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Male Pattern Baldness: Symptoms, Causes and Treatments

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Geoffrey C. Whittaker

Published 11/09/2020

Updated 12/21/2023

If you’ve noticed your hairline creeping backward, your widow’s peak becoming more obvious, a new bald spot or just a few extra hairs on your pillow or in your hairbrush, male pattern baldness could be the culprit.

Male pattern baldness is a common issue that can occur in men of all ages. It can cause diffuse hair loss that affects your entire scalp, a receding hairline, a bald patch, or a mix of different hair loss symptoms that all affect your scalp simultaneously. 

It’s easy to panic when you notice any loss of hair. However, the good news is that male pattern baldness is very treatable, typically with FDA-approved hair loss medications such as finasteride and minoxidil.

Below, we’ve explained what male pattern baldness is, the hair loss symptoms it can cause and the factors that can play a role in its development.

We’ve also covered everything you need to know about treating male pattern baldness, from the most effective hair loss medications to over-the-counter products for stimulating hair growth and reducing issues such as hair breakage.

Male pattern baldness is a genetic and hormonal condition that can cause you to lose hair. It is by far the most common cause of hair loss in men, affecting more than 50 percent of all men by the age of fifty.

A range of different names is used to refer to male pattern baldness, including the clinical term androgenetic alopecia. 

Male pattern baldness usually causes a receding hairline (a V or M-shaped hairline), as well as loss of hair in other areas of your scalp. It’s a common issue that can be seen, in some form, in many adult men.

Although male pattern baldness is most common in middle-aged and older men, it can occur at any age. Many men notice the early signs of male pattern baldness, such as a receding hairline or diffuse thinning, at some point in their 20s and 30s.

Not all hair loss in younger men is male pattern baldness. Other reasons for hair loss under 25 include stress, anxiety and traumatic experiences, medical conditions, certain medications, and in some cases, nutritional deficiencies.

As the name “androgenetic alopecia” might suggest, the main causes of male pattern baldness are genetic factors and androgen hormones, or male sex hormones.

Male Pattern Baldness Symptoms

The most noticeable, visible symptom of male pattern baldness is hair loss. Hair loss from male pattern baldness can develop in a variety of patterns, ranging from diffuse thinning to a receding hairline.

These symptoms usually develop gradually over the course of several years, meaning you won’t typically wake up and suddenly notice that you’re balding.

Instead, you may notice your hairline gradually receding over the course of a decade, or the hair on your scalp slowly but steadily becoming thinner and less able to cover your skin. 

In some cases, you may not notice any hair loss or changes to your pattern of hair for years at a time, then notice hair loss in the mirror when you’re in a room with bright, harsh lighting, or when your hair is wet.

We’ve discussed the most common signs of male pattern baldness in more detail below, as well as how each issue may affect you if you’re prone to this form of hair loss. 

Receding Hairline

Most men begin to notice male pattern baldness as their hairline starts to recede. Male pattern baldness can cause you to develop the classic M-shaped hairline, with receding corners and a longer widow’s peak area (referred to as a forelock).

In addition to balding near your crown, a receding hairline is one of the most common signs of male pattern baldness.

Not every hairline recedes in the same pattern. You may notice that one side of your hairline is more affected by hair loss than the other, or that you have more consistent hair loss that occurs evenly across your entire hairline.

Thinning Crown

Not all men with male pattern baldness experience hair loss around the hairline. If you’re prone to male pattern baldness but don’t have a receding hairline, you might notice the hair near your crown starting to fall out and look thinner.

In some cases, you may also notice thinning around your crown at the same time as a receding hairline. 

Because hair loss around the crown of your head isn’t easy to see in the mirror, it’s common for men affected by crown thinning not to notice their hair loss until it’s quite advanced. 

The easiest way to check for this type of hair loss is to use a handheld mirror or take a selfie of the back of your head. Make sure to take photos in consistent lighting conditions so that you can accurately track your hair loss over time. 

Diffuse Thinning

Diffuse thinning is a form of hair loss that affects your entire scalp, thinning your hair without any obvious effects on your hairline or other specific areas.

Although it’s less common than a receding hairline or hair loss near your crown and is more likely due to a different type of hair loss called telogen effluvium, diffuse thinning can be a symptom of male pattern baldness. 

