Male pattern baldness

The cause in over 90% of hair loss cases is defined as hair loss at the front, top and/or the crown/vertex of the scalp – known as the non-permanent area. The back and sides of the scalp, where hair usually grows for life, is known as the ‘permanent’ area.

Male pattern hair loss is brought on by the presence of hormone receptors in the hair roots in the non-permanent area – no such receptors exist in the so-called permanent area. These receptors are stimulated by the male hormone dihydrotestosterone (DHT) and, when this happens, the hair loss process is triggered. The number and location of these susceptible hairs is determined by inherited genetics from one or both parents.

Hair is lost because of a change in the lifecycle of the hair root caused by DHT. In simple terms, this cycle consists of a growing phase and a resting phase. Before hair loss sets in, the growing phase lasts up to seven years and the resting phase lasts three to four months. Genetic hair loss is a result of the life cycle phases going into reverse i.e. the growing phase becomes shorter and shorter and the resting phase longer. Eventually, the hair grows very little or not at all.

Male pattern baldness

See the cause and the remedies explained


Seven types of male pattern baldness

Rollover the numbers to identify your pattern of hair loss. For the most accurate assessment, stand in front of a mirror while holding a mirror behind your head, just as they do in a hairdressing salon.

  • Male pattern baldness

    Type I is an adolescent or juvenile hairline that is not actually losing hair. This hairline generally rests just above the upper forehead crease.

  • Male pattern baldness

    Type II indicates a progression to the adult or mature hairline that sits a finger’s breadth (1.5cm) above the upper forehead crease, with some temporal recession. Again, this does not represent balding.

  • Male pattern baldness

    Type III is the earliest stage of male hair loss that warrants investigating. It is characterised by a deepening temporal recession.

  • Male pattern baldness

    Type III Vertex represents early hair loss at the crown (vertex) instead of or in addition to the temples.

  • Male pattern baldness

    Type IV is characterised by further frontal hair loss and enlargement of the vertex but there is still a solid band of hair across the top (mid-scalp) separating front and vertex.

  • Male pattern baldness

    Type V is when the bald areas in the front and crown continue to enlarge and the bridge of hair separating the two areas begins to break down.

  • Male pattern baldness

    Type VI occurs when the connecting bridge of hair disappears, leaving a single large bald area on the front and top of the scalp. The hair on the sides of the scalp remains relatively high.

  • Male pattern baldness

    Type VII is characterised by extensive hair loss with only a wreath of hair remaining at the back and on the sides of the scalp – the permanent area.


Other causes of hair loss

While male pattern baldness is the most common type of hair loss in men, there are other causes. Here are just a few.

Did you knowTraction alopecia

Traction alopecia

This is caused by tight braiding or pulling on the hair (e.g. tight ponytail hairstyle) and is temporary if the traction is short-term, but becomes permanent with prolonged pulling. One male example of this is seen in some Sikh men after years of tying up their long hair. It is most usually seen as a bald area at the very front of the hairline. Hair transplant surgery can restore hair permanently, as long as the cause of the problem ceases.

Traction alopecia can be brought on by the excessive use of hair braiding – particularly when pulled very hard.

Did you knowChemical scarring and burns

Chemical scarring and burns

Chemicals, such as those used in hairdressing – dyes, bleaches, perms, straighteners and relaxers – can cause hair breakage that is not true hair loss. However, if the substances are used incorrectly, they can actually cause damage to the skin and to the hair roots, causing permanent hair loss. Similarly, burns to the skin can destroy the hair roots and cause a bald patch. In both of these cases, follicular unit transplants may be a treatment option, but this depends on the amount of scar tissue present.

The use of chemical hair relaxers and perms can not only damage follicles but also cause burns and dry patches on the scalp. If the damage is permanent, a hair transplant can be the answer.

Did you knowPhysical and emotional stress

Severe illness, surgery, medical conditions (such as thyroid abnormalities or low blood count), rapid weight change or emotional stress can cause or accelerate hair loss. Once the source of the stress is removed, hair usually grows back within a few months.

