Why baldness never advances beyond the horseshoe like shaped part of the scalp is no longer a mystery 

Pattern baldness almost never progresses beyond the horseshoe-like shaped part of the scalp.

The muscle tissue (red colour) attached to the outside of the sensitive to baldness area of the scalp of a tendon called galea aponeurotica (peach colour) appears to provide more metabolic protection to hair follicles located there.

The hair follicles located outside of the sensitive to baldness tendon seem to maintain low levels of the hormone DHT and, due to that, uninterrupted hair growth cycles, in comparison to the hair follicles located in the tendon tissue area.

These facts and observations further link pattern baldness to the metabolic disorders associated with modern lifestyle and eating habits.

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This is one of the most advanced pattern baldness in men classified as Norwood 7

The oldest men with baldness, even if over 100 years old, almost never experience thinning hair beyond the edges of horseshoe-like shaped tendon pointing to metabolically protective properties of the muscle tissues in the scalp vs the tendon part called galea aponeurotica.

This observation would further explain the lower concentrations of the hormone dihydrotestosterone (DHT) in and around the hair follicles located in the muscle tissue covering the part of the scalp that never gets affected by baldness.  

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Scalp tissue composition differs between baldness prone area made of a tendon vs the muscle

The baldness prone area of the scalp is unique: it lacks the muscle tissue, unlike the other parts of the scalp, that retain the hair even in the most advanced cases of pattern baldness.

The hair follicles located outside of the horseshoe shaped tendon of the scalp seem to be shielded from higher concentrations of DHT by the extra metabolic protection of the muscle tissue (red) which seems to prevent the hair follicle miniaturization process, which leads to baldness. 

The edges of the horseshoe-like shaped tendon (galea aponeurotica) set the limits to pattern baldness challenging the genetic predisposition as the only cause.

The muscleless tendon (white) located on the top of the head and the crown of the scalp is clearly shaped in the horseshoe like pattern where baldness progresses and reaches its limits.

The tendon’s outer edges connect with the face and neck muscle tissues to form the familiar horseshoe-like shape.

Beyond that line, where the face and neck muscles are located, pattern baldness almost never develops even among the oldest people with the most advanced pattern baldness.

The higher levels of hormone DHT - the culprit of this type of hair loss - have been consistently found in and around the hair follicles located in the tendon part of the scalp versus the hair follicles found the muscle tissue area of the scalp.

These facts and observations provide another link between the metabolic disorders and pattern baldness that are more prevalent in the more developed lands versus the many isolated communities of all races.

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