This type of hair loss is generally easiest to notice when your hair is wet, or in bright lighting that makes areas of the scalp more visible.

What Causes Male Pattern Baldness?

Like with many other common conditions, there are lots of myths and misconceptions out there about the factors that male pattern baldness. 

Contrary to popular belief, habits like wearing a hat, using a non-organic shampoo or forgetting to wash your hair every now and then won’t cause you to develop a pattern of hair loss.

Instead, male pattern baldness is caused by a combination of two main factors: your production of androgenic hormones, such as dihydrotestosterone (DHT), and your genetic sensitivity to the effects of these hormones.

DHT is an androgen, or male hormone, that’s produced naturally by your body. It’s created as a byproduct of the sex hormone testosterone, meaning your body converts a small amount of the testosterone you create into DHT on a regular basis.

During pregnancy, childhood and puberty, DHT is an important hormone for helping you to form male characteristics. 

Physical features like your body hair, your genitalia, the shape of your jaw and your voice are all a result of your exposure to DHT.

DHT is produced by an enzyme referred to as 5-alpha reductase (5AR), which is responsible for the conversion of testosterone to dihydrotestosterone. 

So, what exactly is the relationship between DHT and the symptoms of male pattern baldness, such as a receding hairline or bald spot?

DHT causes hair loss by attaching to receptors in your scalp, called androgen receptors. Once it’s attached to these receptors, DHT causes your hair follicles to shrink and weaken through a process that’s referred to as “miniaturization.”

As your hair follicles miniaturize, they produce finer hairs and eventually lose the ability to grow new hairs at all, resulting in visible thinning and hair loss. 

For some men, DHT isn’t a big deal. It circulates freely in their bodies without affecting their hair in any noticeable way. 

However, some men are highly sensitive to the effects of DHT and notice hair loss that begins in their early-to-mid 20s, or even in their late teens.

The more sensitive your hair follicles are to DHT-related damage, the quicker you’ll likely notice your hair thinning and falling out.

Not all of the hair follicles on your scalp are equally sensitive to the effects of DHT. Even in men with a genetic predisposition to hair loss, it’s common for a rim of hair to remain at the back and sides of your scalp.

Our detailed guide to DHT and male pattern baldness explains more about how this form of hair loss can develop, as well as the role that androgen hormones can have in balding. 

While male pattern baldness is the most common type of hair loss in men, it isn’t the only issue that can cause you to lose hair.

From medical conditions to stress, a variety of issues can cause you to either lose hair, either in the short term or permanently. We’ve discussed these below and explained how each issue can affect your hairline in the future.

Medical Conditions

Hair loss can often occur as a symptom of certain diseases and medical conditions, or as a side effect of some medications:

  • Thyroid issues. Because the thyroid regulates so many hormones, including those that can impact hair growth, conditions like hypothyroidism (an underactive thyroid) or hyperthyroidism (an overactive thyroid) could lead to hair loss.

  • High blood pressure medication. While high blood pressure isn’t typically a cause for hair loss, certain medicines used to reduce blood pressure and treat this condition may contribute to hair shedding.

  • Alopecia areata. This immune condition attacks the follicles that produce hair, causing hair to fall out. It typically causes patchy bald spots that can develop around your scalp and in your facial hair.

Other Factors

Other factors — like eating a diet lacking in certain nutrients or feeling overly stressed — can also take a toll on your hair growth.

  • Anxiety and stress. In some cases, you may develop temporary thinning of your scalp hair after a stressful event. This is known as telogen effluvium — a type of hair loss that isn’t considered male pattern baldness.

  • Nutritional deficiencies. Certain diets lack nutrients that your hair needs to grow to its full potential. For example, iron deficiency and a lack of protein are both associated with temporary hair shedding.

  • Rapid weight loss. While losing weight can be healthy when done steadily through a healthy diet and exercise, rapid weight loss can put a lot of strain on your body, including your hair follicles. In some cases, this can cause temporary hair loss.

  • Use of hard water when you shower. Although hard water (water that’s high in certain dissolved minerals) doesn’t appear to cause hair loss by itself, some research suggests that it may decrease the strength of your hair and contribute to breakage.

Male pattern baldness can affect all men, but certain factors can put you more at risk of dealing with it. Many of these risk factors can also affect the severity of hair loss you experience, from a mild receding hairline to full baldness.

