Hair Thinning at The Front: Why & What to Do

Why is my hair thinning at the front?

Male pattern baldness is commonly associated with the thinning of hair along the forehead, and one of the early signs of balding.

Frontal hair is typically the first area affected. Annoyingly, it’s almost impossible to hide.

Also known as androgenetic alopecia, male pattern baldness is the most common type of hereditary hair loss. Men affected by MPB will start to notice frontal hair thinning from their mid-twenties to mid-thirties. Those affected by MPB will usually see progressive hair loss as they get older, and it is estimated that more than 50% of men over the age of 50 will be affected to some extent. Although age is certainly a catalyst for hair loss, men in their early twenties, and sometimes even their late teens, can also be affected by front hair thinning.

So, what’s the science behind MPB and frontal hair loss? It all comes down to a hormone known as dihydrotestosterone or DHT. If you suffer from MPB, your body naturally produces more DHT, a by-product of testosterone. Past puberty, there isn’t much need for DHT, as it is primarily involved in the development of male characteristics when boys make the transition to men.

Although there isn’t much use for DHT in adult males, it is still produced as a by-product of testosterone. DHT is responsible for shrinking hair follicles to a point where they produce less hair, and eventually, no hair. The hair at the front of head is often the first to be affected, resulting in thinning hair at the front, followed by a receding hairline.

Other causes of hair loss at the front

Alopecia areata

Alopecia areata is a condition that can happen at any age; however, most people will develop or show signs of this condition in their childhood years. Symptoms involve patchy hair loss (including hair loss at the front of the head), which is caused by the body attacking random hair follicles. You don’t necessarily have to be in poor health to suffer from this condition. You are at a greater risk of developing alopecia areata if a close family member has it. The good news is that hair can grow back. The not so good news is that treatments have carrying results, they can cause side effects, and hair regrowth is unpredictable.

Traction alopecia

This is simply hair loss as a result of tension on the hair follicles, causing damage. It can be caused by pulling hair back tightly into a ponytail or bun, hair extension, weaves, using rollers overnight and by having braids or dreadlocks. This form of hair loss can be accompanied by redness and inflammation of the scalp. It can be reversed by reducing the tension on hair follicles.

Telogen Effluvium

The hair cycle has three phases:

1. Anagen phase, also known as the growth phase
2. Catagen phase, also known as the transitional phase
3. Telogen phase, also known as the resting phase

Telogen effluvium is associated with excess hair loss, caused by more hairs entering the resting phase. It can be caused by changes in diet, stress, medication, and illness. It usually resolves by itself after a few months. There is no treatment for this condition.

What else can cause hair thinning at the front?

Medical Conditions

The following medical conditions may exacerbate the progression of hair loss along the front of the scalp:

• Thyroid disorders
• Scalp psoriasis
• Lupus
• Seborrheic dermatitis

Other conditions such as coronary heart disease and prostate cancer are thought to have a connection to hair loss, although concrete medical information linking them is currently inconclusive. Certain cancers may also cause hair loss for some men, and many cancer treatments such as chemotherapy have been known to damage hair causing shedding or balding.

Stress

Stress and anxiety play large roles in worsening hair loss for many men. Embarrassment or depression caused by the onset of hair thinning can create a vicious cycle that results in the accelerated shedding of hair, including hair at the front. Cortisol, the stress hormone, is linked to hair loss, with some experts claiming that the adrenal glands can be overworked due to excess production. The presence of these elevated levels can negatively affect hair health.

Medication

Medication such as antidepressants can contribute to hair loss. Normally, hair follicles continually grow strands for approximately two years before taking a brief break in what is known as the ‘telogen’ stage. During this cycle of hair growth, existing hairs remain on the follicle for a period of three months and fall out once the follicle reactivates. Drugs like fluoxetine and lithium — as well as other tricyclic antidepressants — may cause hairs to release at the beginning of the telogen cycle versus the end.

There are a variety of medications when it comes to blood pressure, from beta-blockers to ACE inhibitors. Commonly used beta blockers such as metoprolol, propranolol and atenolol have all been attributed to causing hair loss, including frontal hair loss.

Other medications that may affect hair health include:

• Thyroid medication
• Chemotherapy
• Cholesterol medication
• Immunosuppressants
• Epilepsy medication
• Weight loss drugs
• Gout treatment

If you’re concerned that your medications may be causing the hair at the front of your hair to thin, consult your doctor or medical professional to see if alternative treatments are available.

Age 

Frontal baldness affects men differently as they age. Whilst most men experience a natural reduction in the thickness of their hair as they get older, it is not only MPB that causes hair loss as you get older. As we age, hair follicles diminish, producing thinner hair, and eventually, no hair. Hair at the front is often the first to be affected.

Vitamin deficiency

A lack of vitamin D is commonly associated with hair loss. Although no conclusive research exists, there may be a link between vitamin D deficiency and the onset of alopecia areata. If you notice you’re suffering from chronic fatigue, swings in mood or excessive muscle weakness you may want to have your vitamin D levels checked.

