Male pattern hair loss (androgenetic alopecia) is the most common cause of hair loss in men. Almost half of all men over the age of 50 are affected. This is about 50 million men and 30 million women in the U.S. When men between the ages of 18 and 49 were surveyed, 42% reported moderate to extensive hair loss.1
Hair loss can begin at any time, even in your teens or twenties. In women, it more commonly occurs after menopause.2 With male pattern baldness, you may notice hair thinning, receding hairline, or balding. Androgenetic alopecia is a common, treatable, and frequently reversible cause of hair loss.
What Causes Male Pattern Baldness?
Male pattern baldness is caused by a genetic sensitivity to dihydrotestosterone (DHT), a form of testosterone. DHT is essential for sexual hair growth. This includes axillary, pubic, and facial hair. Changes in testosterone levels are not directly responsible for androgenetic alopecia. Their metabolite, DHT, is.
Everyone sheds about 50 to 100 hairs each day. There are three phases of hair growth:
Anagen (growth phase) phase can last for several years.
Catagen (transitional phase) phase lasts for about ten days.
Telogen (resting phase) phase typically lasts for two to three months.
Scalp hair is also sensitive to DHT. Some people are excessively sensitive. When researchers plucked hair from men with male pattern baldness and men who did not have the condition, they found that men with male pattern baldness had higher levels of androgen receptors than those who did not.3
DHT sensitivity shortens the hair follicle growth phase from years to weeks or months, and the hair follicles also decrease in size. With a shorter growth phase, more hairs enter the resting phase and fall out. A smaller hair follicle results in hairs that are thinner and less coarse.
Getting older: As we age, the hair follicle growth phase gets shorter, sex hormone levels decline, and hair follicles get smaller. Smoking, ultraviolet light exposure, and poor nutrition can increase age-associated hair loss.
Autoimmune conditions: Alopecia areata is a common autoimmune disorder that causes more patchy hair loss.
Thyroid disease: Decreased thyroid hormone can cause hair loss.
Decreased sex hormones: While decreased estrogen, progesterone, and testosterone do not directly cause male pattern or female pattern hair loss, decreasing sex hormone levels with age can impact the speed and timing at which it occurs.
Cancer treatments: Both chemotherapy and radiation therapy can cause hair loss.
Medications: Some medications can cause hair loss, such as blood thinners, anti-seizure medications, antibiotics, cholesterol-lowering medications, and gout treatment. Check with your doctor or pharmacist to see if hair loss is a common side effect if you are taking medications.
Childbirth: While many women notice increased hair growth during pregnancy, the stress of delivery will commonly cause hair loss.4
Traction: Pulling hair too tightly into a rubber band or barrette can cause localized hair loss.
Infection: Tinea scalp infections cause scaling and circular patterns of hair loss.
Stress: Psychological and physical stress can cause an abnormal increase in the number of hair follicles shifting to a resting phase, causing hair loss.
Trichotillomania: Twisting or pulling on hair can cause hair breakage and loss.
Symptoms of Male Pattern Baldness
Male pattern baldness has a recognizable pattern. You will notice the following:
Thinning: The first sign you may notice is overall hair thinning. You may notice hair falling out when you comb or wash your hair.
Receding hairline: Your hairline will gradually inch up toward the crown of your head, and your forehead will appear broader. Over time, your hairline will take on an “M” shape.
Bald spot: You will notice hair thinning and then balding on the crown of your head.
Balding: Your receding hairline and bald spot will meet. You will notice that the hair at your temples and below the crown of your head remains, but the rest has become bald.
Telogen effluvium is the medical name for hair shedding. With excessive hair shedding from telogen effluvium, you could lose 300 to 500 hairs per day instead of the more typical 50 to 100.5 There are many reasons why your hair may be shedding. It usually happens a few months after a stressful event and lasts less than six months.5 Telogen effluvium does not typically cause baldness, but it can cause noticeable hair thinning.
How To Slow and Prevent Male Pattern Baldness
While you can’t prevent a sensitivity to DHT if you inherited one or reverse male pattern baldness naturally, there are steps you can take to minimize hair loss:
Manage stress: Learn how to manage stress. Whether you like to exercise, be out in nature, or spend time doing a favorite hobby, reducing stress is good for your overall health.
Consume a healthy diet: Consume a diet rich in antioxidants, vitamin E, iron, zinc, biotin, and healthy protein sources to provide your hair follicles with the nutrients they need to grow hair.
Prevent fungal infections: While a rare cause of hair loss, avoid sharing brushes and other personal items to decrease risk.
Avoid traction on hair: Choose hairstyles that do not pull or put traction on hair.
Treat medical conditions: If a hormonal issue or other medical condition may be causing hair thinning or balding, see your doctor.
Chemicals: Use mild hair products to prevent scalp irritation and hair dryness.
Smoking: If applicable, quit smoking. The chemicals in cigarette smoke narrow blood vessels and may decrease blood supply to hair follicles.
Treatments for Male Pattern Baldness
While not everyone wants to slow or reverse male pattern baldness, if you do, the sooner you start, the better your results are likely to be.
Drugs that can slow hair loss and potentially stimulate hair regrowth include:
Finasteride: Finasteride decreases the conversion of testosterone to DHT. Decreasing DHT can slow or reverse hair loss in men with androgenetic alopecia. Finasteride is very effective after a few months, but it can cause sexual side effects, depression, and enlarged male breast tissue. In a literature review, Whiting (2001) found that finasteride produced hair growth in up to 66% of men with mild-to-moderate hair loss and stopped hair loss in 91% of men. If you stop using finasteride, any hair regrowth will be lost within a few months.
Minoxidil: Minoxidil is a foam or liquid that can be applied to the scalp to slow hair loss and potentially stimulate hair regrowth. It takes about 4 to 12 months before most men notice results. If you stop using minoxidil, any hair regrowth will be lost.
Supplements do not treat male-pattern baldness because it is a genetic condition. However, as more is known about anti-aging and age management, more connections are being made between nutritional deficiencies and health conditions.
Glutathione: This potent antioxidant supplement restores glutathione when depleted by stress and infections, two conditions known to trigger hair loss.
NAD+: This potent antioxidant is essential for every cell in the body to produce energy. If your body lacks energy, it will decrease nutrient supply to less essential bodily processes, such as hair growth. Restoring NAD+ allows your body cells to effectively transfer energy from food to body cells.
Lipo B12: Vitamin B12 deficiency is common. Lipo B12 combines three essential lipotropics—methionine, inositol, and choline—to maximize fat-burning and optimize metabolism. It also restores B12, which is necessary for energy production, supplying your hair follicles with the energy they need.
Surgery is another option to treat male pattern baldness.
Laser devices: while not a surgical procedure, FDA-cleared laser devices are available for home use.
Hair transplants: Hair not sensitive to DHT can be removed, separated, and transplanted to bald spots. The procedure does carry risks for scarring and infections.
PRP injections: Platelet-rich plasma injections can help you retain hair regrowth and lessen hair loss.
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.
1. Rhodes T, Girman CJ, Savin RC, et al. Prevalence of male pattern hair loss in 18-49-year-old men. Dermatol Surg. Dec 1998;24(12):1330-2. doi:10.1111/j.1524-4725.1998.tb00009.x