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Male pattern baldness is, in part, a genetically determined condition.

The genetic variant associated with male pattern baldness is inherited maternally.

Male pattern baldness (androgenic alopecia) is the most common form of hair loss in men. Men affected by this condition lose their hair in a well-defined pattern, beginning above both temples.

Over time, the hairline recedes to form a characteristic "M" shape and existing hair may become finer and shorter. Hair also thins at the crown of the head, often progressing to partial baldness (forming a horseshoe pattern of hair around the sides of the head) or in some to complete baldness (see figure).

Some degree of male pattern baldness affects roughly 50% of males of European descent during their lifetime. The proportion of affected males increases steadily with age. The incidence and the effects of male pattern baldness tend to be greatest in men of European ancestry, second highest in Asians and African Americans, and lowest in Native Americans and Eskimos.

Male pattern baldness is, in part, a genetically determined condition, associated with a genetic variant in the Androgen Receptor (AR) gene on the X chromosome , one of the so-called sex-chromosomes. Males have one X chromosome and one Y chromosome whereas females have two X chromosomes. Since sons always inherit their X chromosome from their mothers, the genetic variant in the AR gene associated with male pattern baldness is inherited maternally.

The deCODEme Complete Scan identifies a sequence variant (rs2223841) in the AR gene on chromosome X and provides an interpretation of the associated genetic risk for male pattern baldness in men. Current research has not provided the data to support an interpretation of the associated risk for hair loss in women for this variant.

prevention

Male pattern baldness does not indicate a medical disorder. There is no known prevention for male pattern baldness and treatment is not necessary, unless people are uncomfortable with their appearance. Hair weaving, hairpieces, or change of hairstyle may disguise the hair loss. This is usually the least expensive and safest approach for hair-thinning and baldness. Hair loss is usually permanent, but there are medications available that can slow the hair-thinning process:

• Minoxidil – a solution applied directly to the scalp to stimulate the hair follicles and slow hair loss. It is most effective for people under 40 years of age whose hair loss is recent and has no effect on receding hairlines. The previous degree of hair loss returns when applications are stopped. Minoxidil is the only medication approved for hair loss in women.
• Finasteride – a prescription pill that is used alone or in combination with other medications to treat benign enlargement of the male prostate gland. Like minoxidil, the results are more likely to be slower hair loss than actual new hair growth. The previous degree of hair loss returns when people stop taking the drug.

more information

You can find out more information about male pattern baldness by talking to your doctor and visiting these Web sites:

• American Academy of Dermatology on hair-loss and baldness
• Medline Plus article on Male Pattern Baldness
• Medline Plus article on Female Pattern Baldness
• DermNet New Zealand article on Male Pattern Baldness

scientific references

1. Ellis, J.A., Scurrah, K.J., Cobb, J.E., Zaloumis, S.G., Duncan, A.E., & Harrap, S.B.. Baldness and the androgen receptor: the AR polyglycine repeat polymorphism does not confer susceptibility to androgenetic alopecia.Human Genetics, 121(3-4), 451-457.
2. Ellis, J.A., Stebbing, M., & Harrap, S,B,. Polymorphism of the androgen receptor gene is associated with male pattern baldness.Journal of Investigative Dermatology, 116(3), 452-455.
3. Hillmer, A.M., Hanneken, S., Ritzmann, S. et al. Genetic variation in the human androgen receptor gene is the major determinant of common early-onset androgenetic alopecia.American Journal of Human Genetics, 77, 140-148.

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