Hairloss in men
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Male pattern baldness is a progressive, patterned hair loss from the scalp resulting from the effects of androgens in genetically predisposed men. Typically, hair loss begins at the front of the head followed by the temples and the crown. These areas slowly get larger and join up.
About 70% of men have some degree of baldness but they differ in the pattern and extent of hair loss, age of onset and rate of progression. Baldness starts at age 18-29 years in 40% of men and during their 30s in 24%. An earlier onset usually means faster progression, though only 30% of men develop full baldness with hair confined to the sides and back of the head.
Hair goes through cycles of growth (anagen) and rest (telogen). A gradual reduction in the duration of anagen and a corresponding increase in telogen eventually result in baldness. Hair follicles shrink and hairs become shorter and finer, eventually being microscopic in size. This process, known as miniaturisation, depends on testosterone. Stem cells in the hair follicle are responsible for the hair cycle and recent research suggests that a defect in their conversion to progenitor cells may underlie baldness in men.
Balding is known to be influenced by the interaction of at least four genes. One of these, a polymorphism of the androgen receptor gene, is found in almost all bald men and is inherited from the mother. However, having a father with hair loss doubles the odds that a son will be affected.
Hair is an integral part of our self image. Many people associate a full head of hair with youth and vitality. Men who believe their hair loss is worse than others may be more bothered by it, more dissatisfied with its appearance and more worried about getting older and losing even more hair. These problems seem to be worse for men who think their hair loss is noticeable to others and those who ask for advice about baldness may have greater emotional distress than other men with hair loss.
Treatment options for male-pattern baldness include styling to minimise its impact, camouflage, OTC medicines, hairpieces, prescription medicines and surgery.
Impact on quality of life
Hereditary hair loss is the most common hair loss disorder affecting men. Although some patients with hereditary hair loss may experience a significant reduction in quality of life, the majority of male sufferers have never treated their condition. In contrast, men who treat their hair loss successfully report improved self-esteem and attractiveness.