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Male Pattern Baldness

Male pattern baldness refers to a loss of hair on the scalp in men. It happens as hormone levels change over a man’s lifetime, and especially in the later years.

It is thought to affect 50 million men in the United States, and half of all men by the age of 50 years.

Although a natural part of the aging process for millions of men, hair loss can be psychologically distressing.

Sudden or unexpected hair loss can sometimes indicate a more serious health condition that may need medical attention.

Fast facts on male pattern baldness

Here are some key points about male pattern baldness. More detail is in the main article.

  • Male pattern baldness, or androgenetic alopecia, typically occurs later in life as a result of changing hormone levels.
  • Hair loss can be psychologically distressing for men, and they may seek a variety of treatments.
  • Other causes of hair loss include nutritional deficiencies, infections, and some psychological conditions.
  • Treatments include medications, laser and light therapies, and hair transplantation.

Seeing a doctor

According to Genetics Home Reference, hair loss in men has been linked to prostate cancer, diabetes, obesity and high blood pressure, or hypertension.

It can occur as a reaction to stress or after an illness or major surgery, or as a side effect of some medications, such as anticoagulants, or blood thinners, and vitamin A supplements.

Hair loss can also indicate a health condition, such as lupus, a fungal infection, or a thyroid problem.

Other possible causes include:

  • Iron deficiency
  • Excess vitamin A, possibly as a result of retinoid drugs
  • Severe chronic illness, such as diabetes or lupus
  • Malnutrition
  • Use of anticoagulants, or blood thinners
  • Telogen effluvium, a disturbance of the hair growth cycle

A number of genetic changes have been linked to male pattern baldness, but only one has been confirmed by research, the androgen receptor (AR) gene.

Other research has suggested that an abnormal quantity of a protein called prostaglandin D2 in the scalps of some men could link to hair loss.

Anyone who is concerned that hair loss may be a symptom of a health problem should see a doctor.

Treatment

Many men see hair loss as a natural part of growing older, and they do not perceive the need for treatment.

However, hair loss can trigger negative psychological effects, such as low self-esteem. In some, it can contribute to depression.

Some treatments are available that may help reduce hair loss.

Medication

The U.S. Food and Drug Administration (FDA) has approved two types of drug treatment for male pattern baldness.

Medication

The U.S. Food and Drug Administration (FDA) has approved two types of drug treatment for male pattern baldness.

Minoxidil

Minoxidil, or Rogaine, is a topical treatment applied to the scalp. It is available over the counter (OTC) at pharmacies, usually as a lotion or foam. It is reported to work best on the crown of the head.

 

Treatment for male pattern baldness is available, but a full reversal is not yet possible.

Minoxidil was originally tested to treat blood pressure, but some people noticed additional hair growth as a side effect while using it. It is unclear exactly how it helps prevent hair loss.

It may take 3 to 6 months for results to appear, and the medication must be used indefinitely to preserve effects.

Adverse effects include skin problems, such as itching and irritation, hives, swelling, sensitivity, and contact dermatitis.

More rarely, the user may experience blurred vision, chest pain, a fast or irregular heartbeat, flushing, headache, lightheadedness, and numbness or tingling in the face or the extremities. Rapid weight gain may result.

Finasteride and dutasteride

Finasteride, or Propecia, is an oral treatment available only on prescription.

Finasteride is a 5-Alpha Reductase Inhibitor. It prevents dihydrotestosterone (DHT), a male hormone that plays a role in shrinking the scalp hair follicles. The drug blocks the formation of this hormone in the scalp, slowing the progression of baldness related to DHT.

The effects can take more than 6 months to appear. The 1 milligram (mg) tablet must usually be taken once a day for at least 3 months.

If the pill is stopped, the effects will be reversed.

In rare cases, finasteride can cause sexual dysfunction. This may include reduced libido, difficulty achieving an erection, and ejaculation disorders.

Dutasteride is similar to Finasteride. It is also a 5-Alpha Reductase Inhibitor.