Early balding in men usually shows up in three ways: a receding hairline at the temples, a thinning crown and hair that becomes finer. In the vast majority of cases it is androgenetic alopecia, a genetic and hormonal condition that progresses slowly over years. Here is how to recognise it, work out your stage, understand where it comes from and choose the options that make sense for you.
The first signs of early balding
- The temples recede: the hairline moves back at the sides and takes on an M shape. This is the most common sign. For this specific area, see our article on a receding hairline and thinning temples.
- The crown thins: a lighter patch appears at the top of the back of the head, often spotted in a photo or a lift mirror.
- The hair gets finer: on top, it becomes thinner, shorter and softer than at the back. Your style holds less well.
- Shedding increases: more hair on the pillow, in the shower or on the towel, for several months.
The mechanism is always the same: some follicles on top of the head are very sensitive to DHT, a hormone derived from testosterone. Under its influence they produce finer and finer hairs, until only fuzz remains. The hair at the sides and back is usually spared.
The stages of balding: the Norwood scale in plain words
Doctors describe how male pattern baldness progresses using the Norwood scale, published by the surgeon O'Tar Norwood in 1975 in the Southern Medical Journal. It has seven stages:
- Stage 1: no visible loss, the hairline is the one you had as a teenager.
- Stage 2: the temples recede slightly and evenly. This stage often just reflects the adult hairline.
- Stage 3: the temples recede clearly. This is the first stage of balding in the medical sense. One variant mainly affects the crown.
- Stage 4: the temples recede further and the crown thins, with a band of still dense hair in between.
- Stage 5: that band thins and the two areas move closer together.
- Stage 6: the band disappears and the top of the head is largely bald.
- Stage 7: only a horseshoe of hair remains at the sides and back.
Early balding usually corresponds to stages 2 to 3. Progress is neither linear nor predictable: some men stay at the same stage for years, others move faster.
Is baldness inherited from your mother or your father?
People often say baldness comes from your mother. That is partly true: an important gene, the androgen receptor gene, sits on the X chromosome, which a man always inherits from his mother (Hillmer et al., American Journal of Human Genetics, 2005).
But that is only part of the story. Large genetic studies have identified several hundred regions of the genome linked to balding, spread across many chromosomes and passed on by both father and mother (Hagenaars et al., PLoS Genetics, 2017). So the honest answer is: both sides. A balding father, grandfather or uncle, on either side, raises the risk without making it a certainty.
At what age does balding start?
It can begin as early as the late teens. Balding is called premature when it sets in before about 25. For many men the first signs appear between 20 and 35, and it becomes more common with age. Balding that starts early simply has more time to progress: that is the main reason not to wait before taking stock.
Normal or early balding: how to tell the difference
Not every receding hairline means balding. Between the late teens and your thirties, the childhood hairline often moves back by about a finger's width, evenly: this is the adult, or mature, hairline. It then settles. Losing a few dozen hairs a day is also completely normal.
- Probably normal: a slight, even recession across the whole forehead, with no thinning, that does not change from one year to the next.
- Probably early balding: temples that keep receding, a crown that thins, hair that is finer on top than at the back.
- See a doctor soon: round bald patches, sudden heavy shedding, itching, redness or flaking.
What to do about early balding
There are four options. They do not work in the same way and do not take the same time:
| Option | What it does | Time to judge | With whom |
|---|---|---|---|
| Medical treatment (minoxidil, finasteride) | Slows the loss, sometimes restores density, for as long as you continue | Several months | GP or dermatologist |
| Hair transplant | Moves hair from the back of the head to the bald areas | Several months after the procedure | Specialist surgeon |
| Cosmetic serum | Supports density, with a more modest effect | At least 3 months | On your own, at home |
| Hair thickening powder | Conceals visible scalp, does not make hair grow | Instant | On your own, at home |
1. Medical treatments, with a doctor
Medical treatments exist for male pattern baldness, as a lotion (minoxidil) or a tablet (finasteride). They are the options with the best evidence, but they have contraindications and possible side effects, and their effect stops when you stop them. They should be discussed and monitored with a GP or dermatologist, never self-prescribed. To understand how they differ from a cosmetic ingredient, read our comparison of rosemary and minoxidil.
2. Hair transplant
A transplant moves hair from the back of the head, which resists DHT, to the bald areas; it is a surgical procedure, best considered once balding has stabilised.
3. Cosmetic scalp care
Serums with cosmetic ingredients (rosemary, Redensyl, Aminexil…) are used to support hair density. Their effect is more modest than a medical treatment, and you need at least three months of regular use to judge. Our roll-on hair growth serum by Orvova, 25 ml, combines these ingredients: 3% rosemary, 3% Redensyl, 2% Aminexil and 2% Anagain, with no minoxidil and no hormones, in a roller-ball bottle that massages the scalp, on the temples or the crown. To compare the ingredients, see Aminexil or Redensyl: which to choose.
Some men pair the serum with a derma roller, a small roller with micro-needles used on a clean scalp once or twice a week, never on irritated skin. What we know and do not know about it is covered in our article derma roller for hair: does it really work?
4. Instant concealing
Treatments take months. In the meantime, a hair thickening powder, a 4 g pressed powder available in 6 shades, dabbed onto the temples or crown tints the scalp to the colour of your roots: the skin that showed through is no longer visible. It resists rain and sweat, then washes out with shampoo. It conceals, it does not make hair grow. A shorter cut at the sides also reduces the contrast with the top.
When to see a doctor
See your GP or a dermatologist if shedding is sudden or heavy, if patches appear, if your scalp itches or turns red, or if you can see the balding progress year after year. The doctor confirms the diagnosis, looks for other causes (thyroid, deficiency, medication) and explains the suitable treatments. The earlier you take stock, the more options you have.
Sources
- Norwood OT, Male pattern baldness: classification and incidence, Southern Medical Journal, 1975
- Hagenaars SP et al., Genetic prediction of male pattern baldness, PLoS Genetics, 2017
Frequently asked questions
Does baldness come from your mother or your father?
Both. One key gene is carried on the X chromosome, inherited from your mother, but hundreds of other regions of the genome, inherited from both parents, also play a part.
How can I tell if it is early balding?
Compare photos taken one or two years apart: temples that keep receding, a thinning crown or finer hair on top are the typical signs. A dermatologist can confirm it.
Can baldness be cured?
It cannot be cured, but it can be slowed. Medical treatments prescribed by a doctor can slow the loss and sometimes restore some density, as long as you keep using them.
Can hair grow back with male pattern baldness?
Where fine hair still covers the scalp, a consistent treatment can restore some density. On an area that has been smooth for years, only a transplant brings new hair.
How can I hide early balding?
With a thickening powder in the shade of your roots, dabbed onto the temples or crown, and a short cut at the sides. It holds in the rain and washes out with shampoo.
