Male Pattern Baldness

The male pattern baldness is referred as androgenetic alopecia  ,which “Andro” refers to the androgens (testosterone, dihydrotestosterone) necessary to produce male-pattern hair loss (MPHL) and “Genetic” refers to the inherited gene necessary for MPHL to occur.

Experts in male hair loss tell us that about half of all men will suffer some form of male pattern hair loss over their lifetime. Indeed, It is estimated that 35 million men in the United States are affected by male pattern baldness.

Most men who suffer from male pattern baldness are extremely unhappy with their situation and would do anything to change it. Hair loss affects every aspect of their life. It affects interpersonal relationships as well as their professional life. It is not uncommon for men to change their career paths because of hair loss.

Classification of Hair Loss in Men

Did you know that male pattern baldness has it’s own measurement scale? It’s true. The Hamilton-Norwood Scale is used to measure the degree of hair loss and it is the most widely used classification for hair loss in men. It defines two major patterns and several less common types. In the regular Norwood pattern, two areas of hair loss–a bitemporal recession and thinning crown–gradually enlarge and coalesce until the entire front, top and crown (vertex) of the scalp are bald.

• Type I: No or very minimal hairline recession along the anterior border in the frontotemporal region.
• Type II: The anterior border of the hair in the frontotemporal region has symmetrc triangular areas of recession which extend no further posteriorly than 2 cm anterior to a line drawn in a coronal plane at the level of the external auditory meatus.
• Type III: The triangular areas in Type II extend posterior of the coronal plane which is 2 cm anterior to the external auditory meatus.  This is the minimal level considered to represent baldness.
• Type III Vertex: Most of the hair loss is seen on the vertex.  Frontal hair loss may be similar to Types I or II but should not exceed Type III.  This type is most commonly seen with advancing age.
• Type IV: Hair loss on the vertex associated with frontal loss more severe than Type III, but the frontal and vertex areas are separated by a distinct band of hair.
• Type V: Greater hair loss than Type IV with only a sparse band of hair separating the frontal and vertex areas.  The hair left on the occipital and parietal areas begins to form the shape of a horseshoe when viewed from above (also true for Types VI and VII).
• Type VI: The frontal and vertex areas of hair loss are contiguous with greater lateral and posterior areas of denudation.
• Type VII: The most severe form of male pattern baldness. Only a narrow sparse horseshoe-shaped band of hair is left extending from the ears posteriorly to the occiput.

In addition, Types II through V can also be designated with a Type A variant in which the entire anterior hairline border recedes in unison without leaving the midfrontal peninsula of hair and also in which there is no simultaneous denudation of the vertex.

• Type IIA: The hairline is anterior to the coronal plane 2 cm anterior to the external auditory meatus.
• Type IIIA: The hairline has receded back to a point between the limit of Type IIA and the level of the external auditory meatus.
• Type IVA: The hairline has receded beyond the external auditory meatus but has not reached the vertex.
• Type VA: The area of denudation includes the vertex. Hair loss more severe than Type VA cannot be distinguished from Types VI or VII.