Baldness is a medical condition that affects some 25% of men in their 20’s and an astounding 2/3 of all men after the age of 60. Male-pattern hair loss and baldness does not have any intrinsic side effect aside from hair loss so many consider it a cosmetic medical condition, but for those who suffer from it, its effects it can be devastating with social and psychological consequences.
Androgenetic Alopecia, or “male pattern baldness,” occurs in me whose hair follicles are sensitive or over-exposed to the hormone dihydrotestosterone (DHT). In men, testosterone is converted to DHT. Over time, DHT-sensitive hair (usually found on the top and front of the head) becomes weaker, finer, and eventually stops growing. However, even men who experience advanced baldness have healthy hair follicles mostly around the sides and the back of the head that last a lifetime. Even though these healthy hairs are exposed to DHT, they are resistant to this hormone and survive for a lifetime. The usual life of a hair follicle is 5 years, 4 of those spent growing and the last year being stagnant, but follicles that are damaged fall out and are not replaced by new follicles. This is why male pattern baldness is gradual but irreversible in its later stages.
Male Baldness: The Norwood Scale
Male pattern baldness is characterized by a receding hairline particularly in the temples. The recession can be concurrent with loss of hair over the crown of the scalp. Notably, hair is rarely lost over the back of the scalp. This is particularly important when one considers that hair transplantation takes hair from this “protected” area of the scalp to replace the lost hair over the frontal temporal hair line and crown. Thinning hair and balding are common occurrences, but they don’t appear the same way for everyone. Recognizing the type of hair loss you have is a first step to determining the right treatment plan
- Class 1 represents a normal head of hair with no visible hair loss.
- Class 2 is characterized by the beginning of a receding hairline and a “widow’s peak” on the forehead.
- Class 3 patients exhibit a more significant decline in hair above the temples as well as receding from the forehead. In Class 3 Vertex, hair loss is starting to become significant on the crown.
- Class 4 hair loss may become more noticeable on the crown or patients may have significant hair loss above the temples and/or front anterior areas.
- Class 5 hair loss approaches significant levels with most hair loss occurring on the top of the vertex and crown. Hair transplantation for this Class and higher Class levels may require more grafts to provide coverage and density.
- Class 6 patients show major hair loss, but still have areas with donor hair available. Transplanting this hair can still have excellent results.
- Class 7 patients show the most significant loss of hair. There may still be sufficient donor hair for transplantation; however, results may be limited.