Male pattern baldness refers to a loss of hair on the scalp in males. It is not always possible to prevent it, but there are various treatments that can reduce or reverse some of the hair loss.
Male pattern baldness affects around 50 million men in the United States, and half of all men by the age of 50. It occurs as hormone levels change over time, especially as a person gets older.
Although a natural part of the aging process for many, hair loss can be distressing. Sudden hair loss can sometimes indicate a health condition that may need medical attention.
In this article, learn about the causes and treatment options for male pattern baldness.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
There are different types of hair loss, and they can manifest themselves in different ways. In male pattern baldness, or androgenic alopecia, hair loss typically begins at the hairline or on top of the head. Slowly, the hairline recedes and the hair thins.
For some, the hair loss stops there, leaving the hair on the sides and back of the head intact. Others lose more of the hair, some less.
Hair loss that occurs suddenly, in patches, or with additional symptoms, could be a sign of a different condition that requires treatment.
Many people find they lose hair fullness as they age. This is because hair growth slows down over time. What leads to male pattern baldness is a combination of this slower growth and genetics.
People who inherit certain genes are more susceptible to male pattern hair loss. Research has linked several genetic changes to this type of hair loss, but so far, scientists have only confirmed one of them. This gene is known as the androgen receptor (AR) gene.
The AR receptor gene controls how sensitive cells are to androgens, or male sex hormones. These hormones influence the hair growth cycle.
It is still unclear exactly how the AR receptor gene leads to hair loss, but the result is the gradual shrinkage of the hair follicles. The hair grows progressively shorter and finer until no new hair grows.
Male pattern hair loss affects up to half of all white men by the age of 50 years and up to 80% of men in the same group by the age of 70 years. Male pattern hair loss is less prevalent in other groups, such as among Chinese and Japanese people.
If a person has first- and second-degree relatives who lost their hair due to age, they may have a higher likelihood of experiencing male pattern hair loss.
Male pattern hair loss also has associations with some medical conditions, including:
- hypertension, or high blood pressure
- enlarged prostate
- coronary heart disease
- prostate cancer
Some of these conditions may result in elevated androgens, which could explain the link.
For some, male pattern hair loss can be a typical part of growing older. Some people embrace the change and do not perceive a need for treatment. In others, hair loss can trigger negative feelings, such as low self-esteem.
For people who do want treatment, there are ways to reduce the hair loss, or in some cases, reverse it. The available options include:
- topical treatments
- medicated shampoos
- oral medications
- hair transplant
- laser or light therapy
The U.S. Food and Drug Administration (FDA) has approved two types of drug treatment for male pattern baldness.
Minoxidil is a topical treatment. It is available over the counter at pharmacies, usually as a lotion or foam.
Scientists originally developed minoxidil to treat blood pressure, but some people noticed additional hair growth as a side effect while using it. It is unclear exactly how it works.
It can take 6–12 months for results to appear. To maintain the effects, a person must use the medication indefinitely. Potential adverse effects can include:
Rarely, people can have more serious side effects, such as severe allergic reactions.
Finasteride and dutasteride
Finasteride is an oral medication available only on prescription. It is an 5-alpha reductase inhibitor that works by blocking the formation of dihydrotestosterone (DHT), an androgen that plays a role in male pattern hair loss.
Treatment involves taking a daily pill, which people can use alone or in combination with minoxidil. It can take around 6 months for results to appear. If a person stops the medication, the effects will reverse.
Finasteride can slow down hair loss in around 80–90% of males who take it. It can also result in some regrowth, particularly when people begin finasteride as soon as they notice signs of hair loss.
In some, finasteride causes side effects, such as:
- reduced sex drive
- difficulty maintaining an erection
- breast tissue tenderness or enlargement
This could indicate androgen levels are too low.
Dutasteride is similar to finasteride. It is also a 5-alpha reductase inhibitor.
There is some evidence that certain medicated shampoos can reduce male pattern hair loss.
Ketoconazole is an antifungal and antiandrogen medication present in dandruff shampoos, such as Nizoral. A
However, it is worth noting that one of the researchers was on the medical board for Janssen Biotech Inc., which produces Nizoral shampoo. As a result, there may be a conflict of interest.
Hair transplantation involves taking hair from elsewhere on the body and grafting it onto the scalp.
Surgery involves either:
- taking a strip of skin from another part of the head, complete with hair, to graft it onto the bald area
- transplanting individual hairs, which avoids scarring
The procedure takes time. In the 2–8 weeks after surgery, the hair will fall out, and make look thinner than before when it grows back. This is typical. For most people, the hair will eventually look fuller in 6–9 months.
Hair loss can continue even after a hair transplant, so a doctor may recommend using medications as well.
Laser therapy may have promise for slowing hair loss, but the evidence supporting this option is not as strong as the evidence for other treatments.
A 2017 review of previous research found evidence that low-level laser therapy was a safe noninvasive treatment. It seems to stimulate hair growth, and is suitable for people to do at home. However, the authors say that larger trials with more participants are necessary.
While male pattern hair loss is largely genetic, a
This suggests that differences in environment, diet, or lifestyle may also play a significant role in male pattern hair loss.
Many factors can influence hair growth. These include:
- Nutrition: Deficiencies in iron, zinc, biotin, and protein can all result in hair loss. If a person has a limited diet or does not eat a balance of nutrients, they may benefit from asking a doctor for advice.
- Skin health: Skin conditions such as dandruff, psoriasis, and eczema can all interfere with hair growth if they affect the scalp. Friction or tension on the scalp can also cause hair loss.
- Hormone health: Conditions that affect parts of the body that produce hormones, such as the thyroid, can result in hair loss. Treating these conditions may help reverse it.
- Stress levels: Stress can cause hair loss. If possible, reducing stress and increasing relaxation can allow lost hair to regrow. This may take 6–9 months.
The authors of the review also argue that anti-inflammatory nutrients, such as essential fatty acids and antioxidants, may help.
If hair loss is not the result of an underlying issue, people do not need to treat it unless they want to. Some prefer to shave their head and grow their facial hair, while others opt for a hairpiece or wig.
If hair loss is sudden, patchy, or occurs with other symptoms, people should contact a doctor. These symptoms could include:
- dry, flaky scalp
- unexplained weight loss or gain
- persistent stress, anxiety, or low mood
A doctor will be able to check a person’s symptoms and medical history to look for potential explanations. If necessary, they can also perform diagnostic tests.
Male pattern baldness, or androgenic alopecia, is a common phenomenon that can occur as a person ages. It typically begins with thinning around the hairline or on top of the hair. Over time, the thinning continues, and can result in partial or total hair loss.
Medications, topical treatments, and cosmetic procedures can treat male pattern hair loss. However, it is not necessary to use these options unless a person wants to. If they do, they should speak with a doctor to discuss which option is right for them.
Lifestyle factors, such as stress and nutrition, can also influence hair loss. Eating a balanced diet, reducing stress, and addressing any underlying conditions may be helpful, if relevant.