Male Androgenetic Alopecia

Male androgenetic alopecia or male pattern baldness is a type of hair loss in men caused by a genetic condition. It is the most common cause of baldness and affects nearly 50% of men by age 50. Although the symptoms of male androgenetic alopecia are usually visible in middle-aged to older men, hair loss can begin around the age of 20. Patients may notice the signs of hair loss at the early stage. Treatment is more effective if started as early as possible.

Symptoms of Male Pattern Baldness

Male pattern baldness may take a different duration depending on the patient. Symptoms usually show gradually, often beginning with a receding at the corner of the hairline, giving it the appearance of a bang. However, the entire hairline may recede evenly in some men, which is relatively rare.

Causes of Male Pattern Baldness

Testosterone is converted to by the 5a-reductase to dihydrotestosterone (DHT). A high level of DHT is associated with male pattern baldness. This is because DHT binds to the hair follicles making them weaken and shrink. In addition, this hormone also slows down the growth of hair shafts from the hair follicles and eventually stops new hair growth.

DHT is not the only cause of hair loss. It is a natural hormone produced in our body. The sensitivity to DHT in men depends on genetics and the more the hair follicles are sensitive to this hormone, the more severe the hair loss.

DHT has the opposite effect on the hair below the eyebrows although it causes the hair on the top of the head to become weak and fall out. This is why men suffering from baldness still have a large amount of beard and body hair.

Norwood-Hamilton Scale

Male androgenetic alopecia can be measured using the Norwood-Hamilton scale which is divided into 7 stages. Before hair transplantation, the surgeon will determine the degree of hair loss using this scale, then use it to estimate the number of grafts required for hair transplantation hair and help in planning the procedure. It can also be used to predict the progression of hair loss.

There is no fixed criterion as to what stage of Norwood scale a patient should make a decision to undergo treatment. Patients should treat their hair loss as soon as possible when signs of receding hairline or thinning hair are noticeable. The sooner hair loss is prevented, the more effective the method is to stop it and the natural hair can be preserved if medical treatments are started early. The more severe hair loss, the more difficult it is to treat.

The Most Effective Treatments for Male Pattern Baldness

One of the most effective treatments for male pattern baldness is finasteride. It was originally used to treat an enlarged prostate, but is now used in people with hair loss as well. Patient should take 1 mg of finasteride once a day to prevent hair loss. The mechanism of action of finasteride is to inhibit the 5a-reductase, which preventing testosterone from convert into DHT. However, for the advanced stage of hair loss (Norwood scale 5-7), taking finasteride is not very effective as it is primarily effective in stopping hair loss. Several studies have shown that finasteride has an ability to stop hair loss, especially in the crown area. However, this medication may prevent the progression of baldness or receding hairline in some patients.

Another effective treatment for male pattern baldness is minoxidil. Minoxidil is an antihypertensive that was originally used to treat high blood pressure and was later found to be effective in treating hair loss. For treating male pattern baldness, minoxidil is applied to the scalp twice a day in the morning and evening, which dilates the blood vessels under the scalp and increases blood circulation and nutrient supply to the hair. This medication should be used as soon as possible when you notice any signs of hair thinning. It can improve hair loss after continuous use and even stimulate hair regrowth and increase hair diameter in some patients.

However, there is no way to regrow hair that has been lost, and the only method to solve this problem is hair transplantation.

In hair transplantation process, the patient’s hair is extracted from the donor area and then transplanted into the recipient area. these transplanted hairs are still resistant to DHT, thus preventing shedding and giving permanent results.

The cost of hair transplantation is a big hurdle in deciding to have a hair transplant because although in recent years the cost of hair transplantation has come down considerably but the cost of surgery is still quite high. Hair transplants a cost-effective long-term option as they provide permanent results. In addition, many hair loss medications are effective only with continued use, making the overall cost higher than hair transplantation.

How to Hide Hair Loss Problem

Some people choose to cover up their hair loss by using a wig, toupee, extensions, or comb-over. However, these methods are effective for a short period of time and they become less effective as the hair loss progresses. Celebrities who use comb-over to hide their hair fall include Donald Trump and Nicolas Cage.

Micro hair pigmentation is a more permanent method of masking hair loss, and it has become more popular in recent years. This method does not stimulate hair growth, but instead the ink is deposited on the scalp to make it appear thicker. There are also several advantages of this method, such as no need for surgery and the cost is cheaper than hair transplantation. Of course, Micro hair pigmentation has its drawbacks too. It is not suitable for people with dark hair and the ink may fade after a few years. Another option is to embrace hair loss, which is often achieved by shaving the entire head. As hair is often seen as a symbol of femininity, this method is more popular among men. Celebrities who shave their heads to embrace hair loss problem include Michael Jordan, Dwayne Johnson and Ben Kingsley.

Dr. Suthida Arayametee

– Doctor of Medicine, Chiang Mai University

– Grad.Dip.Clin.Sci.(Radiology), Chiang Mai University

– Diploma in Practical Dermatology, Cardiff University, UK

  • Certificate of completion: Fundamental of Platelet Rich Plasma (PRP) Therapy Training Course
  • Certificate of attendance: Implanter Workshop for Hair Transplantation, Faculty of Medicine Siriraj Hospital
  • Certificate of Completion: Medical Weight Management Specialist, School of Antiaging and Regenerative Medicine, Mae Fah Luang University
  • Certificate of attendance RELIFE Master Network Module 3 Advance Workshop for Thread Lifting (Definisse Free Floating)
  • Certificate of attendance Mid-Face Correction & Enhancement using thread, botulinum toxin, filler Workshop by No 1 Trainer
  • Certificate of attendance: RELIFE Master Network Module 2 Advance Workshop for thread Lifting (Definisse Double thread technique with 23-cm-thread)
  • Certificate of attendance: 9th ITCAM Hands-on Cadaveric Dissection of Toxin and Filler Injections and Thread Lift
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