Family History of Hair Loss

Male and female pattern hair loss is at least partly genetic, meaning you could be more at risk of losing your hair if you have a parent with noticeable baldness. 

Contrary to popular belief, there’s no high-quality scientific evidence to suggest that baldness is passed down only from your mother’s father. In fact, experts aren’t yet aware of the exact genes that cause male pattern baldness to develop. 

Age

The effects of DHT can accumulate over the course of your lifetime, meaning you’re more likely to notice significant hair loss as you get older. This is the main reason why pattern hair loss can often develop in your 40s, 50s, 60s or later. 

However, age isn’t the only factor that’s involved in baldness in men. If you have a high level of sensitivity to DHT, you may notice the early signs of baldness developing in your 20s, 30s, or in your late teens.

Medications

Medications that increase your production of testosterone and/or DHT may cause you to notice male pattern baldness earlier.

For example, testosterone replacement therapy (TRT), a form of treatment for low testosterone, may cause you to develop more noticeable male pattern baldness.

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The best time to seek medical advice about male pattern baldness is as soon as you notice any symptoms developing. Without active treatment, any hair loss you experience from male pattern balding can quickly become permanent. 

By talking to your healthcare provider as early as you can, you’ll be able to get started and treat your hair loss, helping you to slow down or prevent any recession or balding.

Most of the time, your healthcare provider will be able to diagnose male pattern baldness with a quick look at your scalp, especially if you already have a clear hair loss pattern. 

In some cases, your healthcare provider may use a dermatoscope to examine your scalp more closely. 

This process, called dermoscopy, can determine whether or not you’ve lost a significant amount of hair, if your hair follicles have significant miniaturization and the distance between your active hair follicles. 

Your healthcare provider may also ask about your habits, lifestyle and your family history of hair loss. 

Most healthcare providers determine the severity of male pattern baldness using a system that’s referred to as the Norwood scale

This scale features reference diagrams for a range of different hair loss patterns, ranging from a mild receding hairline to almost complete hair loss. 

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Male pattern baldness is treatable. Because hair loss tends to get worse over time, the sooner you take action to treat male pattern baldness after noticing symptoms, the more likely it is that you’ll be able to protect your hair follicles from further damage. 

Hair Loss Medication

Currently, the most effective treatments for male pattern baldness are the hair loss medications finasteride and minoxidil. 

Finasteride is a prescription medication that works by inhibiting 5-alpha reductase, the enzyme that converts testosterone to DHT. This reduces DHT levels throughout your body and reduces damage to your hair follicles.

Minoxidil is a topical, over-the-counter medication that is believed to stimulate hair growth by moving hairs into the anagen phase of the hair growth cycle. It also improves blood circulation in your scalp, which may promote more consistent hair growth.

We offer finasteride online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.

We also offer minoxidil solution and minoxidil foam, with minoxidil and finasteride available with a selection of other hair loss products in our Hair Power Pack

Research shows that both finasteride and minoxidil are effective at stopping the progression of hair loss, with most men who use either medication reporting improvements in hair growth.

In fact, studies suggest that these medications are particularly effective when used together. In one study published in the journal Dermatologic Therapy, more than 94 percent of balding men reported improvements after using both finasteride and minoxidil for one year. 

Over-the-Counter Hair Loss Supplements and Products

Numerous supplements and non-pharmaceutical products are available to help slow down and treat hair loss.

While these supplements aren’t as effective as FDA-approved medications like finasteride and minoxidil, they can be a helpful part of your baldness prevention routine.

Popular supplements and products for hair loss include:

  • Saw palmetto. While it’s not as effective as finasteride, studies show that saw palmetto reduces DHT levels by a modest amount, which may slow down male pattern baldness in men with alopecia.

  • Biotin. While biotin doesn’t directly prevent hair loss, it’s linked to improvements in hair growth in some studies. However, most research on biotin as a supplement for stopping hair loss has focused on hair loss in women.
    Biotin is one of several ingredients in our Biotin Gummy Vitamins, which are formulated to support healthy hair, nails and skin.

  • Hair thickening shampoo. Shampoos that contain ketoconazole or saw palmetto may help to prevent hair loss at the scalp level. Our Thick Fix Thickening Shampoo is made with thicker, fuller-looking hair and better scalp health in mind.

