Andrea Bernhard, MD

Dr. Bernhard became a physician in order to make a positive difference in people’s lives. Her goal is to treat every patient with respect and dignity, and to deliver the highest quality care. Dr. Bernhard has lived in Hawaii for 10 years, and even completed her residency at the University of Hawaii. In her own words, “I get to care for wonderful people in one of the most beautiful places in the world.”


Male Pattern Baldness

Most men experience a type of hair loss called androgenetic alopecia. Otherwise, commonly known as Male Pattern Baldness. It may take anywhere between 15 and 25 years to completely go bald. However, the process may take less time depending on other factors.

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The onset of hair loss and explicit balding may vary from person to person. Most men have some amount of balding by the time they are in their sixties. There are hair loss treatment options available.

About 30% of men in their thirties and 50% of men in their fifties experience visible balding.

In women, balding seems to start at the top of their heads. Also, they experience more of a general thinning all over the head as well. Sometimes menopause can adversely affect this condition. About 30% of women over 70 have suffered hair loss.

The onset of balding in men

The hair starts to thin and recede at the temples. Simultaneously the top of the head also experiences similar thinning of hair density. Gradually, over time, a small bald patch appears on the top of the head. This happens when the receding hairlines from the temples join the balding central patch. It leaves behind a patch of hair in the front which eventually thins out too. On the sides of the scalp and at the back, a rim of hair is sometimes noticeable. This also eventually thins and may result in completely balding in men.

The cycle of hair growth

Hair grows out of tiny pouches just under the skin surface called hair follicles. A single strand of hair grows from each follicle which has a lifespan of around 3 years. The hair is then shed and a new hair grows out of the same follicle. This cycle goes on throughout one’s life.

Causes of balding in men

  • The follicles on the scalp become smaller or shrink in size over time.
  • This causes the new hair to be thinner than the last strand.
  • The average life of a strand of hair also is much lesser as the condition progresses.
  • The hair follicle becomes very small. Only a thin stump of hair remains that does not exit the skin surface.

Balding due to male hormones

  • The scalp skin has some cells that aid in converting testosterone into a different hormone. This other hormone is dihydrotestosterone.
  • Hair follicles affected by balding develop sensitivity to this hormone, leading to shrinking follicles.
  • This condition is believed to be genetically transferred along the bloodline.

Outcome of baldness

Most young men are affected negatively by balding. It affects their general well-being and mental health. Counseling can help them deal with it as a sign of aging. Balding directly increases the risk of sunburn and damage related to excessive exposure to the sun. As a result, hats and sunscreens are always recommended.

In women, higher levels of testosterone can cause balding. Medical conditions like PCOS or polycystic ovary syndrome may result in a receding hairline. It may also result in premature balding in women as well.

Hair loss treatment options for male pattern baldness

It may be difficult at a mental or personal level to come to terms with balding. However, it is important to remember that it is a natural process that comes with age. It is not recommended trying treatments offered by private clinics that promise lustrous growth of lost hair. They are not usually effective and turn out to be very expensive too. Always check with a credible source or your general physician before you agree to such treatment.

Usually, gradual balding with age does not warrant any treatment. Routine hair care involving combing and washing of hair may resume unless otherwise advised. A visit to the salon and finding a style that makes you feel good about yourself will reduce balding induced stress as well. In the case of early onset of the condition of excessive balding, some treatment or artificial hair treatments can help.


Hair loss treatment options include medication. The two most recommended medicines for hair follicle growth are finasteride and minoxidil. They work by preventing testosterone conversion to dihydrotestosterone. Finasteride blocks the hair follicles from getting affected by balding. They also can grow back to their normal size as well. The treatment is not always successful but some men have reported being satisfied with the results of this medicine.

Side effects of finasteride

  • It is a slow process. Furthermore, it can take up to four months to notice any visible difference. Additionally, it can take as long as even 2 years for full growth of hair.
  • This is a long-drawn treatment and abruptly stopping medication will also stop the effect of the treatment.
  • Very rarely, it may cause lower levels of libido or sex drive.
  • This medication is only for use in men and is available only by prescription.

Minoxidil lotion for premature baldness

Minoxidil is an over the counter prescription which can be rubbed on the scalp. The 5% strength is intended for men only. It is also believed to be more effective than the 2% solution. There is no scientific study to prove its effectiveness in hair regrowth, but it is said to prevent further loss of hair.

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