Treatment
Hair loss treatments: what the evidence actually shows
9 min readMedically reviewed by Dr Amara Okonkwo, GMC 7123456
Male pattern hair loss is one of the most heavily marketed conditions in men's health, which makes it unusually hard to find a straight answer. Here is what the evidence supports, roughly in order of how well it is supported.
Treatments with good evidence
Oral 5-alpha reductase inhibitors
These reduce dihydrotestosterone, the hormone that shrinks genetically sensitive follicles. In trials, the majority of men stop losing hair and a substantial minority see visible regrowth, mostly at the crown rather than the hairline. It is prescription-only, takes three to six months to show an effect, and only works while you take it.
The side effects are worth taking seriously rather than dismissing. Sexual side effects — reduced libido, erectile difficulty, problems with ejaculation — are reported by a small percentage of men in trials and usually resolve on stopping. A small number report symptoms persisting. Mood changes are also described. A prescriber should discuss both with you before you start, and you should know that it halves PSA readings if you are ever tested for prostate problems.
Topical minoxidil
Applied to the scalp twice daily, minoxidil extends the growth phase of the hair cycle. It is available without a prescription. Evidence supports it both alone and, more effectively, combined with an oral treatment. Expect increased shedding in the first four to six weeks — this is the old hairs being pushed out and is a sign it is working, not failing.
Hair transplant surgery
Moving follicles from the back of the head, where they are not DHT-sensitive, to where they are needed. It works, and the result is permanent in the sense that transplanted follicles keep their resistance. But it does nothing to protect the hair you still have, so surgeons almost always recommend medical treatment alongside it.
Treatments with weaker evidence
- Low-level laser therapy — some trial support, modest effect, low risk, high cost
- Microneedling — early evidence suggests it may improve minoxidil absorption
- Platelet-rich plasma — mixed results, small studies, no standard protocol
- Ketoconazole shampoo — plausible mechanism, limited direct evidence
Things that do not work
Biotin supplements do nothing unless you are deficient, which is rare. Caffeine shampoos have no meaningful evidence. Saw palmetto is substantially weaker than prescription options and far less studied. Scalp massage, special combs and most 'thickening' products are cosmetic at best.
When it isn't male pattern hair loss
Treatment aimed at the wrong diagnosis wastes months. See a doctor rather than starting treatment if your hair is coming out in distinct round patches, if you are also losing eyebrow or body hair, if your scalp is red, sore or scaly, or if you are shedding heavily all over rather than in a pattern. Those point to alopecia areata, a scarring alopecia or telogen effluvium, and each needs a different approach.
About this article
Written by The clinical team and medically reviewed by Dr Amara Okonkwo, GMC 7123456 on 22 Jul 2026. This article is general information and is not a substitute for advice about your own circumstances.
Male pattern hair loss treatment
Male pattern hair loss, or androgenetic alopecia, is hair loss driven by the effect of hormones on genetically sensitive follicles. It follows a recognisable pattern: receding at the temples, thinning at the crown, or both. Treatment works best when it is started early, because it is far easier to keep hair than to regrow it.