Unfortunately, balding can occur at any age. So, is your hairline a sign of hair loss to come?
This guide will introduce the two most common hairlines seen in adult men: mature, and receding.
I’ll discuss the definition of each, as well as how you can tell the difference.
I’ll also help you to better understand what causes a receding hairline and, more importantly, what you can do to slow it or even stop it entirely.
An Introduction to the Hairline
Before we can discuss the topic at hand, we need to define a few key terms.
The main term throughout this article will be hairline. So, what is it?
The hairline is simply a line of follicles that outline the edges of the hair. This runs alongside the temples and forehead.
As you age, this line will naturally recede.
This is because the initial hairline — the one you’re born with — is immature. It’s more often referred to as a juvenile hairline.
The juvenile hairline is characterized by rounded edges and a lower placement on the forehead and temples.
But as you age, the placement of your hairline will slowly recede into one (or possibly two) more position.
These are known as the mature hairline, and the receding hairline.
The mature hairline is one that has sharper edges and deeper placement on the temples. The receding hairline starts in a similar fashion.
However, the major difference is that the receding hairline continues to move back and perhaps even does so unevenly.
This is indicative of a hair loss condition, known as Androgenetic Alopecia (AGA) or pattern baldness.
Mature Versus Receding: How to Tell the Difference
As mentioned above, there is quite a significant difference between a mature hairline and a receding one.
But how can you tell the difference?
The most noticeable way to tell the difference between a maturing hairline and a receding one is by how it’s moving back.
A mature hairline is a natural progression. As such, there will be a smooth transition from juvenile to mature.
This transition will include an even hairline across the temples.
On the other hand, a receding hairline often moves back unevenly.
You may initially notice that your temple hairs seem to be moving slowly backwards. But you’ll soon recognize that they are moving backwards more rapidly than the forehead line.
As this recession progresses, you’ll begin to see a deep M-shape take form.
The Receding Hairline Pattern
To get a better understanding of what’s a maturing hairline and what’s a receding one, let’s refer to the Hamilton-Norwood scale (1).
This scale covers seven stages of a receding hairline, from mature to bald. These stages are:
- I — Very slight or no recession. There is no cause for concern.
- II — Symmetrical areas of recession at the temples which form a slight triangle on both sides.
- III — Deeper recession is seen at the temples, with often symmetrical recession on both sides. This is the first stage often classified as “balding.”
- IV — Temporal recession has deepened, and the patch of hair on the forehead is becoming thinner. You may also notice a balding patch forming on the crown.
- V — Balding at the crown as worsened, and there’s now just a narrow band of hair that connects the hairline of the temples.
- VI — There is no longer a solid band of hair, and the balding areas of the crown and hairline are no longer separated.
- VII — The only hair that remains is a band that wraps around the sides of the heads and the base of the scalp.
The visual provided above can give you a better idea of where you may fall on the scale.
Disclaimer: If you suspect that you’re balding, it’s best to seek the opinion of a trained medical professional such as a dermatologist. It’s never recommended that you diagnose yourself.
What Causes Hairline Recession?
If you think you’re suffering from a receding hairline, you may be wondering how it’s even possible.
Unfortunately, hairline recession can happen to anyone.
The main cause of this typical recession pattern is Male-Pattern Baldness (MPB), also referred to as AGA above (2).
MPB is a genetic condition in which the follicles along the hairline and into the crown become inflamed. This inflammation is known as miniaturization, and it’s triggered by a few different factors.
One such factor is the presence of the androgen hormone DHT, which is synthesized from testosterone and the enzyme 5-alpha-reductase (5AR) (3). But other factors, including scalp tension, are also likely to play a role (4).
When the androgen hormone attaches to the follicle, it causes inflammation that will cause permanent damage if left untreated.
And in untreated cases, this will mean hairline recession and balding of the crown.
But why the M-shaped pattern?
This is actually explained by the distribution of androgen receptors throughout the scalp.
Androgen receptors are receptors within a cell that accept androgen hormones. There are 1.5 times more androgen receptors in the frontal scalp when compared to the occipital region (5).
This is why baldness is seen most prominently at the temples and forehead.
Another factor is scalp muscle tension.
The presence of androgens is believed to promote muscle tension. But muscle tension by itself is also believed to contribute to the pattern of hair loss.
In short, it’s a cycle that when left on its own can be impossible to stop.
So, who’s most likely to develop MPB?
As a condition with a genetic component, MPB often runs in families.
It’s also interesting to note that women, too, can develop pattern baldness. AGA as it presents in women is slightly different, though (6).
The main difference is that women often see thinning at the crown, which will eventually spread throughout the hair.
How to Stop a Receding Hairline
Unfortunately, there isn’t a cure for AGA. There are plenty of medications, medical procedures, and other such treatments available, though.
So, how can you know which one is right for you?
It often takes quite a bit of trial and error. But here’s a rundown of the most common treatment options.
The androgen hormone DHT is the main contributor to follicle miniaturization. We know this is bad for the follicle, but why?
Miniaturization is essentially chronic inflammation. When the follicle is inflamed for too long, it will become difficult for new hairs to grow.
But there’s even more going on under the surface. More specifically, the connection between the follicle and the blood vessels is slowly being strangled.
