Why do people go bald on the top and not on the sides

Male pattern thinning occurs when built up DHT binds with receptors in the follicle. This causes the follicle to gradually produce thinner and thinner individual hair stands with each shedding and growing cycle. Eventually the hair is too weak to support the follicle, which then collapses. Once that happens that hair and follicle are gone for good.[...]
We do not have those receptors on the sides. This is also why those rear and side follicles are used for hair transplants. Have you ever seen someone who looks like they had a bad transplant? Those strong rear and side follicles are like tree trunks so they are surgically interspersed among the thinner hair on the crown and vertex. Over time those original hairs disappear completely and leave only the transplant hairs on top, which now look unnatural. Think Cheech Marin from Things Are Tough All Over.

CS, do you agree 100% ?

Eventually the hair is too weak to support the follicle

Isn't the opposite ? The hair does not support the follicle, right ?

The hair bulb supports the hair follicle. The dermal papilla produces the hair follicles.

On the why the back and sides tend to be impervious to balding in classical MPB (Androgenetic Alopecia) is because there are fewer to no receptors in the occipital region and the sides.

No receptors means there is no effect, because there are virtually no nuclear receptors to activate or to be bound by hormones.

I'd second CS. This is the main reason why they don't succumb to miniaturization, and if you pinch the lower back and sides of your scalp you will feel increased layers of fatty tissue beneath the skin. This fatty tissue (and underlying muscles) acts as a cushion, and minimizes compression injury to these cells. The cells of the galea area OTOH have minimal fat layers, thus are more prone to mechanical overload from various factors. IMO pillow compression is a very large factor here.

CS, do these receptors in the follicle have an "official" name ?
Do women have the same receptors (and the same amount) on top of the head ?

Hair loss occurs due to excessive production of DHT, or just due to normal production of DHT ?

Xenon wrote:I'd second CS. This is the main reason why they don't succumb to miniaturization, and if you pinch the lower back and sides of your scalp you will feel increased layers of fatty tissue beneath the skin. This fatty tissue (and underlying muscles) acts as a cushion, and minimizes compression injury to these cells. The cells of the galea area OTOH have minimal fat layers, thus are more prone to mechanical overload from various factors. IMO pillow compression is a very large factor here.

Also, the adipose layer in the skin contains stem cells that send molecular signals to the hair follicles. In male pattern baldness, the layer of fat becomes thinner and the absence of stem cells causes the hair follicles to stop regenerating.
https://news.yale.edu/2011/09/01/yale-scientists-find-stem-cells-tell-hair-its-time-grow

Directo wrote:CS, do these receptors in the follicle have an "official" name ?
Do women have the same receptors (and the same amount) on top of the head ?

Hair loss occurs due to excessive production of DHT, or just due to normal production of DHT ?

The DHT binds to androgen receptors.

there was some study here telling that follicles exert protein that help to generate fat cells .. if this is true then hair follicles will exist before fat tissue .

Men pattern baldness, the top area of the head is temporary section. They not live a long time but it might be live long time through medical treatment, better food and healthy diet, Genetic function.

Badness men and women can get natural hairs through hair transplant surgery.

CS, being bald is having hair which are too small to be seen, or is it literally losing the hair (it's not there anymore) ?
Hair follicles are never dead, right?

And being bald is not "losing hair" but not having properly long enough hair development cycles ? Am I correct ?
Hair are still there but they don't have enough time to grow enough to be visible ?

Directo wrote:CS, being bald is having hair which are too small to be seen, or is it literally losing the hair (it's not there anymore) ?
Hair follicles are never dead, right?

And being bald is not "losing hair" but not having properly long enough hair development cycles ? Am I correct ?
Hair are still there but they don't have enough time to grow enough to be visible ?

It can either, because how it's lost depends on the cause. For example alopecia areata (loss of hair) and MPB, miniaturization until the progenitor cells are completely dead (then no hair will be produced).

My bad. I should have been more precise.
I'm not talking about accidents, burning, surgery of the scalp or other MPB. Just in the case of androgenic alopecia with no other health problems.

So what would be your answer then ?

CausticSymmetry wrote:It can either, because how it's lost depends on the cause. For example alopecia areata (loss of hair) and MPB, miniaturization until the progenitor cells are completely dead (then no hair will be produced).

CS: so you mean in MPB (so androgenic alopecia, right? ), miniaturization happens, and then in 100% of the people, hair follicles won't produce any hair anymore, at one point ?
Do you know what make that progenitor cells dead at a certain point ? Why does it not happen right away, once the thinning has begun ?
Some M to F people got regrowth after HRT. Does it mean that their progenitor cells weren't dead yet, or could it be that the theory of dead progenitor cells could be wrong ? (Has it ever been proven in the first place by the way ?)

And would you say that (still only for androgenic alopecia), being bald is not "losing hair" (at least for the first decade) but not having properly long enough hair development cycles ? Is that correct ?
Hair are still there but they don't have enough time to grow enough to be visible ?

I think there is a genetic reason for this.

Xenon wrote:I'd second CS. This is the main reason why they don't succumb to miniaturization, and if you pinch the lower back and sides of your scalp you will feel increased layers of fatty tissue beneath the skin. This fatty tissue (and underlying muscles) acts as a cushion, and minimizes compression injury to these cells. The cells of the galea area OTOH have minimal fat layers, thus are more prone to mechanical overload from various factors. IMO pillow compression is a very large factor here.

Im interested in your pillow compression theory... any studies on this? And how can we mitigate said compression?

I've seen one type of special medical pillow which have a hole on it for the head and another one for the ear, I wonder if these type of pillow absorb the weight somehow and it isn't as direct on the scalp?

In any case, how is it possible that we have 80 year olds like Reagan having NW0's on their deathbed, without not even white hairs but a full juveline black hairline, after 80 years of pillow compression? gravity affects all of us the same... are you saying Reagan had such a thick scalp that it didn't have an impact on it? or was it just inmune to DHT? I still don't fully get the tension theory, but im not willing to call it nonsense because as far as I can tell it is the only model that describes the shape of the horseshoe pattern.