Male Pattern Hair Loss

Male pattern hair loss, also known as androgenic alopecia, refers to the most common type of hair thinning and balding occurring in adult males. The condition may be caused by a combination of genetic predisposition and hormones (androgens). The clinical features of male pattern hair loss are characterised by a receding hairline and/or hair loss occurring on the top or front of the scalp.

Male pattern hair loss results from genetic predominance. More specifically, it is caused by a genetically determined sensitivity to the effects of dihydrotestosterone (DHT) in certain areas of the scalp. Many body tissues, including the skin and prostate gland, contain DHT. DHT is associated with the decline in the hair growth cycle, from a regular three to six year cycle duration to a period of weeks to months. This occurs simultaneously with a decrease in follicular number, which leads to the growth of fewer and finer hairs.

Many genes are involved in male pattern hair loss, depending on age, progression, pattern, and family history. The susceptible genes are inherited from both biological parents. Currently, any genetic testing done for determining the predisposition to balding is considered unreliable.

Women who have excessive levels of androgens may also experience male pattern hair loss. These women may also present with severe acne, irregular menstrual cycles, and excessive hair growth on the face and body.

Male pattern hair loss affects a majority of the male population at some point in their lives. Approximately 50% of all Caucasian males will experience some form of hair loss by the age of 50. By age 70, approximately 80% of males will be affected. Males of Japanese and Chinese origins are less affected by pattern hair loss.

Male pattern hair loss is not solely a cosmetic issue. It negatively affects self-esteem and may cause psychological difficulties. Many studies show a direct link between hair loss and depression, introversion, low self-esteem, and feelings of unattractiveness. It is also believed that Western cultural values emphasising youthful attractiveness reinforce negative attitudes towards male baldness. Some studies have shown that appearance alone creates a lifelong negative impact, as men who experience hair loss view themselves as less assertive, attractive, likeable, and successful compared to those who do not.

Current treatment options for male pattern hair loss include hair replacement and transplantation, micropigmentation to resemble a shaved scalp, cosmetics, hairpieces, minoxidil solution, and finasteride tablets.

Low-level laser therapy and platelet-rich plasma (PRP) treatments have shown significant improvements in patients with hair loss after a course of sessions.