Male Pattern Baldness Causes and Treatments

Male pattern baldness is by far the most common type of hair loss in men. According to the U.S. National Library of Medicine, more than 50% of all men over the age of 50 will be affected male pattern baldness to some extent.

We all recognize men who lose the hair at the temples, in a strip along the center of their head and crown, leaving hair intact on the sides and along the back the head. The main factors of the hair loss are genetics, age, and hormones.

In men, testosterone is metabolized to dihydrotestosterone. In some men, the hair in the central strip of the scalp will not grow in the presence of dihydrotestosterone. The hair follicles in this zone gradually produce shorter, finer hairs until the follicles cease to function. In other men, the hair in this zone is not affected by the dihydro-testosterone and the hair continues to grow normally.

The tendency to develop male pattern baldness can be attributed to genetic factors. If a male wants to know if he might develop male pattern baldness, he should observe his father, his grandfather, his uncles and other male relatives. Although the hereditary tendency is not straight forward, observing your male relatives will give some clues.

Why does this occur in men, and not in women? Women, of course, are not susceptible to this type of baldness due to the fact that they do not have the same level of testosterone as males.

The key to treating male pattern baldness is early recognition of hair loss and early treatment. We do not tend to recognize we are losing hair at a significant rate until we have already lost approximately 50% of our hair follicles.

Hair follicles don’t suddenly stop producing hair shafts. Hair shafts produced by the follicle gradually begin to become shorter and finer until the hair follicle stops producing hair shafts altogether. At this point, the loss is irreversible and that follicle permanently ceases to function.

Therefore, if the process of hair loss is recognized early while the hair shafts are in the process of becoming shorter and finer, it is possible with appropriate treatment for the hair follicle to be saved and the process reversed causing the follicle to again produce a thicker, most substantial hair shaft.


Effective treatment is required to reverse the process of hair loss. There are many treatments that are not effective and have no science supporting their use. If these ineffective treatments are used for prolonged periods of time before effective treatments are started, further significant and permanent hair loss can occur.

Laser and light therapies are popular, but they have no been shown to slow or prevent male pattern baldness, and the FDA has not approved them for efficiency. Hair transplantation is also an option, but often expensive.

The FDA has approved two types of drug treatment for male pattern baldness – minoxidil and finesteride. It may take 3 to 6 months to see results from these medications. And they must be used indefinitely to preserve effects.


The use of medication is essential in the treatment of male pattern baldness. There are two goals in the use of medication. The first is to prevent or slow down further hair loss. A secondary benefit is to cause regrowth in hair follicles that have not yet ceased to function.

There are three main scientifically-proven products from which to choose:

Propecia (Finasteride)
Typically an oral treatment option, Propecia prevents the formation of dihydrotestosterone from testosterone. There is a small incidence of sexual side effects associated with Propecia, thought to be reversible when the medication was discontinued. However, in the last few years, there have been questions whether the side effects are reversible in all cases.

Rogaine (Minoxidil)
Rogaine is a topical over-the-­counter medication. Rogaine is less effective than Propecia and is mainly effective for hair loss in the crown. There are no significant side effects. It is acceptable to use both Propecia and Rogaine in the treatment of male pattern baldness.

Formula 82
This compounded preparation is available only through a medical office. Formula 82 is a topical preparation developed by a group of leading hair transplant physicians. It contains a retinoid, minoxidil, steroid and a multi-vitamin complex. It acts by balancing the blood flow to the hair follicles. The hair shafts it regenerates are thicker and more substantial than those obtained by commercially available Rogaine. It works more effectively throughout the scalp and there are no known side effects. There are two forms of Formula 82 – one that contains minoxidil and another that contains Propecia. We offer both Formula 82 products in addition to a shampoo + conditioner. To learn more visit:

Hair loss can be distressing. For men beginning to see hair loss, even those in their early 20s, it’s vital to start a treatment plan to retain full and healthy hair before too much is lost. If you have concerns about hair loss, our experts will be happy to schedule a consultation with you and help determine the best treatment plan for you.