Temples and crown: the same fight?

You’ve been keeping an eye on your temples in the bathroom mirror for years. Then one day, a changing room with two mirrors facing each other, or a photo a friend took from behind, and you see the top of your head. Thinner than you thought. First question: is it the same thing as your temples, or a second problem?

It’s the same baldness. But the two zones don’t behave in quite the same way, and that matters for what comes next.

One mechanism

Male pattern baldness is called androgenetic alopecia. A hormone derived from testosterone, DHT, acts on some of the follicles on your scalp. The hairs they produce get finer and lighter with each cycle, until the follicle stops making hair altogether. Dermatologists call this miniaturisation².

The mechanism is the same at the temples and on the crown. It depends mostly on your genes, which come from your father as well as your mother: over 190 genes have been identified². Those genes also explain why, within one family, baldness doesn’t take the same shape or start at the same age for everyone².

Temples first, crown later

The European guideline on androgenetic alopecia describes the most common pattern in men: the hairline recedes, mainly in a triangle at the temples, followed later by thinning on the crown¹. The French Society of Dermatology describes the same progression: the temples recede, then the top of the head, called the vertex, thins in turn³.

It isn’t a fixed rule. The American Academy of Dermatology notes that the first sign is often a receding hairline or a bald spot on top of the head⁴. So some men lose their crown before their temples. Others lose mostly the front: in an American study, 12% of men had predominantly frontal baldness⁵.

If your temples have receded slightly since your teens, almost all men of European descent have that¹ and it doesn’t necessarily mean baldness: we explain it in our article on a receding hairline at 20.

The Norwood scale, zone by zone

To describe how far baldness has gone, dermatologists use the Hamilton-Norwood scale, from I to VII¹. The early stages describe the temples receding, the later ones the crown thinning, then the two meeting. It has variants: a stage III “vertex”, where the crown is already involved at stage III⁶, and “A” variants, where the loss stays mostly at the front⁵.

Over the years, the bald areas can spread and join up. What’s left is a horseshoe of hair on the sides and at the back³. Stages VI and VII, a scalp that’s bald on top, affect 50 to 60% of men by the age of 70¹.

The European guideline points out a limit: the stage often doesn’t reflect the course of the baldness well¹. It tells you where you are, not how fast you’re moving.

Why the back and sides hold out

In male pattern baldness, the hair on the sides and back of the head is spared². That’s no accident: those follicles are typically more resistant to miniaturisation by DHT². The French Society of Dermatology puts it another way: the back of the head is not very sensitive to the hormones behind baldness³.

This is useful in two ways. A dermatologist compares the hairs at the front with those at the back: under magnification, the signs of baldness are more common at the front than at the back¹. And that’s the area follicles are taken from for a transplant².

One caveat: sometimes a diffuse thinning also affects the top of the sides and the back, on top of the usual pattern¹.

Not the same speed for everyone

Baldness usually progresses very slowly, over years or even decades. An earlier start may come with faster progression². The guidelines don’t give a separate speed for the temples or the crown: one man’s temples can stay stable for years while his crown thins, and for another it’s the reverse.

Age, on the other hand, weighs heavily. A study of men aged 18 to 49, recruited from the community rather than from clinics in the United States, shows this clearly⁵.

This study has its limits: it dates from 1998, its authors worked for a pharmaceutical company, and it looks at each man only once. So it can’t tell you how fast each of them progressed afterwards. The French Society of Dermatology gives similar benchmarks: about 15% of men at 20, 30% at 30, one in two at 50³.

The crown, out of the mirror’s sight

You see your temples every morning, head on. Your crown, almost never. And the AAD points out that the signs of baldness are gradual and subtle: you can lose hair for months or even years before you notice⁷. On the crown, that’s even more true.

On a hair loss forum, a young man describes exactly that⁸.

Testimonial posted on the HairLossTalk forum⁸.

The replies are split: for some, it’s just the natural cowlick on the crown, for others the start of thinning. One member points out that the angle and the lighting in the photo make it impossible to tell. That’s the trouble with a random photo: with nothing to compare it to, it worries you without proving anything. To spot other quiet early signs, read the signs that go unnoticed.

What it means for a transplant

This is where the difference between the two zones becomes concrete. A transplant can improve baldness by up to three Norwood stages, in a candidate with enough hair to harvest¹. But the follicles at the back are not unlimited.

When baldness is still progressing, the European guideline says to keep a reserve of donor hair for a second procedure, and not to transplant the crown first¹. The reason: baldness keeps advancing around the grafts, and it may call for another procedure or treatment later on¹. To understand the techniques, read our article on FUE, FUT and DHI.

On the treatment side, your doctor can suggest a treatment suited to what they see, on one zone or both. What will help them decide most is knowing whether your baldness is progressing, where, and how fast.

Tracking both zones in photos

To know what your temples and crown are doing, you need to look at them separately, in the same conditions every time. Head on, hair pulled back, for the temples. From above, phone held over your head, for the crown. And a photo of the back, the zone that doesn’t move, as a benchmark. We go through the method in our guide to taking two comparable photos.

Calvap tracks up to 7 zones, including the left temple, the right temple, the crown and the back. At each session, your previous photo shows as a ghost on the camera: you move the phone until you line up with it, and you shoot at the same angle, from the same distance. Your photos are arranged zone by zone on a timeline. After a few months, you can see which zone is moving and which is holding, and you have dated photos to show your doctor. They stay on your phone.