Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 11/07/2020
Looking a little thin on top? You’re definitely not alone. Hair loss due to male pattern baldness is a very common problem that typically happens as you enter your 20s, 30s and forties.
According to the American Hair Loss Association, more than two thirds of all men develop some degree of hair loss by the age of thirty-five. By age 50, approximately 85 percent of men have thinning hair.
There’s no currently no cure for hair loss caused by male pattern baldness. However, there are a variety of treatments approved by the Food and Drug Administration (FDA) available that can help you to treat hair loss and, in some cases, even regrow some of the hair that you may have already lost.
Below, we’ve explained how hair loss typically develops, as well as the main factors that affect the thickness and longevity of your hair. We’ve also looked at why there’s currently no cure for hair loss.
Finally, we’ve listed the treatment options that are currently available for treating male hair loss, as well as recent developments toward a permanent hair loss cure.
Hair loss can occur for a variety of reasons, from genetic factors such as sensitivity to certain hair-related hormones to health issues such as stress, use of some medications, malnutrition and even exposure to chemicals or styling products that damage your hair.
Some types of hair loss are temporary and reversible. For example, if you lose your hair as a result of stress or a nutrition deficiency (a type of hair loss referred to as telogen effluvium), it will normally grow back once the specific underlying issue is treated.
In men, permanent hair loss — the type we’re generally most worried about — is caused by a combination of genetics and hormones. This type of hair loss is called male pattern baldness.
More specifically, male pattern baldness, medically called Androgenetic alopecia, is caused by a genetic sensitivity to a hormone called dihydrotestosterone, or DHT.
DHT is produced by your body as a byproduct of testosterone. It plays a vital role in helping you develop male secondary sex characteristics as your body develops during pregnancy, childhood and adolescence.
Characteristics such as your genitalia, voice, body hair, muscle mass and others are all caused by the effects of androgens such as testosterone and DHT.
Unfortunately, DHT can also affect your hair. If you’re genetically sensitive to DHT, it can bind to receptors in your hair follicles and cause them to miniaturize. This slows down your rate of new hair growth and, once enough time has passed, leads to permanent hair loss.
Not everyone is equally sensitive to the effects of DHT, which is why hair loss can vary hugely in severity from one man to another. While one person might only lose a small amount of hair near their temples, another might become completely bald by their 20s or 30s.
Scientific research hasn’t yet worked out how to permanently stop DHT from miniaturizing hair follicles in men prone to male pattern baldness.
However, there’s a lot of interesting research going on regarding hair loss, some of which may eventually lead to a cure.
One study from the University of Edinburgh identified 287 independent genetic signals that play a role in hair loss due to male pattern baldness. This research could help to increase scientific knowledge of how and why baldness happens on a genetic level.
There’s also interesting ongoing research into using stem cells to regrow hair in people affected by male pattern baldness and other forms of hair loss.
In a 2015 study, researchers were able to use human embryonic stem cells to generate dermal papillae-like cells capable of producing hair follicles in mice. These cells may eventually play a key role in cell-based treatments for male pattern baldness and other hair loss conditions.
These studies are both interesting and promising. However, research into a permanent cure for male pattern baldness is still in its relatively early stages, meaning it could be decades before a safe, viable cure is available.
Because of this, if you’re currently losing your hair, waiting for a cure isn’t the best option if you want to avoid losing more. Instead, it’s far better to take action now using one or several of the scientifically-backed, FDA-approved treatment options that are already available.
Although there’s no cure for hair loss, there are currently several proven treatments that either stop or reverse hair loss in men. All of these treatments work via one of three approaches:
Blocking the hormones that cause hair loss. Medications like finasteride target DHT at its source, reducing your level of exposure to hormones that can miniaturize your hair follicles and affect your hairline.
Encouraging hair growth. Medications like minoxidil work by creating an environment in which hair can grow more easily without targeting hormones like DHT, helping you to grow a thicker, fuller head of hair.
Replacing lost hair follicles with DHT-resistant ones. This is the basis for treatments like hair transplantation, in which DHT-resistant hair follicles are taken from the sides of your scalp and transplanted into areas affected by male pattern baldness.
Depending on the type of hair loss you have, the best treatment option might use one, two or all of the approaches listed above. We’ve explained how modern hair loss treatments work, as well as the options that are currently available, in more detail below.
