Clinical Management of Male Pattern Baldness (MPHL)

While genetic predisposition remains a constant factor, clinical management at Terra Medical focuses on addressing the physiological drivers of hair thinning. Our practice utilizes evidence-based protocols designed to either modulate the hormonal conversion of testosterone to Dihydrotestosterone (DHT) or provide direct biological support to the follicular environment.

At Terra Medical Clinic, treatment is tailored to your diagnosis, hair goals and budget. Options include:

• FUE hair transplant — FUE is a minimally invasive method that extracts individual follicular units to recreate natural density and permanent coverage in areas with established thinning.
• Regenera AMT (Autologous Micrograft Transfer) — a regenerative technique using your own micrografts to activate dormant follicles, improve hair density and support early to moderate hair loss.
• Terra Scalpboosters — Terra Scalpboosters help promote targeted infusion of growth factors and nutrients that strengthen roots, improve scalp condition and support healthier hair cycling.
• Low-level laser light therapy (LLLT) — a non-invasive light-based treatment that enhances blood flow and cellular activity to encourage active growth phases.
• Hair supplements — clinician-guided nutraceuticals that correct deficiencies, support hair cycling and provide foundational nourishment for thinning hair.
• Holistic hair and scalp wellness programmes — structured plans combining diagnostics, scalp therapy and lifestyle guidance to maintain long-term scalp health and manage early-stage hair loss.

The Norwood Hamilton Scale of Hair Loss

If you are experiencing balding, how would you know if your hair loss is due to androgenetic alopecia, or is a result of a separate scalp condition (like seborrheic dermatitis or areata alopecia)?

There are several factors of male pattern hair loss which can identify if you are experiencing androgenetic alopecia.

• Age

It can happen any time after puberty to late teens, but most often happens in the 20s to 30s and the rate of balding often increases as age progresses.

• Family History

If you have a strong family history of male hair loss, your risk of developing the condition is higher. There are studies showing that many of those who experience apparent balding also have had a father who experienced male pattern baldness.

• Hair Loss Pattern

By far the most common way to diagnose androgenetic alopecia, the first sign that indicates androgenetic alopecia is thinning of hair that was once thick and strong. As mentioned, DHT interferes with the hair growth cycle and makes hair follicles smaller (‘miniaturisation’), so hair also becomes more difficult to grow back. Once it does, it is often thinner and less pigmented, starting at the hairline (nearest to the forehead) or at the crown (middle of the scalp). As more and more hair follicles become smaller from DHT damage, it causes the thin hair that grows to fall out easily. This results in the classic M-shaped recession at the front of the scalp and balding. The same process happens in female pattern hair loss, just in different scalp areas.

The Norwood-Hamilton Scale shown illustrates the progression of male pattern baldness and the different patterns that are possible. Some men will experience hairline recession first, some may experience thinning around the crown, and some may have a combination of both. Not everyone experiences progression through all the stages of baldness as it depends strongly on genetics, and treatment may help to minimise progression.

• Scalp Conditions

Some scalp conditions can contribute to hair loss. For example, seborrheic dermatitis is a scalp condition that can be considered as a chronic form of eczema. When an overly oily scalp causes the overgrowth of Malassezia yeast, it results in an inflamed and itchy scalp with dandruff formation. A person may start scratching at the scalp, causing crusty scabs and damaging hair follicles in the process if this condition is left untreated. Alopecia areata is caused by an abnormal immune response – a stressful event like infections, chronic illness, or hormonal changes triggers a person’s immune system to attack the hair follicles resulting in patchy hair loss. For this condition, small injections of medication over the bald patch, or using tablet and intravenous medication usually helps.

• Telogen Effluvium from Chronic Stress

‘Telogen effluvium’ is the excessive shedding of telogen hair when the body is put under chronic stress. Telogen hairs are the hairs on our scalp which are in the ‘resting phase’ and ready to shed. At any one time, 8%-10% of the hairs on our scalp are in that shedding phase. When stress is prolonged, blood flow to the scalp and skin are reduced so that it can focus on your main organs like your heart due to survival mode, and stress hormones like cortisol can also damage hair follicles. This causes a higher percentage of hairs to be pushed into that telogen phase, hence causing increased hair loss. This is often reversible with stress management and scalp treatments.

• Use of External Supplements

Supplements like whey protein and creatine have been linked to hair loss, but not by direct mechanisms. Long-term use of these supplements may increase the levels of hormones which lead to hair loss such as di-hydrotestosterone (DHT), especially if the person taking it is already genetically predisposed to male pattern hair loss. BCAAs, or Branched Chain Amino Acids, are a trio of three essential amino acids which are commonly supplemented. When taken in excessive doses, they can cause a surge in testosterone levels which then increase the risk of greater DHT production in the hair follicles. Injections of performance-enhancing drugs like anabolic steroids may also cause hair loss because they are a synthetic version of testosterone. Again, the increase in testosterone and DHT production all contribute to male pattern hair loss. 

• Poor Dietary or Product Choices

Long-term chronic dietary deficiencies without enough essential nutrients like proteins, zinc, and fatty acids can cause poor hair growth as well as brittle hair that breaks off easily. If a person is excessively dieting and is not ingesting enough calories to meet their daily requirements, the nutrients that they are taking in will go mainly to support the essential systems (like your heart, lungs, and organs) instead of hair, leading to hair loss. Poor product choices also cause hair loss because use of harsh shampoos or chemical treatments such as hair dyes can cause contact dermatitis of the scalp and increased skin sensitivity. Over time, if not addressed, the scalp becomes chronically inflamed and hair follicles are damaged.

• Other Medical Conditions 

Systemic issues can have the unfortunate side effect of also causing hair loss. For example, thyroid conditions or autoimmune conditions like lupus can cause hair loss because of disruptions to hormones which causes poor development of the hair root, or lesions on the scalp which result in scarring of hair follicles. Some medications can also cause hair loss when taken long-term such as heparin or warfarin for heart conditions, cholesterol-lowering drugs like statins, or even blood pressure medications. Prescribed medications should not be stopped because of hair loss, but a discussion with your healthcare provider can help identify if there are alternatives to address these side effects.