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Androgenetic alopecia is the most common cause of hair loss in men, accounting for approximately 95% of cases.
While hair loss can result from a variety of factors—including chronic or autoimmune diseases, skin conditions, reactions to medications, seasonal changes, stress, poor diet, environmental pollution, and other aspects of modern life—the primary cause in men is genetic. Hereditary factors are responsible for up to 81% of male pattern hair loss cases, making genetics the most significant contributor. In fact, family history plays a key role in determining whether a man will experience hair loss, as well as when it will begin, how it will progress, and its ultimate severity.
For more information on the causes of hair loss, how it is diagnosed, and the range of available treatments,
Accurate diagnosis of male pattern hair loss is essential to ensure the right treatment—one that can halt thinning and support the health of hair follicles. A thorough medical history, a phototrichogram (a type of hair analysis), and, when necessary, a scalp biopsy, allow dermatologists to identify the underlying cause of hair loss. Since the prognosis and effectiveness of treatment depend heavily on an accurate diagnosis, this step is crucial.
Advanced Hair Clinics, each case of male hair loss is approached individually. We tailor treatment plans based on each man’s unique needs, ensuring personalized care. As one of the leading clinics specializing in male hair loss, our team has successfully treated thousands of patients across Greece, Europe, and the Middle East.
“Regarding androgenetic alopecia, there is strong evidence that the pattern and the speed of development in each man has hereditary background.”
Dr. Anastasios Vekris,
Plastic SurgeonScientific Director of Advanced Hair Clinics
The most common pattern of androgenetic alopecia in men begins with thinning at the frontal hairline and temples, often progressing toward the crown. Over time, the thinning area at the crown typically expands and may merge with the receding hairline at the front, resulting in more extensive hair loss.
Male pattern hair loss affects approximately 25% of men by the age of 30 and 50% by the age of 45–50. The typical progression starts at the end of puberty, with the most rapid thinning occurring between the ages of 20 and 30. After the age of 30–35, the rate of hair loss generally slows down. In older men, the process continues at a slower pace, often mirroring the natural decline in male hormone (androgen) levels.
Men who experience androgenetic alopecia (male pattern hair loss) have inherited a genetic sensitivity in their hair follicles to the hormone dihydrotestosterone (DHT). DHT is a byproduct of testosterone, created when testosterone is converted by the enzyme 5-alpha reductase. Once formed, DHT binds to receptors in the hair follicles, triggering a gradual process of follicle miniaturization.
This sensitivity causes the hair follicles to shrink and alters their natural function, leading to shorter, thinner hairs and a reduced lifespan of each hair strand. Over time, this results in decreased hair density across the scalp.
Specifically, DHT shortens the anagen phase (the active growth phase of hair) and speeds up the telogen phase (the resting phase, when growth stops). As a result, hairs become weaker, thinner, and fall out more easily, ultimately contributing to visible hair loss and thinning.
In many cases, men who first notice thinning hair are not experiencing immediate hair loss but rather a gradual reduction in hair density caused by progressive hair shaft miniaturization. This process occurs before noticeable hair shedding begins.
Over time, the affected hair follicles undergo gradual degeneration. The hair growth cycle shortens, resulting in hairs that are increasingly thinner, weaker, and have a shorter lifespan. With each new growth cycle, the hairs become progressively finer, until they eventually reach a vellus-like state—thin, transparent, and resembling soft, downy fuzz.
The rate at which this process unfolds varies from person to person. However, without treatment, the affected follicles typically continue to shrink and weaken, eventually leading to visible hair thinning and baldness.
Today, advancements in medical genetics make it possible to predict a young man’s risk of developing androgenetic alopecia (male pattern hair loss) with remarkable accuracy. Specialised genetic tests can identify specific variations in an individual’s DNA that are linked to male pattern baldness. These genetic markers—often found on chromosomes like the X chromosome (inherited from the mother) and other regions associated with hair follicle sensitivity—play a crucial role in determining both the likelihood of hair loss and its severity.
