HAIR RESTORATION
Male Pattern Hair Loss: Assessment and Treatment Options
Why treatment decisions benefit from proper assessment, and how to choose the right next step.
Male pattern hair loss (androgenetic alopecia) is the most common cause of progressive hair thinning in men. It affects roughly half of men by age 50, though it can begin in the late teens or early 20s. The typical pattern involves recession at the temples, thinning at the crown, or both — progressing at variable rates depending on genetics and individual factors. While the pattern itself is familiar, treatment decisions still benefit from proper assessment. Not every receding hairline is straightforward, and sudden shedding, patchy loss, or hair change alongside other symptoms may indicate a different process altogether.
The management plan depends on the stage, the patient’s goals, and whether treatment is clinically appropriate.
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How male pattern hair loss develops
Male pattern hair loss is driven by the effect of dihydrotestosterone (DHT) — a derivative of testosterone — on genetically susceptible hair follicles. Over time, affected follicles gradually miniaturise, producing thinner, shorter hairs before eventually ceasing to produce visible hair. The process is progressive but variable: some men experience rapid thinning over a few years, while others thin slowly over decades. The Norwood-Hamilton scale is commonly used to classify the stage of loss, from early recession at the temples (stage II) through to extensive loss across the crown and front (stage VI-VII). Earlier intervention generally preserves more hair because miniaturised follicles are harder to recover than active ones.
Medical treatment
Treatment options
Finasteride is a prescription medication that blocks the conversion of testosterone to DHT, reducing the hormone’s effect on hair follicles. It has good evidence for slowing progression and, in some men, producing modest regrowth. Side effects should be discussed properly before prescribing. Minoxidil (topical) can help stimulate growth and slow further loss through a different mechanism.
PRF treatment may be discussed as a regenerative option for selected patients, typically as part of a broader treatment plan rather than a standalone intervention.
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Getting assessed
When assessment changes the approach
Not all male hair loss is pure androgenetic alopecia. Sudden diffuse shedding may indicate telogen effluvium — which has a different prognosis and does not require anti-androgen treatment. Hair loss accompanied by fatigue, weight change, or low libido may warrant blood tests to check thyroid function, iron, and hormone levels.
Men with concurrent symptoms may benefit from a broader men’s health review alongside hair-specific assessment. A clinical assessment distinguishes between these patterns and avoids patients spending money on treatments that address the wrong cause.
When to seek help
Assessment is worthwhile if you have noticed progressive thinning and want to understand your options before it advances further, if the pattern does not look typical (sudden, patchy, or diffuse), if you want to discuss finasteride and understand the risks and benefits properly, or if hair loss sits alongside other symptoms that may warrant broader investigation. Book an appointment.
Frequently asked questions
Does finasteride actually work for hair loss?
Finasteride has good evidence for slowing hair loss progression and, in some men, producing modest regrowth. It works by reducing DHT — the hormone responsible for follicle miniaturisation. It is taken as a daily tablet and typically needs 6–12 months before results can be assessed. Side effects occur in a small proportion of patients and should be discussed properly before prescribing.
Is male pattern hair loss preventable?
The genetic predisposition cannot be changed, but progression can often be slowed with treatment. Finasteride and minoxidil are the most established options. The earlier treatment starts — while follicles are still active rather than fully miniaturised — the more effective it tends to be. This is one of the main reasons for seeking assessment sooner rather than later.
When is hair loss too advanced for treatment?
There is no absolute cut-off. Medical treatments such as finasteride and minoxidil work best on miniaturising follicles that still have some activity. Once follicles have been lost completely, medical treatment is less likely to produce visible improvement in those areas. A clinical assessment helps determine the current stage and which treatments are realistically worth considering.
FURTHER READING