Dealing with a balding crown: why it happens and how to treat it

Published on February 26, 2021
Updated on February 26, 2021
The back of a man's head, showing a balding crown
Balding at the crown is one of the most distinctive signs of male pattern hair loss

If you’re losing hair at the top of your head, chances are that you’re experiencing a specific symptom of androgenic alopecia (commonly called male pattern baldness). Both genetic and hormonal factors cause this type of hair loss.


The good news is that you don’t have to go bald. You can stop your hair loss from progressing! There are quite a few ways to prevent male pattern baldness. If you start these treatments early enough, you also stand a good chance of being able to grow your hair back.



Androgenic alopecia symptoms



Male pattern hair loss is a progressive condition. If you’re losing hair at the crown, chances are that you might have noticed some other symptoms, too. A receding hairline and hair loss around your temples are two of the other first signs of androgenic alopecia. You might have also noticed hair that’s thinner than usual or that’s taking an unusually long time to grow back.


Without treatment, male pattern hair loss will continue progressing. According to a study published in the Journal of Cutaneous and Aesthetic Surgery, you’ll eventually lose all the hair at the crown of your head. At the same time, you’ll also lose hair at your temples and hairline.


Over time, all the hair on the top of your head will become thinner and fall out. You’ll be left with a thin strip of hair around your ears and the hair at the very back of your head.



Treating male pattern hair loss



Male pattern hair loss is treatable. If you start noticing symptoms, you should consider starting a treatment right away. 


Mild to moderate signs of androgenic alopecia, like hair loss at the temples and the crown, can be treated in a wide variety of ways. If you let your hair loss progress to baldness, you’ll likely require a more extensive and expensive treatment, like a hair transplant.




Minoxidil is a hair loss treatment that’s been around since 1988. According to a study in the journal Drugs, minoxidil acts as a vasodilator. It’s thought to work by increasing both blood flow and the release of hair-related growth factors in the scalp and reducing inflammation.


Minoxidil is available in concentrations of 2 and 5 percent and can be purchased as a serum or foam. You’re meant to apply these solutions topically each day. You can also obtain other minoxidil products, like minoxidil shampoo, but only the 2 and 5 percent versions are FDA-approved as treatments for hair loss.




Like minoxidil, finasteride is a well-established and popular treatment for male pattern hair loss. This drug is available in pill form, and works by acting as a DHT blocker. DHT, or dihydrotestosterone, is converted from testosterone. It’s thought to be the hormonal component that’s partially responsible for androgenic alopecia.


Finasteride is an affordable prescription drug. Given that all you need to do is pop a pill in your mouth each day, it’s easy to take. The study in Drugs says that the main downside is that this drug comes with a variety of side effects. 


Finasteride is particularly infamous for causing sexual problems like erectile dysfunction. Since this hair loss treatment needs to be taken indefinitely, these side effects can be a serious deterrent from taking this treatment.


Low-level laser therapy (LLLT)


LLLT is the newest FDA-approved treatment for androgenic alopecia. According to the Journal of the American Academy of Dermatology, this treatment is just as effective as minoxidil or finasteride in counteracting hair loss. 


LLLT devices are typically sold as combs, brushes, or caps. With no side effects, it might seem like a miracle treatment for hair loss. The biggest downside is cost. Buying your own device will set you back anything from hundreds to thousands of dollars — and going into a clinic to receive a treatment is likely to have a similar cost.


Surgical treatments for a balding crown


If you’ve been struggling with androgenic alopecia for a while, you can still try using minoxidil, finasteride, or LLLT. However, if you already have extensive hair loss, it’s likely that your doctor will recommend a hair transplant, as well. These days, you’ll likely choose from two surgical treatment options.


According to the journal Hair Transplantation Forum International, these are known as follicular unit excision (FUE) and follicular unit transplantation (FUT). FUE, the newer of these surgical techniques, involves the extraction and transplantation of follicular units (between one and four hair follicles). FUT removes a strip of scalp, harvests follicular units from the strip, and transplants them back into the area where there is hair loss.


Both FUE and FUT are effective ways of dealing with male pattern baldness – but as surgical procedures, they also come with a hefty price tag. According to the Dermatology Online Journal, the average hair reconstruction procedure requires the transplantation of 700 to 1,500 follicular units. With extraction costing as much as $7.00 per follicular unit, this means you’re potentially looking at a bill of around $10,500 — and that’s assuming you only need one surgery.  


Other treatment options


Minoxidil, finasteride, and LLLT are the only treatments that are currently approved for the treatment of male pattern hair loss. However, there are many other treatment options currently being researched. 


Some researchers have looked into the importance of certain nutrients and their relationship with hair loss. Others are looking into natural DHT-blockers as alternatives to finasteride, in the hope of finding a similar treatment with less side effects. There are even combination treatments being tested, like using minoxidil with a microneedling device to enhance hair regrowth results. 


If you’re not happy with the results of minoxidil, finasteride, or LLLT on their own, you may want to talk to your doctor about a combination treatment. Alternatively, you can also try combining your treatment with a home remedy for hair loss.





The best way to deal with a balding crown is to try and resolve the problem right away. Talk to your doctor about minoxidil, finasteride, or low-level laser therapy and determine which treatment is best for you. You might also want to consider combining these FDA-approved treatments with other hair loss products, like those containing natural DHT-blockers, or trying out a combination treatment strategy, like minoxidil and microneedling.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.


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