Androgenetic alopecia, or male pattern hair loss, is the most common cause of thinning hair in men. It is not a disease or a sign of poor health, but a hereditary and hormonal process that unfolds over time. Understanding how it works helps you make informed decisions at the right moment.
What is androgenetic alopecia?
It is a gradual "miniaturisation" of the hair follicles. With each growth cycle, the affected follicles become smaller and finer, producing ever shorter and thinner hairs until, eventually, growth stops. The process often begins as early as your twenties or thirties and progresses at different rates.
The role of DHT and genetics
The main factor is sensitivity to the hormone dihydrotestosterone (DHT). DHT is a derivative of testosterone, and certain follicles are genetically sensitive to its effects. It is this sensitivity, rather than the overall amount of the hormone, that determines whether and how much the hair thins.
- Heredity – the predisposition can come from either your mother's or your father's side.
- DHT sensitivity – sensitive follicles shrink under the influence of DHT over time.
- Age – the effect accumulates over the years, so thinning usually deepens gradually.
It is worth knowing that the follicles at the back and sides of the head are usually resistant to DHT. This is precisely why these areas tend to remain intact and can be used as the donor region for a transplant.
How hair loss progresses – the Norwood scale
Male pattern hair loss follows a recognisable pattern, described by the Norwood scale. It typically begins with:
- the hairline receding at the temples, creating an M-shaped outline;
- thinning at the crown;
- the gradual merging of these two areas.
The Norwood scale helps the doctor assess which stage the pattern has reached and how it is likely to develop. It is also a useful tool when discussing treatment options.
Treatment options
There are several approaches to androgenetic alopecia, and the most suitable one depends on how far the pattern has advanced. Decisions should always be made together with a doctor.
- Medical treatment – under a doctor's guidance, options such as minoxidil or finasteride are sometimes used. These are intended to support existing hair and slow down thinning, but their suitability and possible side effects should always be discussed with a doctor.
- Hair transplantation – once the pattern has stabilised, DHT-resistant follicles can be transplanted into the thinning areas using the FUE method. This is a permanent solution that uses your own hair.
- Watching and waiting – in the early stages, a doctor may recommend monitoring the condition before taking a bigger step.
A combined approach – for example, medical treatment to preserve existing hair alongside a transplant to restore the thinning areas – makes sense in many cases. Because each person's pattern and sensitivity are different, results vary too, and the best plan becomes clear through a personal assessment. You can find more information on our website.
When should you see a specialist?
If you notice a persistently receding hairline, thinning at the crown or a clear loss of density, it is worth having the situation assessed early. The sooner the pattern is identified, the more options you usually have.
If you would like to know which solution suits your situation, you are welcome to book a free consultation. The Rubenhair team in Riga will help you understand your hair loss pattern and discuss the right steps for you.