Is Self Diagnosis of MPB Possible?

Can a man diagnose himself of having MPB?

Yes! In men, male pattern baldness (MPB) or Androgenic Alopecia (AGA) can be identified and defined visually. The use of the Hamilton Norwood Classification scale or other scales aids in this process and offers a more accurate classification.

Let me repeat: Self diagnosis for MPB is possible. I diagnosed myself, I then went to see the family doctor and asked him “what’s happening to my hair” he answered “male pattern baldness”. Don’t take my word for it, a study published in December, 2004 entitled “Validity of self reported male balding patterns in epidemiological studies” examined and compared the accuracy and reliability of the assessment of balding patterns when conducted by “trained observers” verses assessments of balding patterns conducted by “men” who are experiencing the balding themselves.

In this study, the trained observers and “men” used a classification system known as the “Hamilton-Norwood classification system” (shown below). This study found while it was best to have a trained observer assess the balding pattern, it found that “men’s self evaluation is accurate enough to ensure reliability and validity of results.” In other words, a man should be able to assess his own hair loss pattern using this scale reliably. [*1]

How to identify?

MPB causes a gradual thinning of the hair on the scalp, following a certain pattern. With MPB, the hair line either recedes uniformly from the forehead (this is known as frontal hair loss or frontal balding) or it recedes in a manner that follows an “M” shape (known as vertex hair loss). Vertex hair loss is also accompanied by hair loss at the crown or back of the head. [21] [23]

Both patterns could progress to partial baldness that leave hair around the sides of the head (resembling a “U” shape) or even to total baldness. The Hamilton Norwood scale is used by researchers and individuals to access or quantify their baldness pattern. [21] [23]

Since this type hair loss follows a predictable pattern (in contrast to spots of baldness or alopecia totalis), most noticeably in men, it is commonly referred to as male-pattern baldness (MPB). To many, the term male pattern baldness (MPB) is interchangeable with androgenic alopecia (AGA).

I have heard of women who where told they had “male pattern baldness” by their doctors (because her doctor viewed it is a male-hormone dependent condition)

According to current understanding, women also experience AGA. [13] [20] [23] [26][28] In women, the hair loss progresses as a diffused thinning of hair all over the top areas and crown of the head (i.e. parietal region). [5] [13] In this case, this hair loss is either referred to as male-pattern baldness, or as female-pattern baldness. [13]

Thirteen percent (13%) of pre-menopausal women are thought to experience some symptoms of AGA, this number climbs up to 75% of women experiencing AGA after the age of 65. [13]   Hair loss is increasing in both men and women, men in their early twenties are now experiencing MPB.

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This is the original Hamilton Norwood Classification Scale, published in 1975:

Figure 1. Hamilton Norwood Classification Scale (OT Norwood, 1975)

I have read of people that were able to stop the progression of MPB for many years and some were able to reverse it, at least one of these people was told by their doctor they had misdiagnosed their male pattern baldness. I am not going to judge either doctor nor self-diagnosing man, the true story will never be known.

I sometimes refrain from using the term Androgenic Alopecia (AGA) because it implies an androgen dependent hair loss while hair loss, including MPB can be caused by a myriad of issues, androgens are just one of tens of baldness-causing factors. Read more on the origins of the term Androgenic Alopecia here

A couple related articles posted today 9/18/2011:

Male Pattern Baldness: classification and Incidence – by NORWOOD, O’TAR T. MD features a PDF document with the full text by Dr Norwood himself and his scale.

Photographic documentation of hair growth in androgenetic alopecia. and Guideline for Diagnostic Evaluation in Androgenetic Alopecia in Men, Women and Adolescents  offer some guidelines on how to use photography to document hair loss over time.

*1. Rosalind Taylor, Julia Matassa, Justine E Leavy, and Lin Fritschi. “Validity of self reported male balding patterns in epidemiological studies”. School of Population Health, University of Western Australia, Perth, Australia. Received August 17, 2004; Accepted December 13, 2004. Retrieved July 2, 2010 from PubMed Central on the World Wide Web: on the World Wide Web: (Full paper)

Written: 12/29/2010, Edited: 9/18/2011

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