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Male pattern hair loss is a common condition affecting over 50% of men below 50 years old.1 It often begins with mild thinning but can gradually progress into more significant hair loss over the course of many years.
While balding is often dismissed as a natural part of ageing, male pattern hair loss is a medical condition that can be effectively managed with the right treatment.
Male pattern baldness typically happens in stages, and identifying which stage you’re currently in is a crucial step when it comes to treatment success.
The Norwood Scale is a widely-accepted system used to classify the progression of male pattern hair loss. Let’s break down each hair loss stage below:
No hair loss is currently seen. In balding men, this stage usually lasts from adolescence to adulthood.
Your hair may start to mature at this stage, causing a “V”, “U”, or “M” shaped hairline. This is not yet considered as balding.
Your hairline at the front recedes further back, and you may notice some thinning at the crown as well. But the middle of the head should remain unchanged.
Hair loss becomes more noticeable, with the crown and hairline continuing to thin. You may notice a bridge of hair in the middle of your head.
Arguably the most drastic change in the scale, most of your hair at the front and middle of your head has now fallen out, and the bridge of hair connecting the sides is very thin or broken.
The front and middle of the head is now mostly or completely bald, but the sides and back of the head should remain unaffected.
This is the final stage in the Norwood Scale. While some hair may remain around the back and sides, there is none left otherwise.
“Hair loss treatment is more effective the earlier you begin, and regrowth more likely. However, you can still benefit from treatment at any stage of hair loss.”
Hair loss can happen for many reasons. Stress, physical injury, certain medicines; all can cause your hair to fall out. But male pattern baldness works a little differently.2
Male pattern baldness, also known as androgenetic alopecia, is a genetic condition that happens specifically because of a hormone called testosterone.
That’s where Finasteride comes in. By stopping testosterone from converting to another hormone called DHT, it directly stops the process that causes male pattern hair loss.
After puberty, men begin producing more testosterone. Some testosterone converts to another hormone called dihydrotestosterone (DHT).
DHT binds to hair follicles and begins a process called “miniaturisation”, causing them to shrink over time.
As follicles shrink, hair becomes thinner, falls out more easily, and doesn’t grow back afterwards.
The medication lowers DHT levels by blocking the enzyme that converts testosterone into DHT, helping reduce hair loss and promote hair regrowth.
Finasteride not only prevents further hair loss, it can also promote regrowth in some men. A clinical trial on Finasteride’s effectiveness3 found that:
Experienced no further hair loss
Experienced hair regrowth
*Average results from a clinical trial involving 1,879 men with androgenetic alopecia. Individual responses to treatment may differ.
While everybody’s journey with hair loss treatment is different, here’s what you can generally expect after 12 months.
Month 0
Month 12
Images for illustration purposes only. Results depend on individual responses to treatment.
Weeks 1-4
Months 4-6
Months 7-12
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I was worried about my thinning hair, but the consultation was simple and reassuring. The treatment plan felt clear, and I now feel more confident managing it.
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I had put off getting help for a long time. The process was straightforward, and the guidance helped me understand what treatment could do and what to expect.
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I was unsure whether treatment was right for me, but the process explained everything clearly. I feel more positive about looking after my hair now.
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I kept ignoring my hair loss, but this made it easy to get proper advice. The treatment plan was clear and suited my needs.
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Baldness can be caused by many things, but male pattern baldness is primarily driven by a mixture of genetics and hormones.4
If hair loss runs in your family, you are far more likely to experience it yourself. This is the trigger. This can lead to your hair follicles being more sensitive to a hormone called dihydrotestosterone, which is converted from testosterone. This leads to hair follicles shrinking, followed by hair loss.
Not everyone is sensitive to the hormone DHT, and so hair loss doesn’t happen to every man.
You are far more likely to experience it yourself if you have family members with male pattern hair loss. However, that doesn’t mean it is guaranteed, and it doesn’t mean it can’t be treated with prescription medicines.
Hair loss caused by genetics and hormones typically starts in your early 20s, and gradually develops as you age. However, it can start later for some, and earlier for others. Everyone’s journey is different.
Early hair loss usually starts at the corners of your hairline or the crown of your head before spreading towards the middle. You can see the Norwood Scale for the expected development of hair loss.
A hair transplant involves a surgeon taking hair follicles not susceptible to hair loss and implanting them on areas of your scalp that are. In this way, it does fix the problem of male pattern baldness as the new hair should not fall out as easily.
However, it does not prevent further hair loss in the remaining natural hair, so many patients still choose to use treatments to maintain their overall hair density. Some people even choose to do both to give themselves maximum protection.
Hair loss treatments containing finasteride are generally not recommended for women, as it can potentially cause birth defects in male foetuses if exposure occurs during pregnancy.
Women also produce far less DHT than men, so finasteride is far less effective. For women, doctors will usually prescribe Minoxidil instead, as it stimulates hair growth directly by widening blood vessels in the scalp.
The most common side effects of Finasteride are:
Some men also report sexual and emotional side effects persisting even after they stop treatment. This is known as Post-Finasteride Syndrome, although it is rare, and doctors aren't entirely sure why it happens.
For a full list of side effects, consult the patient information leaflet.
No, Finasteride does not cure hair loss entirely. It is only effective for as long as you are taking it.
Once you stop treatment with Finasteride, levels of the hormone DHT increase, and hair loss may start again. The good news is, Finasteride is considered generally safe to take long term.
Yes, stress can cause hair loss in some men. This is called telogen effluvium, a temporary condition often triggered by physical or emotional stress. Because this is not driven by the hormone DHT, treatments like finasteride are not effective.
To treat stress-related hair loss, Minoxidil may be more effective, as well as stress-relieving activities like regular exercise, meditation, or counselling.
Whether you can prevent hair loss without prescription medication depends on the cause.
If your hair loss is due to male pattern baldness (androgenetic alopecia), it is caused by genetics and hormones, so lifestyle changes alone are generally insufficient to stop it. In this case, proven treatments like finasteride are best suited to manage the condition.
If your hair loss is caused by external factors like stress (telogen effluvium), it is often temporary. Since this isn't caused by DHT, finasteride is not effective.
Starting treatment early significantly improves the likelihood of regrowth and prevents further hair loss.
Also, while the medicine does the heavy lifting, maintaining a healthy lifestyle, including proper hydration, regular exercise, and effective stress management, can help prevent further hair loss.
