Male Pattern Hair Loss: Stages, Causes, and Treatments

Have you ever experienced male pattern hair loss? If you or someone you know is struggling with this issue, it’s important to understand that it is quite common, and many men face it at some point in their lives. Male pattern hair loss, also known as male androgenetic alopecia, is not only related to appearance; it can also have considerable psychological effects. But what causes it, and how is it classified? In the following sections, we will address questions related to male pattern baldness.

What is Male Androgenetic Alopecia?

Androgenetic alopecia is a type of hair loss caused by genetic and hormonal factors. For instance, a man in his thirties may notice a receding hairline on his forehead and thinning hair on the crown of his head. These changes occur gradually and follow specific patterns. It is important not to confuse androgenetic alopecia with alopecia areata, which occurs suddenly and affects specific areas of the scalp. In the following sections, we will discuss this type of hair loss in more detail.

Male Pattern Baldness Causes

Male pattern baldness, which begins gradually and worsens over time, is primarily attributed to two key factors: genetics and hormones. Dihydrotestosterone (DHT), a derivative of testosterone, plays a major role in shrinking hair follicles. Over time, this process causes the hair to become thinner and eventually fall out.

The genes associated with this type of hair loss are inherited from both parents, which is why some individuals may experience this issue at a young age. This condition can have considerable effects not only physically but also psychologically, leading to feelings of discomfort and a decrease in self-confidence.

Hereditary-Patterned Baldness: Male hair loss & Genetics

One common question about male pattern baldness is whether male androgenetic alopecia is inherited from the mother or the father? The answer is complex and depends on the combination of genes from both parents. The likelihood of hair loss is generally about 50/50, meaning that genes from both the father’s and mother’s sides contribute to this issue. However, studies have shown that genes on the X chromosome, inherited from the mother, play a more considerable role in this process.

For example, men with a family history of hair loss on their maternal side are more likely to develop baldness. This is because the genes on the X chromosome, which are passed from mother to son, are responsible for producing receptors for androgen hormones (such as dihydrotestosterone, or DHT). These hormones are directly related to hair loss. Thus, if a maternal grandfather or uncles experience hair loss, their male relatives may also be at risk for male androgenetic alopecia (MAA).

However, the genetic contributions from the father’s side also play a role in this process. Ultimately, the combination of these genes determines an individual’s susceptibility to hair loss. In other words, while the mother’s genes may have a more pronounced impact, the influence of the father’s genes should not be overlooked.

Is Baldness a Sign of High Testosterone?

A common belief is that hair loss male pattern is a sign of high testosterone levels in the body. However, this is not always true. Male pattern baldness is not directly related to testosterone levels, but rather to the sensitivity of hair follicles to dihydrotestosterone (DHT), a derivative of testosterone.

In fact, dihydrotestosterone (DHT), which is produced from testosterone, is responsible for shrinking hair follicles. Individuals whose hair follicles are sensitive to DHT are more prone to hair loss. Therefore, even if a person’s testosterone levels are within the normal range, they may still develop male pattern hair loss (MPHL) if their hair follicles are sensitive to DHT.

This means that not all bald individuals necessarily have high testosterone levels. Some people may have moderate or even low testosterone but still experience hair loss.

Male Pattern Baldness Symptoms

One of the primary symptoms of male pattern baldness is the miniaturization of hair. In this case, the hair on the front of the head and the temples gradually becomes thinner, shorter, and weaker. This process, known as hair miniaturization, occurs when hair follicles shrink due to the effects of dihydrotestosterone (DHT), resulting in hairs that are thinner and weaker than before.

In the early stages, a person may notice a receding hairline at the forehead and temples. This retraction typically forms an M-shaped pattern, gradually exposing more of the scalp. It is also common for hair to fall out more easily in these areas.

Another symptom of male pattern baldness is thinning hair on the crown of the head. This issue usually appears after the hair on the front begins to thin and gradually spreads to other areas. Eventually, these areas may connect, creating a horseshoe pattern, with only the sides and back of the head retaining hair.

Male Pattern Baldness Stages

To accurately describe and evaluate male pattern baldness, doctors and specialists use various classification systems. Over the years, several classification systems for male pattern hair loss have been developed, each with its own characteristics, strengths, and weaknesses. From the first system created by Hamilton in the 1950s to newer systems like BASP, these classifications have become increasingly accurate and efficient.

