Male vs Female Pattern Baldness

April 2, 2024
Zak Ibrahimi
Featured image for “Male vs Female Pattern Baldness”

Pattern hair loss, known as androgenetic alopecia, is a common condition that affects both men and women, typically presenting with distinct patterns and characteristics based on gender. Male pattern hair loss usually manifests as a receding hairline and thinning at the crown, often progressing to partial or complete baldness over time. This condition affects a significant portion of men, with up to half experiencing some degree of hair thinning by the age of 50.

Female pattern hair loss, while sharing a common mechanism with male pattern baldness, typically presents differently. Women usually experience a general thinning of their hair, particularly over the crown, with the hairline remaining intact. The thinning often develops into a widespread thinning across the central scalp but may also take on a distinctive “Christmas tree” pattern, which is characterised by more severe thinning at the front of the scalp and less towards the back. Unlike men, complete baldness in women is rare, and the condition is more likely to become noticeable after menopause.

Both male and female pattern baldness are influenced by genetics, and scientific research has linked variations in certain genes to an increased likelihood of developing these conditions. Although the underlying genetic and biological mechanisms are complex and polygenic, involving multiple genes, the sensitivity to androgens—a group of hormones that includes testosterone—plays a pivotal role in the progression of patterned hair loss in both sexes. Despite these similarities, the manifestation and progression of hair loss in men and women differ, necessitating tailored approaches towards diagnosis and treatment.

Understanding Pattern Baldness

Pattern baldness, known as androgenetic alopecia, is a common hereditary hair loss condition affecting both men and women, although it presents differently between the sexes. In men, male pattern baldness (MPB) typically begins with a receding hairline at the temples and progresses to thinning on the crown, leading to a horseshoe-shaped pattern across the scalp. Approximately 30% to 50% of men will experience some degree of MPB by the age of 50.

Women experience female pattern baldness (FPB) differently, often with a general thinning across the top of the head. It can sometimes follow a “Christmas tree” pattern, where hair thins more extensively at the front than at the back. FPB affects up to half of women by the time they reach menopause.

Key Differences Between Male and Female Pattern Baldness

Male Pattern Baldness Female Pattern Baldness
Begins at temples General thinning
Horseshoe pattern Christmas tree pattern
Crown thinning Less frontal involvement

Both MPB and FPB are influenced by hormones and genetics. Alterations in the hair follicle’s sensitivity to dihydrotestosterone (DHT), a derivative of the male hormone testosterone, play a crucial role. Hereditary factors determine how susceptible a person is to the effects of these hormones on their hair follicles.

Understanding pattern baldness involves recognising that while hair loss can significantly affect one’s self-esteem, advancements in treatment are continually being made. Identifying the condition early allows for a wider range of potential interventions.

Despite common misconceptions, the impact on the scalp is not attributed to poor circulation, vitamin deficiencies, or hats, but rather to this hormone-driven, genetic predisposition. It is a natural part of the ageing process for many, but various treatments and lifestyle adjustments can manage the condition.

Risk Factors and Symptoms

Risk Factors

One’s likelihood of experiencing pattern baldness increases due to several factors. In both men and women, age is a key risk factor, with the incidence climbing as individuals grow older. Hormonal changes, particularly around menopause for women, can also elevate the risk. Androgens, such as testosterone, play a significant role; their by-products can shrink hair follicles, leading to hair loss. For females, hormonal fluctuations after childbirth can trigger significant hair shedding, known as telogen effluvium.

Medication-induced hair loss is another concern. Certain medications can contribute to hair thinning and baldness. Additionally, stress can influence the hair cycle, potentially accelerating hair loss.


The symptoms of pattern baldness differ between sexes.

  • In males:
    • Receding hairline at the temples
    • Baldness on the crown
    • Eventually, a horseshoe-shaped pattern of hair around the head
  • In females:
    • Widening of the parting line
    • General thinning on the crown
    • Rarely results in complete baldness

Pattern baldness is primarily diagnosed by the pattern and history of hair loss. Identification of these symptoms at early stages can lead to more effective management of the condition.

