The early stages of balding in men

Early balding in men: no miniaturization no hairline changes

The very earliest stages of male balding are challenging to diagnose properly. I'm not talking about early AGA but rather 'very early' AGA. This stage is even challenging for clinicians and patients alike. The general public and even phsycians have come to recognize male balding as having changes in the hairline (or crown) as well as miniaturization of hairs. This is certainly present in early balding but may not be present at the very earliest stages. 

The very earliest stages of balding are associated with slightly increased hair shedding and subtle changes in hair caliber. These changes generally go unrecognized for many years. The reason this is so important is that males who feel they are losing hair but feel their hairline is the same can not be conclusively told they don't have male balding. 

The following are common misconceptions. 

1) I don't see any change in my hairline so I must not have balding. It is important to remember that some forms of male pattern balding don’t affect the frontal hairline so we can’t conclude a male does not have MPB with this fact alone.

2) I don't see any miniaturization.  The very earliest stages of MPB are associated with shedding and subtle changes in hair diameter that a patient simply can’t detect. So the fact that a patient says they don’t see miniaturized hairs does not impact the diagnosis in my opinion.  The best test in these cases are bulk measurements of hair density using something like the HairCheck.