You may be wondering why these classifications are important. They help doctors assess hair loss conditions more accurately and suggest appropriate treatment methods based on that assessment. Understanding the stages and types of hair loss with a male pattern is the first step in effectively managing this issue.

Hamilton Classification

The Hamilton Classification was the first official system for male pattern hair loss, introduced by Hamilton in the 1950s. After studying more than 700 individuals across various age and sex groups, he divided hair loss into two main categories: baldness and thinning. This classification includes eight different types of hair loss, ranging from Type I, which shows no shedding, to Type VIII, indicating the most severe level of baldness.

• Type I: No hair loss in the frontal hairline.
• Type II: Slight receding of the hairline in the frontal areas.
• Type III: A borderline condition with unusual and difficult-to-classify areas.
• Type IV: Deeper receding in the temporal areas, along with baldness in the central part of the scalp.
• Type IVA: A wide band of hair loss across the frontal hairline.
• Type V: Increased baldness in the crown and temporal areas.
• Type VI: Severe hair loss in a horseshoe shape, with only a small area of hair remaining in the center.
• Types VII and VIII: The most severe stages of baldness, with no separation between the crown and frontal areas.

This system is noted for its high accuracy and reproducibility; however, one of its weaknesses is that Type III is defined as a borderline and vague condition, which can lead to confusion in diagnosis.

Norwood-Hamilton Classification (The Most Widely Used)

This system was introduced in 1975 by Dr. Norwood, and it is based on Hamilton’s classification but modified for greater accuracy. The Norwood-Hamilton classification includes seven types and five subcategories that provide more detailed insights into hair loss patterns. Dr. Norwood added clarity to the system by removing Hamilton’s Type III, which had caused confusion.

1. No Hair Loss: At this stage, the individual shows no signs of hair loss, and the hair is naturally healthy and in place.
2. Receding Hairline: At this stage, the hairline begins to recede at the front of the head. This retraction is usually visible in the temporal or forehead area and is likely to progress gradually.
3. Hair Loss in the Vertex Area: At this stage, only the vertex area (top of the head) experiences hair loss. This condition may be accompanied by thinning hair in the crown, while the hairline in the front may remain unchanged.
4. Receding Hairline and Hair Loss in the Vertex Area: At this stage, both the hairline at the front and the temples recede, with hair loss also affecting the vertex area. This situation indicates considerable male pattern baldness.
5. Receding Hairline Without Loss in the Vertex Area: At this stage, the hairline recedes, but the vertex area remains completely intact. This condition may provide a temporary sense of relief, as the individual still has hair in the central part of the head.
6. Receding Hairline and Hair Loss in the Central Area: At this stage, the hairline continues to recede, and both the vertex and the center of the head experience hair loss. This condition can considerably impact the individual’s appearance.
7. Most Extreme Baldness: At this stage, all areas of the head (including the front, sides, and crown) have lost hair, leaving no hair in the central or frontal areas. This represents the most severe form of male pattern baldness and can have profound psychological and social effects on an individual.

Today, this classification is the most widely used method in clinical studies, but due to its complexity, it may not always be highly reproducible.

Adapted Norwood-Hamilton Classification

To improve the Norwood-Hamilton classification and address its reproducibility issues, this modified version was developed by Khumalo and Gumedze. While it retains the core structure of the original Norwood-Hamilton system, it enhances accuracy by simplifying the classification and adding indices such as A and V to distinguish the primary site of hair loss (frontal or crown region).

• Types I to VII: Similar to the original Norwood-Hamilton classification.
• Types A and V: Indicate changes in the frontal area or crown of the head.
• Omission of Type IIA: This was done for simplification.

In small studies, this adapted system has shown considerable improvements in reproducibility.

BASP Classification

The BASP classification is the most recent system, introduced in 2007 by Lee et al. This system combines detail, practicality, and repeatability. It includes two main components: one describes the shape of the hairline using the letters L, M, C, and U, while the other specifies hair density in different areas (such as the front or crown of the head).

