Male pattern baldness is common. In this the front hairline recedes, the hair on the vertex drop off and finally, the entire front and top becomes bald or very sparse. The back and sides still retain good hair in most cases. This is because this hair does not respond to male hormones while the frontal and top hairs are hormone sensitive. In presence of male hormone and after a certain age, these hair roots simply become weaker and weaker and eventually die.
There is medical treatment that can be advised for early cases, mesotherapy for more advanced cases or for those that do not want surgery and there is hair transplantation. Hair transplantation is done by taking a strip method or by FUE. Strip method is still the gold standard.
In strip method a narrow strip of hairy skin is removed from the back of the head; the defect is closed directly. This strip is now cut into numerous grafts by trained technicians. Each tiny graft may have 1-3 hairs with the roots. These grafts are then implanted into the bald areas by making small slits, much the same way as rice transplantation in fields. The grafts then take up new blood supply and start producing hairs after a gap of 3-4 months. By 6 months good growth can be expected. To improve density of hairs, a second session is usually necessary.
In the FUE method, small grafts are directly ‘extracted’ from the back of head and other areas and directly ‘implanted’ in the bald area. Although it sounds superior, there are many technical issues and there is still ongoing debate among experts about the merits of both methods. Strip method is still the gold standard however.