How to treat thinning hair at the front

If you have started to notice frontal balding, there are treatment options. This is provided that hair loss is attributed to MPB. Let’s take a look at some of the common, effective and readily available countermeasures a man can undergo in order to hold off the effects of MPB.

Finasteride

Commonly sold under the brand name Propecia, which contains finasteride 1mg, is a treatment that may be the most effective means of fighting the symptoms of MPB.

Remember how MPB is caused by excess DHT? Finasteride works by blocking DHT, reducing the levels of this hormone in your body. This allows hair follicles to reactivate and grow new hairs.

The recommended dosage of finasteride is one tablet, consumed at approximately the same time each day. Tablets can be taken with or without food and should be swallowed whole. 

Finasteride starts working on the scalp almost immediately, but it usually takes around 6 months before you notice any results. Whilst a noticeable difference is commonly observed after 12 months of treatment, it is important to recognise that results may vary, and that persistence is the key to effectively maintaining your hair with a drug protocol.

Minoxidil

Sold under the brand name Regaine, minoxidil is a topical foam designed to prevent hair loss and regrow hair. Minoxidil works by increasing blood flow to hair follicles, resulting in an expansion in the size of the follicle that stimulates hair growth. The process also strengthens existing hair thanks to the increased availability of nutrients within the extra blood flow that the medication provides.

Applied twice daily, many men notice the effects of Regaine within two months of beginning treatment. 

It takes around 2 months of consistent use before you will notice the effects of Regaine. Although starting treatment may result in hair shedding, this is normal, and healthy. The medication is beginning to improve the health of hair follicles, and older, weaker hair may fall out as a result. From around 3-4 months, many men notice that hairs are appearing to look thicker and that their hair has a fuller effect. Whilst this is the general consensus, everyone has a different rate of hair growth, and it may take slightly longer before you see results.

Scalp massage

One should never underestimate the benefits of good old-fashioned head rub. Consistent scalp massages can increase blood flow to the hair follicles along the front of your head, which stimulates healthy hair growth. 

Begin by massaging the skin at the base of your scalp and slowly work your way up and through your hair. Apply moderate pressure for thirty second intervals, followed by thirty seconds of rest. Once you’ve become accustomed to the cadence of the massage, you — or the individual kind enough to assist you with the scalp massage — can experiment with different pressures and durations.

Vitamins

Supplementing your diet with vitamin D can help reduce the progression of MPB. Additional vitamins such as A, C and E may also provide some benefits, although individual results may vary.

Vitamins can help to prevent hair loss that is caused by a bad diet. Poor nutritional intake causes hairs in the “growth” stage to enter into the “rest” phase earlier than they should. This causes hair to fall out prematurely, resulting in excess shedding of hair. Incorporating the right hair loss vitamins and minerals can help to promote hair growth and reduce shedding.

Shampoo

There are many topical shampoos available on the market that contain ingredients to promote healthy hair and reduce thinning. 

Some ingredients to look for include:

• Histidine. An amino acid, histidine absorbs excess copper from hair, and protects hair from UVA and UVB damage.
• Phyto-caffeine. Noted for its excess testosterone suppression benefits, shampoos with phyto-caffeine have been known to reduce DHT at the root of the hair.
• Biotin (Vitamin H). A popular shampoo ingredient, biotin promotes hair fullness and prevents damage.
• Niacin (vitamin B3). This vitamin promotes hair fullness. It also stimulates circulation and blood flow in the scalp.

Substituting your existing shampoo for one with these and other helpful ingredients can be used in tandem with hair restoration medication to reinforce your hair health protocol.

Surgery

Hair transplant surgery is often amongst the most effective methods of hair restoration.

Hair transplants work by surgically removing grafts from donor sites at the back of the head – where hair is generally thicker and unaffected by MPB – and implanting them at the front of the head where hair is falling out.

Once the skin heals, the treated areas should continue to produce and grow new and healthy hair.

Hair transplants are carried out in the form of one of the two following procedures:

Follicular Unit Extraction (FUE): FUE procedures involve the harvesting of healthy hair via small, circular incisions from different areas of the head, resulting in tiny round white scars. The healthy hairs are then implanted into areas with thinning hair, restoring the appearance of a full and thick head of hair.

Follicular Unit Transplantation (FUT): This procedure involves the removal of a thin strip of tissue along the back and sides of the scalp. Once removed, individual follicles are removed via stereo-microscopic dissection, and then implanted back into the thinning areas of the head. Although FUT leaves a ‘strip scar’ along the back and sides of the head, it is generally considered to be a more effective and longer lasting treatment than FUE.

The Verdict 

If you notice hair thinning at the front, or even balding from the front, it is most likely cause by male pattern baldness. Unless you’re completely bald, it’s not too late to do something about it.

Regardless of your chosen treatment protocol, rest assured that hair loss medication, vitamin supplementation or hair restoration surgery may effectively prevent the worsening of your condition.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.