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All types and stages of male pattern baldness

The nature of the development of this type of alopecia is closely related to sex hormones and a hereditary factor. Thinning and hair loss is triggered by the sensitivity of hair follicles to genetically transmitted dihydrotestosterone. Under the influence of this hormone, spasm occurs in the hair follicles. As a result, dystrophy of the hair follicle develops, most of the follicles die.

A characteristic manifestation of androgenetic alopecia is the lack of hair in the forehead and crown and the continued growth of hair in other places insensitive to sex hormones.

There are 3 types of androgenetic alopecia:

  1. Horseshoe. The clinical picture is manifested in excessive hair loss of the frontal part from the side of the temples. Further, the process expands throughout the frontotoparietal part, gradually forming a bald head that looks like a horseshoe.
  2. Nest. The hairline begins to thin in the forehead. Gradually, the process captures the parietal zone, forming a bald head resembling a nest.
  3. Mixed type. Hair at the same time thinning in the fronto-parietal part and on the crown of the head. Bald patches appear in the shape of the letter M. If the process is not stopped, baldness flows into a horseshoe type.


This type of alopecia is most often diagnosed in women as a result of hormonal changes in the body during pregnancy, lactation, or puberty. Diffuse baldness is characterized by uniform hair loss over the entire surface of the head.

Note! Also provoke the development of diffuse baldness can be nervous overstrain, drug use, uncontrolled use of antibiotics and tablet contraceptives.

Diffuse alopecia is divided into two subspecies:

  • anagenic (occurs during the period of active growth of the hairline),
  • telogen (diagnosed in the phase of complete rest of the follicle).


Abundant local hair loss is diagnosed as focal or nesting alopecia. A characteristic feature of this type of baldness are bald patches of a rounded or oval shape.

The process of hair loss with focal alopecia passes through three stages:

  1. Progressive - foci of baldness are actively expanding, gradually merging with each other.
  2. Inpatient - hair loss ceases.
  3. Regressive - healthy hair growth is restored.

A prolonged state of stress, head trauma, imbalance of hormones in the body, and autoimmune diseases can provoke the development of focal alopecia.


The irreversible process of hair loss, accompanied by severe inflammatory, atrophic and scarring processes diagnosed as cicatricial alopecia. Factors that provoke the development of this type of baldness are: autoimmune diseases, infectious lesions of the skin, genetic predisposition.

With cicatricial alopecia, hair follicles are destroyed, on the site of which scars appear. These connective tissue seals completely stop the growth of new hair.

Attention! The clinical picture of cicatricial alopecia is manifested in asymmetric foci of prolapse, on which scars and atrophic lesions are visible. At the center of these areas are some healthy hair.

The following forms of cicatricial alopecia are distinguished:

  • secondary - develops as a result of any disease,
  • X-ray - develops after an X-ray examination of mycotic lesions of the skin,
  • idiopathic - is extremely rare, has an unclear nature of development.


This type of alopecia is characterized by complete baldness not only of the head, but also of other parts of the body (arms, legs, genital area, eyebrows and eyelashes fall out). Total alopecia develops rapidly. Within two months from the beginning of the fallout, very large bare patches merge with each other.

The process of active hair loss provokes a prolonged state of stress, hormonal disruptions, fungal infections of the skin, exposure to radioactive and chemical substances, uncontrolled use of antibiotics, chemotherapy, and head injuries.

Distinguish alopecia:

  • total - hair loss throughout the body,
  • subtotal - develop more slowly, affect only the remaining hair on the head,
  • universal - the pathological process of baldness affects the whole body, the nail plate is thinning.

Stages and degrees of baldness according to Norwood

Before designating a course of treatment therapy for alopecia, the doctor trichologist determines the degree of hair loss. For this purpose, the Norwood scale is used - a table with figures and a detailed description of the severity of hair loss. The Norwood scale combines all existing types of alopecia.

Norwood's classification of baldness includes seven degrees of male alopecia:

  • Initial stage. Manifested by the loss of hair from the front, temporal and frontal areas of the head.
  • The second one. Small bald patches in the forehead and temples advance a few centimeters toward the back of the head. As a result, the temporal and frontal parts take the shape of a triangle. The hair of the parietal zone of the head.
  • Third. The area of ​​the temples and forehead is thinning even more, pronounced bald patches appear, moving more than 2 cm from the frontal line.
  • BEHIND. Alopecia areata, which is characterized by active hair loss at the crown. Most often, 3A baldness develops in men after forty-five years.
  • Fourth. On the parietal zone, the hair thinns even more or almost everything falls out. The area of ​​the temples and forehead is exposed. The parietal and frontotemporal zones are separated by a strip of hair.
  • Fifth. The hair on the crown almost disappeared. The forehead and whiskey are even more exposed. The process of baldness covers a significant part of the head, forming a horseshoe-shaped shape of the hairline.
  • Sixth. The hair connecting the frontal and crown areas earlier falls out. As a result, a large bald spot is formed.
  • Seventh. Complete loss of hair of the front and back of the head. A small part of the hairline remains only in the area of ​​the ears, neck and neck.

