Hair loss in men: what is happening and what to do

Most men notice some thinning as they get older, and many start in their 20s. The most common cause is genetic and hormone-driven, and it is also the best studied.

Male pattern hair loss

Hair at the temples and crown becomes thinner and shorter over years as follicles react to DHT, a hormone made from testosterone. It is graded on the Norwood scale. Starting treatment early protects more hair.

Find your Norwood stage →
  1. Stage 1
  2. Stage 2
  3. Stage 3
  4. Stage 3V
  5. Stage 4
  6. Stage 5
  7. Stage 6
  8. Stage 7
The Norwood scale, seen from above (front of the head at the top)

Common causes

Pattern hair loss

Genetic sensitivity to DHT. Gradual recession at the temples and thinning at the crown.

Read the guide →
Stress shedding

Diffuse shedding 2–3 months after illness, fever, surgery, a crash diet or a major stressor. Usually recovers.

Read the guide →
Alopecia areata

Round, smooth bald patches, sometimes in the beard. Autoimmune, often treatable.

Read the guide →
Dandruff and scalp problems

Severe dandruff or seborrhoeic dermatitis can inflame the scalp and add to hair fall.

Read the guide →

What works for men

All treatments →
Finasteride 1 mg · RxLowers DHT. Stops progression in most men; some regrowth.StrongMinoxidil (topical)Lengthens the growth phase. Best at the crown and on recent thinning.StrongOral low-dose minoxidil · RxA small daily tablet, prescribed off-label. Growing body of evidence.ModerateKetoconazole 2% shampooTreats dandruff well; small studies suggest a modest extra benefit for pattern loss.EarlyPRP injectionsSeveral sessions using your own blood. Best alongside minoxidil.ModerateHair transplant (FUE)Moves permanent follicles. Works best alongside medicine.Strong

Rx = prescription medicine: talk to a doctor before starting. Evidence ratings are drafts pending dermatologist review. How we rate evidence

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The full guide

Most men who lose hair have male pattern baldness. It's genetic, it's common, and it's treatable if you start early. But it isn't the only cause, and some of the others are easy to fix. Start by working out which one you have.

Step 1: What does your hair loss look like?

What you notice Most likely cause Go to
Hairline moving back at the temples (an "M" shape) Male pattern baldness Receding hairline
Thinning or a bald spot on the crown Male pattern baldness Crown thinning
Overall thinning, lots of shedding, started 2–3 months after illness, fever, surgery, crash diet or stress Telogen effluvium (temporary shedding) Telogen effluvium
Round, smooth bald patches on the scalp or beard Alopecia areata Alopecia areata
Itchy, flaky scalp with hair fall Dandruff or seborrhoeic dermatitis Dandruff and hair fall
Not sure Take the cause finder

Male pattern baldness in 60 seconds

  • Why it happens: some men's hair follicles are sensitive to DHT, a hormone made from testosterone. DHT gradually shrinks those follicles until the hairs are thin and short, and then stop growing.
  • It's not caused by wearing caps or helmets, or by washing your hair often.
  • It usually follows a pattern, measured in stages (the Norwood scale, 1 to 7). The earlier the stage, the more you can keep. → What stage am I?
  • It can start in your late teens or 20s. → Hair loss in your 20s

What actually works (ranked by evidence)

Option Evidence What it does Prescription? Typical monthly cost
Minoxidil 5% (topical) Strong Regrows some hair and slows loss ₹160–300 generic; up to ₹1,180 branded
Finasteride 1 mg Strong Lowers DHT and stops progression in most men Yes ≈ ₹45 (Jan Aushadhi) to ₹360
Minoxidil + finasteride together Strong Usually works better than either alone Finasteride part: yes ₹230–1,000 as a combined solution
Oral minoxidil (low dose) Moderate, growing For people who can't use topical Yes Low; depends on dose
Dutasteride Moderate A stronger DHT blocker, used off-label Yes ≈ ₹150–1,070
Ketoconazole 2% shampoo Early to moderate (add-on) Treats dandruff; may modestly help ₹62–350 per bottle
PRP / GFC Moderate, varies by clinic Injections from your own blood Clinic procedure price being updated per session
Hair transplant Strong for suitable candidates Moves follicles to bald areas; you still need medicines to protect the rest Surgery Phase 2 guide
Biotin, onion oil, rosemary oil, redensyl serums Weak to early Little proof for pattern baldness No Varies

The honest summary: for male pattern baldness, the most proven approach is minoxidil and/or finasteride, started early and used for at least 6–12 months. Oils and serums are not substitutes. → Minoxidil vs finasteride

Before you spend money

  • Give any treatment at least 6 months before judging it.
  • Take a monthly photo in the same light and from the same angle.
  • Don't stack 5 products at once, or you won't know what's working.
  • Branded "hair kits" often contain the same medicines as cheap generics. → Traya decoded · Man Matters decoded

See a doctor soon if you have: round bald patches that appear suddenly · hair coming out in clumps · redness, pain, pus, scaling or scarring on the scalp · hair loss with fever, weight loss, irregular periods, acne or new facial hair · eyebrow or eyelash loss · hair loss in a child.

Sources

  1. Kaufman KD, et al. Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol. 1998;39:578–89.
  2. Olsen EA, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in men with androgenetic alopecia. J Am Acad Dermatol. 2002;47:377–85.
  3. Gupta AK, et al. Relative efficacy of minoxidil and the 5-α reductase inhibitors in androgenetic alopecia treatment of male patients: a network meta-analysis. JAMA Dermatol. 2022;158(3):266–74.

Medical review pending: not yet reviewed by a dermatologist. Medical disclaimer

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