Table Of Contents:
Alternative names
Definition
Causes, incidence, and risk factors
Prevention
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Alternative names:
alopecia in men; baldness - male; hair loss in men; androgenic
alopecia in men
Definition:
A typical pattern of loss of hair in men, caused by hormones and
genetic predisposition.
Causes, incidence, and risk factors:
Scalp hair grows from the hair follicle at an average rate of 1/2
inch per month. Each hair grows for 4 to 7 years, then rests, and
finally falls out. A new hair then begins growing in its place. At
any one time, about 85% of the hair is growing and 15% is resting.
Baldness occurs when there is a progressive miniaturization of the
follicle resulting in shorter and finer hair. The end result is a
miniature follicle with no hair. The cause of the failure to grow a
new hair is not well understood, but it is associated with a genetic
predisposition and the presence of endocrine hormones (androgens),
especially testosterone. The follicle, however, remains alive,
suggesting the possibility of new growth.
The typical pattern of male-pattern baldness begins at the hairline.
The hairline gradually recedes to form an "M" shape. The existing
hair may be finer and does not grow as long as when younger. The
hair at the crown also begins to thin, and eventually the top points
of the hairline "M" meet 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 would usually be associated with other causes.
Prevention:
There is no known prevention.
Symptoms:
- absent hair or hair loss
- receding hairline
- hairline recedes from the front toward the back over
time
- thinning of hair
- loss of hair at the crown of head
- progression of hair loss in a typical "M"-shaped pattern
which eventually results in a loss of hair over the top of the
head, and a horseshoe ring shape to remaining hair
Signs and tests:
Classic male-pattern baldness is usually diagnosed based on the
appearance and pattern of hair loss. Hair loss that occurs in an
atypical manner 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.
Treatment:
The hair loss of male-pattern baldness is permanent. No treatment is
required if the person is comfortable with the appearance.
The only drug/medication approved by the United States Food and Drug
Administration (FDA) to treat male-pattern baldness is minoxidil,
used topically on the scalp. It may help hair to grow in 10 to 20%
of the population, and in 90% it may slow the loss of hair.
Treatment is expensive, however, costing about $600 per year for the
recommended twice a day use. Hair loss recurs when its use is
discontinued.
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 low risk for skin infection. The procedure usually
requires multiple transplantation sessions and may be expensive.
Suturing of hair pieces to the scalp is not recommended as it can
result in scars, infections, and abscess of the scalp or brain. The
use of hair implants made of artificial fibers was banned by the FDA
because of the high rate of infection.
Hair weaving, hair pieces, or change of hair style may disguise the
hair loss. This is usually the least expensive and safest treatment
for male-pattern baldness.
Expectations (prognosis):
Male-pattern baldness is cosmetically important and does not
indicate a medical disorder, but it may affect self-esteem or cause
anxiety. The hair loss is usually permanent.
Complications:
- psychological stress
- loss of self-esteem from change in appearance
Calling your health care provider:
Call for an appointment with your health care provider if
male-pattern baldness develops and there is a desire to attempt to
treat the hair loss.
Also call your health care provider if hair loss occurs in a pattern
not typical for male-pattern baldness (there could be a treatable
medical cause for the hair loss), or if hair loss is accompanied by
itching, skin irritation, or other symptoms.
