Male pattern baldness (alopecia), or androgenetic alopecia, is the patterned balding of a man. Although the condition may affect both the appearance and self-esteem of some men, one should note that the condition is not a medical disorder. The hair loss is non-scarring and has a genetic basis. Sex steroids (androgens) – specifically, dihydrotestosterone – play a role in this form of balding.
Who's At Risk
Male pattern baldness affects many different types of men, spanning both age and race. While black men have more frontal baldness than white men, they less commonly have balding at the crown region of the scalp.
Male pattern baldness may be hastened by other forms of hair loss, such as chemotherapy-induced hair loss. Likewise, male pattern baldness becomes more common as age increases.
Signs and Symptoms
The most common location for male pattern baldness occurs at the frontal hairline. Hair loss may move toward the back of the scalp (posteriorly), or it may be first noted as thinning at the crown of the scalp. While the underlying scalp may appear normal, a man might see miniaturized hair follicles.
When to Seek Medical Care
Male pattern baldness is not a medical disorder and does not require therapy. However, cosmetic restorative therapy may be sought, based upon personal desire.
Treatments Your Physician May Prescribe
Hair loss in male pattern baldness is non-scarring, so the hair follicles are not destroyed. A population of cells remain that can grow and enlarge the hair. The only clinically proven pharmacologic methods to prevent loss are minoxidil (a topical medication) and finasteride (an oral medication). However, with discontinued use of the products, accelerated hair loss may occur.
Scalp reduction or hair transplantation therapies are effective surgical procedures, but they can become expensive and should only be performed by a qualified dermatologic surgeon or plastic surgeon.
Bolognia, Jean L., ed. Dermatology
, pp.1044-1047, 2426-2627. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine
ed, pp. 643-645. New York: McGraw-Hill, 2003.