What Is Male Pattern Hair Loss? A Simple Explanation

Male pattern hair loss – also known as androgenetic alopecia – is the most common type of hair loss in men. It’s a genetic condition where hair follicles become gradually miniaturised over time, causing hair to grow back thinner, shorter and eventually not at all.

Around 30-50% of men experience this type of hair loss by age 50 and it usually follows a predictable pattern, starting at the temples, crown or both.

What Actually Causes Male Pattern Hair Loss?

Male pattern hair loss (MPHL) happens when your hair follicles are affected by a hormone called DHT (dihydrotestosterone). Here’s what that means:

1. DHT shrinks hair follicles

If you're genetically predisposed to pattern hair loss, a hormone called dihydrotestosterone (DHT) causes a change in the hair follicles on the scalp. In a process termed “miniaturisation”, hairs produced by the affected follicles become gradually thinner and lighter in colour until eventually the follicles shrink completely and stop producing hair.

2. Growth phase becomes shorter 

Over time, the growth (anagen) phase shortens, so your hair doesn’t reach the length or thickness it used to.

3. Eventually the follicle stops producing hair

This doesn’t happen overnight – it’s gradual and often very slow. But without treatment, MPHL typically progresses over the years.

Where Does Male Pattern Baldness Start?

Male pattern hair loss follows a recognisable pattern:

1. A receding hairline

Hair around the temples begins to move back, forming an M-shaped hairline.

2. Thinning at the crown

A small bald spot may appear at the top/back of the head and slowly widen.

3. Both areas spread and eventually meet

This creates the classic horseshoe pattern many men associate with balding.

Not everyone follows this exact order – some men see hairline recession first, others experience crown thinning first.

Early Signs to Watch Out For

Male pattern hair loss usually starts subtly. You might notice:

• Widening temples
  
  

• Thinner hair at the crown
  
  

• Extra scalp showing through
  
  

• Shorter or softer hairs around the hairline
  
  

• Hair that doesn’t style the way it used to
  
  

• A more noticeable “V” shape at the front

Spotting it early matters. The sooner treatment begins, the easier it is to slow or reverse.

Who Gets Male Pattern Hair Loss?

MPHL is a result of a combination of genetic and hormonal factors. It is believed this can be inherited from either or both parents. Over 190 genes have been identified as contributing, which helps to explain how MPHL affects family members to varying degrees of severity and at different ages. Not all patients who have a bald father will develop pattern hair loss. 

It can also begin quite early at any time from your late teens, but many men notice the first signs in their 20s or 30s.

Does Stress Cause Male Pattern Hair Loss?

Stress doesn’t cause male pattern balding – but it can make shedding more noticeable.

Conditions such as telogen effluvium (stress-related shedding) can happen at the same time as MPHL, making hair loss seem worse.

If hair falls out diffusely all over the scalp rather than in a pattern, it may not be MPHL alone.

Is Male Pattern Hair Loss Permanent?

Without treatment, male pattern hair loss does tend to progress.

But the good news is that there are treatments which are:

• Clinically proven
  
  

• Widely used & safe
  
  

• Effective for many men

And earlier action leads to better results.

How is Male Pattern Hair Loss Diagnosed?

In a clinic setting, a clinician will examine your scalp and perform trichoscopy to assess hair changes. In combination with a detailed clinical history, diagnosis is easily made and biopsy is not required.

Pattern hair loss can also be diagnosed safely and accurately through teledermatology. At Hair + Me, your online consultation is reviewed by a qualified Pharmacist Prescriber trained in hair and scalp conditions. You’ll be asked to provide clear photographs of your scalp from specific angles, alongside details about your medical history, symptoms and medications. Because MPHL has a recognisable pattern, it can usually be identified without the need for an in-person visit.

If anything in your history suggests a different cause, such as thyroid imbalance or iron deficiency, you may be advised to seek further tests before treatment is prescribed. This ensures your diagnosis – and any treatment plan – is both personalised and medically appropriate.

Is There a Cure for Male Pattern Baldness?

There’s no permanent “cure,” but there are treatments that can delay or stop the progress of hair loss for many men.

When Should You Get Help?

You should consider speaking to a dermatologist or pharmacist if you:

• Notice sudden or patchy hair loss
  
  

• See a widening bald spot or rapid thinning
  
  

• Have a family history of early hair loss
  
  

• Feel unhappy, stressed or self-conscious about hair changes
  
  

• Want to prevent further progression

Early intervention is key.

Treatment Options

Here are the most common evidence-backed treatment options:

1. Minoxidil

Improves circulation and supports hair growth.

2. Finasteride / Dutasteride

Targets DHT to prevent further follicle shrinkage.

3. Combination therapy

Using minoxidil and finasteride/dutasteride in combination can often be the most effective approach.

4. Hair transplants

A surgical option for more progressed cases of male pattern hair loss. 

5. Low-level laser therapy/aesthetic treatments

A supplementary treatment with some scientific support. Microneedling, platelet-rich plasma injections (PRP) and hair camouflage (e.g. concealer, hair pieces, hair fibers, toupés and wigs).

Final Thoughts

Male pattern hair loss is:

• Very common
  
  

• Related to genetics
  
  

• Caused by sensitivity to DHT in patients who are genetically predisposed
  
  

• Progressive without treatment

But importantly – it’s also manageable, especially when treated early.

References:

1.Asfour L, Cranwell W, Sinclair R. Male Androgenetic Alopecia. [Updated 2023 Jan 25]. In: Feingold KR, Ahmed SF, Anawalt B, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278957/

2. Devjani S, Ezemma O, Kelley KJ, Stratton E, Senna M. Androgenetic Alopecia: Therapy Update. Drugs. 2023 Jun;83(8):701-715.

3. Kanti V, Messenger A, Dobos G, Reygagne P, Finner A, Blumeyer A, Trakatelli M, Tosti A, Del Marmol V, Piraccini BM, Nast A, Blume-Peytavi U. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men - short version. J Eur Acad Dermatol Venereol. 2018 Jan;32(1):11-22. 

4. Jimenez F, Alam M, Vogel JE, Avram M. Hair transplantation: Basic overview. J Am Acad Dermatol. 2021 Oct;85(4):803-814.