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Hair · Article

Male Pattern Hair Loss: What's Actually Happening

Male pattern hair loss is genetic and progressive. The biology is straightforward and the interventions are well-established.

The mechanism

Genetically susceptible hair follicles on the scalp respond to dihydrotestosterone (DHT) by gradually shrinking. Each growth cycle produces a slightly thinner hair. Over a decade or two, the follicle stops producing visible hair entirely.

The pattern

Almost always frontal recession first (the M shape), then crown thinning, then convergence. The pattern is so consistent it's been used to classify severity for decades (Norwood scale).

The interventions that work

Block DHT at the follicle: finasteride or dutasteride. Improve follicular blood supply: minoxidil. Everything else is marginal or unproven.

Frequently asked questions

Is hair loss reversible?

Early loss is reversible. Long-dormant follicles are harder.

Can lifestyle stop hair loss?

No. It's genetic and androgen-driven.

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