When this happens, blood flow is severely limited.
Rogaine, a medication that was initially developed to treat hypertension, is the most popular hair loss drug on the market. It has a variety of mechanisms, but one of the most powerful is believed to be its ability to increase circulation to the area (7).
When Rogaine is applied to the scalp, the blood vessels will receive more blood.
This will give the follicles a greater chance of getting the oxygen and nutrients they require so as to promote hair growth even in the presence of DHT.
How effective is Rogaine at promoting hair growth?
There have been ongoing studies since the 80s which prove that minoxidil is able to stop shedding and even regrow hair (8).
However, the more recent studies have focused on which formulation is best.
Study: A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men (2002)
By 2002, Rogaine has already been on market shelves for over a decade. So, researchers knew it worked (9).
But they wanted to know if a higher concentration (5 percent) would be more effective than the standard one (2 percent).
A total of 393 men with diagnosed AGA were recruited for this 48-week, multi-center study.
The men were split into three treatment groups, which were 2 percent minoxidil, 5 percent minoxidil, or placebo.
Efficacy was evaluated by scalp target area hair counts and patient and investigator assessments.
As expected both the minoxidil groups saw greater results than the placebo group.
But even further, the 5 percent minoxidil group saw superior results and a shorter response time.
How much more significant were the results?
There was 45 percent more hair regrowth in the 5 percent minoxidil group than in the 2 percent minoxidil group at week 48!
That’s not to say that you’ll see results overnight, though.
Minoxidil can take a few months to have effect, and you may even see a slight increase in shedding at the start.
But consistency is important if you choose minoxidil for your regrowth process.
What if you’ve decided that Rogaine isn’t right for you?
There are other mainstream options, such as Propecia. Or you can consider the alternative route with peppermint oil, rosemary oil, and saw palmetto.
Do keep in mind, though, that “natural” options too can have their own side effects.
If minoxidil doesn’t seem like the right fit for you, then other options do exist. Propecia, for example.
Propecia, known by the generic name finasteride, is an oral hair loss drug.
It was initially developed to treat Benign Prostatic Hyperplasia (BPH); however, researchers soon found the medication promoted hair growth in balding men (10).
Contrary to popular belief, Propecia is not a DHT blocker. Instead, it inhibits the enzyme 5AR which reduces the levels of DHT within the body (11).
While DHT may be a nuisance to those with AGA, it still has its purpose. And it’s main purpose is in sexual function.
If you block DHT entirely, you’re going to suffer from severe sexual side effects. But if you reduce the amount instead, you’re likely to see good hair growth with less side effects.
Let’s take a look at the research which outlines its efficacy in treating hair loss.
Study: Finasteride in the treatment of men with androgenetic alopecia (1998)
In 1998, researchers from Merck Research Laboratories published the combined results of two one-year studies that consisted of 1,553 men total (12).
In the first study, 1,553 men received either 1 mg of oral finasteride or a placebo for one year.
At the end of this study, clinically significant increases in hair count were observed in those who had received the finasteride treatment.
1,215 men continued treatment into the second year, and these increases in hair counts continued.
Just how much regrowth was seen?
At the one year mark, there was an average increase of 107 hairs within a 1-inch diameter circular area of the balding vertex scalp. And at two years? An increase of 138 hairs!
And while these numbers may not seem significant, you’ll want to consider two things.
First, these increases are only those seen in that one-inch diameter circular area mentioned above.
Second, those in the placebo group didn’t experience any increases at all but, instead, lost hair throughout these studies.
Now, it’s important to keep in mind that these results were reported by researchers employed by Merck which is the company that manufactures Propecia.
However, these results have been replicated numerous times over the years (13). So while it’s good to be wary, it’s also important to consider the overwhelming evidence that show Propecia’s contributions to hair growth.
Hair transplantation is a surgical procedure in which hair follicles are harvested from one area of the scalp (the donor site) and transplanted to the hairline (the recipient site).
This procedure has evolved significantly over the years with fast recovery times and better visual results.
However, this isn’t an option that’s available to everyone.
The best candidates for a hair transplant are those who have gotten their hairline recession under control.
Because, unfortunately, transplanted hair follicles can become sensitive to DHT once they’ve been moved to their new location.
This is especially true if the surrounding tissues have not recovered from the effects of balding – namely, calcification and fibrosis (14).
That’s not to say that hair transplants aren’t worthwhile to consider.
If you’ve gotten your recession under control, and you have healthy donor hair, then a transplant may be just what you need to restore your hairline.
But if you go this route, it’s best to seek out the advice of multiple trichologists before you move forward with the procedure.
It can be discouraging to watch your hairline slowly recede and your hair become thinner. But for many men and women, this is a reality.
Before you become too concerned with your hairline, though, it’s important to understand the difference between maturation and recession.
Maturation and recession are both types of hairlines that occur in adolescents and adults. But only one – the receding hairline – is a concern.
Fortunately, there are things you can do to slow your recession and perhaps even stop the hair loss entirely. These include conventional medications (like Rogaine and Propecia), alternative treatments (such as rosemary oil and saw palmetto), and even surgical procedures (like hair transplants).