Only a careful attitude to yourself and diagnosis of alopecia at the initial stage will quickly eliminate the problem and avoid complete baldness.

Diffuse baldness

If we consider all types of baldness in men, the next most common is considered to be diffuse alopecia, which can be triggered by the aggressive influence of external factors. A distinctive feature of this type of hair problem is the uniform loss of hair throughout the head. To date, in medical practice, two forms of diffuse alopecia are considered - the telogen and anagen forms.

Telogen form

If adverse factors affect the scalp and hair roots, the hair follicles go to the resting stage, which is called the telogen phase in medicine. In general, according to normal indicators, about 15% of the scalp should be in the telogen stage, but with a diagnosis of diffuse telogen alopecia, doctors diagnose up to 80% of hair in long-term rest.

The causes of telogen diffuse alopecia are as follows:

  • nervous loads, stress, mental overstrain in a chronic form,
  • low protein diets
  • vitamin deficiency
  • acute, chronic, somatic, systemic and infectious diseases,
  • long-term use of antibiotics, antidepressants, antipsychotics, antitumor drugs, etc.,
  • hormonal disorders and thyroid disease.

Anagen form

If we consider the anagen form of diffuse alopecia, doctors talk about a pronounced damaging effect of aggressive factors on the hair, as a result of which they simply do not have time to go into the resting phase, falling out on the anagen growth phase. In this case, there is a long period between the aggressive influence of factors and the onset of hair loss.

The causes of the anagen form are as follows:

  • adverse environmental conditions
  • body intoxication,
  • radiation, chemotherapy,
  • radiation effect
  • treatment with toxic chemotherapeutic drugs.

Diffuse Hair Loss Treatment

Despite advertising various means and procedures, trichologists insist that diffuse baldness and even its initial degrees are not treated as such. The fact is, despite the negative incidents with hair, the measles and hair follicles themselves function as before. And there are no points on which it will be necessary to influence drugs and procedures.

The main goal of treating diffuse alopecia is to identify the causes of hair problems and eliminate triggers. After this, a man can at home accelerate hair restoration using folk remedies. Also, the doctor can prescribe pharmacy lotions, solutions, shampoos and balm to stimulate hair growth, strengthen the roots and hair structure. The best growth stimulants are tricomin and foligen in the forms of spray, shampoo and conditioner.

Causes of the disease

The etiology of focal alopecia is still under study by specialists, doctors note the following possible factors:

  • heredity,
  • hypo-, hyper- or vitamin deficiency,
  • increased production of dihydrotestosterone,
  • chronic infections and viral diseases,
  • digestive diseases
  • congenital follicular defects,
  • prolonged contact with chemical and toxic substances, radiation and radiation,
  • impaired metabolism,
  • overload of the psychoemotional background, stress, depression,
  • chemotherapy,
  • taking potent drugs, for example, antipsychotics, anti-inflammatory and antitumor drugs, antibiotics, antidepressants, etc.,
  • bad habits and poor nutrition, sedentary lifestyle,
  • autoimmune processes in the body.

Stages of alopecia areata

Symptoms and clinical manifestations will help to determine the stages of development of alopecia areata, as well as a trichologist who knows for sure how to determine the phase of the disease. The stages of alopecia can be as follows:

  • active phase - the patient may experience swelling and hyperemia, itching and a burning sensation in the area of ​​hair loss, and the hairs themselves are easily separated from the skin by contact with them,
  • stationary phase - in the area of ​​hair loss, a pale spot without hair is observed, normal hair roots and follicles are visible at the border,
  • remission phase - on the spot of bald patches, the appearance of cannon hair is visible, but with insufficient pigmentation.

In addition to changes in the condition of the hair, doctors often diagnose changes in the nail plate, namely, a rough surface, deep grooves, blotches of white color, foliation of nails and brittleness. If the doctor observes the total spread of alopecia areata, in 95% of cases there will be problems with the nails.

Treatment of focal baldness

Regardless of what stages of baldness of focal alopecia are observed in a patient, therapeutic measures will be comprehensive and phased. First, the causes of alopecia are determined, in connection with which corrective treatment is prescribed. It may be as follows:

  • the use of hormonal agents of prednisone or glucocorticoids,
  • treatment to restore the balance of sex hormones,
  • local treatment to restore hairline by revitalizing follicles, stimulating growth,
  • the use of folk remedies to stimulate hair growth (masks with mustard and red pepper, oil masks and herbal conditioners),
  • correction of the state of immunity,
  • physiotherapeutic methods to increase the effectiveness of therapy, for example, darsonvalization, current stimulation, mesotherapy, massage, etc.,
  • correction of diet and lifestyle.

Particular attention should be paid to a man choosing cosmetics. A trichologist can prescribe shampoos, balms, lotions and solutions for topical hair treatment containing components that accelerate blood flow. Thanks to this effect, nutrition of the hair roots is established, and sleeping follicles are also awakened.


