Male Pattern baldness, also known as androgenic alopecia, is the most common type of hair loss in men. According to the U.S National Library of Medicine (NLM), more than 50 percent of all men over the age of 50 will be affected by male pattern baldness to some extent.
Main causes of hair loss in men
The main cause for male pattern baldness is genetics. It is especially associated with the male sex hormone dihydrotestosterone (DHT). After puberty, the body produces more testosterone and DHT, which affects hair follicles in those who are genetically disposed to hair loss. The hair follicles shrink, producing shorter and finer strands of hair in each hair life cycle until it can no longer grow hair at all. This process is sometimes referred to as hair miniaturization.
Hair loss may also be caused by health conditions and high stress levels. Itchy scalp, a receding hairline, formation of bald spots, inflamed hair roots, and red areas on the scalp may indicate the start of male pattern baldness.
In this article, we will discuss the process of male pattern baldness, how to identify it, and the 7 stages of this process, often measured on a Norwood scale.
How to identify hair loss and know if you have male pattern baldness?
Male pattern baldness tends to develop in three ways: A receding hairline, sparseness at the crown, or overall thinning (sometimes also known as ‘invisible baldness’).
Identifying male pattern baldness is not always easy. There are several signs that you can look out for that may identify whether or not you have male pattern baldness.
- A receding hairline is one of the biggest signs of male pattern baldness. Your hair might begin to thin at the temples, creating a more prominent widow’s peak, and a hairline that resembles M or horseshoe.
- Rapid hair loss. We all lose about 100 hairs each day. But if you start to witness your hair falling at a much higher rate than before, then it’s a sign that your hair might be permanently thinning.
- Hair at the crown or back top of the head becoming sparser until the classic bald spot is evident is also one of the signs.
- Invisible balding or your hair getting thinner overall is a sign. You may not notice any bald spots or receding hairline because your hair loss is so balanced that you may only notice it until after almost 50% of your hair has been lost.
- If your hair growth cycle is becoming shorter. If hairs are shedding earlier than before, or if stops growing at a shorter length than before, then it may be a sign of male pattern baldness.
Hamilton Norwood Scale: 7 stages of male pattern baldness
James Norwood introduced a scale to measure the stages of male pattern baldness in the 1950s. Dr. O’Tar Norwood then significantly improved this scale in the 1970s. The Norwood scale defines seven stages of baldness, with a specific model for each type of baldness. Each stage has a normal pattern and a class A pattern. The normal pattern tends to start with a bald spot on top of the head. Class A is when the hairline recedes from the front to the back instead.
Norwood 0: no visible hair thinning
It is the control stage. People in this stage of male pattern baldness still have a full head of hair with little to no signs of baldness or a receding hairline.
Norwood 1: slightly receding and mature hairline
In this stage, there is only slight evidence of receding or mature hairline, generally around the temples.
Norwood 2: increasingly receding hairline and frontal hair loss
Hair loss starts to become visible in this stage. Hairline typically pulls backward from the temples, giving it a curved M-shaped form.
Norwood 3: balding in front, hair thinning on top of head and vertex
In terms of receding hairline, this stage vertex is less drastic than the previous one. However, people losing hair will experience a small bald spot or hair loss on the crown of the head.
Norwood 4: increasingly thinning on top and balding on the vertex
In stage 4, the hairline recedes farther and experiences a significant hair loss. The bald spot on the crown is larger, but there is still a strip of hair between the bald spot and the receding hairline.
Norwood 5: increasingly thinning on top
Stage 5 shows a similar progression to stage 2 but is more severe. There is still a small section of hair between the receding hairline and the balding crown. However, the strip of hair is much thinner than in the previous stage.
Norwood 6: complete hair loss and balding on top
Someone in this stage is mostly bald on the front and top of their head. The two bald areas now join together and there is no strip of hair between them. There may still be hair on the sides, but the crown and front of the head are mostly bald.
Norwood 7: horseshoe-shaped male pattern baldness
The baldness also begins to affect the sides of the head until only a thin ring of hair encircles outside the head. The hair that grows is likely to be weak and thin.
How long does the male pattern process take?
Some men may find their male pattern baldness progress quickly, losing much of their hair within 5 years. However, it is more common for hair loss to progress more slowly, usually over 15 to 20 years or even slower.
Once hair loss starts, does it always progress until one is bald?
Since the hair loss progresses slowly, it takes several years to go completely bald. One can take up treatments to stop baldness and hair loss.
Hair loss usually stops at Norwood stage 7 baldness, but there are also treatments to regrow hair and recover your bald head like hair transplant along with several other medications and hair stimulants.
Typically, the sooner one starts hair loss treatments, the more effective they are. If one waits until most hair has been miniaturized, it may be impossible to reverse the hair loss process, or it has minimal effect as the hair follicles are considered dead.
Can male pattern baldness stop on its own?
Unfortunately, male pattern baldness will not stop on its own. It’s up to you if you want to treat it or accept it. It can be stopped or slowed down through various forms of treatments, and may also be reversed in some cases.
It may be hard for genetic male pattern baldness to be stopped permanently, but with treatments and medications that are taken according to a doctor’s prescriptions and suggestions, one’s hair may be maintained at one’s current stage for years or decades longer than in the case of no treatment at all.