Finasteride, the active ingredient in Propecia, belongs to a class of medications referred to as 5-alpha-reductase inhibitors. It works by blocking the effects of 5-alpha-reductase, the enzyme responsible for converting testosterone into dihydrotestosterone (DHT).
Studies of finasteride have shown that it can lower DHT levels by more than 70 percent. If you suffer from male pattern baldness, this reduction in DHT levels may slow down your rate of hair loss or stop your hair loss altogether.
Clinical trials have also found that finasteride causes hair regrowth for many men, meaning you may grow back hair in parts of your scalp affected by hair loss.
Finasteride is a prescription medication, meaning you’ll need to talk to a healthcare provider before you can purchase and use it.
We offer generic finasteride online following an online consultation with an independent healthcare professional, who will determine if a prescription is appropriate for you.
In addition to finasteride, there are several other hair loss treatments that work by blocking DHT, either at the scalp or at its source:
Dutasteride. Like finasteride, dutasteride is a 5α-reductase inhibitor that reduces DHT levels. Although it’s effective (it actually blocks more DHT than finasteride), it’s currently only approved by the FDA as a treatment for prostatic hyperplasia, not hair loss.
Ketoconazole. Shampoo containing ketoconazole is a common part of many men’s hair loss prevention routines. Although research is limited, there’s some evidence that topical use of ketoconazole may disrupt the effects of DHT on the scalp and stop hair loss. Unlike finasteride, ketoconazole shampoo doesn’t require a healthcare provider consultation and is available over the counter.
Saw Palmetto. Although the research is thin and admittedly controversial, there’s some evidence to suggest that saw palmetto — an over-the-counter natural supplement extracted from a type of palm tree — may help to reduce DHT levels in the body and prevent hair loss.
Minoxidil, the active ingredient in Rogaine, is a topical medication that encourages the growth of hair. It works by dilating blood vessels in your scalp, improving the flow of blood to the scalp and pushing hairs into the anagen (growth) phase of the hair growth cycle.
Studies show that minoxidil works, especially when used for the long term. In a 2019 scientific review, researchers analyzed several different studies of minoxidil and concluded that it offers “remarkable” benefits for people with hair disorders.
Research shows that it’s safe to use minoxidil with finasteride. In fact, two two medications are often used together over the long-term as part of a hair loss prevention routine. We’ve covered this in more detail in our guide to how minoxidil and finasteride work.
Like finasteride, minoxidil is approved by the FDA to treat hair loss. Unlike finasteride, it doesn’t require a prescription and can be purchased over the counter.
We offer generic topical minoxidil online, with discreet, convenient home delivery either monthly or only when you need it.
Hair transplantation involves surgically removing DHT-resistant hairs from the back and sides of your scalp and using them to replace lost hair in the areas of your scalp affected by hair loss.
Unlike finasteride and minoxidil, both of which are medications, hair transplantation is a type of surgical procedure. Despite the old reputation of producing fake-looking, “pluggy” hair, modern hair transplants can produce results that look and feel very natural.
Hair transplant surgery isn’t cheap, and you may have to use medications like finasteride and minoxidil after surgery in order to maintain your hairline. However, it could be an option worth considering if you have advanced hair loss that doesn’t respond to other treatments.
We’ve explained more about how hair transplantation works, the different methods used and more in our guide to hair transplants.
In addition to finasteride, minoxidil and hair transplant procedures, there are a variety of other over-the-counter products and supplements marketed for treating hair loss. Some of these are backed up by real scientific evidence, while others aren’t.
Common hair loss prevention and hair growth products include vitamins such as vitamins A, D and biotin, shampoos containing ingredients such as pyrithione zinc, natural oils that purport to stimulate hair growth and unique products such as laser combs, scalp massagers and more.
We’ve dug into the science (or lack thereof) behind these products in more detail in our guide to hair growth products.
There’s no currently no cure for hair loss caused by male pattern baldness. However, a variety of effective treatments are available, including FDA-approved medications such as finasteride and minoxidil.
If you’re starting to lose your hair and want to do something about it, it’s much better to act now using existing treatments than to wait for a cure. While curing hair loss may be possible, it could be a decade or longer before a safe, effective cure for hair loss is discovered.
By treating your hair loss now, you’ll be able to preserve as much of your hair as possible and, in some cases, potentially even grow back some of the hair that you’ve lost.
Want to learn more before you get started? Our guide to how hair loss prevention medications like finasteride and minoxidil work goes into more detail about the process behind these drugs and the results you can expect after you start treating your hair loss.