Hair Loss in Men: Causes, Treatment and How to Stop Hair Fall

Finding the right hair loss treatment can feel overwhelming when marketing claims blur the line between proven solutions and hopeful promises. Pattern baldness, medically known as androgenetic alopecia, is genetically predetermined^[1]. Unlike temporary shedding from stress or illness, genetic hair loss requires different treatment approaches, and only topical minoxidil and finasteride are FDA-approved specifically for male androgenetic alopecia^[2].

This article provides general education on hair fall causes, evidence-based treatments, and prevention strategies. It is not a personalised treatment recommendation. Always consult a dermatologist for proper diagnosis.

What causes hair fall in men?

In the Indian population, androgenetic alopecia has been reported to affect approximately 58% of men aged 30–50 years, with its prevalence increasing progressively with age^[3].

The condition is primarily driven by an enzyme called 5-alpha-reductase, which converts testosterone into dihydrotestosterone (DHT). DHT causes genetically susceptible hair follicles to miniaturise, meaning they shrink and produce progressively thinner, shorter hairs with each growth cycle^[4]. Over time, affected follicles may stop producing visible hair altogether.

Other factors that can contribute to hair fall in men include^[5]:

• Severe stress or illness

• Nutritional deficiencies

• Certain medications
• Medical conditions such as thyroid disorders and diabetes, or lupus

Androgenetic alopecia vs temporary hair shedding: why the distinction matters

Understanding whether your hair loss is genetic or temporary is crucial for choosing effective treatment.

Androgenetic alopecia (pattern baldness) is a progressive condition caused by genetic sensitivity to androgens. It typically follows a predictable pattern: a receding hairline at the temples and thinning at the crown. Without treatment, this type of hair loss may continue to progress over time^[1].

Telogen effluvium (temporary shedding) occurs when a significant stressor causes hair follicles to prematurely enter the resting phase. Common triggers include severe illness, surgery, infection, or hypothyroidism. The key difference is that telogen effluvium causes diffuse thinning across the entire scalp, not a patterned recession^[6].

Hair shedding in telogen effluvium typically ceases within 3-6 months once the triggering factor is eliminated, with spontaneous regrowth following^[7]. Pattern baldness, however, is progressive and may require ongoing treatment to maintain results and limit further hair loss.

If you are unsure which type of hair loss you have, consult a dermatologist for proper diagnosis.

FDA-approved treatments for hair loss

Only two medications have FDA approval specifically for treating male pattern baldness: minoxidil and finasteride. Both can help slow or halt hair loss progression and may stimulate partial regrowth^[2].

Minoxidil (topical)

Applied directly to the scalp, minoxidil helps stimulate hair growth and prolong the growth phase of the hair cycle. It is available over the counter in 2% and 5% solutions or as 5% foam. Common side effects include scalp itching, local irritation, and flaking, which may be caused by propylene glycol or alcohol in the formulation^[1].

Finasteride (oral)

This prescription medication blocks 5-alpha-reductase, the enzyme that converts testosterone to DHT. A daily 1 mg dose can reduce scalp DHT levels by approximately 64% and serum DHT by 68%. Common side effects include sexual dysfunction, such as erectile dysfunction, reduced libido, and difficulty achieving orgasm, although these effects are uncommon and often resolve without discontinuing treatment^[2].

These medications should be used under the guidance of a healthcare provider. Do not self-medicate.

Other treatment options: what does the evidence show?

Beyond FDA-approved medications, several other treatments show varying levels of evidence. The following table summarises current research^[2],^[8], ^[9],^[10]]:

Discuss these options with your dermatologist to determine what may be appropriate for your situation.

How to prevent or slow hair fall

While genetic hair loss cannot be fully prevented, several strategies may help slow its progression^[11]:

• Consult a dermatologist: Seek professional advice early to identify the cause of hair loss and determine appropriate treatment.
• Use gentle hair-care practices: Wash with a gentle shampoo, apply a moisturising conditioner after shampooing, and use a leave-in conditioner or detangler to reduce breakage.
• Avoid excessive heat and chemical treatments: Limit the use of blow-dryers, curling irons, hot combs, hair colouring, perming, and chemical straightening.
• Comb gently: Avoid pulling or tugging while brushing or combing to minimise hair damage.
• Quit smoking: Smoking-related inflammation may worsen hair loss.
• Maintain a healthy diet: Ensure adequate intake of protein, iron, and other essential nutrients, as nutritional deficiencies and insufficient calorie intake can contribute to hair loss.
• Use supplements cautiously: Check for nutritional deficiencies before taking hair-growth supplements, as excessive amounts of certain nutrients, including selenium and vitamins A and E, may worsen hair loss.

For men with advanced hair loss, hair transplantation remains an option. The procedure involves removing hair from the occipital scalp (back of the head), which is genetically resistant to balding, and reimplanting it into thinning areas^[2].

Conclusion

Hair loss in men is most commonly caused by androgenetic alopecia, a genetic condition driven by DHT sensitivity. Distinguishing between pattern baldness and temporary shedding is essential, as each requires different management approaches. Minoxidil and finasteride remain the only FDA-approved treatments for male pattern baldness that can slow or halt progression and stimulate partial regrowth. Early intervention, consistent treatment, and consultation with a dermatologist offer the best chance of maintaining hair. If you notice thinning, speak with a healthcare provider to discuss evidence-based options suited to your situation. 

Medical Disclaimer

This article is for informational purposes only and does not constitute medical advice. The information provided should not be used for diagnosing or treating health conditions. Always consult a qualified healthcare provider for diagnosis, treatment, and personalised medical advice. Do not disregard professional medical advice or delay seeking it because of information found in this article. If you have a medical emergency, contact your doctor or emergency services immediately.