Hair grows from follicles which look like tiny pouches which we have just under the surface of our scalp skin. The life cycle of hair is normally a three year. Hair grows from each follicle for around three years. It then falls off and a new hair grows from the same follicle. This cycle of hair growth, hair falling and new hair growth continues throughout our lives.

Male pattern hair loss, it is also known as androgenetic alopecia. It is caused by a combination of genetic and hormonal factors. A hormone called dihydrotestosterone (DHT) causes a change in the hair follicles on the scalp. The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in colour until eventually the follicles shrink completely and stop producing hair. It is believed this can be inherited from either or both parents.

Men can become aware of scalp hair loss or a receding hairline at any time after puberty. There are usually no symptoms on the scalp. Hair loss may cause significant psychological difficulties.

The usual pattern of hair loss is a receding frontal hairline and loss of hair from the top of the head. Hairs in the affected areas are initially smaller in diameter, and shorter compared to hairs in unaffected areas, before they become absent.


The following is Norwood’s basic scale along with an illustration:

Type I. There is minimal or no recession of the hair line.
Type II. The hairline shows definite recessions at each side of the temples which are usually symmetrical.
Type III. This classification shows hair loss that is sufficient to be considered as baldness with deep recessions at the temples.
Type III Vertex. In addition to the recession at the temples, there is the beginning of a bald spot at the vertex (top) of the head.
Type IV. The receding hairline on the temples is much more severe than Type III, and the bald spot or sparse hair at the vertex is much more noticeable. The two areas are separated by a band of thicker hair that extends across the top of the head and to each side of the scalp. With Type IV, there is more hair loss at the crown than in the Type III Vertex.
Type V. The front of the hair is now receding with less distinct division between the temples. The balding vertex region is still separated with a narrower band of hair from the front and temples, but it is less distinct. Viewed from above, types V, VI, and VII are all characterized by surviving hair on the sides and back of the scalp forming a distinct horseshoe shape.
Type VI. The strip of hair across the crown is now gone except for sparse hair that remains. The front temporal and vertex regions are now joined together with the amount of hair loss greater.
Type VII. As the most severe form of hair loss, there is only a narrow band of hair on the sides and the back of the scalp that is not dense. At the nape of the neck, the hair is sparse and in a semi-circle over the ears.


No, there is no cure. However, it tends to progress very slowly, from several years to decades. An earlier age of onset may lead to quicker progression.


Surgical treatment includes (i) hair transplantation, a procedure where hair follicles are taken from the back and sides of the scalp and transplanted onto the bald areas; and (ii) scalp reduction, where a section of the bald area is removed and the hair-bearing scalp stretched to cover the gap. Tissue expanders may be used to stretch the skin.

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