Hair loss conditions Mostly affects men
Male pattern hair loss (androgenetic alopecia)
Male pattern hair loss, also called androgenetic alopecia, is the most common type of hair loss in men. It is caused by a combination of genes and the hormone DHT, usually shows first at the temples or the crown, and tends to progress slowly over years. There is no cure, but treatment can slow it for some men, and choosing not to treat it is a perfectly reasonable choice.
What is male pattern hair loss?
In male pattern hair loss, a hormone called DHT (dihydrotestosterone, made from testosterone by an enzyme called 5-alpha-reductase) gradually changes how certain scalp follicles behave. The British Association of Dermatologists (BAD) describes the process as miniaturisation: the hairs produced by affected follicles become thinner, shorter and lighter in colour over successive growth cycles, until eventually the follicles shrink completely and stop producing visible hair.
Genes decide which follicles are sensitive and how strongly. The BAD notes that over 190 genes have been linked to it, which is why the pattern and pace can differ even between brothers. The follicles at the sides and back of the head are spared, which is why a horseshoe of hair usually remains however far the loss goes.
It is extremely common. Alopecia UK estimates that around half of men over 50 are affected, and it can begin at any age after puberty, including in the late teens and twenties (see hair loss in your 20s).
Doctors often describe the stage using the Norwood scale. In plain terms, it runs from little or no recession, through triangular recession at the temples, to the point Norwood counted as the first true stage of balding (type III), then increasing loss at the front and the crown until the two areas join. Some men lose hair mainly at the front (see receding hairline), some mainly at the crown (see thinning crown), and many at both.
The BAD is clear that there is no cure, but that it tends to progress very slowly, over several years to decades. That slow pace matters: there is time to read up, get a proper assessment and decide what, if anything, you want to do.
Signs to look for
- The hairline at the temples moving back, often into an M shape
- Thinning or a widening spot at the crown (the top and back of the head)
- Hairs that look finer, shorter or lighter than they used to
- More scalp showing under bright light or in photos
- Hair at the sides and back of the head staying thick
- Gradual change over months and years rather than sudden loss
What causes it
Genetics
Many genes are involved, so it often, but not always, runs in the family on either side.
DHT sensitivity
Genetically sensitive follicles shrink under the influence of DHT, a hormone made from testosterone.
Age
It becomes more common and usually more advanced with age.
Things that can look similar or add to it
Shedding after illness or stress (telogen effluvium), iron deficiency and thyroid problems can cause thinning too, and can sit on top of pattern loss.
How it is diagnosed
Male pattern hair loss is usually diagnosed from the story and an examination: when it started, how it has changed, whether relatives are affected, and the pattern on your scalp. The BAD leaflet does not list blood tests as part of making the diagnosis when the pattern is typical.
A blood test becomes useful when the picture is not typical: thinning all over rather than in a pattern, sudden heavy shedding, loss that started after an illness, or symptoms such as tiredness or weight change. Alopecia UK notes that a GP or dermatologist may check iron stores, thyroid function and hormones to rule out other causes. If that applies to you, read our page on diffuse thinning, where testing matters most.
Treatment options
Every option below has trade-offs, and choosing not to treat is a reasonable decision too. Medicines are only prescribed after a doctor has reviewed your history and confirmed they are suitable for you.
What to expect
Medicines for pattern hair loss work slowly and only for as long as you use them, which the NHS also notes. With finasteride, the NHS says you can expect to see some improvement after 3 to 6 months, and the BAD says continuous use for up to 14 months can be needed before a benefit is usually seen. With topical minoxidil, the BAD suggests at least 6 and possibly up to 12 months. Some people notice more shedding in the first weeks of minoxidil, which usually settles.
The realistic aim is to slow or stop further loss; some men also see some thickening, but results vary and medication does not work for everyone. If you stop, the UK finasteride product information says the benefits begin to reverse by six months and return to baseline by 9 to 12 months, and the licensed minoxidil leaflet says regrown hair may disappear 3 to 4 months after stopping. Our guide to stopping safely explains what to expect for each medicine. Taking photos in the same light every three months is the most reliable way to judge progress (see how to tell if treatment is working).
When to see a doctor promptly
See your GP soon, rather than waiting or self-treating, if you notice any of these:
- Sudden hair loss, or hair coming out in clumps
- Round or oval bald patches, or loss of eyebrow, beard or body hair
- A scalp that is red, scaly, itchy, painful or burning, or skin that looks shiny and scarred
- Hair loss with other symptoms such as unexplained weight loss, tiredness, fever or feeling unwell
- Hair loss in someone under 18
How WMG Meds can help
WMG Meds is the online prescribing service of Westminster Medical Group, a CQC-registered provider on Harley Street. If you have male pattern hair loss, you complete an online assessment and a GMC-registered doctor reviews it and decides whether treatment is clinically appropriate for you. If it is, the options we can prescribe include finasteride 1 mg (licensed), topical minoxidil, and, where suitable, off-label oral minoxidil or dutasteride. The doctor explains the MHRA safety advice before you start, and any off-label or unlicensed status.
We cannot diagnose patchy, scarring or sudden hair loss online, and we do not treat alopecia areata or scarring alopecia with medication. If your answers suggest something other than pattern hair loss, we will say so and point you to your GP, a dermatologist or a blood test. If you would like a doctor to look at your situation, you can start the free online assessment, with no obligation to go ahead.
Frequently asked questions
Can male pattern hair loss be cured?
No. The British Association of Dermatologists says there is no cure, but that it tends to progress very slowly, over several years to decades. Treatments aim to slow it down, and they only work while you keep using them.
Is male pattern baldness inherited from your mother's side?
It can come from either side. The BAD notes that over 190 genes have been linked to male pattern hair loss, which is why it does not follow a simple rule and why relatives can be affected differently.
Do I need a blood test before starting treatment?
Not usually, if the pattern is typical: diagnosis is based on your history and the look of your scalp. A blood test is worthwhile if you are thinning all over, shedding suddenly, or have other symptoms, because iron deficiency or a thyroid problem can cause similar thinning. See our diffuse thinning page for when testing helps.
Can I get treatment for male pattern hair loss on the NHS?
The NHS notes that not all hair loss treatments are available on the NHS, and the BAD says hair transplants are private only. We explain the detail in is hair loss treatment available on the NHS?
How long do I need to keep taking treatment?
For as long as you want the benefit. Pattern hair loss continues in the background, and the UK finasteride product information says benefits begin to reverse by six months after stopping and return to baseline by 9 to 12 months. If you want to stop, talk to your prescriber first.
Sources
- British Association of Dermatologists: Hair loss, male pattern (androgenetic alopecia), patient information (June 2024)
- NHS: Hair loss
- Propecia 1 mg film-coated tablets: Summary of Product Characteristics (eMC)
- MHRA Drug Safety Update: Finasteride and dutasteride, updated safety warnings for psychiatric side effects and sexual dysfunction (11 May 2026)
- Alopecia UK: Androgenetic alopecia (pattern hair loss)
Facts checked against these sources on 4 October 2026. This page is general information, not a diagnosis. Read our editorial policy.