Only knowing the first signs of alopecia, a man will be able to consult a doctor in a timely manner to prevent a pathological process. Only knowing the causes of hair loss, the trichologist will be able to choose an effective course of treatment, restoring the patient’s hair health. Today, the most common androgenic and diffuse forms of alopecia are more difficult to treat scar and focal alopecia.

How is it manifested?

When the cause is eliminated, the hair condition is restored, and their growth resumes.

Progressive alopecia is considered as an independent, most often irreversible disease.. It is of a staged nature, accompanied by the appearance of areas on the head that are deprived of hair, and often leads to complete baldness. Distinguish between androgenetic and focal alopecia.

Focal baldness is characterized by the formation on the head of round or oval bald patches with clear boundaries. The disease is predominantly autoimmune in nature and is expressed in men and women with the same clinical symptoms..

Androgenetic alopecia is a progressive baldness caused by the action of androgen hormones on hair follicles.

Most often, the disease begins in adulthood and is associated with aging..

The process of hair loss occurs gradually, begins with small areas and gradually spreads to other areas of the head.

Baldness in women and men with androgenetic alopecia is manifested in different ways.

In men, the anterior parietal zone is primarily affected along the edge line of hair growth, in women, baldness begins with a central parting on the crown of the head.

Stages of baldness in men

The stages of baldness in men according to Norwood - Hamilton are characterized as follows:

  1. I. Signs of alopecia are not observed..
  2. II. A slight shift of the boundary line occurs back, the frontal cavities symmetrically become deeper, the hair on the central part of the forehead forms a trapezoid.
  3. II-A. The shift of the boundary line back together with the hairs on the frontal cavities. The front line of hair growth looks almost even, only slightly protruding forward in the center.
  4. III. The boundary line moves back even further, thinning is observed in the central part, an acute triangle is formed from the "trapezoid".
  5. III-A. Thinning occurs somewhat stronger than in stage II-A; the hairs on the frontal cavities and in the center fall evenly.
  6. III-V. Thinning occurs simultaneously along the front marginal line, as in stage III, but at the same time a rounded center of baldness forms on the upper occipital part.
  7. IV. The central part thins, merging with the frontal cavities almost in a straight line, in the upper occipital region forms a rounded bald spot.
  8. IV-A. The hairline along the front central zone retreats back further than the frontal cavities, forming a concave arc.
  9. V. The boundary line begins in the center, from the crown, externally forming a concave arc. A limited lesion on the back of the head extends to the middle occipital part.
  10. V-A. The hairs fall out on the entire front parietal part, merging with the center of baldness on the back of the head.But hair remains in the temporal region.
  11. V-v. The hair on the front central frontal part is preserved in the form of an acute triangle. A round focus of baldness affects the parietal and upper occipital parts.
  12. VI. There is no hair on the parietal, upper occipital and partially on the middle occipital region. Hair in the temporal-lateral part is preserved.
  13. VII. Saved hairs in the lower occipital region, and in the lower lateral zone.

Hair loss in men occurs gradually, terminal hard hairs in the foci of baldness are replaced by thin fluffy, and then completely disappear.

Alopecia progresses very slowly and lasts for years and decades.

Treatment should begin with severe hair thinning..

Preparations for external use with the active active ingredient minoxidil have high pharmacological effectiveness in androgenetic alopecia in men.

Minoxidil turns the hair follicles into terminal hair follicles and prolongs the active phase of hair growth, preventing their loss.

For oral administration, finasteride is prescribed, which reduces the concentration of dydrogesterone in the male body, thereby stopping the process of baldness.

We examined all degrees of baldness in Norwood. In the next paragraph of the article, we will consider hair problems concerning the beautiful half of humanity.

Hair loss in women

The stages of hair loss in women were classified by Ludwig in 1977. There are three in total:

  • A uniform thinning of the hair occurs immediately on a large area in the central zone of the head.
  • The line of the central parting expands, on the parietal zone the hair is thinned. Up to 70% of hair falls in the central zone.
  • A rounded area, completely devoid of hair, forms in the central parietal zone.

In women with endocrine disorders, male pattern baldness occurs. Treatment of alopecia includes the external use of solutions of minoxidil already from the first stage of alopecia, as well as the intake of antiandrogens ("Diane-35", "Cyproterone", "Chloe") inside. In the second and third degrees of alopecia, transplantation of active hair follicles is recommended. As camouflage means wigs and false hairpieces are used.

Regressive stage

Focal alopecia in patients proceeds in 3 stages:

  1. Progressive or Active. Over the course of several weeks, intense hair loss occurs on the rounded portion of the head until a limited bald spot forms. The skin in the focus is swollen, along its edges are short broken hairs with a thickened tip.
  2. Stationary. The skin in the focus is not changed, the process of hair loss stops.
  3. Regressive stage. In alopecia, growth of thin cannon hair is observed along with stiff terminal hair.

Treatment of focal alopecia is aimed at enhancing hair growth. Cyclosporin preparations and irritants are used (to inhibit the autoimmune action of hair follicles), as well as a solution of minoxidil.

Watch the video: Male Pattern Baldness and Hair Loss Information (March 2020).

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