Losing your hair? You have more options than you think
Male pattern hair loss is so common that it can feel inevitable. Around half of men show noticeable thinning by the age of fifty, and for many it begins far earlier, in their twenties or thirties. Yet the way it is talked about, somewhere between a punchline and a lost cause, does men a disservice. Male pattern hair loss is a medical condition with well understood biology and treatments that are genuinely effective, especially when started early.
This guide explains what causes male balding, sets out the treatments that have the strongest evidence behind them, and looks honestly at where platelet rich plasma fits in.
What is actually happening
Male pattern hair loss, known medically as androgenetic alopecia, is driven by genetics and hormones. In men who are genetically susceptible, hair follicles on the top and front of the scalp are sensitive to a hormone called dihydrotestosterone, or DHT, which is produced from testosterone. Over time, DHT causes these follicles to shrink in a process called miniaturisation. With each growth cycle the hairs become finer, shorter and lighter, until eventually they stop producing visible hair altogether.
This is why male balding follows a recognisable pattern, typically starting with a receding hairline at the temples and thinning at the crown, while the hair around the back and sides, which is not DHT sensitive, is usually spared. The same biology explains why hair transplants work, since follicles taken from the resistant area keep their resistance when moved.
Why timing is everything
The single most important thing to understand about hair loss is that treatment protects the hair you still have far more reliably than it regrows hair you have already lost. Once a follicle has fully miniaturised and disappeared, it is very difficult to bring back. Follicles that are thinning but still active can often be rescued and strengthened.
This means the earlier you act, the more you have to protect, and the better your long term result. Waiting until the loss is advanced narrows the options. If you have noticed thinning, a receding hairline or more hair than usual on the pillow or in the shower, that is the moment to seek advice, not after years of decline.
The evidence based treatments
Two medications form the foundation of medical hair loss treatment. Both are backed by large, long term studies, and recent comparative analyses have confirmed how they rank against one another.
Finasteride
Finasteride is an oral medication that blocks the enzyme converting testosterone into DHT, reducing scalp DHT levels significantly. By removing the cause of miniaturisation, it slows or halts hair loss in the large majority of men and produces visible regrowth in many. It is one of the most effective single treatments available and the evidence for it spans decades.
Finasteride is generally well tolerated. A minority of men report sexual side effects such as reduced libido, and in most cases these resolve on stopping the medication. These effects are uncommon, but they are worth discussing openly with a doctor so you can make an informed choice. As with all the treatments here, the benefit is maintained only while you continue, since the underlying genetic tendency does not go away.
Minoxidil
Minoxidil works through a completely different mechanism. Rather than acting on hormones, it improves blood flow to the follicle and extends the active growth phase of the hair cycle, encouraging thicker, longer hairs. It is available as a topical solution or foam applied to the scalp, and increasingly as a low dose oral tablet prescribed under medical supervision.
Because finasteride and minoxidil work in different ways, they are frequently used together, and the combination is more effective than either alone. Recent analyses of clinical trials consistently rank finasteride combined with minoxidil among the most effective approaches for male pattern hair loss.
Dutasteride
Dutasteride is closely related to finasteride but blocks DHT production more completely. Recent network meta analyses have suggested that oral dutasteride may be the single most effective medical treatment for male pattern hair loss, ahead of finasteride and minoxidil. It is a strong option, used under medical guidance, particularly for men who want maximum effect or who have not responded fully to finasteride.
The role of platelet rich plasma
Platelet rich plasma, or PRP, is a regenerative treatment made from your own blood. A small sample is drawn, spun in a centrifuge to concentrate the platelets, and the resulting plasma, which is rich in growth factors, is injected into the scalp. The aim is to stimulate the follicles, prolong the growth phase and strengthen thinning hair.
The evidence here is genuinely encouraging, with some important caveats. A large 2025 systematic review pooling more than forty randomised controlled trials found that activated PRP increased hair density compared with placebo. Other studies comparing PRP directly with topical minoxidil have found similar results between the two. At the same time, researchers consistently note that PRP preparation methods and treatment protocols vary widely between clinics, which makes results less consistent and means quality of technique matters a great deal.
The most sensible way to view PRP is as a valuable complementary treatment rather than a replacement for medication. It works well alongside finasteride and minoxidil, can be a useful option for men who prefer to limit or avoid medication, and is increasingly used to support hair transplant results, where it has been shown to improve follicle survival and speed up regrowth. Because it uses your own blood, the safety profile is excellent. A typical course involves an initial series of sessions spaced about a month apart, followed by maintenance treatments, with results building gradually over several months.
Hair transplantation
For men with established baldness where follicles have already been lost, a hair transplant can restore hair to areas that medication can no longer help. Modern techniques move individual follicles from the resistant donor area at the back of the scalp to the thinning areas, where they continue to grow naturally and permanently. Transplantation works best as part of a wider plan, since medication is still needed to protect the surrounding native hair from continued loss. PRP is often used to support recovery and density after the procedure.
Building the right plan
There is no single best treatment for everyone. The right approach depends on your age, the pattern and stage of your hair loss, how aggressively it is progressing and your own preferences. For most men, the strongest results come from combining treatments that protect existing hair, stimulate growth and, where appropriate, restore what has been lost.
A thorough consultation should map the pattern and degree of your hair loss, look for any other contributing factors, and set realistic expectations about what each treatment can achieve and how long it will take. Honesty matters here. Good hair loss care is about steady, lasting results, not overnight transformation.
The takeaway
Male pattern hair loss is common, but it is not something you simply have to accept. With early, evidence based treatment, the great majority of men can keep the hair they have and often regain density they thought was gone. The biggest mistake is waiting. The sooner you understand what is happening and start a plan suited to you, the more you stand to keep.
This article is for general information and does not replace personalised medical advice. To discuss a hair loss assessment and a plan suited to you, you are welcome to arrange a consultation with The Wellness.