Balding at the Temples | Diagnosis, Causes & Treatments

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Did you know that balding at the temples is an early warning sign of future hair loss? In fact, it can be just the beginning of the hair loss condition, Androgenetic Alopecia (AGA).

But how can you tell whether the hairline recession you see is a normal part of aging, or something more?

In this post, we’ll discuss what it means to be balding at the temples.

This will include an in-depth look at AGA, also known as pattern hair loss, and it’s cause. We’ll also help you to distinguish between a mature hairline and a receding one, as well as share tips on how you can stop hair loss and even begin to regrow your hair.

Let’s begin!

What Causes Pattern Hair Loss?

For decades, the cause of pattern hair loss has been attributed to the androgen hormone DHT.

And while DHT does play a role in hair loss progression, it’s not the cause.

According to new research on the subject, the cause of pattern baldness is actually unmediated scalp tension.

Let me explain.

The scalp is composed of various layers, which includes skin, subcutaneous, galea, subgalea, and pericranium.

The galea is a layer of fibrous tissue that covers the scalp from the eyebrows (frontalis muscle) to behind the ears (occipitalis muscle) (1). Because this layer is connected to the muscles, it can have a significant impact on the tension within the upper layers of the scalp.

What kind of impact?

If the tension is chronic, it can trigger an inflammatory response within the hair follicles.

This then leads to the recruitment of non-inflammatory mediators, such as DHT, which itself can induce the secretion of Transforming Growth Factor (TGF)-β1 (2). And as TGF-β1 has been shown to play a role in pattern hair loss progression, it triggers an unsavory cycle.

The process of hair follicle miniaturization in hair loss

But something else to keep in mind is that chronic inflammation reduces blood flow to the scalp. This means there is a deficiency in oxygen and nutrient delivery, and this can cause its own problems for the hair follicle.

Mature Versus Receding Hairline: How to Tell the Difference

It’s important that you treat any signs of a receding hairline as quickly as possible. This may help to reduce the hair loss, and it also makes it more likely that regrowth can occur.

But first, you should determine whether you’re actually suffering from a receding hairline.

There are two types of hairlines in adult males. These are mature, and receding.

A mature hairline is a natural “side effect” of adolescence and adulthood. It differs from a juvenile hairline in that the hairline is slightly more angular. A mature hairline also sits slightly farther back on the temples and forehead than a juvenile one.

When the hairline recedes beyond this point, though, you may have an actual problem.

Now let’s take a look at some tell-tale signs of a receding hairline as opposed to a mature one.

(Learn more about hairline recession here.)

Uneven Hairline Recession

If you think you suffer from a receding hairline, it’s easy to misinterpret a naturally mature hairline with a receding one. But one way that’s easy to distinguish the two is by analyzing the recession pattern.

In a mature hairline, the hair at the temples will recede evenly. This should occur slowly as you age from adolescent to adult, and it should stop before the recession becomes asymmetric and almost triangular.

On the other hand, if you’re experiencing hairline recession than you’ll likely notice that one side is receding more quickly than the other.

You’ll also notice that the recession is much deeper than a natural hairline, and it may even begin to emulate a deep ‘C’ shape.

Increased Hair Fall

It’s normal for anywhere from 50 to 150 hairs to shed on a daily basis.

But when the number of hairs lost per day exceeds this amount, it may be an indication of pattern balding.

You’ll often notice the most hair fall on your pillow and in the shower drain. This is because your scalp is most agitated as you toss and turn throughout the night, as well as when you wash it in the shower.

Thin, Wispy Hairs at the Temples

In a mature hairline, it’s common to see a clear demarcation of the hair follicle line. This means there’s a distinctive line which divides the hair follicles from the facial skin.

If your follicles are struggling to produce terminal hairs, though, then you’ll soon notice thin, wispy hair at the temples and hairline.

These thin, wispy hairs will often be outside the boundaries of a clear hairline. They will also often be lighter in color than your terminal hairs, and they’ll feel closer to peach fuzz than scalp hair.

The Norwood Scale of Hair Loss

So, just how bad is your hair loss?

That’s where the Norwood scale can be helpful.

The Norwood-Hamilton scale

In simplest terms, the Norwood hair loss scale is a classification method that determines the severity of hair loss (3). The scale is split into seven classifications, which are:

  • Type I – Little to no hairline recession.
  • Type II – Triangular, often symmetrical, areas of frontotemporal hairline recession.
  • Type III – Deep, symmetrical recession of the temples that are bare or very minimally covered by hair.
  • Type IV – Deepening frontotemporal recession, with little to no hair on the vertex.
  • Type V – Deepening frontotemporal recession and expanding vertex balding with the areas becoming less distinct from each other.
  • Type VI – The frontotemporal and vertex hair loss regions are not combined, but there’s only sparse patches of hair remaining between the two.
  • Type VII – Just a horseshoe pattern of hair remains with the hair wrapping around the back and sides of the head. The rest of the head is bald.

Type I is not considered to be hair loss, and Type II is actually a mature hairline versus a receding hairline. But if the recession deepens and crosses the line into Type III, then this can be considered a sign of pattern baldness.

A Special Note on Female Thinning at the Temples

While the majority of this article touches on male-pattern hairline recession, it’s possible for women to experience a similar pattern of hair loss.

