Male Pattern Baldness

Male pattern baldness is the most common type of hair loss in men. Male pattern baldness usually follows a typical pattern of receding hairline and hair thinning on the crown, and is caused by hormones and genetic predisposition.

About 95 percent of all cases of hair loss are the result of androgenetic alopecia (also known as male pattern baldness in men). Androgenetic alopecia occurs much more frequently in men than in women. It affects roughly 40 million men in the United States. Approximately 25 percent of men begin balding by age 30; two-thirds begin balding by age 60.

Symptoms of male pattern baldness may begin appearing in men as young as 20 years old and can consist of thinning hair; a receding hairline, usually from the front toward the back over time; loss of hair around the crown of the head; or progression of hair loss in a typical "M"-shaped pattern.

There are two main drugs used to treat male pattern baldness:

Minoxidil

Minoxidil (Rogaine) - a solution that you apply directly to the scalp to stimulate the hair follicles. It slows hair loss for many men, and some men grow new hair. The previous degree of hair loss returns when you stop applying the solution.

Finasteride

Finasteride (Propecia, Proscar) - a prescription pill that inhibits the production of the male hormone dihydrotestosterone. Like minoxidil, you are more likely to have slower hair loss than actual new hair growth. In general, it is somewhat more effective than minoxidil. The previous degree of hair loss returns when you stop taking the drug.

It is advisable for you to make an appointment to see your doctor about male pattern baldness if:

You lose hair suddenly
Hair loss is in clumps or significant enough that you notice large amounts on your pillow or in the shower
Hair is covering the back of your clothes

Male Pattern Baldness Research

While this type of hair loss does not represent typical male baldness, but it does require a diagnosis. Don't worry. Hair loss can occur for a number of reasons and can often be treated successfully and may not necessarily be male pattern baldness.

Male pattern baldness is thought to occur in varying forms in about 66% of adult males at some point in their lives. It is characterized by hair receding from the lateral sides of the forehead, known as "receding hairline" or "receding brow." An additional bald patch may develop on top (vertex). The trigger for this type of baldness, which is also known as androgenic alopecia, is currently believed to be 5-alpha reductase, an enzyme that converts the hormone testosterone into dihydrotestosterone (DHT), which, in genetically-prone hairs on the scalp, inhibits hair growth. Onset of hair loss sometimes begins as early as end of puberty, and is mostly genetically determined. Male pattern baldness is classified on the Hamilton-Norwood scale I-VIII. Previously, early baldness of the androgenic type was thought to be autosomal dominant in males and to be autosomal recessive in females (who would transmit the trait if heterozygous but are bald only if homozygous).

Further research suggests that the gene for the androgen receptor, which is significant in determining probability for hair loss, is located on the X chromosome and so is always inherited from the mother's side.[[2]] There is a 50% chance that a person shares the same X chromosome as their maternal grandfather.

However research has also shown that a person with a balding father also has a significantly greater chance of experiencing hair loss.

There is no consensus regarding the details of the evolution of male pattern baldness. Most theories regard it as resulting from sexual selection. A number of other primate species also experience hair loss following puberty, and some primate species clearly use an enlarged forehead, created both anatomically and through strategies such as frontal balding, to convey increased status and maturity. This is supported by the fact that the distribution of androgen receptors in the scalp differes between men and women, and older women or women with high androgen levels often exibit diffuse thinning of hair as opposed to male pattern baldness.

One theory, advanced by Muscarella and Cunningham, suggests baldness evolved in males through sexual selection as an enhanced signal of aging and social maturity, whereby aggression and risk-taking decrease and nurturing behaviours increase. This may have conveyed a male with enhanced social status but reduced physical threat, which could enhance ability to secure reproductive partners and raise offspring to adulthood.

In a study by Muscarella and Cunnhingham, males and females viewed 6 male models with different levels of facial hair (beard and moustache or clean) and cranial hair (full head of hair, receding and bald). Participants rated each combination on 32 adjectives related to social perceptions. Males with facial hair and those with bald or receding hair were rated as being older than those who were clean-shaven or had a full head of hair. Beards and a full head of hair were seen as being more aggressive and less socially mature, and baldness was associated with more social maturity.

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