Male Pattern Baldness

androgenetic alopecia

Although it mainly affects men psychologically there has been recent studies that show a relation with increased incidence of cardiovascular diseases, higher blood pressure and cholesterol levels. It is now even considered as an early marker of prostate diseases.


As spoken before there is a high genetic prevalence of why men go bald. These factors modify the hair follicles’ response to circulating androgens. Specifically the variation in the androgen receptor (AR) gen found on the X chromosome.

Those with high genetic risk will start going bald in their early years as teenagers. This, combined with the number of affected family members will increase the risk of baldness.

In a normal hair cycle, each telogen hair will be replaced by a new anagen hair. Anagen, the growing phase lasts around 3-5 years, while the telogen lasts around 3 months. In male pattern baldness, the growing phase decreases with each cycle while the length of telogen remains, making the growing phase so short that won´t even let new hair to reach the surface of the skin.


There are many options available for balding men. Since it is not a life threatening condition, allowing it to progress naturally is still an option most men do. Although not life threatening, its psychological impact is still very marked, that is why the cure is still trying to be found like the holy grail.

Wigs and hairpieces

Hair style changes, scalp dyeing and adding small fibers are some of the cheapest and satisfactory measures men can do. Modern wigs may be washed and give a natural look. Hair weaves can be sewn into your natural hair. It has the advantage that it will always stay throughout the day. The bad part is it can damage your natural hair.

Medical Treatment

FDA approved drugs are topical minoxidil and oral finasteride. Both prevent hair loss but cannot completely reverse the effects of baldness. Its effects start showing up 6-12 months after, so it is recommended for you to use it at least one year before deciding to change treatment.

Minoxidil works as a hair growth promoter, but the slow miniaturization of hair follicles continue in spite of treatment. It is available in 2% and 5% solutions. Recent studies have found that 5% solutions are more effective. Some of the side effects it may produce are itching of the scalp, increased dandruff and skin irritation.

Finasteride diminishes the conversion of testosterone, the male hormone responsible in part to hair loss. It has been reported to slow progression of hair loss and partially produces hair growth. A daily dose of 1 milligram has shown benefits and reduces the hormone by up to 64%. Some of the side effects are loss of libido and erectile dysfunction.

Other emerging medical therapies include topical antibiotics to combat the inflammatory cells seen in male pattern baldness, growth factors and laser treatment.

Surgical treatments involve hair transplantation from the back side of the scalp that have active hair growth factors to the front and mid section of the head. The effects can only be seen after three months after surgery and the success of the grafts is up to 90% effective.  Some of the side effects are risk of scarring and infection. Multiple treatments are necessary depending on the surgeon’s skills and patient’s factors.