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Treating Male Patterned Baldness


Many men, as they get older, start to lose hair above the temples.

The hair loss continues over time around the top of the head and sometimes claims the hair on the sides and rear of the head as well, leading to complete baldness. This is called androgenic alopecia because it's linked with the presence of androgens (hormones that control masculine characteristics). This article will help you understand how it works, and how there are things out there that can help you.

Man looking in the bathroom mirror

Understanding how male pattern baldness works

This particular kind of hair loss is related to levels of free (unbound, circulating) testosterone, which gets converted into dihydrotestosterone (DHT). Some men, because of their genetics, have hair follicles that respond to DHT by shrinking. In order to combat male hair loss on a biological level, you can:

  • Lower the level of free testosterone in your body (which is not the same as the level of total testosterone)
  • Prevent free testosterone from being converted into DHT

Drugs tend to work by inhibiting any further hair loss, although sometimes they stimulate new hair growth. When you stop taking them, the hair loss tends to pick up wherever it left off when you started the medication. Hair loss medications include:

  • Minoxidil, applied directly on the scalp.
  • Finasteride, taken orally in the form of a prescription pill. It is somewhat more effective than minoxidil. It works by binding to the enzyme that would otherwise convert free testosterone to DHT.

Other possible solutions to hair loss include:

Hair transplant

Tiny patches of hair are moved from one part of your scalp to the balding area in several sessions. There's a small risk of skin infection and it can be expensive, but the results are effective and permanent. The reason it works is because hair is moved from parts of your head where the follicles aren't sensitive to DHT.

Stimulate hair growth

When hair follicles go dormant, you begin to lose your hair. The dormant follicles no longer create hair, so when enough of the follicles in a specific area shut down, your hair will appear thinner. You're not bald - you just have a lot of dormant hair follicles that haven't been awakened yet.

Prevent insulin resistance

Excess levels of insulin circulating in your blood (hyperinsulinemia) are associated with the presence of male pattern baldness (among other unpleasantries, like near-sightedness and the formation of skin tags). Hyperinsulinemia is a common symptom of insulin resistance, which is linked with a high-carbohydrate diet, and remedied by exercise and weight loss. This suggests that avoiding excess carbs and being fit will help you keep a full head of hair, and even though no study has proven that conclusively yet, at the very least it'll make you look and feel better in other ways.

Further points...
  • Females can also experience male-pattern baldness, although the hair loss tends to be less extreme in females than in males.
  • 'Alopecia' is the medical term for the common word 'baldness.'
  • There is no difference between the term 'baldness' and 'alopecia.' Both mean the same - partial or complete absence of hair on the scalp.
  • You can maximize your results from minoxidil by dying your hair after two to three months of treatment. Minoxidil tends to create very fine hairs at first, and dying the hair increases the contrast between the hairs and the scalp, making the new hair growth area look denser. This is one common technique in before/after photos for hair loss treatments.
  • You may want to consider non-medical solutions to your hair loss in conjunction with or instead of the solutions listed above. These include custom made toupees, custom made wigs and hair pieces, hair weaves and hair extension solutions.
  • Any hair loss "cure" that isn't listed above hasn't been backed up by science and should be considered a "snake oil". That being said, in many studies there are some people whose hair loss is mitigated or reversed via the placebo effect, so thinking something will work might make it work, just not reliably enough to be substantiated by science.
  • There are many different types of baldness, and they have different causes, and are (or are not) treatable in different ways. To determine why you're going bald, you can begin by doing a little internet research, but you may also want to see a doctor or a Hair Loss Specialist.
  • It was previously believed that baldness was inherited from the maternal grandfather. While there is some basis for this belief, both parents contribute to their offspring's likelihood of hair loss. Most likely, inheritance is technically 'autosomal’ dominant with mixed penetrance.
  • One of the most common forms of baldness is androgenic alopecia ("male pattern baldness"). Some good, modern, scientific studies have been done on the subject, and good explanations of these studies in layman's terms can be found on the internet. It is inherited through both parents via the X chromosome. The gene that causes MPB is a recessive trait. Much like colour-blindness, MPB is much more common in men than in women - a woman would have to have two X chromosomes with the genetic defect to show MPB, whereas a male would only have to have one X chromosome with the defect.
  • If you're planning on surgical hair replacement, be sure your hair loss has stabilised, otherwise your hair loss will continue and create a bald ring on your scalp around the implanted hair.
  • If you use any of the drugs mentioned above, make sure you investigate how to use them properly, and are aware of any potential side effects. The most common side effect of topical minoxidil is skin redness at the point of application.