Alopecia in Men: Beyond the Hairline

Welcome back, DERM Community!

Last week, we examined the nuances of intertrigo, an often-dismissed “rash” that in reality reflects deeper dysfunctions in skin barrier, friction, and microenvironment.

This week, we’re shining the spotlight on a condition that appears in nearly every dermatology and primary care practice:

Male Alopecia.

We’ve covered hair loss before, but today we’re going deeper.
Beyond the basics, into what really drives male alopecia and how to recognize, diagnose, and manage it with confidence.

Often dismissed as “just aging,” male pattern hair loss (androgenetic alopecia) is far more than a cosmetic issue.

It’s a lens into genetic predisposition, androgen signaling, and scalp health_; while its impact reaches beyond the hairline, affecting confidence, quality of life, and overall well-being.

Featured on This Week’s Chapter:

Understanding and Managing Male Alopecia

• Recognizing the hallmark patterns of male pattern hair loss (receding hairline, thinning crown, diffuse shedding)

• Exploring the role of androgens, genetics, and follicular miniaturization in pathophysiology

• Diagnostic approaches: when to screen for thyroid disease, nutritional deficiency, or autoimmune causes

• Current and emerging management strategies: from FDA-approved therapies to advanced interventions

• Addressing the psychosocial impact of hair loss on patient care and adherence

What is Alopecia?

Alopecia simply means hair loss, but the causes and clinical outcomes vary widely. In men, the leading type is androgenetic alopecia, affecting nearly 50% by age 50.

But clinicians must also recognize:

Clinical Features of Male Alopecia

A few shed hairs in the shower or on your pillow?

That’s usually normal (most people lose 50–100 hairs a day as part of the natural growth cycle).

The red flag comes when shedding is excessive, sudden, or patterned. Here’s what to look for:

• Androgenetic Alopecia (Male Pattern Baldness):

  Gradual thinning along the temples and crown. On closer exam, follicles may appear miniaturized.

• Alopecia Areata:

  Sudden, well-defined bald patches. Look for “exclamation point hairs” (short, broken hairs that taper at the base).

• Scarring Alopecia:
  Hair loss accompanied by redness, scaling, pustules, or visible scarring, always a reason for urgent referral.

• Telogen Effluvium:
  Diffuse, generalized shedding often triggered by stress, illness, or medications. Typically self-limiting once the cause is resolved.

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Hair loss is more than “just genetics.”

Discover the hidden factors and the treatments changing the game:

Beyond the Hair: Emotional Impact

Hair loss is deeply tied to identity and confidence, particularly in men where it can alter social interactions, self-esteem, and even career dynamics.

Clinicians should integrate psychosocial screening and be ready to recommend support groups or counseling where appropriate.

Want to Explore More Cases of Alopecia?

Our Hair & Scalp Disorders Module brings together case-based learning across the alopecia spectrum, helping you build confidence in diagnosis, treatment, and long-term patient care.

Looking for a job?

Whether you’re actively exploring new opportunities or just curious about what’s available, now is the perfect time to discover dermatology roles focusing on lymphatic and vascular skin conditions.

Why browse now?

• Find positions with specialized wound and lymphatic care focus

• Discover roles offering leadership and innovation in multidisciplinary teams

• Explore telemedicine and research opportunities advancing lymphatic medicine
  

Explore new locations, new teams, or new modalities (hello, AI-driven diagnostics!)

👋🏻 See you next Thursday, DERM community!

Alopecia may present as “just hair loss,” but its impact extends far deeper. Whether it’s the steady march of androgenetic alopecia or the sudden shock of areata, our role is to identify patterns early, treat with evidence-based strategies, and support patients through the emotional toll.

If today’s insights helped clarify alopecia care, share them with colleagues, trainees, or your care teams.

— The Derm for Primary Care Team