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What causes male pattern hair loss?

The average man has 100.000 hairs on his scalp before the first symptoms of common baldness arise. The finer the hair, the more hairs are present in a given area. Blonde hairs are the finest, and the total amount of blonde hairs on a male head are about 140.000. Men with black hair have on average 110.000 hairs on their head, and redhaired men 90.000 hairs.

There are three factors that cause male pattern hair loss:

  1. Presence of testosterone and dihydrotestosterone. The higher the levels of these male sex hormones are, the more prone a man is to experience androgenetic alopecia.
  2. Aging. In most men that get older there is an increased prevalence and magnitude of male pattern baldness.
  3. And last but not least the most important factor: inherited predisposition.

These factors are interdependent and do not cause hair loss on their own. For example, someone who has high levels of male sex hormones in his body but lacks the inherited predisposition, will not go bald. Vice versa, if a man has the genetic factor but lacks high levels of androgens then hair loss with also not occur. These three factors together form a synergy which makes the majority of men prone to common baldness. This means, that if we are able to take one of these factors out of the equation, we could prevent men from going bald. Here finasteride comes into play.

How to determine whether I suffer from hair loss?

Hairs on the male scalp follow a growth cycle of approximately 16 months that can be distinguished into three different phases. The growth phase (also called anagen phase), haltered growth (catagen phase) and resting (telogen phase). Hairs fall out when they are going through the resting phase. The amount of hair that a man loses every day depends on the individual, but in general a man loses an average of 100 hairs per day. At the same time, approximately the same amount of hairs grows back, so that the amount of hairs remains constant. Overall, around 90 per cent of your hairs are in the growing phase at any time. And the hair grows 1cm per month. The degree of hair loss also depends on the seasons which can also be different for every individual. If more hairs are lost than that hairs grow back at the same time, then in most cases we talk about male pattern baldness. So how to determine whether you are losing more hair than usual?

Firstly, you can simply look in the mirror and compare the density of your hair with how it looked before. Scalp hair that follows the pattern of common baldness will unfold in a typical manner as a response to the three factors we mentioned above. Each consecutive generation of hair on the scalp will decrease in diameter and the hair-covering growth becomes finer, until the hair follicle no longer produces hair and shrivels away.

Secondly, the hairline is often a good indicator to conclude whether hair loss is occurring. The most common male hair loss pattern starts with an M-shaped hairline, where hair loss in the frontal region on both sides of the temples forms a triangular bald area. This often already starts in the puberty of males as their hormone levels increase, and the majority of men experience this. It is often referred to as frontal alopecia of adolescents and is the forerunner of male pattern hair loss, which consists of further progressed frontal alopecia that merges together with the gradually balding spot on the vertex.

Thirdly, people in your surrounding who have known you for a longer time and see you on a regular base will be able to notice a difference in your hair condition.

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