Balding only at the crown? Learn how to stop it in its tracks.

A balding crown and receding hairline can be early signs that you have male pattern baldness. Learn more about why this happens and the different methods that can help stop it.
A balding crown and receding hairline = male pattern baldness
Written by: Jack Health Team
Reviewed by: Sarah Bento-De Sousa PharmD. RPh

Many men experience hair thinning at the crown creating an ever widening bald spot. In fact, many men start experiencing hair loss much earlier than they would have expected. According to the American Hair Loss Association, approximately two-thirds of men will experience some hair loss by age 35. By age 50, as many as 85% will have experienced hair thinning or will have experienced significant hair loss. It’s totally normal and totally okay, but if you’re looking to halt or reverse this hair loss, there are treatments available.

What condition causes balding at the crown? 

A bald spot at the crown is an early sign of androgenetic alopecia, also known as male pattern baldness. Approximately, 25% of men who have male pattern baldness started showing signs as early as 21

Male pattern baldness is believed to happen due your genes as well as hormone levels.
According to the NCBI, male pattern baldness is primarily caused by a sex hormone known as dihydrotestosterone. Commonly referred to as DHT, it is a powerful androgen that is converted from testosterone. Although the conversion of testosterone into DHT is a normal process, DHT can have problematic side effects. If you happen to have low testosterone, it can also affect hair loss. The only way to check is to get a full blood panel done to review your t levels. 

As hair follicles tend to be sensitive to DHT, hair follicles tend to become weaker and shrink. Furthermore, DHT can also shorten the length of the anagen phase of the hair growth cycle, and subsequently increase the length of the telogen phase. This leads to new hair taking much longer to regrow and in some cases not growing back at all. 

The follicles that tend to be most sensitive to DHT reside in the crown and the hairline region. If you have lots of loss there, it’s really pointing to DHT issues.
Balding is also a typical sign of ageing. As men age, four out of five men report having some degree of baldness by age 70 according to the Canadian Dermatology Association.

Leading classification (Norwood Scale) used to measure the extent of male pattern hair loss. Image from Healthline.

What are the most common early signs of male pattern baldness? 

As the common saying goes “the best defence is a good offence.” Addressing the loss of hair sooner rather than later increases the odds of regrowth and success. 

Here are some of the common signs of male pattern baldness: 

Hair loss at the crown 

  • Hair loss that occurs at the top of your head is an early warning sign of male pattern baldness. It is also the most difficult place to catch it, you may not see any difference in your hair elsewhere including with your hair on the sides looking the same as before. So unless you have a tall partner, a mirror above your bed or are looking for it, you might miss it. 
  • It might be a good idea to ask a trusted one for their opinion if you suspect male pattern baldness, the answer might not be what you want to hear but an honest opinion can help you combat male pattern baldness earlier on. 

Thinning Hair 

  • You may notice that your hair density has had an overall reduction in specific regions such as the top of your head leaving the sides and the back of your head untouched for the most part. 
  • There is a general reduction in the strength of individual hair strands and they tend to be much finer and look weak. Often you can tell looking at your temples, seeing more scalp through your hair or noticing your part is looking wider.

Receding Hairline 

  • Even though this one does not include a balding crown, it is an early sign of male pattern baldness which can indicate a balding crown is not too far away. A receding hairline is one of the easiest early symptoms to assess which can be done by comparing your current hairline to older images of yourself. Often focuses on the sides of your hair, giving you a widow’s peak look. 

 

Can I stop it from spreading or will I completely go bald? 

Many men feel that their hair is a part of their identity and losing it can be a stressful and confidence busting experience. Thankfully, there are proven solutions to male pattern baldness that can help slow and even reverse hair loss. 


Here are our recommendations:

Minoxidil

  • Commonly known by the brand name Rogaine, this treatment increases blood flow to the scalp, encouraging healthier follicles and thus more growth. The extra oxygen and nutrients boosts the follicle’s hair production. 
  • Minoxidil is commonly available in a solution in varying concentrations of 2% and 5%. The medication has been clinically proven to regrow hair for nearly 62% of patients.  An important factor to keep in mind regarding the medication, minoxidil can take as long as two to four months to start working effectively. 

Finasteride

  • Finasteride is one of the most effective treatments against male pattern baldness. The medication directly targets DHT and inhibits the enzyme, thereby reducing your body’s overall DHT levels. Hence, your hair follicles will not undergo the process of becoming smaller and weaker.
  • The medication is backed by studies and has been shown to stop hair loss in nearly 90% of patients, while 65% of them also saw the benefits of increased hair growth and thickening of existing miniaturized hairs. 

Tretinoin

  • Tretinoin can work like a boosting agent, when paired with minoxidil, it can help make the scalp more responsive to the effects of minoxidil. In some individuals, minoxidil alone might not work well due to their bodies having low sulfotransferase activity, an enzyme that converts minoxidil from the bottle into minoxidil sulfate which promotes hair growth. Tretinoin helps increase the sulfotransferase activity thereby boosting the effects of minoxidil. 
  • The combination of topical tretinoin with 0.5% minoxidil resulted in hair regrowth in 66% of subjects studied after 1 year of use.

Rosemary Oil

  • Rosemary is a medical plant with diverse applications, including increasing nutrient-rich blood circulation to your hair follicles, thereby facilitating hair growth.
  • Rosemary oil has been clinically tested and backed by studies to prove that it works to treat of male-pattern baldness (androgenetic alopecia). After a 6 month period, the group using rosemary oil experienced a significant increase in hair count when compared with the baseline (0 months).

 

Physical treatments

 Scalp massagers 

  • Scalp massagers stretch the cells of hair follicles, stimulating the follicles and promoting better circulation, which in turn makes for healthier hair. 
  • After conducting a small study in 2016, researchers concluded that a regular scalp massage can help increase the thickness of your hair in 24 weeks. It also feels incredible!

Microneedling 

  • Micro-needling is a minimally invasive dermatological procedure in which small, fine needles are used to create very small punctures in the skin. This procedure is used for several issues, including male pattern hair loss.
  • There is evidence that when paired with other treatments such as topical minoxidil 5%, significant increase in total hair count can be noticed.
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