What causes male pattern baldness?

[gmonasco]

I was reading the Wikipedia article on androgenic alopecia (i.e., male pattern baldness), and it contains the following passage about the causes of MPB:

 

Male pattern baldness is caused by a genetic sensitivity of hair follicles to DHT, which causes them to shrink or "miniaturize" when exposed to it. This shortens their lifespan and prevents them from producing hair normally.

 

Recently the existing theories have been challenged on the ground that while the androgens in question are responsible for hair growth on the face and all over the body of men, hair loss is only occurring at the top of the scalp. In a new theory it has been propounded that androgenic alopecia is a counterproductive outcome of the anabolic effect of androgens. It explains how hormonal changes in males lead to structural changes in skin and scalp which in turn cause hair loss.

 

I don't understand what the second paragraph is trying to say. Can anyone explain it in simpler terms?

[Dr. William Lindsey]

With rare exceptions, male baldness is a combination of bad genes and bad luck. Not water, vitamin deficiency, diet, radio waves hitting the scalp, or cell phone use....all of which have been alledged to cause baldness by people seeing me since Jan 1 2011. Not counting the hypotheses that I heard last year or the year before or...

 

You get your genetic potential for MPB from both parents. If everyone in both sides of your family is bald, I'd say you have bad genes (with regard to your potential for hair loss). If noone is bald, you have good genes. But as many bloggers know, there are gobs of examples of bald families with one kid having a full head of hair AND there are gobs of examples of hair filled families with a bald decendent. That is the luck component.

 

Its probably genetic also, but scientists are not yet able to detect the nuances of the genetic code and all of the pre-destined variables one is "born with".

 

So, as all patients to my office hear: If you have good genes, you may have good luck and not need much hair or any at all. But if you have bad genes, you ought to be conservative about how you spend your donor hair as you may need alot of it in the future. Which means, for younger patients with a significant history of major hairloss in their family, I'd push for a very conservative hairline, and avoiding the crown until it looks like the front is not "going".

 

Dr. Lindsey McLean VA

[ziggy00]

That's really good info to keep in mind when thinking about a HT. Thanks!

[crowningglory]

With rare exceptions, male baldness is a combination of bad genes and bad luck. Not water, vitamin deficiency, diet, radio waves hitting the scalp, or cell phone use....all of which have been alledged to cause baldness by people seeing me since Jan 1 2011. Not counting the hypotheses that I heard last year or the year before or...

 

You get your genetic potential for MPB from both parents. If everyone in both sides of your family is bald, I'd say you have bad genes (with regard to your potential for hair loss). If noone is bald, you have good genes. But as many bloggers know, there are gobs of examples of bald families with one kid having a full head of hair AND there are gobs of examples of hair filled families with a bald decendent. That is the luck component.

 

Its probably genetic also, but scientists are not yet able to detect the nuances of the genetic code and all of the pre-destined variables one is "born with".

 

So, as all patients to my office hear: If you have good genes, you may have good luck and not need much hair or any at all. But if you have bad genes, you ought to be conservative about how you spend your donor hair as you may need alot of it in the future. Which means, for younger patients with a significant history of major hairloss in their family, I'd push for a very conservative hairline, and avoiding the crown until it looks like the front is not "going".

 

Dr. Lindsey McLean VA

 

Well explained and so easy to understand. Is MBP and AGA the same? I believe AGA is also said to be hereditary.

[Steven Gabel, MD, FACS]

Dr. Lindsey - Excellent explanation.

 

It is in the genes 95% of the time- the hairs on the top of everyone's head are programmed to do what they do; either stay, or thin, change color, or atrophy and go away. Clearly, there are outside influences that change this like medical disorders such as thyroid problems, infections, traction alopecia - the list goes on. But, most of the time, it is in the genetic programming that people are born with.

 

In my own case, everyone in my family has thick hair, but my hair has gone down the path of male pattern baldness.

 

I hope this helps.