Types of hairline recession in androgenetic alopecia and perceptions of aging in Asian males

Background Cranial hair loss is one of the characteristics of age. Hairline recession has been confirmed adversely to affect the perceptions of age in Western males. However, comparatively little is known about the effect of frontal recession on the perceived facial age (PFA) of East Asian males. Moreover, specific roles of different types of hairline recession in PFA of different age groups still remain a mystery. Objective To investigate and quantify the effect of different types of hairline recession on PFA in East Asian young males of different age groups. Methods Thirty non-bald males were selected and divided equally into three groups (20s, 30s, and 40s). With the aid of modern software, the frontoparietal area of facial images from 30 experimenters was modified into three basic types of hair loss (M2 , C2 , and U2 ) according to the basic and specific classification of androgenic alopecia. In a web-based survey, approximately 900 naive participants were asked to estimate the PFA of males from their original and modified facial images. Results Perceived facial age increased to 1.58 ± 0.79, 4.19 ± 1.27, and 5.90 ± 1.00 years when the original facial images were modified to have hair loss types M2 , C2 , or U2 , respectively. In addition, the PFA of males with hair loss type C2 or U2 appeared significantly older than the original facial images in the 30s group. Conclusion Different types of hairline recession can increase the PFA to different degrees in East Asian males of different age groups.