Until the 1990s, scientists could not pinpoint the exact cause of androgenetic alopecia. Since then, researchers have discovered that hair follicles which produce an enzyme called 5 alpha reductase and combined with testosterone, produce dihydrotestosterone (DHT). DHT "attacks" the hair follicles, slowly breaking it down until the hair follicle falls out.

In men with MPHL all the hairs in a DHT affected area may eventually (but not necessarily) become involved in the process and may with time cover the region with fine (vellus) hair. Pigment (color) production is also terminated with miniaturization so the fine hair becomes lighter in color. The lighter color, miniaturized hairs cause the area to first appear thin. - -American Hair Loss Council

The hair follicles most sensitive to DHT in males is in the temporal, frontal, vertex and crown. Hair on the sides of the head and back are NOT sensitive to DHT. Male pattern hair loss usually begins in the temporal regions and affects 96 percent of all mature caucasian men whether or not they are going to have typical male pattern hair loss.

"Although the density of hair in a given pattern of loss tends to diminish with age, there is no way to predict what pattern of hair loss a young man with early MPHL will eventually assume. In general, those who begin losing hair in the second decade are those in whom the hair loss will be the most severe. In some men, initial male-pattern hair loss may be delayed until the late third to fourth decade. It is generally recognized that men in their 20s have a 20 percent incidence of MPHL, in their 30s, a 30 percent incidence of MPHL, in their 40s, a 40 percent incidence of MPLH, and so on." - International Society of Hair Restoration Surgery

Male pattern hair loss is an inherited condition and can come from either the mother or father's side. Androgens do not have to be in abnormal amounts for hair loss to occur. Normal amounts of androgens can produce hair loss in one man while normal amounts in another can leave him largely unaffected. Those who begin to see the first signs of male pattern hair loss at an early age are more likely to see it progress and worsen over time.

Androgenetic alopecia is the cause of hair loss in 95 percent of men. The other 5 percent could be affected by:

Alopecia Areata: Hair loss which occurs in patches on the scalp. Thought to be caused by an autoimmune disorder.
Alopecia Totalis: Hair loss which occurs over the entire scalp.
Alopecia Universalis: Hair loss which occurs over the entire body.
Traction Alopecia: - This refers to hair loss which occurs do to traction place on hair. Traction alopecia is commonly seen with braids, pony tails and other hairstyles which create traction on the scalp.
Anagen Effluvium: - Generally due to internally administered medications, such as chemotherapy agents, that poison the growing hair follicle.

Myths about hair loss:

1. Hair loss is not caused by clogged pores.
2. Hair loss in not caused by lack of oxygen to the pores
3. Hair loss is not caused by poor blood circulation
4. Hair loss is rarely caused by vitamin deficiency. ( you would have to be practically starving to death and dying of scurvy).

Approved Treatment Options

1. Learn to live with hair loss.
2. Hair replacement systems.
3. Minoxidil is the generic name of the brand name drug Rogaine. Rogaine is manufactured by Upjohn and is FDA approved for the treatment hair loss. Minoxidil is available in the form of a topical lotion with varying strength from 2% to 5%. Minoxidil was the first drug to be approved by the FDA for the treatment of androgenetic alopecia. It requires twice a day application and is more effective in stopping hair loss then it is in causing new hair to grow.
4. Finasteride. Testosterone is converted to DHT by the enzyme, 5¤ -reductase. Finasteride (PropeciaŽ) acts by blocking this enzyme and decreasing the amount of DHT.
5. Hair Transplants. Hair transplant surgery has improved greatly over the last 10 years with the advancement of follicular unit hair transplantation. When hair is transplanted from the back of the head (where most donor area strips are extracted) and implanted to these other areas, the hair follicles retain their resistance to DHT.
6. Hair Loss Surgery such as scalp reduction or flaps. Effective but leave noticable scars. Temporal Flaps cause the hair to fall in a different way in which it naturally grew and you will have to learn how to restyle it accordingly (<-webmaster personal experience). Since skin is elastic, bald areas reduced by scalp reductions can sometimes "stretch back." Some doctors who specialize in this surgery claim they have perfected it. Men considering scalp reductions should research the matter thoroughly.

More Information

• Norwood Hair Loss Chart
• Please visit "Articles and Research"
• Frontal Hair Loss

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