Guide to Growing Hair Hair loss advice for women and men
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The back of a man’s head, with thinning across the crown.
Photograph: Before My Ken. CC BY-SA 3.0, via Wikimedia Commons

Causes

Male pattern baldness

A receding hairline and a thinning crown, common enough to be ordinary, and still worth understanding before you buy anything.

Guide to Growing Hair Updated

Written in the UK, for women and men.

Male pattern baldness is genetically determined, patterned and progressive. Dihydrotestosterone shortens the growth phase and miniaturises susceptible follicles. NICE CKS says that, in general, 30% of white men are affected by 30, 50% by 50 and 80% by 70. The NHS names finasteride and minoxidil. Both only work while you use them, and they are not routine NHS prescriptions.

See a GP if hair loss is sudden, patchy, or comes with illness, a rash, or other symptoms. The NHS asks for that conversation before a private clinic.

On this page

On this page

  1. What is the hormone doing?
  2. What are the choices?
  3. Questions
  4. Sources
Two common patterns of hair loss Male pattern often starts at the front and crown. Female pattern often widens the parting while the frontal hairline stays. Often in men Often in women Front and crown thin. Sides often stay. Parting widens. Hairline often stays.
Illustration: Guide to Growing Hair. Patterns vary. This is not a clinical scale.

Male pattern hair loss, or androgenetic alopecia, is the diagnosis most men are walking towards if the men in the family went bald in the same shape. NICE CKS calls it genetically determined, patterned and progressive. The front and the crown go first. The sides and the back usually stay, which is why a transplant borrows from there.

What is the hormone doing?

Dihydrotestosterone binds the androgen receptor in susceptible follicles, shortens the growth phase, and the hair becomes finer until the scalp shows. The British Association of Dermatologists describes the same miniaturisation. It is not dirt, hats, or shampoo.

NICE’s prevalence line is specific: in general, 30% of white men are affected by age 30, 50% by age 50, and 80% by age 70, with the highest prevalence in Caucasians. Diagnosis is clinical. If it looks odd, the clinician thinks about thyroid function, a full blood count, ferritin and vitamin D. Those tests are for the atypical case, not a shopping list for every man of 25.

What are the choices?

NICE’s management page includes no treatment, topical minoxidil, oral finasteride 1 mg, cosmetic options, and surgery. Treatment is not available on the NHS as a routine. Minoxidil is bought. Finasteride 1 mg is a private prescription. Surgery is paid for by the patient. The NHS adds the limits: the medicines do not work for everyone, they only work while they are used, and women should not use finasteride.

The detail is on finasteride side effects and does minoxidil work. A transplant, without a made-up price, is Turkey and the UK.

Red light is optional. Research suggests it may help pattern hair loss over months of consistent use. It is not DHT blockade. The hats are compared under devices, and the medicine comparison is red light or minoxidil.

Common questions

What causes male pattern baldness?

A genetic sensitivity to dihydrotestosterone. NICE says DHT binds the androgen receptor, shortens the growth phase and miniaturises the follicle. The British Association of Dermatologists describes recession at the front and thinning on top, with the sides and back spared.

How common is it?

NICE CKS: in general, 30% of white men by age 30, 50% by age 50, and 80% by age 70. Prevalence is highest in Caucasians.

Can it be something else?

If the pattern is unusual, NICE says consider thyroid tests, a full blood count, ferritin and vitamin D. Sudden or patchy loss is not this diagnosis until a GP says so.

Sources

  1. NICE CKS: Male pattern hair loss
  2. NICE CKS: Managing male pattern hair loss
  3. British Association of Dermatologists: male pattern hair loss
  4. NHS: Hair loss