Genetics and Hormones

Male pattern baldness is caused by hormones, most notably testosterone, and is hereditary. If the men on the mother or father’s side of a man’s family have male pattern baldness, then there is a predisposition to losing hair that is genetic in nature. In addition, the rate of hair loss, time of onset and amount of hair loss are all determined by genetic factors.

As men age, an enzyme (5-alpha reductase) converts the testosterone in their body to something called dihydrotestosterone, or (DHT). DHT damages hair follicles, making them produce shorter, weaker hair. In addition, DHT slows down or completely stops hair production

Most men begin to bald in their 30s, but male pattern baldness can begin at any time after puberty. It is a slow process and does not itch or cause pain. At this time, no way of preventing male pattern baldness is known.


Male pattern baldness usually follows a certain pattern. Although baldness can occur anywhere, it almost always starts either at the temples or the very top, or crown, of the head. Often, it starts in both places at the same time. Over the years, the two bald spots may converge. The thinning progresses slowly at first, then more quickly, and usually over a number of years. While some men lose all of their hair entirely, most lose the hair on the top of their head and retain some on the sides, in a horseshoe shape.


There are three basic treatments for hair loss, other than trying to ignore it: medication, surgery, or a toupee. The most popular type of medication is Minoxidil (Rogaine). Rogaine claims to regrow hair in 10 to 20 percent of users, and slow the rate of hair loss in 90 percent of users. It causes hair to grow for a longer period of time and makes the hair follicles larger.

Hair transplantation is when follicles that are producing hair are removed from one area of the scalp and transplanted in the balding area. Usually only one or two follicles are taken at a time, but sometimes entire “flaps” of hair are transplanted.

Finally, some men choose to wear toupees, which are removable wigs created especially for men. Some are made of real hair, while others are synthetic.