What is male pattern hair loss, and can it be treated?
The most common cause of hair loss in men, male pattern hair loss can begin early. Sometimes, it starts in your late teens or early twenties.
Usually, it appears later. By 50 years of age, more than half of white men have a visible sign of male pattern hair loss like noticeable thinning, a receding hairline, or balding.
Male pattern baldness tends to develop slowly
Beginning as a receding hairline or bald spot on the top of your head, this type of hair loss can cause thinning and hair loss for years.
While you don’t need to treat this type of hair loss, treatment options exist. Treatment can reduce further hair loss, and some men regrow a bit of their hair. The men who tend to see the best results start treatment soon after noticing hair loss.
Here’s what’s available to treat androgenetic alopecia (the medical name for this type of hair loss).
FDA-approved medications for male pattern hair loss
The U.S. Food and Drug Administration (FDA) has approved the following medications to treat male pattern hair loss. Here’s the lowdown on each.
Topical minoxidil (available without a prescription)
Widely available at stores and online, this is the most commonly used treatment for male pattern hair loss.
What studies show: In clinical trials, minoxidil has been shown to reduce hair loss, stimulate hair growth, and strengthen existing strands of hair. While minoxidil can help, you’re unlikely to see full regrowth.
How to use: Apply to your scalp.
When to use: Minoxidil is applied twice a day, every day.
How long it takes to see results: Some men respond to minoxidil better than others, and some men fail to see any difference. If minoxidil works for you, it can take up to six to 12 months to see results. It’s important to follow directions, which includes applying minoxidil every day.
Possible side effects: When using minoxidil, some men develop an irritated scalp. The newer formulation, which is a foam, seems to reduce this risk. Other possible side effects include an itchy scalp or headaches.
Can be used alone: Many men see results when they use only minoxidil. If you see a dermatologist, your dermatologist may add a prescription medication to your treatment plan. This can improve results.
If you stop using minoxidil: When you stop applying minoxidil, you lose its benefits. Because minoxidil helps you maintain your hair’s thickness, some hairs may look and feel thinner. You’ll also gradually notice that you’re shedding more hair.
FDA-approved medications for male pattern hair loss
With all FDA-approved treatments, men tend to have better results when they start treatment soon after noticing hair loss.
Finasteride (prescription medication)
This is a prescription medication that you would take long term.
What studies show: Finasteride has been shown to slow down further hair loss in about 80% to 90% of men taking it. Some men also see some hair regrowth, which tends to occur in men who start finasteride when they first notice signs of hair loss.
How to use: Take a pill.
When to take: Every day.
How long it takes to see results: If finasteride helps you, you will start to see results in about 6 months.
Possible side effects: Some men who take finasteride have developed side effects. These include loss of libido (desire to have sex), inability to get or keep an erection, swelling and tenderness in their breasts, and depression. It’s been reported that sexual side effects can continue after a patient stops taking finasteride. Due to the seriousness of these side effects, your dermatologist will want to know more about you before prescribing finasteride. Your dermatologist will give you a complete exam and ask you about preexisting conditions and medications you take.
Can be used alone: If finasteride is part of your treatment plan, you may take it alone or use it along with minoxidil.
If you stop taking finasteride: To maintain results, you must continue taking one pill every day. Once you stop taking this medication, hair loss returns.
About laser devices for male pattern hair loss
Several laser devices are now available to treat hair loss at home. The FDA has cleared some. If you see “FDA cleared” on the packaging or within information about the laser, this means the FDA recognizes the laser as a safe treatment.
The requirements for getting FDA cleared are much less stringent than for getting FDA approved.
Procedures used to treat male pattern hair loss
Depending on the location and extent of your hair loss, your dermatologist may recommend one (or both) of these procedures:
Hair transplant: If you’re looking for a permanent solution, you may want to consider a hair transplant. This procedure no longer involves moving plugs of hair from one part of your scalp to another. Today, a hair transplant can give you permanent, natural-looking results.
Platelet-rich plasma (PRP): While PRP is not a permanent solution, maintenance treatments can help you maintain results.
PRP can be used alone or given before a hair transplant to improve results.
If your dermatologist recommends PRP for you, here’s what you can expect. A small amount of your blood would be drawn and placed into a machine that separates your red blood cells from the plasma.
Your plasma is then injected into your scalp. This takes about 10 minutes.
You will need to return for more injections. For the first three months, you return once a month. Then you return once every three to six months.
Within a few months, PRP can help lessen hair loss. Soon after, some patients see thickening of their hair or regrowth.
How a dermatologist can help with hair loss
If you want to do something about hair loss, making an appointment to see a dermatologist can be a great place to start. A dermatologist can tell you what type of hair loss you have. This is important because different types of hair loss require different treatments.
A dermatologist can also tell you what results you can expect from treatment. If you want to treat the hair loss, a dermatologist can talk with you about options that will help you see the most improvement.
Related AAD resources
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References
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American Academy of Dermatology. “Research demonstrates potential of platelet-rich plasma therapy for hair loss.” News release issued March 1, 2019. Last accessed May 17, 2021.
Avci P, Gupta GK, et al. “Low-level laser (light) therapy (LLLT) for treatment of hair loss.” Lasers Surg Med. 2014;46(2):144-51.
Basaria S, Jasuja R, et al. “Characteristics of men who report persistent sexual symptoms after finasteride use for hair loss. J Clin Endocrinol Metab. 2016;101(12):4669-80.
Irwig MS. “Depressive symptoms and suicidal thoughts among former users of finasteride with persistent sexual side effects.” J Clin Psychiatry. 2012;73(9):1220-3.
Jimenez JJ, Wikramanayake TC, et al. “Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study.” Am J Clin Dermatol. 2014;15(2):115-27.
Lee SW, Juhasz M, et al. “A systematic review of topical finasteride in the treatment of androgenetic alopecia in men and women.” J Drugs Dermatol. 2018 Apr 1;17(4):457-63.
Phillips TG, Slomiany WP, et al. “Hair loss: Common causes and treatment.” Am Fam Physician. 2017;96(6):371-378.
Suchonwanit P, Thammarucha S, et al. “Minoxidil and its use in hair disorders: A review.” Drug Des Devel Ther. 2019;13:2777-86.
Written by:
Paula Ludmann, MS
Reviewed by:
Kesha Buster, MD, FAAD
Sandy Marchese Johnson, MD, FAAD
Shari Lipner, MD, PhD, FAAD
Bassel Hamdy Mahmoud, MD, PhD, FAAD
Last updated: 12/13/22