What Causes Male Pattern Baldness? 

Male pattern baldness is primarily caused by genetics and a hormone called dihydrotestosterone (DHT), which causes hair follicles to shrink, leading to premature hair thinning and loss. In this article, we will explain the causes, types, and hair transplant options for male pattern baldness. 

What is Male Pattern Baldness? 

Male pattern baldness, also called androgenetic alopecia, is the most common type of hair loss. It follows a distinct pattern, typically starting with a receding hairline at the temples and thinning at the crown. Over time, these areas may connect, leading to partial or complete baldness in some men.

Unlike temporary hair shedding, male pattern baldness is permanent. It progresses gradually due to a combination of genetic predisposition and hormonal changes, particularly the effects of dihydrotestosterone (DHT) on hair follicles. 

What Causes Male Pattern Baldness? 

The primary cause of male pattern baldness or androgenetic alopecia are genetics and the hormone DHT. Derived from both your mother and father, it is influenced by multiple genes from both of your parents. If male relatives on either side of your family have experienced baldness, you’re more likely to develop it too.

Genetics determine how sensitive your hair follicles are to DHT, the hormone that causes hair follicles to shrink. Over time, these smaller follicles produce thinner, shorter hairs until they stop growing hair altogether.

While genetics and DHT are the main culprits, other factors can cause hair loss, though they aren’t classified as male pattern baldness. These include:

  • Stress (Telogen effluvium): High levels of stress can push hair follicles into a resting phase, causing sudden shedding. It’s often triggered by events like illness, surgery, or major life changes. This type of hair loss is usually temporary, and hair growth resumes when you manage your stress levels. 
  • Medical conditions: Conditions like thyroid disorders (both hyperthyroidism and hypothyroidism) disrupt hormone balance, which can weaken hair follicles. Alopecia areata, an autoimmune disease, causes the immune system to attack hair follicles, leading to patchy hair loss. Scalp infections, like ringworm, can also cause hair to fall out.
  • Nutritional deficiencies: Your hair needs nutrients like iron, zinc, biotin, and protein to grow strong and healthy. When your diet is lacking, hair growth can slow, and shedding may increase. Correcting the deficiency often restores hair growth.
  • Medications: Hair loss is a known side effect of certain medications, especially those used to treat cancer (chemotherapy), high blood pressure, arthritis, and depression. The type and severity of hair loss depend on the medication and dosage.

Unlike these temporary forms of hair loss, male pattern baldness is a permanent, progressive health condition driven by genetics. The good news is that there are many ways to treat pattern baldness, including nonsurgical options like hair loss medications, topicals, and laser hair therapy. 

Male Pattern Hair Loss Types​

Male pattern hair loss follows a predictable progression, which is classified using the Norwood Scale. This scale outlines the stages of hair loss, from a mild receding hairline to more advanced baldness. 

These are the stages of male pattern baldness: 

  • Stage 1: No visible hair loss. The hairline remains intact with no signs of thinning.
  • Stage 2: Hairline begins to recede at the temples, forming an “M” shape. This is often considered the earliest sign of male pattern baldness.
  • Stage 3: The receding hairline becomes more prominent, with deeper hair loss at the temples. Some men may also experience thinning at the crown (top of the head).
  • Stage 4: Hairline recession progresses further, and noticeable bald spots begin to form on the crown. The two areas of loss (temples and crown) remain separate.
  • Stage 5: The balding areas on the temples and crown start to connect, creating a larger area of hair loss. The “M” shape of the receding hairline deepens and becomes more defined. 
  • Stage 6: Significant hair loss on the top of the head. The bridge of hair that previously separated the front hairline from the crown is gone, leaving only hair on the sides and back of the head.
  • Stage 7: The most advanced stage of baldness. Hair is only present on the sides and back of the head, often forming a horseshoe shape.

Most men seek treatment between stages 3 and 6, when there’s still a chance to restore fuller hair. 