Other Hair Loss Treatments

In addition to medication and supplements, other treatments can help to improve the health of your scalp hair follicles, promote hair growth and/or make hair loss less visible. 

Common cosmetic procedures, products and other options for hair loss include:

  • Hair transplantation surgery. Hair transplant surgery is a procedure that involves the removal of hair follicles from the back and sides of your head, which are used to create extra hair density in your hairline, crown or other areas with noticeable hair loss.
    Performed by a skilled surgeon, a hair transplant can improve your hairline and almost completely eliminate signs of hair loss. Like other cosmetic surgeries, a hair transplant can be highly effective but is costly and rarely covered by insurance.

  • Scalp micropigmentation. Scalp micropigmentation is a cosmetic procedure that can change the pigment of your scalp, creating the appearance of small, short hairs and a fuller head of hair. It’s similar to a tattoo that hides, rather than treats, hair loss.
    Although scalp micropigmentation can make it look like you have a thicker head of hair, it’s not an actual treatment for male pattern baldness and does not restore any real hair follicles. 

  • Hairpieces. While they won’t help you grow back any real hair, hairpieces and weaves can produce surprisingly good results if you need to fill in thin areas and cover up your hair loss for an important event.
    Our guide to the pros and cons of toupees goes into more detail about the advantages and disadvantages of “treating” hair loss with a hairpiece.

Finally, there’s acceptance. If your hair loss is severe and you’re not interested in treating it, you can simply accept it. 

Whether you choose to shave your head or keep your remaining hair cut short, rocking the bald look can be a great option if you’ve got the confidence. 

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Androgenic alopecia can develop at almost any age, including your late teens, 20s and 30s. If you’ve recently started to notice your hairline receding or some extra hairs on your pillowcase, it’s best to take action as soon as you can to prevent the problem from getting worse.

The good news is that hair loss is usually easy to treat when it’s caught early, with medications and medical treatments available to preserve your hairline and stimulate growth. 

We offer several hair loss medications online that you can use to shield your hair from damage and promote more consistent hair growth. 

By taking action early and not feeling overwhelmed, you can prevent male baldness from getting worse and enjoy a fuller head of hair throughout your life.

Interested in getting started? You can take part in a hair loss consultation online, or learn more about your options with our guide to the best treatments for thinning hair

12 Sources

  1. Androgenetic alopecia. (2015, August). Retrieved from https://medlineplus.gov/genetics/condition/androgenetic-alopecia/
  2. Ho, C.H., Sood, T. & Zito, P.M. (2022, August). Androgenetic Alopecia. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430924/
  3. Kinter, K.J. & Akenar, A.A. (2022, March 9). Biochemistry, Dihydrotestosterone. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK557634/
  4. Hughes, E.C. & Saleh, D. (2022, June 26). Telogen Effluvium. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430848/
  5. Alopecia Areata. (2021, April). Retrieved from https://www.niams.nih.gov/health-topics/alopecia-areata
  6. Luqman, M.W., et al. (2018). To Evaluate and Compare Changes in Baseline Strength of Hairs after Treating them with Deionized Water and Hard Water and its Role in Hair Breakage. International Journal of Trichology. 10 (3), 113-117. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028999/
  7. Osterberg, E.C., Bernie, A.M. & Ramasamy, R. (2014). Risks of testosterone replacement therapy in men. Indian Journal of Urology. 30 (1), 2-7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897047/
  8. Zito, P.M., Bistas, K.G. & Syed, K. (2022, August). Finasteride. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513329/
  9. Badri, T., Nessel, T.A. & Kumar, D.D. (2021, December). Minoxidil. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482378/
  10. Hu, R., et al. (2015). Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients. Dermatologic Therapy. 28 (5), 303-308. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26031764/
  11. Hair Transplantation and Restoration. (n.d.). Retrieved from https://www.plasticsurgery.org/cosmetic-procedures/hair-transplantation-and-restoration/procedure
  12. Rassman, W.R., Pak, J.P., Kim, J. & Estrin, N.F. (2015, March). Scalp micropigmentation: a concealer for hair and scalp deformities. The Journal of Clinical and Aesthetic Dermatology. 8 (3), 35-42. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382144/
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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