Male patterned balding occurs in approximately 45% of the male population, and it is believed to be caused by programmed earlier hair cell death in the affected areas. This type of hair loss typically affects the scalp while sparing the hair around the sides and back of the head, known as permanent hair. Transplantation is possible by utilizing the permanent hair from the back and sides to cover the balding areas. In contrast, female hair loss tends to be more diffuse, impacting the hair all over the head, including the sides and back. Consequently, hair transplantation is generally less suitable for women due to the lack of a permanent hair wreath. The reason for the permanent rim of hair in men is not fully understood, but there are theories connecting it to evolutionary adaptations. One such theory suggests that the 7% of men with extreme balding may have had specialized roles in tribal living, including left-handed spear tossers, color-blind individuals who could spot camouflage, and gay men who protected the tribe's women. While these theories are interesting, they remain speculative explanations for male patterned balding.
The scalp on top and the scalp on the sides and back of your head originate from different sources embryonically. As a result, they respond differently to DHT (dihydrotestosterone) and have varying abilities to produce alpha 1 reducatase. DHT does not have the same negative effect on all hair follicles. For example, facial hair tends to become thicker with increased levels of DHT.
The hair follicles in the donor zone, located in the back of the head, are genetically resistant to the DHT hormone and are less susceptible to hair loss.
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