Male Pattern Hair Loss

Male pattern hair loss, also called male pattern baldness or androgenetic alopecia, is the most common cause of hair loss in men. It affects up to half of men by the age of 50 and follows a recognisable pattern, starting at the temples and crown then slowly spreading. The good news is that, treatment can slow it and even regrow some of the hairs especially if you start treatment early. In this guide we explain what male pattern hair loss is, what causes it and how it is diagnosed. We also cover the stages and best treatments for male pattern hair loss.

City Skin Clinic is an online clinic. We provide custom topical hair-loss treatments and do not offer in-clinic procedures such as hair transplants, PRP or laser devices. However, we have explained all the options below because we believe the public deserve clear, evidence-led information without commercial bias.

What is Male Pattern Hair Loss?

Androgenetic alopecia is the most common type of hair loss in adults and presents as either male or female pattern hair loss. Male pattern baldness usually begins at the temples and the crown, and it affects around half of men by the age of 50. Genetics and the hormone DHT (dihydrotestosterone), a derivative of testosterone, drive it. DHT gradually shrinks sensitive hair follicles, so each hair grows back finer and shorter until it stops altogether. This has a distinct appearance and progression which is why many people also call it male pattern baldness. Female pattern hair loss on the other hand, causes diffuse thinning all over the scalp rather than a receding hairline and balding at the crown.

What Does Male Pattern Hair Loss Look Like?

Male pattern hair loss has a distinctive shape, because follicles in different areas vary in their sensitivity to DHT. It affects the temples and crown first, whilst the back and sides keep their hair for longer. The main signs of male pattern hair loss are:

• A receding hairline: The hairline moves back, usually starting at the temples. This often creates a characteristic “M” shape.
• Thinning at the crown: The hair thins in a circle at the crown, which can widen into a bald patch.
• Reduced overall density: The hair on top looks thinner and finer, so the scalp becomes more visible.
• A horseshoe pattern: In advanced stages, the bald areas merge, leaving a ring of hair around the back and sides.

What Causes Male Pattern Hair Loss?

The main causes of male pattern hair loss comes are genetics and hormones with ageing also adding to it over time. Whilst the central driver is DHT and how sensitive your follicles are to it, there are a number of factors that make someone more likely to develop male pattern hair loss:

• Genetics: A family history is the strongest risk factor. The genes that control follicle sensitivity to DHT can come from either parent.
• Hormones: DHT binds to receptors in the follicles and shrinks them. Higher DHT levels, or follicles that are more sensitive to it, speed up the process.
• Ageing: Follicles naturally shrink and growth cycles shorten with age. This makes hair loss more common and more noticeable over the years.
• Lifestyle factors: Smoking, stress, poor diet and some health conditions do not cause male pattern hair loss, but they can make it worse.

Can Women Get Male Pattern Hair Loss?

Male pattern hair loss is far more common in men, but women can develop it too. Most women with hair loss have the diffuse female pattern, which keeps the frontal hairline. However, some women develop the male pattern instead, with a receding hairline and thinning at the crown. This is uncommon and usually reflects raised androgen levels, the male-type hormones that everyone makes in some amount. It can point to an underlying cause such as PCOS or a hormone-producing tumour. For this reason, doctors check the hormones of any woman who has a male pattern of hair loss. The treatments are similar, though the right medication depends on her hormones and whether she has been through the menopause.

How is Male Pattern Hair Loss Diagnosed?

A doctor can usually diagnose male pattern hair loss from your history and appearance. The pattern of thinning is often enough to confirm it. A closer look with dermoscopy can show the follicle miniaturisation that is typical of the condition. Doctors may also sometimes run blood tests if the hair loss is sudden, severe or in someone young, to rule out other causes. They then grade the severity using the Hamilton-Norwood scale, which runs from minor recession to extensive loss. Figuring out the stage of male pattern of hair loss is useful because it helps choose the right treatment and track progress.

How is Male Pattern Hair Loss Treated?

There is no cure for male pattern hair loss, but treatment can slow it down, thicken the hair and regrow some of what was lost. It works best when you start early, before too many follicles permanently disappear. Most effective approaches combine more than one treatment for the best effect. The main male pattern hair loss treatments are:

• Minoxidil: This medication prolongs the growth phase of hair follicles and also boosts blood flow to them. helps regrow hair and is often the first-line treatment for most people. You normally apply it to the scalp and can find it over the counter in 2% and 5% serums, foams and sprays. Minoxidil is also available by prescription as an oral medication or topical compounded hair loss treatments.
• DHT blockers: Finasteride and dutasteride block the enzyme that makes DHT, which slows follicle shrinkage and help stop shedding. These DHT blockers are available by prescription only as tablets or compounded topical solutions. Topical spironolactone is also increasingly being used as an alternative to finasteride and dutasteride to treat male pattern hair loss. Doctors often combine hormone blockers with minoxidil treatment to help stop shedding and regrow hair.
• Procedures & devices: Low-level laser therapy, microneedling and platelet-rich plasma (PRP) can stimulate the follicles and help regrow hair. A hair transplant can move hair to balding areas in advanced cases where the hair follicles have been completely damaged and can’t be rescued.

Topical and oral treatments take time to work and most people require 3 to 6 months of consistent use to see a change. The benefits also continue only while you keep using them. Non-surgical procedures usually require multiple courses and also several months to see results. The also require maintenance. Surgical hair transplants can offer a permanent solution if successful but are associated with cost and possible side effects. Even if you opt for surgical or on-surgical procedures, optimal results usually require using oral or topical treatments alongside them.

Can Male Pattern Hair Loss Be Reversed?

Once a follicle has stopped producing hair, you can’t rescue it and it will not grow again. However, treatment can slow further loss, thicken existing hair and regrow follicles that are only miniaturised. The key is to start early, while there is still hair to save. With consistent treatment, many men hold onto their hair for years and see real improvement. So although you cannot fully reverse it, it is very much treatable.

Living With Male Pattern Hair Loss

Alongside medical treatment, a few habits support healthy hair and overall wellbeing. A balanced diet with enough iron, zinc and biotin gives the follicles what they need. Gentle hair care helps too, so it is worth avoiding harsh products, excessive heat and very tight styles. Managing stress is also useful, since stress can worsen shedding. Hair loss can be hard emotionally, and there is no shame in finding it tough. Talking to friends, family or a counsellor can help and so can joining a support group.

At City Skin Clinic, our doctors create personalised hair loss treatments for men to slow shedding and support regrowth. Where appropriate, we use prescription actives like minoxidil, spironolactone, finasteride, dutasteride, melatonin and caffeine compounded into a serum tailored to your hair and scalp. Every plan starts with an online consultation built around your hair and your goals. Start your online consultation today. The journey towards great hair starts here.

This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your hair or treatment options.