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Male pattern baldness

In shortMale pattern baldness is inherited hair loss driven by the hormone DHT. It starts at the temples or crown and moves slowly over years. About half of men have some by 50. It isn't an illness and needs no treatment, but minoxidil and finasteride slow it and a transplant can restore some of it.

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Which are you?

Why it happens

You inherit follicles that are sensitive to DHT, a hormone your body makes from testosterone. Over years DHT shrinks those follicles. Each new hair grows finer and shorter until the follicle stops. Hair at the back and sides isn't sensitive, which is why it stays, and why it can be transplanted. The genes come from both sides of the family.

A barber cutting grey hair that has thinned at the crown

The stages

StageWhat you see
1 to 2A slight move back at the temples. Many men stop here.
3Clear recession at the temples, an M shape, often a thin crown starting
4 to 5The crown opens up and the band of hair between it and the hairline narrows
6 to 7Front and crown join, leaving a horseshoe at the back and sides

Doctors call this the Norwood scale. How far and how fast you go depends on your genes: some men reach stage 3 at 25, others at 60.

Is it something else?

Pattern loss is gradual and the scalp looks normal. See your GP first if the hair loss is sudden, patchy, coming out in clumps, or your scalp is itchy, sore, scaly or scarred. Those need a diagnosis before any clinic treatment. Our causes guide lists what else it can be.

What slows it

Minoxidil (€50 to €85 for three months) and finasteride (€79 for 12 weeks) are the two licensed medicines. They work better at keeping hair than regrowing it, so earlier is better. See treatment for men.

Myths worth dropping

  • Hats cause baldness. They don't.
  • Washing your hair often makes it fall out. It only removes hairs that had already let go.
  • Bald men have more testosterone. It is about how sensitive your follicles are, not how much hormone you have.
  • It only comes from your mother's father. Both sides count.
  • Cutting it makes it grow back thicker. It doesn't change the follicle.

Doing nothing is fine too

Plenty of men cut it short and get on with life. If it's getting you down, say so to your GP: the HSE says to see a GP if you're worried about your hair loss, and how you feel is reason enough.

Questions people ask

At what age does male pattern baldness start?

Any time after puberty. Many men notice it in their twenties or thirties; about half have some by 50.

Does it come from your mother's side?

Partly. Genes from both parents play a part, so a bald grandfather on either side counts.

Can it be reversed?

Medicines can thicken thinning hair and slow the loss. Bare, shiny scalp doesn't regrow; a transplant moves hair there.

Is male pattern baldness a sign of illness?

No. It is a normal inherited trait. See a GP only if the loss is sudden, patchy or comes with scalp symptoms.

More guides

Female pattern hair lossAlopecia areataSudden sheddingAfter pregnancyMenopauseCauses of hair lossReceding hairlineScalp problemsTreatment for menTreatment for womenWhich treatment works?FinasterideMinoxidilPRP for hair lossHair transplantLaser therapyScalp micropigmentationNatural treatmentsWigs and the grantOur price guideYour GP and blood testsWho treats hair loss?Choosing a clinicReading reviewsTurkey or Ireland?

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