Men around the world, regardless of age, fear of losing their hair or going bald unites the masses. In this blog, I will discuss a common type of hair loss in men, Androgenic Alopecia (AGA), also known as Male Pattern Hair loss, answering the most common questions.
What causes hair loss in men?
Androgenic Alopecia is the leading cause of hair loss in men and will affect up to 80% of males by the time the reach 80 years of age. (1) The onset is usually around the mid twenties and will start as a receding hairline or thinning of the crown area.
Androgenetic Alopecia is loosely translated into – hair loss caused by androgens. The androgens in this case are the hormone Testosterone. Free testosterone in the body is converted into a more potent form called DHT (dihydrotestosterone) by the enzyme 5-alpha-reductase. The DHT causes the hair follicle to slowly stop producing terminal hair and instead have a shorter growth cycle resulting in shorter, fine hairs vellus hair, found on other areas of the body.
AGA is an autosomal dominant trait, which means that it can be inherited from either the mother or father although it is not normally expressed in women due to low levels of testosterone.
Why is my hairline receding?
The first symptom of AGA is usually a receding hairline. The Hamilton–Norwood classification system shows the clinical progression of hair loss (2). The diagrams depicts 7 stages of hair loss which all start with a general regression of temple hair. However this study was not without its flaws as it was only conducted on caucasian males and may not include racial differences.
How do you stop a receding hairline?
Once you start to notice hair loss it is imperative to speak to a professional who can accurately diagnose and prescribe the correct treatment options. AGA is notoriously difficult to treat but there are other contributing factors which have been known to speed up its progression.
- Men who are very active or take supplements have to be careful when taking whey protein isolate that may contain extra testosterone that is not needed in the body and can be converted into DHT. (3)
- Stress is a major cause of hair loss due to the chemicals released by the nervous system. It can even result in an immune reaction where the follicles are attacked or permanently destroyed. (4)
How can I regrow my hairline?
Often once it’s very hard to stop or reverse without the use of drugs. There are two medications on the market that are commercially available and have been used as a treatment option for treating male pattern baldness and receding hairlines.
- Minoxidil is used topically and is sold most notably as the brand Regaine. It is a potent vasodilator and increases blood flow to the area increase the length of anagen, the growth part of the hair cycle. The specific mechanism are unknown but the concentrations of 2&5% have been found to restore hair to a cosmetically pleasing level. The major downside of minoxidil is that the success rate are very low, around 20%. (5) It must be applied consistently and for life as once usage is stopped, so will any progress and the hair loss will return with immediate effect.
- Finasteride is another product that can be taken orally but has to be prescribed by a medical doctor. It inhibits the activity of the enzyme 5 alpha reductase which is the key component in converting testosterone into DHT and subsequently causing hair loss (6).
Both of these medication have very serious side effects which some men will find outweigh the rewards of increased hair growth. They are mostly due the the lowering of testosterone which can affect libido, erectile function and other blood vessel disorders.
How can I hide my receding hairline?
If you have realised that you’re suffering from alopecia or just general thinning of your hair, there are several steps you can take to reduce the visibility of the hair loss and hide if you so choose:
Grow your hair longer
Only certain parts of the scalp are affected by AGA, so even if you experience loss in certain areas you may still be able to grow hair to a reasonable length to hide or shield thinning areas.
Use hair fibres
Hair fibers can be used to darken of fill sparse areas, reducing the visibility of the scalp.
Hair replacement units
For more widespread hair loss, a wig or toupee can be used in conjunction with the remaining hair for a seamless blend that is virtually undetectable.
Many men opt to have a hair transplant as a more permanent action to tackle AGA. Donor hairs are taken from the occipital area and inserted into the hairline and crown. This can be expensive but the technology is rapidly improving for less scarring and better results. It is important to note that some people require several surgeries and the newly implanted hairs do not always take or causing subsequent growth.
- Deepani Rathnayake & Rodney Sinclair (2010) Male androgenetic alopecia, Expert Opinion on Pharmacotherapy, 11:8, 1295-1304,
- Hamilton JB. Patterned loss of hair in man; types and incidence. Ann N Y Acad Sci. 1951;53:708–28.
- Amino Acid Supplements and Recovery from High-Intensity Resistance Training Sharp, Carwyn P M; Pearson, David R. Journal of Strength and Conditioning Research. 24(4):1125-1130, April 2010.
- Botchkarev VA. Stress and the Hair Follicle: Exploring the Connections. The American Journal of Pathology. 2003;162(3):709-712.
- 1: McClellan KJ, Markham A. Finasteride: a review of its use in male pattern hair
loss. Drugs. 1999 Jan;57(1):111-26. PubMed PMID: 9951956.