Hair loss is a common problem that affects millions of men in the United States. Approximately seventy-five percent of American men will experience some hair loss by the age of thirty-five, and 85 percent of men will have significantly thinner hair by the age of 50. Male pattern baldness (also known as androgenetic alopecia) accounts for more than 95 percent of men’s hair loss.
Male pattern baldness follows a classical and well-defined pattern of hair loss, which begins with a receding hairline and thinning of the hair at the crown of the head. Although there are many factors that may contribute to hair loss in men, such as illness or having an adverse reaction to certain medications, heredity is by far the most common factor. There is currently no cure for hair loss. However, hair loss can be effectively managed and diminished by utilizing treatments that help promote hair growth or hide hair loss.
Male pattern baldness usually follows a characteristic pattern, which begins at the hairline. The hairline slowly recedes and forms an “M” shape. Gradually, the hair becomes shorter and thinner at the crown and creates a horseshoe pattern of hair around the sides of the head. The end result may be partial or complete baldness. Male pattern baldness is not associated with any other symptoms.
Some men may also experience temporary hair loss. The pattern of hair loss and symptoms vary with the type of hair loss experienced. Below are symptoms associated with various temporary hair loss conditions:
- Alopecia areata. This type of hair loss condition is associated with hair loss that usually occurs in small patches about the size of a quarter. Although this disease does not usually result in complete baldness, it may cause hair loss of other areas of your body, including eyebrows, eyelashes and beard. Soreness and itching may precede the hair loss.
Telogen effluvium. This type of temporary hair loss is associated with the loss of clumps of hair that come out when you are combing or washing your hair. This type of hair loss usually causes overall hair thinning and not bald patches.
Gradual hair thinning is a normal part of aging. However, baldness develops when the rate of hair loss exceeds the rate of regrowth. The factors associated with hair loss differ depending on the type of hair loss condition.
- Heredity. Some men are genetically predisposed to male pattern baldness. These men inherit hair follicles, which exhibit sensitivity to the hormone Dihydrotestosterone (DHT). DHT is produced as a result of the conversion of testosterone (another hormone) by an enzyme called 5-alpha reductase. DHT acts on the hair follicle and slows down the rate of hair production as well as promotes the generation of weaker and shorter hair. In some cases, DHT may completely inhibit the hair growth from the follicle.
- Inflammation. Cicatricial alopecia develops when inflammation damages the hair follicle and prevents hair from growing. This type of hair loss is often associated with such conditions as lupus erythematosus or lichen planus. The exact trigger for this inflammation is unknown.
- Autoimmune disorder. Alopecia areata is thought to be an autoimmune disorder. However, the exact cause of alopecia areata is unknown.
- Emotional or physical stress.
- Poor nutrition.
- Medication or medical treatments. Certain drugs used to treat gout, arthritis, depression, heart problems and high blood pressure may cause hair loss. Additionally, chemotherapy or radiation therapy may also cause temporary hair loss.
- Scalp infection. Infections, such as ringworm on your scalp can lead to hair loss. Once infections are treated, hair generally grows back.
The type of hair loss is diagnosed by taking the following factors into consideration:
- Medical history
- Prevalence of hair loss in your family
- Examining the appearance and patter of hair loss
A doctor may also use the following tools and tests to confirm a diagnosis of hair loss:
- Densitometer. This instruments help the doctor assess the total number of hairs in the field, looks at the number of hairs per follicular unit and measure the diameter of the hair, looking in particular for abnormal levels of miniaturization (decreased hair shaft diameter caused by the effects of DHT). A densitometer is placed on the scalp in an area where the hair is clipped short’
- Skin biopsy. This is utilized to rule out other disorders that my cause hair loss
- Pull test. Several dozen hairs are gently pulled to see how many come out. This helps determine the stage of the shedding process.
Hair loss is not a condition that poses a serious health risk and therefore treatment is not necessary. However, for those that may be uncomfortable with the appearance of hair loss, the following treatments are available.
Two medications are approved to treat male pattern baldness:
- Minoxidil (Rogaine) is a solution that you apply directly to the scalp to stimulate the hair follicles. In some men, minoxidil may decrease the rate of hair loss for and/or promote the growth of new hair. Hair loss returns when you stop using this medicine.
- Finasteride (Propecia, Proscar). This medication is a pill that inhibits the enzyme that produces DHT and therefore decreases the rate of hair loss. Hair loss returns if treatment is discontinued.
Men may also opt to have hair transplants. A hair transplant is a procedure in which hair that is continuing to grow is removed and placed in areas that are balding. This can cause minor scarring and in some cases infection. The procedure usually requires multiple sessions and may be expensive. Results, however, are often excellent and permanent.