Hair Transplant Options for Men​

A hair transplant is the only permanent solution for male pattern baldness, and the two most common methods are FUE and MDEE. Both methods are very effective, but they differ in surgical technique and are best suited for different candidates.

FUE (Follicular Unit Extraction)

FUE involves removing individual hair follicles from the safe donor area (usually the back or sides of the head) using a small punch tool. The follicles are then transplanted into recipient sites created by your hair transplant surgeon in your balding and thinning areas. This method leaves tiny, pinpoint scars that are barely visible, even with short hair.

Ideal Candidates for FUE:

  • Want to wear their hair short on the sides and back
  • Prefer a minimally invasive procedure with no linear scar
  • Need fewer grafts or have smaller areas of hair loss
  • Have good donor hair density to ensure enough follicles for extraction
  • Are willing to undergo multiple sessions if a large number of grafts is needed

MDEE (Microscopically Dissected Elliptical Excision)

MDEE (formerly known as FUT) involves removing a thin strip of scalp tissue from the safe donor area, usually at the back of the head. The hair follicles are dissected from the strip into the naturally occuring follicular units of 1 to 4 hairs and transplanted into the recipient sites created by your hair transplant surgeon in the areas of hair loss and hair thinning. This method allows for the harvesting of a large number of grafts in one session.

Ideal Candidates for MDEE:

  • Need a large number of grafts to cover significant hair loss
  • Don’t mind a thin, linear scar that can be hidden with longer hair
  • Want to complete their hair restoration in fewer sessions
  • Have good scalp elasticity to ensure easy removal of the donor strip
  • Want maximum follicle yield from a single procedure

How Much is a Hair Transplant for Men?

The cost of hair transplant varies based on several factors, but a general range is $10,000 to $18,000 or even higher depending on the amount of hair loss, the required number of grafts, type of surgical procedure performed, clinic location, and surgeon experience. Beware of cheap hair transplant offers, as they often come with inexperienced surgeons, low-quality results, and a higher risk of complications.

Watch Dr. Craig Ziering Share How to Choose a Hair Transplant Surgeon 

Choose NYC’s #1 Hair Restoration Clinic — Ziering Medical. 

For over 20 years, Ziering Medical has been New York City’s #1 hair transplant clinic with thousands of  successful hair restoration surgeries performed. Call us or visit a Ziering Medical clinic near you to book a consultation today. 

We serve patients all over the greater Tri-state area of New York, New Jersey, and Connecticut as well as the greater Southern California area from Los Angeles and Beverly Hills to Newport Beach and San Diego. 

Male Hair Transplant Before and After

Restoring a natural hairline requires precision and artistry. Your Ziering Surgeons will design a hairline that fits your natural facial structure, age, and hair loss pattern. 

Grafts are placed at specific angles, direction, and orientation to mimic your existing and natural hair growth patterns. Each follicle is strategically placed to avoid an unnatural appearance or your transplanted hair growing out in the wrong direction. Check out these amazing hair transplant transformations at Ziering Medical. 

Frequently Asked Questions

Can medications like finasteride or minoxidil stop male pattern baldness?

Finasteride and minoxidil can slow or stop hair loss, but they don’t exactly “cure” male pattern baldness. At this time, there is no cure for genetic hair loss. Finasteride blocks DHT, while minoxidil promotes hair growth. Both work best in the early stages of hair loss.

How many grafts do I need for a hair transplant?

The number of grafts depends on the extent of hair loss, the quality and quantity of your donor hair, and your hair restoration goals. Small areas may need 500-1,000 grafts, while larger areas may require 2,000-3,000 grafts or more. Your surgeon at Ziering Medical will create a personalized graft estimate during your consultation.

How do I choose the right hair transplant clinic?

Look for a clinic with experienced surgeons, proven results, and positive patient reviews. Avoid clinics that rely on unlicensed technicians, offer steep discounts, or lack transparent information about the surgeon performing the procedure.