• Type L: No receding hairline (linear hairline).
• Type M: M-shaped receding hairline (with four subtypes: M0 to M3).
• Type C: C-shaped receding hairline (with four subtypes: C0 to C3).
• Type U: Horseshoe-shaped receding hairline (with three subtypes: U1 to U3).
• F/V Type: Reduction of hair density in the front area (F) or crown (V), categorized into three different levels.

This system is simple and easy to understand, making it applicable for assessing hair loss in women as well.

Are These Systems Perfect?

While the Hamilton and Norwood-Hamilton classifications have proven to be very useful and efficient, it is important to note that no system is perfect. In some cases, hair loss patterns can be more complex than these classifications can adequately describe. For example, if a person experiences hair loss in multiple areas of the head simultaneously, a more detailed diagnosis is necessary.

Male Pattern Baldness Age

Men’s Hair Loss typically begins in the second or third decade of life. Although the age at which hair loss starts can vary from person to person, the final pattern of hair loss is usually evident by the age of 27. Statistics indicate that about 25% of men show signs of hair loss by age 25, and this figure increases to 40% by age 40 and 65% by age 60. Influential factors such as stress, poor diet, and lifestyle choices can also affect the onset of hair loss.

Key Characteristics of an Ideal Doctor for Treating Male Pattern Baldness

Selecting the right specialist for treating male pattern baldness is crucial. An ideal doctor should possess valid educational qualifications and recognized professional certifications. Completing specialized training in hair transplantation and having sufficient experience in this field are essential to provide the best treatment options for patients.

The doctor should be well-versed in advanced hair loss treatment techniques and utilize modern methods, such as FUE hair transplantation. Accurate assessment of hair loss and correct diagnosis, as well as thorough follow-up care, are also key attributes of a competent physician.

Effective communication skills are another important characteristic of a suitable doctor. The doctor should be able to address patients’ questions and concerns and guide them through the treatment process. Providing examples of previous successful procedures can also make it easier for patients to choose the right doctor.

The Best Treatments for Male Pattern Baldness

Now, we come to the most important part: treatment for male pattern baldness. To set expectations from the start, apart from hair transplantation, there is no absolute cure for male pattern hair loss. The available methods can only temporarily control or slow down the progression of hair loss. The most commonly prescribed medications for this purpose are Minoxidil and Finasteride. These drugs may help strengthen hair and reduce the rate of hair loss in the short term, but their effects are not permanent, and hair loss resumes once treatment is discontinued. Below, we will highlight some of the more effective treatments offered at Helia Clinic:

• G Cell Hair Loss Treatment: G-Cell is one of the best non-surgical solutions for combating androgenic hair loss, based on stem cell technology and available at Helia Clinic. This innovative method enhances microcirculation and strengthens hair follicles, thereby reducing hair loss and stimulating hair regrowth. It is particularly suitable for those seeking modern and effective treatments for hair loss.
• Hair Mesotherapy: Mesotherapy can be beneficial as a supportive and complementary method for individuals experiencing hereditary hair loss. It helps strengthen the hair and prevent further progression of hair loss. This procedure involves injecting a blend of vitamins, minerals, and essential medications directly into the scalp. These injections improve blood circulation and nourish hair follicles, boosting their health and resilience.
• Hair Filler: DR.CYJ Hair Filler treatments are performed gradually over multiple sessions and involve injecting a mixture containing hyaluronic acid and strengthening compounds into the scalp. Using biologically compatible and skin-friendly ingredients, this method promotes hair growth and enhances hair quality.
• Final Solution – Hair Transplantation: When hair loss reaches a point where these treatments and medications are no longer effective, hair transplantation becomes the only definitive option. Advanced techniques such as DHI hair transplant offer clients the opportunity to achieve more natural and long-lasting results, allowing them to enjoy restored hair and renewed confidence.

conclusion

If you are experiencing androgenetic alopecia, don’t worry! The expert physicians at Helia Clinic can identify the exact stage of hair loss using established classification systems and recommend the most effective treatments. While it may be unlikely to completely prevent male pattern baldness, appropriate follow-up and treatment can slow its progression and, in some cases, even stimulate hair regrowth. For more advanced hair loss, reliable options such as hair transplantation are available to achieve natural and long-lasting results. Finally, we would love to hear about your experiences—feel free to share them with us!