Male Pattern Hair Loss

norwood's classification showing stages of male pattern hair loss

Male Pattern Hair Loss

Hair loss generally known as baldness or alopecia refers to the loss of a significant amount of hair from the scalp beard or other body parts. As per new data, more than 50% of the male population over the age of 30 started going bald or affected by androgenic alopecia / male pattern baldness or started having signs of it.

Male Pattern Hair Loss

It found genetics play a major role, as men who have close relatives with baldness or androgenic alopecia are more likely to develop the same but at an early age. 

The main mechanism through which it happens is the action of DHT on the hair follicular growth cycle for slow and poor growth of certain specific areas of the scalp in a patterned manner. DHT not only causes poor hair growth but also leads to dandruff, oily scalp, and many more scalp problems as well.

In the Initial days when hair transplants and PRP treatment were not available, only DHT-blocking medicines were the only choice of treatment option available.

Triggers of Baldness

  • Hereditary hair loss: Most common cause of hair loss worldwide. In men and women, it’s called male pattern hair loss, and female pattern hair loss respectively. The medical term is androgenic alopecia.  An inherited gene causes your hair follicles to shrink and eventually stop growing hair. Shrinking can begin as early as your teens, but it usually starts later in life. In women, the first noticeable sign is overall thinning or a widening part. In men, the first sign is a receding hairline or bald spot at the top of his head.
  • Age: With age, most people notice some hair loss because hair growth slows. As hair follicles stop growing hair, it causes the hair on our scalp to thin. Hair starts to lose its color. A woman’s hairline naturally starts to recede.
  • Hair care: If you color, perm, or relax your hair, you could be damaging your hair. Over time, this damage can lead to hair loss
  • Medication: A possible side effect of some medications is hair loss. If you think a medication is causing your hair loss, ask the doctor who prescribed it if hair loss is a possible side effect.  It’s essential that you do not stop taking the medication before talking with your doctor. Abruptly stopping some medications can cause serious health problems.
  • Scalp psoriasis: Many people who have plaque psoriasis develop psoriasis on their scalp at some point. This can lead to hair loss.
  • Scalp infection: A scalp infection can lead to scaly and sometimes inflamed areas on your scalp. You may see what looks like small black dots on your scalp. These are actually stubs of hair. Some people develop a bald spot.
  • Low Energy Levels: The body’s ability to convert the food we eat to energy is what determines how much or how little energy we have. This is called metabolism. A good metabolism is required for the body to break down nutrients from food and supply them through the blood to the follicles. 
  • Hormonal Imbalance: The fact that hormonal issues cause hair fall is something that is new to everyone. Conditions like PCOS, thyroid imbalance, diabetes, menopause, and pregnancy all involve fluctuating hormones, and along with other hormones, it also takes a toll on the hormone DHT which causes it to spike and leads to severe hair shedding. In reality, hormonal-triggered hair loss is one of the leading causes of genetic hair loss.
  • Nutritional Deficiencies: Hair needs food too. Biotin, iron, zinc, etc as in all macro and micronutrients are required by a hair for it to grow in an ideal manner. 
  • This means that when any of these nutrients fall short in the body, it aggravates the hormone DHT and the excess of it has a negative effect on the hair strands and reflects as hair thinning along with looking dull, and lifeless.
  • Lack of sleep: The Circadian cycle also called the sleep-wake cycle plays an important role in hair health. This is why sleep is of utmost importance when it comes to literally any organ activity. 
  • Irregular sleeping patterns also aggravate stress and cause hair thinning. A hormone called melatonin is released during sleep which is very essential for the smooth functioning of the hair cycle. 
  • This melatonin also works against DHT – the main hormone responsible for hair fall where it causes DHT to unbind from the hair follicle receptors. Lastly, if melatonin is not produced in equal amounts due to not getting proper 8 hours of sleep, this can hamper the cycle and cause genetic hair loss.
  • Stressful Events: When stress builds up in the body, cortisol a.k.a the stress hormone takes control. Be it work stress, the loss of a loved one, or a serious traumatic event, in other words, both short-term and chronic stress hampers the regular functioning of the hair growth cycle and causes hair loss.

Signs or symptoms of male pattern hair loss

  • More than usual hair fall / hair shedding per day
  • Hair density thinning in front to top crown area
  • Receding hairline from the corners
  • Sudden hair loss
  • Bald patch or skin visibility increased on the crown area
  • Increased Scalp itchiness or dandruff triggered more frequently
  • Poor or slow growth of hair follicles

Classification of Male Pattern Hair Loss:

Norwood and Hamilton are the scientific researchers and doctors who have analyzed the typical sequence in which people suffer from male pattern baldness.

They noticed that hair loss initially leads to thinning of the frontal and temporal area of the hairline and then starts receding towards the crown. Which is known as the early stage/ level of baldness. Later on, at the top of the scalp, the crown area also starts thinning and showing bald patches or areas that gradually merge with the front baldness zone with age. When the front and crown are merged, this stage of baldness is known as the advanced stage of baldness.

Why is it important to know the stage or level of baldness?

Because the treatment plan or prevention of baldness is set according to the level of baldness, if someone is in the initial early stage of baldness that is grade 1-2-3, there are still chances he may recover his lost hair growth or density through medical management if done on time.

If someone is at an advanced stage, it’s not possible to recover a full scalp from baldness, and to get such an outcome he may need to go under a hair transplant procedure as well along with routine medical management.

What does hair loss look like for each stage?


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