Male Pattern Baldness - A guide to Male Hair Loss

This is a very common form of hair loss which affects more than half of men in the UK. In fact it is so common that many men consider it a normal part of the ageing process and fully expect to lose their hair by the time they reach middle age.

Once hair has been lost it progresses in a distinctive pattern in which the scalp becomes bare but hair remains in a ‘horseshoe’pattern around the sides, just above the top of the ears.

Hair loss is caused by a variety of factors which include:

  • Stress
  • Age
  • Genetics
  • Poor diet
  • Side effects of certain medications
  • Damage from hair treatments/products
  • Disease and illness
  • Trichotillomania (more common in women)

You can find out more about these and hair loss in general in our hair loss guide.

But male pattern baldness is usually caused by hereditary, age and male hormones.

Male pattern baldness is responsible for the vast majority of hair loss and often starts when a man is in his thirties although it can start in the teenager years. Once it starts it is irreversible and leads to permanent baldness.

What is male pattern baldness?

The medical term for this is ‘androgenetic alopecia’. Male pattern baldness occurs when there is a ‘fault’ with the normal hair growth cycle.

Your hair undergoes a constant cycle of growth and loss which occurs in three stages:

  • Growing (anagen)
  • Resting (telogen)
  • Shedding (catagen)

New hair is grown from the follicles, maintains its current length and is then shed. Once these are shed the follicles can grow new hair and this cycle is repeated on a regular basis.

Male pattern baldness and dihydrotestosterone (DHT)

Various enzymes and hormones are involved in this cycle but the most important ones are the male hormone testosterone and a derivative or androgen called ‘5-dihydrotestosterone’ or 5-DHT for short. These are found in the hair follicles and help to nourish and encourage hair growth.

When testosterone is converted by the enzyme 5-alpha-reductase the end product is 5-DHT.

DHT is a form of testosterone which plays a major part in this cycle and stimulates the growth of hair on the scalp and other areas of the body. It is also responsible for hair growth during puberty.

But if excess DHT is produced it has the opposite effect on the hair follicles and causes them to shrink. This disrupts the shedding phase of the hair growth cycle so that new hair is unable to grow. This then leads to hair loss and eventually baldness.

Will you get male pattern baldness?

Your genetics will also affect this. If your father or grandfather suffered male pattern baldness then there is a very good chance that you will do the same. This genetic ‘fault’ is usually passed down in families, often from the mother’s side as well as the father’s side and is irreversible.

So if your grandfather went bald by his forties then you are likely to do the same.

Conversely you may assume that because your grandfather did not go bald that you won’t either. But this is not always the case as male pattern baldness can skip a generation or two. There is also the possibility of inheriting the risk of male pattern baldness is a close relative suffered from it.

In other words you may have inherited the gene for male pattern baldness but on the other you may have got lucky and escaped it.

Your genes play a big part but so does your age and hormones.

Male pattern baldness follows a definite pattern which starts at the front of the head. Hair is lost from there and spreads over the top of the scalp until it reaches the back of the head. Your hairline (around your temples) will assume an ‘M’ shape and you will be left with a bald area on the top of your head.

This will leave hair around the sides of your head which resembles a horseshoe shape.

This form of hair loss can also affect women although it takes a different form. Find out more in our female baldness section.

Can it be prevented?

Unfortunately no. At present there is no way of stopping this as it is largely genetic. All you can do is to look at hair loss in your own family as this will give you a good idea of how this will affect you. If you can find determine when they went bald, at what age, the degree of baldness and the progression then you will know what to expect.

This means that you can plan ahead for this either by choosing to hide the hair loss via a wig or to undergo a hair transplant.

Once male pattern baldness starts it cannot be stopped but it can be slowed down. There isn’t a cure per se but there are ways of dealing with the problem and surgery is one of these ways.

Can male pattern baldness be cured?

One thing to bear in mind is that a hair transplant will improve your hair loss but won’t stop the hair loss process. You will still continue to lose hair even after treatment as the treated area will contain DHT-resistant hairs which will remain in place but other areas of your hair will thin as per normal.

So you may need more than one operation.

You will also need enough hair on the back and sides of your head if further surgery is required. If you don’t then what can happen is that you end up with thinning hair or bald patches next to the areas with transplanted hair.

But before you look at treatment such as hair transplant surgery it is worth thinking about the degree of baldness you have.

In other words, how bald are you?

In order to help with this have a look at the Hamilton-Norwood Scale.

Male hair loss Guide Index:



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