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Male pattern alopecia - Hair and Scalp
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Other Resources UpToDate PubMed

Male pattern alopecia - Hair and Scalp

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Contributors: Vivian Wong MD, PhD, Susan Burgin MD, Mary Gail Mercurio MD
Other Resources UpToDate PubMed


Male pattern alopecia, or androgenetic alopecia, refers to the common patterned hair loss affecting many men and some women. Male pattern alopecia is mediated by dihydrotestosterone, the potent form of testosterone, which induces miniaturization of androgen-sensitive hair follicles. There is a gradual conversion of terminal hairs into indeterminate and finally vellus hairs. The condition may profoundly affect self-esteem and impair psychosocial functioning for some men, and an association between early onset male pattern alopecia and coronary artery disease has been shown. The hair loss has a strong genetic basis. Onset is usually prior to age 40.

A 2022 cross-sectional study of male balding patterns in people of color found variation between different races and ethnicities compared with White men: South Asian men had greater odds for vertex balding but lower odds for temporal balding; Chinese men were less likely to experience balding in any pattern; Black men also had lower odds for temporal, vertex, and severe balding (but to a lesser extent than Chinese men); and Black men were 4 times more likely to exhibit no or minimal balding.


L64.9 – Androgenic alopecia, unspecified

87872006 – Male pattern alopecia

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Other causes of nonscarring alopecia should be considered if the hair loss does not fit the typical frontal / temporal or vertex pattern of hair loss.

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Last Reviewed:07/19/2017
Last Updated:11/10/2022
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Patient Information for Male pattern alopecia - Hair and Scalp
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Male pattern baldness (alopecia), or androgenetic alopecia, is a common hair loss that affects men. The condition is not considered a medical disorder, but it can affect both the appearance and self-esteem of men. This type of hair loss often has a genetic basis, and a type of testosterone called dihydrotestosterone often plays a role in male pattern alopecia.

Who’s At Risk

Male pattern alopecia affects men of nearly any age, although it is more common as age increases. It can also affect any race / ethnicity, but it is most common in White men, followed by Asian men and Black men.

Signs & Symptoms

The most common location for male pattern alopecia is at the frontal hairline. Hair loss may then move toward the back of the scalp. Alternatively, it may first be noted as thinning at the crown of the scalp. The skin of the scalp often appears normal (eg, there is no skin color change), and small hairs may be seen in the area.

Self-Care Guidelines

The hair loss associated with male pattern alopecia, although permanent, requires no treatment if you are comfortable with your appearance.

Hair loss can have a significant psychologic impact. Creative hair styling or hairpieces can help to minimize the effects of hair loss.

Those with male pattern alopecia should take measures to protect their scalp from ultraviolet (UV) radiation with sunscreens, hats, or hairpieces.

Topical minoxidil 5% (eg, Rogaine) is available without a prescription. This may help the hair to grow in some men, and it will stop or slow hair loss in most. The medication is expensive, however, and note that the hair loss will rapidly progress when minoxidil use is discontinued.

When to Seek Medical Care

Although male pattern alopecia is not a medical disorder and it does not require medical care, see a medical professional if you would like to find out more about cosmetic restorative therapy.

If you are experiencing hair loss or if there is redness, itching, or skin changes associated with the hair loss, seek medical advice, as there are sometimes other causes for hair loss or other issues that can coincide with hair loss that should be treated.

Some individuals with male pattern alopecia have psychological symptoms, such as feelings of helplessness, preoccupation with hair loss and aging, and loss of self-esteem. If you have these sorts of feelings, seek medical care.


The diagnosis of male pattern alopecia is usually straightforward for the medical professional because of the typical pattern of hair loss. However, certain blood tests will help rule out other causes of hair loss, such as low blood count (anemia) or a thyroid disorder. A skin biopsy may be recommended.

Oral finasteride (Propecia, Proscar) or oral minoxidil (Loniten) may be prescribed.

Specialized centers may offer platelet-rich plasma scalp injections to stimulate hair growth.

Surgical therapy to improve the appearance of alopecia includes scalp reduction, flaps, and hair transplants (micrografting). Note that not everyone is considered a good candidate for these procedures.
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Male pattern alopecia - Hair and Scalp
See also in: Overview
A medical illustration showing key findings of Male pattern alopecia : Vertex scalp, Hair loss
Clinical image of Male pattern alopecia - imageId=2863495. Click to open in gallery.  caption: 'Extensive thinning of hair over the frontal scalp.'
Extensive thinning of hair over the frontal scalp.
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