MALE PATTERN HAIR LOSS (MPHL)
Male Pattern Hair loss is also known as androgenic alopecia, is the most common type of hair loss affecting almost 70% of men at some point of their life. It usually follows a pattern of receding hairline and hair thinning on the crown, and is caused by hormones and genetic predisposition.
Male pattern baldness usually starts at the hairline, and gradually moves backward to forms an "M" shape. Eventually the hair becomes finer, shorter and thinner, creating a U-shaped pattern of hair around the sides of the head. This has been referred to as a 'Hippocratic wreath', and rarely progresses to complete baldness.
The Hamilton – Norwood Diagram
In order to classify the stages of MPHL, hair restoration doctors use a 50-year-old system that compares the patient’s hair loss pattern to a set of black and white drawings. The system was introduced by Hamilton in 1951 and improved by Norwood in 1984. The Hamilton-Norwood classification provides 12 categories into which the hair loss pattern must be placed.
The role of male hormones in MPHL has been considered since ancient times when Hippocrates and Aristotle observed the absence of baldness in eunuchs.
Now it is understood that the metabolism of testosterone to 5-alpha-dihydroxytestosterone (DHT) is catalyzed by the enzyme 5-alpha-reductase. DHT, a metabolite of testosterone, is the principal causative agent of MPHL.
Studies have shown that balding scalp contains higher levels of 5-alpha-reductase and DHT than non-balding scalp.
Fortunately, the drug Finasteride (Propecia), an inhibitor of 5-alpha-reductase, is proven to be the most effective medical treatment for MPHL.
MPHL also has a strong genetic component that is easily shown from family history.
When to Seek Medical Professional Help
- When your hair loss occurs in an abnormal pattern, including rapid and widespread shedding, hair loss in patches, or frequent hair breakage.
- When it occurs with itching, skin irritation, redness, scaling, pain, or other symptoms.
- When the hair loss begins after starting a medication.
- When it is affecting your self-esteem, causing anxiety or inconvenience in daily life.
MPHL can usually be diagnosed based on the appearance and pattern of the hair loss. However, a detailed skin biopsy, blood tests, or other procedures may be needed to diagnose other disorders that cause hair loss.