Male-pattern baldness

• absent hair or hair loss
• receding hairline
  • hairline recedes from the front toward the back over time

• thinning of hair
• loss of hair at the crown of head
• progression of hair loss in a typical "M"-shaped pattern which eventually results in a loss of hair over the top of the head, and a horseshoe ring shape to remaining hair

Signs and Tests:
Classic male-pattern baldness is usually diagnosed based on the appearance and pattern of hair loss . Hair loss that occurs in an atypical manner may be caused by other medical disorders.

A skin biopsy or other procedures may be needed to diagnose other disorders that cause loss of hair . Hair analysis is not accurate for diagnosing nutritional or similar causes of hair loss.

Treatment:
The hair loss of male-pattern baldness is permanent. No treatment is required if the person is comfortable with the appearance.

The only drug/medication approved by the United States Food and Drug Administration (FDA) to treat male-pattern baldness is minoxidil, used topically on the scalp. It may help hair to grow in 10 to 20% of the population, and in 90% it may slow the loss of hair . Treatment is expensive, however, costing about $600 per year for the recommended twice a day use. Hair loss recurs when its use is discontinued.

Hair transplants consist of removing tiny plugs of hair from areas where the hair is continuing to grow and placing them in areas that are balding . This can cause minor scarring in the donor areas, and carries a low risk for skin infection. The procedure usually requires multiple transplantation sessions and may be expensive.

Suturing of hair pieces to the scalp is not recommended as it can result in scars, infections, and abscess of the scalp or brain. The use of hair implants made of artificial fibers was banned by the FDA because of the high rate of infection.

Hair weaving, hair pieces, or change of hair style may disguise the hair loss. This is usually the least expensive and safest treatment for male-pattern baldness.

Prognosis:
Male-pattern baldness is cosmetically important and does not indicate a medical disorder, but it may affect self-esteem or cause anxiety . The hair loss is usually permanent.

Complications:

• psychological stress
• loss of self-esteem from change in appearance

Call Your Healthcare Provider:
Call for an appointment with your health care provider if male-pattern baldness develops and there is a desire to attempt to treat the hair loss .

Also call your health care provider if hair loss occurs in a pattern not typical for male-pattern baldness (there could be a treatable medical cause for the hair loss), or if hair loss is accompanied by itching , skin irritation, or other symptoms.


Baldness appears to be a heritable trait, although the exact mode of inheritance is still in question. Typically it begins with recession of the hairline high on each side of the forehead backward across the scalp. The crown of the head may begin to bald shortly thereafter.