Severe male pattern baldness
By The Treatment Registry editors
Advanced androgenetic alopecia in men, typically Norwood VI-VII, with extensive crown and frontal loss and a limited donor area. Distinct from earlier-stage hair loss in that the treatment goal is realistic distribution of a limited donor resource rather than full coverage. Treatment combines medical management to preserve the donor, hair-transplant surgery, and (in some cases) micropigmentation or hair systems.
Treatment ladder
Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.
Conservative
- Topical minoxidil
FDA-approved topical treatment with modest effect on density and good tolerability in most patients. Effect is lost on discontinuation.
- Oral finasteride
Prescription-only 5-alpha-reductase inhibitor. Effective at slowing progression but carries a small risk of sexual side effects that may persist; assess against the patient's priorities.
Procedural
- Scalp micropigmentation
A cosmetic tattoo that mimics shaved hair. Permanent (within touch-up cycles), avoids the limits of donor area, and is often paired with shaved-head presentation in severe cases.
- PRP for hair loss · View procedure page
Platelet-rich plasma injections into the scalp. Evidence base for severe cases is limited; effect is gradual and requires repeat sessions.
Surgical
- Hair transplant (FUE) · View procedure page
Follicular unit extraction from the donor area to the recipient site. Donor preservation is critical in severe cases; over-harvesting produces a visible donor depletion that cannot be reversed.
- Sapphire FUE · View procedure page
FUE using sapphire-blade recipient channels. Marketed claim of improved healing; evidence base is mixed. Subject to the same donor-preservation constraints as standard FUE.