Male Hair Loss

About Male Hair Loss – Male Pattern Baldness - Plano, TX*

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Plano, TX hair transplant surgeon, Dr. Joseph Yaker, is a male hair loss specialist and hair transplant surgeon who offers both nonsurgical and surgical treatments for men who desire hair restoration. Hair loss among men is more common than you think. In fact, more than 50 million men in the U.S. will experience some degree of hair loss at some point in their lives, with 50% having noticeable hair loss by the time they are 50.  Unfortunately, hair loss does not become detectable until around 50% of one’s normal hair is lost. Because of this, oftentimes, men don’t seek help until they have lost a significant amount of hair.

Emotional Impact of Hair Loss

Because a full head of hair is sometimes viewed as youthful and a semblance of strength, when a man begins to lose his hair, stress, frustration, and a loss of self-esteem can settle in. More than just aesthetics and appearance, many men feel powerless because they cannot control their hair loss, and depressed because they feel that the loss has to do with their mortality and a passage of time. Hair restoration helps countless men overcome these feelings by creating fuller, thicker hair.  

Male Pattern Baldness

The most common type of hair loss among men is male pattern baldness, known as androgenetic alopecia. This affects up to 80% of men by the age of 80. It is a condition caused by age, genetics and a specific hormone called DHT (dihydrotestosterone) that attacks hair follicles leading to a disruption of the normal hair growth cycle. This disruption causes follicles to shrink and grow at a slower pace, eventually leading to the hair falling out and the pattern repeating itself with other hair follicles in other parts of the scalp. This process can affect the entire scalp, except for the hair at the back and sides of the head, which is not subject to male pattern baldness. This is a genetically permanent zone, which makes it a viable solution to be used for hair transplant surgery.

What Causes Male Pattern Hair Loss?

Hair Loss Predictability

Unfortunately, the onset, rate, and severity of hair loss are often unpredictable, but we do know that hair loss may begin at any time after puberty when blood levels of male hormones rise. In most cases, male pattern baldness starts in the late 20’s and early 30’s. It is usually subtle at first, followed by alternating periods of slow and rapid hair loss, interspersed with periods of stability. Loss of hair in the frontal area is usually the first place where hair is lost. This usually involves receding of the hairline near the temple areas, which forms an “M” shape. In some men, the loss stops there and never progresses, while in other men, hair loss continues into other areas of the scalp, including the crown. Eventually, these two regions may merge until the entire front, top and crown area are bald, resulting in a U-shaped or “horseshoe” pattern of hair around the sides of the head. Ultimately, hair follicles, even those with no genetic predisposition, may succumb to the effects of either the DHT-driven miniaturization process or from age-related volume loss, which is why most men in their 70’s and 80’s will show some signs of hair thinning or hair loss.

Norwood Classification Scale

The Norwood Classification Scale has been developed as a universal way to identify a man's stage of hair loss. It breaks down male pattern baldness into distinct categories ranging from Stage 1, meaning no hair loss, to Stage 7, depicting near total hair loss with hair remaining only around the back and on the sides of the scalp (“horseshoe” pattern).  Most cases of male pattern baldness follow this pattern although there are other rare patterns such as overall thinning throughout the top of the head. The Norwood Classification Scale categories include:

Norwood Classification Scale


Stage 1 represents an adolescent or juvenile hairline with very minor or no recession of the hairline. Therefore, no treatment is required. 

Stage 2 indicates a progression to the adult or mature hairline where there is a mild recession of the frontal hairline, slightly evident at the frontotemporal areas. This also does not represent balding.

Stage 2A represents the deepest recession of the frontotemporal hairline. 

Stage 3A is characterized by the deepest recession of the frontotemporal hairline with more extensive thinning in the front. 

Stage 3 is the earliest stage of male hair loss. It is characterized by a deepening frontotemporal recession producing a 'M' shaped pattern. These areas are completely bald or only sparsely covered by hair. 

Stage 3 Vertex represents early hair loss primarily in the crown (vertex). 