Male Pattern Baldness

Male pattern baldness, or male androgenetic alopecia, is characterised by a receding hairline coupled with hair loss on the temples and the crown. It primarily affects men and is the most prevalent form of hair loss encountered.

Age and Genetic Factors

Male pattern baldness typically begins between the ages of 30 and 50. It has a strong genetic predisposition, with heredity being a significant determinant.

  • Genetic Transmission: Often passes from either the maternal or paternal side.
  • Early Onset: May start as early as the late teenage years.

Hormonal Influence & Life Events

Male pattern baldness is closely linked to androgens, specifically dihydrotestosterone (DHT), which shortens the hair growth phase.

  • Androgen Sensitivity: Hair follicles shrink due to increased sensitivity to DHT.
  • Life Events: Stress and lifestyle changes can exacerbate the condition, but the primary cause remains hormonal.

Environmental Factors

External factors such as nutrition, smoking, and UV exposure may contribute to the severity of hair loss but are not primary causes.

  • Nutrition: Poor diet can weaken hair strands but doesn’t directly cause male pattern baldness.
  • Smoking: A correlation exists between smoking and the extent of baldness, possibly due to its impact on circulation.

Female Pattern Baldness

Female Pattern Baldness (FPB), or female pattern hair loss, is characterised by a progressive thinning of hair in women. It primarily affects the central and top portions of the scalp, with varying degrees of hair density reduction.

Age and Genetic Factors

Hair loss in women typically becomes noticeable around the age of 50, with a significant proportion of women experiencing some degree of hair thinning by this age. Genetic predisposition plays a critical role in determining the likelihood and pattern of hair loss. While it isn’t limited to post-menopausal women, the incidence of FPB does increase with age.

Hormonal Influence & Life Events

Hormonal changes, particularly those related to oestrogen and androgens, have a profound impact on the progression of FPB. These changes can be associated with life events such as menopause, where a decrease in oestrogen can lead to hair thinning. Pregnancy can also influence hair density due to fluctuating hormone levels.

Environmental Factors

While genetics and hormones are significant influencers, environmental factors also contribute to FPB. These factors include:

  • Nutrition: A diet lacking in essential nutrients can exacerbate hair loss.
  • Stress: Chronic stress can lead to telogen effluvium, a condition that causes hair to fall out.
  • Health conditions: Thyroid disorders and anaemia can also affect hair health.

Mitigating environmental risks can help in managing the condition, although the efficacy varies from person to person.

Treatment and Management Options

In addressing male and female pattern baldness, various treatments have proven efficacy. Each therapy has its own merits, backed by scientific evidence, catering to the specific needs of hair loss.

Medical Treatments

Minoxidil and Finasteride are the mainstays of medical treatment for pattern baldness. Minoxidil, sold under the brand name Rogaine among others, is a topical solution or foam applied to the scalp that can stimulate hair regrowth and slow hair loss. It’s suitable for both men and women. Finasteride, a tablet taken once daily, works by inhibiting the hormone responsible for hair loss in males and is typically prescribed for male pattern hair loss.

In women, Spironolactone can be used to treat female pattern baldness due to its antiandrogenic properties.

PRP Hair Treatment

Platelet-rich plasma therapy for hair involves drawing a patient’s blood, processing it to enrich platelets, then re-injecting it into the scalp to stimulate hair growth. The growth factors in the plasma promote healing and hair regrowth:

  • Process: Blood draw → Platelet enrichment → Scalp injection
  • Frequency: Several sessions, usually a month apart

PRF Hair Treatment

Platelet-rich fibrin therapy for hair is similar to PRP but uses a different preparation method that retains more growth factors. PRF releases these factors over a longer period, potentially offering more sustained benefits:

  • Preparation: Requires no anticoagulants
  • Application: Injected into the scalp similarly to PRP

Overall, while both medical and plasma therapies offer avenues for hair regrowth, they work best when tailored to individual cases, sometimes in combination with other treatments such as microneedling or hair transplants. Low-level laser therapy is another non-invasive option that some individuals might opt for, which uses therapeutic laser light to stimulate hair follicles. A scalp biopsy may be conducted in uncertain cases to better understand the hair loss condition and guide the treatment process.

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