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Alternative
names
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Alopecia in men; Baldness - male; Hair loss in men
Definition
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Male
pattern baldness is the most common type
of hair loss in men. It usually follows
a typical pattern of receding hairline
and hair thinning on the crown, and is
caused by hormones and genetic predisposition.
Causes,
incidence, and risk factors
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Hair
grows about an inch every couple of months.
Each hair grows for 2 to 6 years, remains
at that length for a short period, then
falls out. A new hair soon begins growing
in its place. At any one time, about 85%
of the hair on your head is in the growing
phase and 15% is not.
Each
hair sits in a cavity in the skin called
a follicle. Baldness in men occurs when
the follicle shrinks over time, resulting
in shorter and finer hair. The end result
is a very small follicle with no hair inside.
Ordinarily, hair should grow back. However,
in men who are balding, the follicle fails
to grow a new hair. Why this occurs is not
well understood, but it is related to your
genes and male sex hormones. Even though
the follicles are small, they remain alive,
suggesting the possibility of new growth.
Symptoms
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The
typical pattern of male baldness begins
at the hairline. The hairline gradually
recedes to form an "M" shape. The existing
hair may become finer and shorter. The hair
at the crown also begins to thin. Eventually
the top of the hairline meets the thinned
crown, leaving a horseshoe pattern of hair
around the sides of the head.
Hair
loss in patches, diffuse shedding of hair,
breaking of hair shafts, or hair loss
associated with redness, scaling, pain,
or rapid progression could be caused by
other conditions.
Signs
and tests
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Classic
male pattern baldness is usually diagnosed
based on the appearance and pattern of the
hair loss. Any atypical hair loss may be
caused by other medical disorders. A skin
biopsy or other procedures may be needed
to diagnose other disorders that cause loss
of hair.
Hair
analysis is not accurate for diagnosing
nutritional or similar causes of hair loss.
However, it may reveal substances such as
arsenic or lead.
Treatment
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Treatment
is not necessary if you are comfortable
with your appearance. Hair weaving, hairpieces,
or change of hairstyle may disguise the
hair loss. This is usually the least expensive
and safest approach for male baldness.
There
are two main drugs used to treat male pattern
baldness:
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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.
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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.
Hair
transplants consist of removing tiny plugs
of hair from areas where the hair is continuing
to grow and placing them in areas that are
balding. This can cause minor scarring in
the donor areas and carries a modest risk
for skin infection. The procedure usually
requires multiple transplantation sessions
and may be expensive. Results, however,
are often excellent and permanent.
Suturing
hair pieces to the scalp is not recommended.
It can result in scars, infections, and
abscess of the
scalp. The use of hair implants made of
artificial fibers was banned by the FDA
because of the high rate of infection.
Expectations
(prognosis)
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Male
pattern baldness does not indicate a medical
disorder, but it may affect self-esteem
or cause anxiety. The hair loss is usually
permanent.
Complications
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- Psychological
stress
- Loss
of self-esteem due to change in appearance
Calling
your health care provider
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Call
your doctor if:
-
Your
hair loss occurs in an atypical pattern
-- rapid hair loss, diffuse shedding,
hair loss in patches, or breaking
of hair shafts.
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Your
hair loss is accompanied by itching,
skin irritation, redness, scaling, pain, or other symptoms.
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Your
hair loss begins after starting a
medication.
-
You
want to attempt to treat your hair
loss.
Prevention
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There
is no known prevention for male pattern
baldness.
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