So, what are the most likely causes?

Female-pattern hair loss is a possibility, but it’s not the most likely culprit.

This is because androgenetic alopecia in women often presents differently than in men. In particular, women will experience a diffuse pattern of hair loss which results in overall thinning and balding at the vertex.

A young woman with thinning

That’s not to say that the temples can’t recede, but they often don’t.

What other causes are there for female hair loss, then?

A few other possibilities include:

  • Unbalanced hormones, such as estrogen and testosterone
  • Nutrient deficiencies
  • Stress
  • Damaging hair care practices
  • Pregnancy and menopause

You can learn more about the most common causes of female hair loss, and how to combat them, here.

3 Ways to Combat Balding at the Temples

If you’re experiencing hairline recession, then time is critical.

Here are three ways you can begin to combat balding at the temples, and perhaps even regrow lost hair.

Hair Loss Drugs

If you’re looking for a popular solution to your hair loss, then you may want to consider drugs such as minoxidil and finasteride.

Minoxidil, more commonly known as Rogaine, is a topical drug that works by increasing blood circulation and opening potassium channels (4).

How does this help to reduce hair loss and perhaps even promote hair growth?

As mentioned above, scalp tension triggers a cascade effect which eventually leads to a reduction in blood flow to the scalp.

Minoxidil doesn’t treat the problem at it’s source (i.e. scalp tension). Instead, it increases blood flow so as to make hair growth possible even in an inhospitable environment.

Finasteride, an oral drug known by the brand name Propecia, is another FDA-approved option for hair loss.

It works differently from minoxidil in that it does treat one potential cause for hair loss.

Finasteride works by inhibiting the activity of 5-alpha-reductase, the enzyme responsible for converting testosterone to DHT (5).

With less 5-alpha-reductase there’s less DHT in the body and, therefore, less of the androgen at the hair follicles.

And while finasteride does work in many people, there are some unsavory side effects (6).

This drug, similar to minoxidil, also doesn’t treat the true cause of hair loss which is scalp tension.

Natural Topical Ingredients

There are quite a few natural ingredients – including oils, extracts, and seeds – that may have similar effects to that of minoxidil and/or finasteride.

One example of a natural topical that may benefit men with a receding hairline is peppermint oil. Let’s look more closely at a 2014 study which measured its effects against those of minoxidil (7).

Peppermint oil surrounded by peppermint leaves

This animal study consisted of 20 male mice, all of which were shaved on their back to standardize telogen phase.

The 20 mice were then split into four groups of five. The groups received a topical application of either:

  1. Saline (SA)
  2. Jojoba Oil (JO)
  3. 3% Minoxidil (MXD)
  4. 3% Peppermint Essential Oil (PEO)

To determine the effects of the topicals on hair growth, the researchers took photographs throughout the study. And then at the end of the study, skin biopsies were taken.

These were the results.

The saline and jojoba oil groups say minimal hair growth throughout the entire four-week study.

The minoxidil and peppermint oil groups, however, began to see hair growth at week two.

As you’ll see here in Figure 3 (B), there was significant follicular activity in both the minoxidil and peppermint oil groups. This activity was slightly increased in the peppermint oil group over the minoxidil group.

What does all of this mean?

In short, the various properties of peppermint oil may make it a great topical solution for combatting hairline recession.

Its effects on AGA should be further explored, though.

Is peppermint oil not appealing? There are quite a few options available. Just a few more topicals with potential hair-growth abilities include rosemary, cedarwood, tea tree, and pumpkin seed oil.

Scalp Tension Relief Devices

If scalp tension is the true cause of hair loss, then it makes sense that you’d want to reduce that tension immediately and effectively. One way to do so is with a specialized device known as a growband.

A growband is a scalp tension relief device that, well, relieves scalp tension.

The device is placed on the head, and the user will then use the connected pump to inflate the inner tubes that rest on the sides and back of the head.

As the device inflates, it gently lifts the scalp so as to reduce tension immediately.

The most obvious benefit of this device is the increase in blood circulation to the oxygen- and nutrient-starved hair follicles. As a side effect, this increased blood flow will reverse fibrosis and prevent scalp calcification.

Learn more about the Growband here.

The growband isn’t the only tool that can reduce scalp tension and improve blood flow, though.

Scalp massage is a technique that you can use anytime, anywhere. And whether you do it with your hands or a specialized massage tool, you can work to break down fibrosis and stimulate new hair growth.

Does this seem too good to be true? According to research on the topic, it’s not!

In one study, published in 2016, standardized scalp massage was shown to increase hair thickness (8).

How?

The study shows that “stretching forces result in changes in gene expression in human dermal papilla cells.”

This means that scalp massage and similar such exercises can have positive effects on hair growth!

In Conclusion

It’s true that hairline recession at the temples can be a sign of future hair loss. This doesn’t mean that you need to give in and accept your fate, however.

There are many ways to combat pattern hair loss, both with FDA-approved drugs and with more natural treatments.

But it’s important that you begin to implement these treatments right away. After all, time is of the essence when it comes to combating hairline recession and pattern baldness.

Do you have any questions about the information shared above? Please leave a comment below.

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