Opinion article
Male pattern hair loss: what the science says about baldness
Male pattern hair loss is driven by dihydrotestosterone (DHT), a derivative of testosterone that, in genetically sensitive follicles, causes progressive miniaturisation until they stop producing visible hair.
The typical pattern
A receding hairline, especially at the temples, together with thinning at the crown. Over time these two areas can merge, in a pattern well described by the Norwood scale. It can start as early as a person’s twenties.
Treatment
- Topical minoxidil: stimulates and prolongs hair growth, available over the counter, requires ongoing use.
- Oral finasteride: inhibits the enzyme that converts testosterone into DHT, slowing hair loss progression in most users. It should be discussed with a doctor because of possible sexual side effects, usually reversible after stopping the medication.
- Hair transplant: a surgical option for those with established hair loss who want a permanent result, moving DHT-resistant follicles from the back of the scalp.
Wearing a hat or washing your hair often doesn’t cause or worsen hair loss. It’s one of the most persistent myths, with no scientific basis whatsoever.
As with female pattern hair loss, treatment works best when started early, while follicles are still miniaturised but active, rather than after they’ve become completely inactive.
This article is for information only and does not replace a medical consultation.
Sources
- Kanti V, Messenger A, Dobos G, et al. Evidence-Based (S3) Guideline for the Treatment of Androgenetic Alopecia in Women and Men. Journal of the European Academy of Dermatology and Venereology. 2018
- Kaufman KD, Olsen EA, Whiting D, et al. Finasteride in the Treatment of Men with Androgenetic Alopecia. Journal of the American Academy of Dermatology. 1998