Hair Loss & Restoration Article: What about your male pattern baldness?

What About Your Male-Pattern Baldness?

A man can read a lot about male-pattern baldness (androgenetic alopecia) without learning what HE wants most to know: “How about my baldness, specifically?”

If he has close male relatives with male-pattern baldness, specific questions a man might ask are:

“I know that male-pattern baldness runs in families. So, how soon should I expect to begin losing hair like my male relatives?”

“If I begin to lose hair, how fast will I lose it?”

“How much hair will I eventually lose?”

“If I lose hair, will I lose it in a pattern similar to that of [my father] [my brother] [my uncle]?”

“If I get to be 40 years old and have not developed male-pattern baldness, does that mean I have dodged the bullet despite a family history of male-pattern baldness?”

“If I begin to develop male-pattern baldness, how soon should I begin to consider hair transplantation?”

How Soon Should I Begin to Consider Hair Transplants?

For men who are concerned at the earliest indication of hair loss, it might be well to consider the last question first: “If I begin to develop male-pattern baldness, how soon should I begin to consider hair transplants?”

The decision to have hair transplantation should not be made as a snap judgment. No ethical physician hair restoration specialist would allow you to do so. No one should use your concern about hair loss to sell or pressure you into a decision to have hair transplants.

Many men are concerned at the earliest sign of male-pattern hair loss, and are not sure what to do about it. Consultation with a physician hair restoration specialist is a logical step in your quest for (1) answers about the cause and probable course of your hair loss, and (2) options for treatment. [See About hair loss and Hair loss analysis and diagnosis to learn what a physician hair restoration specialist may want to know about your individual case of hair loss before making any recommendations for treatment.]

Based on a medical examination, scalp examination, your medical history and family medical history, a physician hair restoration specialist can make recommendations such as:

Some men with very early male-pattern hair loss may not be good candidates for hair transplantation until they have had a trial of medical treatment with a hair restoration drug—minoxidil (Rogaine®) or finasteride (Propecia®). In most men with early male-pattern hair loss, these hair restoration agents will slow or reverse hair loss and delay the need for hair transplantation. In fact, the earlier a hair loss sufferer begins medical therapy, the more hair he will preserve. He may be able to delay hair restoration surgery for many years using these medications.

Hair transplant surgery is a well accepted procedure with a high rate of success and reliable esthetic results when planned and carried out by an experienced hair restoration surgeon. It is a surgical procedure with potential side effects and complications that should be fully explained and discussed before the procedure is undertaken. Hair transplantation should be undertaken only when it is the best treatment for you at this time.

While androgenetic alopecia is by far the most common cause of hair loss in men, it is not the only cause. Some conditions associated with hair loss require medical treatment. Hair transplantation should not be undertaken until the cause of hair loss has a confirmed diagnosis.

Male-Pattern Baldness Runs in My Family. How Soon Should I Expect to Begin Losing Hair?

While male-pattern baldness is known to have hereditary factors, no specific “baldness gene” has yet been identified in humans. Even in families with many bald males, inheritance patterns are unpredictable. No one can tell you with certainty when male-pattern hair loss may begin, no matter how many of your close male relatives are bald or balding. Generally speaking, male-pattern baldness can be expected to occur in 25% of men aged 25-30 years, in 40% of men aged 40, and in 50% of men 50 years old or older. Male-pattern hair loss can begin to occur as early as mid to late teens. It may be that several genes, interacting with one another and with environmental factors, are involved in male-pattern hair loss.

If I Begin to Lose Hair, How Fast Will I Lose It?

“How Fast” is usually as unpredictable as “How Soon” for an individual. A physician hair restoration specialist may be able to predict “how fast” with some degree of certainty on the basis of years of experience in diagnosing and treating male-pattern hair loss. Hair loss that begins early and progresses rapidly is likely to continue relentlessly, sometimes with occasional pauses. The rate and progression of male-pattern hair loss are influenced by genetic and environmental factors that are not well understood.

If I Lose Hair, Will I Lose It in a Pattern Similar to That of Male Relatives?

Even in its most complete form, male-pattern baldness spares the hair at the temples, over the ears, and at the back of the head. These areas are under genetic control that is different from the factors that influence hair loss over other areas of the scalp. [See male pattern baldness and look at the Norwood-Hamilton Scale for illustrations of the patterns of male androgenetic alopecia]. The sequence of male-pattern hair loss usually starts at the frontal hairline (above the forehead), and moves in an “M” pattern from the frontal area into the central area of the scalp. Simultaneously or later, there may be loss of hair over the vertex (crown) of the scalp. The frontal and vertex patterns may enlarge until they merge. In some men, the progression of male-pattern baldness may halt temporarily at any stage, giving the false impression that hair loss has ceased. In some cases, the progression is relentless until hair has been lost over the entire scalp except for those “protected” areas at the temple, over the ears, and at the back of the head.

The rate of progression is an important factor when a physician hair restoration specialist is planning hair transplantation. When a patient wants hair transplantation to keep pace with relentlessly progressive hair loss, enough donor hair in the “protected” areas must be conserved to furnish grafts for future transplantation. While the rate of progression is not predictable with 100% certainty, the physician hair restoration specialist can usually make an educated guess based on information such as (1) rate and progression of hair loss to date, (2) family history of hair loss, and (3) experience with many previous cases.

If I Get to Be 40 Years Old and Have Not Developed Male-Pattern Baldness, Does That Mean I have Dodged the Bullet Despite a Family History of Androgenetic Alopecia?

Almost everyone can cite an instance of a man whose father was bald, but who went through life with a full head of hair. When true, such a story confirms the unpredictability of genetic and environmental factors in male-pattern baldness. A person with male-pattern baldness can’t be certain he has “dodged the bullet” if he reaches age 40. A substantial number of men begin to have recognizable male-pattern hair loss after age 40. A man may also begin to have early signs of male-pattern hair loss without recognizing them. Onset can be minimal and gradual. The typical onset of male-pattern baldness is a gradual shortening of the anagen (growth) phase of hair. Terminal hairs in affected areas become progressively finer and shorter, with loss of color. The process nay be rapid, but it can be so slow that it is not recognized as the beginning of permanent, progressive hair loss.

For you, the individual person, the ultimate question is not about hair loss but how you FEEL about hair loss. Some men are simply not concerned that they are losing hair. If you are concerned about hair loss and the way it affects your appearance, you should seek a consultation with a physician hair restoration specialist to discuss options (for diagnosis and treatment).