Hair loss is a global concern of dermatologists. It occurs due to changes in the normal hair growth cycle. Normally, most of the hair follicles lie in the anagen phase-the growth phase of the hair growth cycle that usually lasts for 3-10 years before it enters into the catagen phase- a transitional phase lasting for 2-3 weeks and finally goes into the telogen phase- a resting stage lasting for 3-4 months wherein the hair starts shedding from the scalp and new hair grows in their place. Hair loss occurs due to a much shorter anagen phase of weeks or months and a longer telogen phase. This leads to hair thinning or balding. Both men and women can suffer from hair loss at any age due to various factors. This article focuses on everything that one must know about a type of hair loss called male pattern baldness.
What is Male Pattern Hair Loss?
Male pattern hair loss medically referred to as androgenetic alopecia, is the most common type of baldness or hair thinning seen in adult men. It is characterized by the loss of hair starting at the hairline above the temples and resulting in a receding hairline followed by hair loss on the crown or top of the scalp, thereby giving a horse-shoe-shaped pattern of hair. It tends to develop gradually and hair thinning or hair loss can take place for years.
While male pattern hair loss is noticed mostly in older men, even younger adult men can get affected by it. It can happen early in their life starting in their late teens or early twenties but usually, it appears beyond this age. It can be seen in about 1 in 5 men who are in their 20s, 1 in 3 men who are in their 30s, and 1 in every 2 men who are in their 40s. Mostly, it is found among Caucasian men. [1, 3]
Causes
Male pattern hair loss is known to be linked with inherited genes that affect how some of the hair follicles respond to male sex hormones- androgens. Generally, the receding hairline or bald spots occur when the hair follicles shrink over time. Hair follicles are the tiny cavities or holes in the skin from which hair strand grows. When the hair follicles shrink, it results in shorter and finer hair and eventually these follicles stop growing new hair strands. However, the hair follicles remain alive, which suggests that it is possible to grow new hair even if hair growth is not taking place naturally on its own. [2, 3]
Symptoms
The typical male hair loss pattern starts at the hairline. When hair starts shedding at the hairline, it gradually recedes (moves backward) and forms an “M” shape. Over time, thinning is noticed in the vertex- a circular area on the top of the head that keeps getting bigger when not treated. Eventually, if the hair loss continues, men can notice their hair becoming finer, shorter, and thinner, creating a horseshoe or “U” shaped pattern of hair around the sides and back of the scalp. [2, 3]
Diagnosis
When men start noticing hair thinning or balding, they must consult a certified dermatologist or a hair expert. Such doctors can help in diagnosis by discussing with their patients their general health status, their hair loss symptoms, and if they have any family history of hair loss. They would ask their patients to come for a physical examination of their scalp, especially in areas of hair thinning or baldness. Based on the appearance and pattern of hair loss, the classical male pattern baldness is usually diagnosed. In some cases, dermatoscopy for a detailed examination, skin biopsy, or blood tests may be performed by the dermatologist to rule out any other conditions that could cause hair loss and confirm the diagnosis. [2, 3]
Treatment
Some individuals may not choose to treat their male pattern hair loss, but the treatments are available. These treatments are usually done for cosmetic purposes and work by either reducing further hair thinning or balding or allowing hair regrowth. The safest and simplest option among all is to wear a hairpiece such as a toupee or a wig, weave hair, or change hairstyle that may disguise the hair loss. However, this may not be appealing to most men. The good news is that few medical treatments are advertised to be effective for male pattern baldness. For optimal results, men must start their treatment as soon as they notice hair loss.
Here are all possible existing treatments for androgenetic alopecia:
1. Medications
FDA has approved certain medications to treat male-pattern hair loss including topical minoxidil (available without a prescription) and finasteride- a prescribed medication. In clinical studies, minoxidil has been shown to stimulate hair growth, reduce hair loss, and strengthen existing hair strands. It can be applied every day, twice a day on the bald or hair thinning area. Finasteride is taken in pill form and helps in delaying further hair loss. The results of using medications are usually noticed within 6 months.
2. Laser Treatment
There are some laser devices cleared by FDA that can stimulate the hair follicles to grow new hair.
3. Platelet-Rich Plasma Therapy (PRP)
It is a temporary hair restoration solution that can be performed alone or after a hair transplant surgery to improve the results and maintain a natural-looking head full of hair. During PRP therapy, the doctor draws a small amount of blood from the patient’s left arm and collects it in a centrifuge tube. The collected blood sample is then processed in a centrifuge machine to separate the red blood cells from the plasma. The platelet-enriched plasma is then extracted and injected into the bald or thinning areas of the scalp. This treatment needs to be done in multiple sittings with a monthly interval for the first three months followed by maintenance sessions once every 3-6 months.
4. Hair Transplantation
This is a permanent hair restoration solution. In this surgical procedure, the surgeon removes the hair follicles from donor areas that are resistant to hair loss (usually the back or sides of the head) and places them one by one in balding recipient areas. [1, 3]
References:
- https://www.aad.org/public/diseases/ hair-loss/treatment/male-pattern-hair-loss-treatment#:~:text=Topical%20minoxidil %20(available%20without%20a,strengthen %20existing%20strands%20of%20hair.
- https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/male-pattern-baldness
- https://www.healthdirect.gov.au/male-pattern-baldness
