2C%20baldness%20occurs%20when%20the,does%20not%20grow%20new%20hair.
4. ¹²⁹ https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/male-pattern-baldness#:~:text=Male%20pattern%20baldness%20is%20related,the%20skin%20called%20a%20follicle.
5. ¹³⁰ https://www.bad.org.uk/shared/get-file.ashx?id=3831&itemtype=document
6. ¹³¹ https://www.aafp.org/afp/1999/0415/p2189.html
7. ¹³² https://www.aad.org/public/diseases/hair-loss/treatment/male-pattern-hair-loss-treatment
8. ¹³³ Cervelli, V., Garcovich, S., Bielli, A., Cervelli, G., Curcio, B. C., Scioli, M. G., ... & Gentile, P. (2014). The effect of autologous activated platelet rich plasma (AA-PRP) injection on pattern hair loss: clinical and histomorphometric evaluation. BioMed research international, 2014.
9. ¹³⁴ Avram, M., & Rogers, N. (2009). Contemporary hair transplantation. Dermatologic surgery, 35(11), 1705-1719.
10. ¹³⁵ Torres, A. E., & Lim, H. W. (2021). Photobiomodulation for the management of hair loss. Photodermatology, photoimmunology & photomedicine, 37(2), 91-98.