Hereditary-Pattern Baldness (Genetic Baldness): Causes, Diagnosis and Treatments
Hereditary-pattern baldness, scientifically known as "Androgenetic Alopecia" is one of the most common causes of hair loss—especially among men. Baldness often leads to feelings of embarrassment and low self-confidence, particularly when it appears at an early age. But what causes it? How can it be treated? And at what age does it usually start? This …
Hereditary-pattern baldness, scientifically known as “Androgenetic Alopecia” is one of the most common causes of hair loss—especially among men. Baldness often leads to feelings of embarrassment and low self-confidence, particularly when it appears at an early age. But what causes it? How can it be treated? And at what age does it usually start? This article answers these questions and provides further details.
What is Hereditary-Pattern Baldness (Androgenetic Alopecia)?
Hereditary-pattern baldness is a highly prevalent condition and is responsible for most hair loss cases. It is not merely “hair shedding” in the conventional sense but rather a gradual process affecting hair follicles that are sensitive to hormonal changes in genetically predisposed individuals.
The condition is characterized by the progressive miniaturization of hair follicles with each growth cycle. Over time, the resulting hairs become shorter, thinner, and lighter in color until the follicle eventually atrophies and stops producing hair, leading to visibly bald areas.
Causes of Hereditary-Pattern Baldness
The primary cause of hereditary-pattern baldness is the interaction between two fundamental factors: genetic predisposition and androgen hormones.
Genetic Predisposition: Contrary to the common belief that baldness is inherited only from the maternal side, recent research shows it is more complex. Hereditary-pattern baldness is a polygenic condition, meaning multiple genes contribute to its development, and these genes can come from either parent. If baldness is common in your family, whether on your father’s or mother’s side, your risk increases.
Role of Androgens: Androgens are male hormones, primarily testosterone, present in varying levels in both men and women. A portion of testosterone is converted into a much stronger hormone called dihydrotestosterone (DHT) in body tissues, including hair follicles, via the enzyme 5-alpha reductase. In genetically predisposed individuals, hair follicles in specific scalp areas have DHT receptors. When DHT binds to these receptors, it triggers follicle miniaturization, shortens the hair growth phase (anagen), and ultimately leads to permanent hair loss.
Stages of Male Pattern Baldness
Male androgenetic alopecia is classified into 7 stages:
Stage 1: Receding hairline at the front with mild thinning.
Stage 2: Mild hair loss near the temples and from the front or sides of the scalp.
Stage 3: Noticeable M-shaped or U-shaped hairline recession on both sides.
Stage 4: Hair loss extends to the crown area with significant thinning.
Stage 5: Hair loss in the crown and front areas merges, leaving the scalp fully visible at the front.
Stage 6: Severe hair loss across most of the scalp with only minimal hair remaining on top, insufficient for coverage.
Stage 7: Extensive baldness across most of the scalp, with only a thin strip of hair remaining at the back of the head.
Signs and Patterns of Hereditary-Pattern Baldness
The pattern of hereditary-pattern baldness differs significantly between men and women.
Male Pattern Baldness:
Usually begins any time after puberty and can appear as early as the twenties. The hair loss follows a recognizable and predictable pattern:
Receding Hairline: Hair starts to thin at the temples, creating an “M” shape.
Crown Thinning: Simultaneously or subsequently, the crown area (top rear of the head) begins to lose hair.
Merging Bald Spots: Over time, the front and crown bald areas expand and eventually merge, leaving a horseshoe-shaped ring of hair around the sides and back of the head.
Female Pattern Baldness:
Typically develops later than in men and becomes more noticeable after menopause, though it can begin at any age post-puberty. It features:
Widening Part Line: A common early sign is a gradually widening part in the center of the scalp.
Diffuse Thinning: Hair becomes generally thinner across the crown, making the scalp more visible.
Preserved Hairline: Unlike men, women rarely experience a receding front hairline or complete baldness.
Watch Hereditary-Pattern Baldness Treatment Results With Dr. Sherif Hegazy
Diagnosing Hereditary-Pattern Baldness
Diagnosis is primarily clinical. A dermatologist or aesthetic physician will typically perform:
Medical and Family History Review: Inquiring about the onset and pattern of hair loss and any family history.
Scalp Examination: Using a dermatoscope to assess the hair follicles and thinning pattern.
Pull Test: Gently tugging a small section of hair to gauge shedding severity.
Laboratory Tests: In some cases, especially for women, blood tests may be ordered to rule out other causes like iron deficiency, thyroid dysfunction, or hormonal imbalances.
Hereditary-Pattern Baldness Treatment
Fortunately, scientific advancements have introduced numerous effective treatment options that can halt hair loss and, in many cases, promote regrowth. It’s essential to understand that most treatments require long-term commitment for sustained results.
Topical and Oral Medications:
Minoxidil: The most popular FDA-approved topical treatment for both men and women, available in 2% and 5% formulations as a solution or foam. It works by dilating scalp blood vessels and stimulating follicles to prolong the growth phase. Requires consistent daily use.
Finasteride: An oral FDA-approved treatment for men only, it inhibits 5-alpha reductase, reducing DHT levels in the scalp. Proven effective in halting hair loss and stimulating regrowth. Not prescribed for women of childbearing age.
Spironolactone: An oral anti-androgen prescribed to women, it reduces the effect of male hormones on hair follicles.
Injectable Therapies:
PRP (Platelet-Rich Plasma) and mesotherapy.
Nano-fat injections to boost density.
Stem cell therapy for severe hair loss.
Hair Transplant Surgery: The Permanent Solution
A permanent solution for advanced baldness, involving transferring DHT-resistant follicles from donor areas (usually the back/sides) to bald spots. Techniques include:
Direct Hair Implantation (DHI) with Choi implanter pens
Treating Hereditary-pattern baldness by Hair Transplant Results with Dr. Sherif Hegazy
Conclusion
Hereditary-pattern baldness may be a long-term journey, but it is far from a dead end. Thanks to major advances in aesthetic medicine, treatment options are more diverse and effective than ever before. The most crucial step is to consult a specialist —such as Dr. Sherif Hegazy, who is considered one of the leading experts in hair transplantation— who can provide an accurate diagnosis and create a personalized treatment plan tailored to your condition and expectations. Early intervention remains key to achieving the best possible outcomes and preserving thick, healthy hair.