The anxiety of hair loss in these situations can exacerbate the stress that caused the loss in the first place! Good news is that the hair should grow back naturally after a few months.

Did you knowPlastic surgery

Plastic surgery

When this involves major pulling on the face and scalp as in a face or brow lift, hair loss around the frontal hairline can occur. This can be effectively treated with hair transplantation.

Hair loss following facial cosmetic surgery can be temporary and will grow back after time – but it may be permanent. A consultation with one of our team of experts can help identify your particular condition and advise you of the best option going forward.

Did you knowAlopecia areata

Alopecia areata

This is thought to be an auto-immune condition where the body produces antibodies against your own hair causing hair loss. The condition usually appears as one or more isolated patches of complete baldness. In more severe forms, there is total baldness of the scalp (alopecia totalis) and, in extreme cases, total loss of all body hair (alopecia universalis). Sometimes medical treatment is successful in treating the less severe forms of the hair loss. In many cases, the condition clears up by itself, but may recur at a later stage.

That, contrary to commonly held beliefs, alopecia areata doesn’t cause pain, nor can you pass it on to others, as it is a disease related to your autoimmune system and is not inherited.

Did you knowMedications

There are over 100 drugs known to cause hair loss – these include some forms of blood thinning drugs, thyroid medications, chemotherapy for cancer and contraceptive pills. Again, the effects should be reversible once the drug is changed or stopped.

The first people you should consult if you are worried about potential medication-induced hair loss are your GP and pharmacist, who can conduct a review of the medication you’re on, and most importantly, the potential risks of a combination of medications.

Did you knowSkin conditions

Skin conditions

Localised skin problems such as eczema, psoriasis, scarring conditions and infections can cause temporary or permanent hair loss. If the hair loss is permanent, we offer a choice of surgical treatments to restore hair to the area in cases where the underlying skin condition has been successfully treated or has become dormant.

Many of these conditions tend to be chronic, or at least have the tendency to flare up now and again. Surgery should only be considered when the skin condition is definitely dormant.

Did you knowChemotherapy and radiotherapy

Chemotherapy and radiotherapy

A lot, but not all, of the drugs used in chemotherapy to treat cancer work through attacking the cancer cells and disrupting their growth. Unfortunately, they can also affect normal cells in the body – including those of the hair follicles. A potentially effective way to reduce hair loss during chemotherapy is to wear a ‘cool cap’ that inhibits the amount of chemotherapy-related drugs reaching the scalp. Happily, in most cases, hair will grow back following the completion of a course of chemotherapy.

The rays used in the radiotherapy treatment of cancer will only cause hair loss in the area exposed to the treatment. Hair doesn’t always grow back following radiotherapy, and we are happy to advise of the options open to you.

Before doing anything, we would first advise you to see your GP, specialist nurse or cancer support specialist as we would most likely need to liaise with them.

Other forms of cancer treatment – hormonal and biological among them – can sometimes affect your hair. If this is the case, seek the advice of your GP, specialist nurse or cancer support specialist.

Did you knowTrichotillomania


Trichotillomania is a compulsion disorder where a person uncontrollably pulls their hair out. They may do so from their scalp, eyebrows or even eyelashes. It is a psychological condition where the person is simply unable to stop themselves from carrying out this action.

Usually there is an intense urge to pull your hair out and an immense relief after pulling out the hairs. Pulling out hair on the scalp or other areas can leave bald patches.

Sufferers may feel guilt, embarrassment, shame or other negative feelings.

The first line treatment should be counselling and psychological therapy. Only when assured that the urge to pull is no more, can treatments such as hair transplant surgery be considered if needed.

Dispelling male pattern baldness myths

Hair loss is related to poor blood circulation in the scalp

Not true – the scalp is the same all over and is usually rich in blood supply and therefore, contrary to commonly heard myths, male pattern hair loss has nothing to do with lack of blood supply.

Too much sun can cause hair loss

There is no scientific evidence to support this belief. Likewise, the use of tanning beds has not been linked to hair loss.

The most virile men go bald early

As ego-boosting as this belief may be, it is untrue. Neither is it true that men who suffer from hair loss have higher levels of testosterone in their system.