Male Pattern Hair Loss: Causes, Treatments That Work and What to Avoid

Male pattern baldness affects most men at some point in life. It’s mainly down to genes and hormones. It isn’t harmful, but it can affect confidence. A few treatments have good evidence, and many products online have none.

Imagine noticing your hairline retreating at 25, and the crown thinning in photos. You’re bombarded with adverts for shampoos, supplements and “miracle” serums. Before spending money, it helps to know which treatments actually work, and their trade-offs.

What causes it

Hair follicles become sensitive to a hormone called dihydrotestosterone (DHT) and gradually shrink. It usually starts at the temples or crown and runs in families.

Treatments with evidence

• Minoxidil: a lotion or foam applied to the scalp; slows loss and regrows some hair in some men; must be used continuously
• Finasteride: a prescription tablet in many countries that reduces DHT. Rare side effects include sexual problems and mood changes; talk them through with a doctor or pharmacist
• Hair transplant surgery: for suitable candidates, done by qualified surgeons

Results take several months, and hair loss resumes if treatment stops. Be cautious of cheap surgery abroad offered by unqualified providers.

But when is hair loss a sign of something else?

See a doctor if hair loss is sudden, patchy, comes with itching or scaling, or with other symptoms such as tiredness or weight change. Causes such as thyroid problems, iron deficiency, fungal infections or alopecia areata need different treatment.

Sources: NHS (Hair loss), American Academy of Dermatology, British Association of Dermatologists, UK Medicines and Healthcare products Regulatory Agency (finasteride safety review). This guide is for general information and does not replace advice from your own nurse, doctor or pharmacist.