Male Pattern Baldness (Alopecia)

Male Pattern Alopecia (Male Pattern Baldness)

Male pattern alopecia (MPA)  is the most common cause of hair loss in men, and is the most common indication for hair transplant in our San Diego practice.  We don’t know exactly why some men are susceptible to this condition and others not, but we do know there is a genetic component. In the past, hair loss was thought to be transferred from the mother’s side, but we now know it is not so simple, and this condition can be inherited from either the mother or the father’s side, and skip certain relatives or generations entirely.

The Norwood scale is pictured above. This scale shows the most common patterns seen in men with MPA.  Hair loss can progress from Class 1 all the way to Class 7 or may stop at any point along the scale.

The goal of the hair transplant procedure is to take a man backward on the Norwood scale- as far as possible toward a class 1 or 2.  However, some limitations set in because we want your result to look natural in the event of future continued hair loss. In other words, we don’t want to create a low hairline in a 25 year old who will progress to a Class 7 and then appear unnatural( with  dense hairline and bald midscalp).

Luckily, with increasing age comes increasing stability of hair loss, allowing more aggressive hair transplant procedures.  In the meantime, younger men can slow down and stabilize their loss with proven medications such as minoxidil and finasteride. Minoxidil (Rogaine) is a topical medication that is thought to increase blood flow to at-risk follicles. Finasteride (Propecia) inhibits the enzyme that converts testosterone to dihydrotestosterone (DHT).  DHT   affects  follicles susceptible to hair loss,  resulting in baldness, so blocking  DHT helps maintain or grow hair. Both of these medications are FDA approved.

At the individual hair level, male pattern baldness causes what is called miniaturization.  Terminal hairs which are normally thick and long become thin and short, almost “see through” and are subsequently lost. It is these hairs that benefit most from treatment with finasteride (Propecia) and minoxidil (Rogaine).  Furthermore, starting these medications months before your hair transplant procedure can protect miniaturized hairs from “shock loss” after the procedure.