Male Pattern Hair Loss

What is male pattern hair loss?

By Dr Jane Benjamin, GP at Blossoms Healthcare and Roodlane Medical.

Male pattern hair loss or androgenic alopecia is the most common type of hair loss in males and affects half of all men over 50 years of age. 

It is caused by a combination of genetic and hormonal factors. You are more likely to be affected if you have a close relative who was affected and this can be inherited from one or both of your parents.

A hormone called dihydrotestosterone (DHT) causes changes in the hair follicles of the scalp. The affected follicle produces, smaller, shorter and lighter hairs until the follicle no longer produces any hairs at all.

What are the symptoms of male hair loss?

Male pattern hair loss can occur any time after puberty. The earlier the onset of symptoms the quicker the progression. Men usually notice a receding frontal hairline and thinning of hair over the top of the head. The hairs in this area becomes, smaller, thinner and lighter before becoming absent altogether. The skin of the scalp remains normal. There can be a large amount of psychological distress associate with this. The diagnosis is normally made by a combination of these clinical findings and a family history of male pattern hair loss.

Managing male hair loss

There is no cure to male pattern hair loss but in most cases the progression is slow over many years or decades.

What treatments are available for male hair loss?

Medical treatments:

The available medical treatments aim to delay the hair loss process and help regrowth of hair in affected areas. The treatments are only beneficial for the time they are used and possibly a few months after.

5% Minoxidil liquid or foam – This helps to delay hair loss. This is applied twice a day to the affected area. A prescription may be needed for this dosage. You can get 2% Minoxidil over the counter but this tends to be less effective. It normally takes up to 6 months before you can notice the benefits and some people can have some hair loss in the first few weeks but this normally settles. It is only beneficial during the time it is used. Minoxidil can cause dryness of the scalp or skin irritation.

Finasteride – These tablets reduce dihydrotestoterone levels, help reduce hair loss and aid regrowth. A prescription is needed for this medication. The tablets need to be taken daily and you will need to take them for 3-6 months before any benefit is noticed. The beneficial effects of this medication are usually reversed 6-12 months after stopping treatment. Sexual side effects such as loss of libido and erectile dysfunction have been reported. Mood changes and depression have also been reported but are much less common. If you do experience any side effects while on this medication you should stop the medication and discuss this with your doctor. You should not take these tablets if you are trying to conceive or if your partner is pregnant (unless you wear a condom), as Finasteride is excreted in semen and can affect the male foetus.

Wigs – You can get synthetic wigs which can last 6-9 months or real hair wigs which are more expensive, have a more natural look and can last 3-4 years. These can be a good option for some individuals.

Surgical treatments

The most common surgical treatment is hair transplantation where follicles are removed from the back and side of your scalp and transplanted into the areas affected. Cosmetic results can be excellent.

Scalp reduction surgery removes the affected areas of your scalp and stretches the existing scalp with good hair growth over this area.

Make sure you choose a reputable clinic and that the surgeon you see is fully registered with the British Association of Plastic Reconstruction and Aesthetic Surgeons.

You can find out more about hair transplants, where HCA offer this treatment.

Seeking psychological support services for male hair loss

Male pattern hair loss can cause a great deal of distress. If further support is needed you can contact one of the following support groups:

What should I look out for?

In some cases, hair loss can be the result of an underlying medical condition such as illness, cancer treatment, iron deficiency, thyroid abnormalities or stress. If you notice the sudden onset of hair loss, patchy hair loss, weight loss associated with hair loss or any skin changes in your scalp please see your GP so they can arrange further testing as these symptoms are not consistent with male pattern hair loss.