Stage 4 is characterized by further frontal hair loss and enlargement of vertex, but there is still a solid band of hair across the top (mid-scalp) separating the front and crown.

Stage 4A is similar to Stage 4 only with more thinning on the upper and frontal part of the scalp.

Stage 5 shows worsening hair loss in the front and crown, and the bridge of hair separating the two areas begins to break down. When viewed from above, stages 5 to 7 show the remaining hair at the sides and back as a distinct horseshoe shape. 

Stage 5A is similar to Stage 5 only with extended thinning on the upper and frontal part of the scalp.

Stage 6 occurs when the connecting bridge of hair disappears with only minimal hair remaining. The hair loss on the sides of the scalp has extended further.  

Stage 7 is the most severe form of hair loss. Only a narrow band of hair remains on the back and sides of the scalp. This hair may be quite thin. 

Diagnosis of Male Hair Loss

The diagnosis of typical male pattern baldness is diagnosed based on the appearance and pattern of hair loss. A comprehensive medical history, including a list of medications, history of hair loss, and a thorough scalp examination is performed. This evaluates the degree of miniaturization of hair follicles and is done to rule out medical conditions, skin disorders of the scalp or nutritional deficiencies that may lead to hair loss. Health and/or skin conditions that could lead to hair thinning or hair loss may be associated with scalp itching, redness, tenderness, skin peeling, hair breakage, patchy hair loss, sudden hair shedding or an unusual pattern of hair loss. A scalp biopsy may also be performed if the cause of hair loss is uncertain or there is a concern for scarring alopecia. Dr. Yaker utilizes specialized hair and scalp scanning technology to assess the distribution of hair loss, hair architecture, and scalp surface. Using a hand-held digital microscope and intelligent trichology software, Dr. Yaker generates a detailed measurement of hair thickness, hair lengths, and how much hair is present in a particular area. He can even determine actual and average rates of hair growth and hair shedding.

Male Hair Loss Treatments


Nonsurgical Treatments

Nonsurgical solutions include hair and scalp therapy using Dr. Yaker’s TCHR Volumizing Glycolic Acid Shampoo and Conditioner. These products restore vitality to the hair by deep cleaning the scalp and reestablishing the moisture content and physiological pH of the scalp and hair. Dr. Yaker has also formulated his own blend of Aminoplex hair repair supplements. This completely natural oral supplement is made up of the amino acids (building blocks of protein) that produce keratin, which makes up close to 97% of our hair. In addition, Dr. Yaker offers specially compounded FDA approved medications such as Finasteride (brand name: Propecia®) and Minoxidil (brand name: Rogaine®) that are clinically proven to help slow down, stop and even reverse hair loss. Other nonsurgical treatments offered are Platelet Rich Plasma (PRP) with placenta-derived extracellular matrix therapy and low-level laser therapy (LLLT) to help restore thinning hair. Lastly, Dr. Yaker offers scalp micropigmentation (SMP), where the scalp is pigmented, creating micro dots to replicate the natural appearance of hair follicles. Incredibly, these nonsurgical treatment options work synergistically, resulting in significant hair improvements as compared to if one method were used alone.

Hair Transplant Surgery

For some patients, nonsurgical hair restoration methods may not be enough to restores one’s hair loss, especially patients who have advanced loss. As a result, hair transplantation surgery would be the best approach to restore one’s confidence and quality of life by restoring hair through extremely advanced techniques. Modern surgical hair restoration procedures such as Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) allow surgeons to take hair from the back of the head and transplant it to the areas where balding has occurred. The reason why the hair does not fall out once transplanted in its new location is because the transplanted hair follicles take on the same characteristics as the hair in the area where it originated, which is the genetically permanent zone. Both approaches result in natural, everlasting outcomes. The primary difference between the two techniques is in the way in which the hair is extracted. Dr. Yaker will determine if you have ample, good quality hair in the permanent hair zone in order to be able to relocate those hair follicles to the areas of hair loss.

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