Understanding Hair Loss

Understanding hair loss

In the UK, male pattern hair loss affects 30% of white men under 30, and around 80% of men over 70 (it happens less in black men, and later and more gradually in Asian men). Its causes are well established, but poorly understood and to those with the problem, it’s a cruel trick of nature on the genetically vulnerable!

So, it’s not just your youth that puberty heralds the end of, as soon as it hits, the days of guaranteed follicle profusion are over. It’s rare for male pattern baldness to start before the age of 18, but as soon as you notice an increase in the amount of hair falling out, or some thinning, you should act. The earlier the better as the more hair that’s lost, the more difficult it is to restore the original density. Frequently check your hairline and crown for signs of thinning, using your phone camera.

Is every strand present? Follow some simple guidelines and lifestyle improvements to keep things that way……everyone – even the most hirsute should adhere to some basic follicle-friendly rules:

  • Don’t wash your hair in hot water, use lukewarm. And don’t rub wet hair with a towel– just dab it dry.
  • Get at least seven hours sleep as growth hormone levels shoot up at night
  • Eat a Mediterranean diet to ensure a correct mix of nutrients and maximise good health

Hair Loss Treatment

There are just two clinically proven drug hair loss treatments which can prevent further hair loss and promote growth. Finasteride (marketed as Propecia) and minoxidil (most famously sold as Regaine).

  • A combination of both is the best basis for any course of treatment

The efficacy of Minoxidil for hair growth was noticed in the nineteen sixties by men who took it during blood pressure trials. And this link is still not fully comprehended, however that didn’t stop the FDA approving it as a hair loss treatment for men in nineteen ninety-eigh,t but explaining that it won’t work for all. However, it does seem to work for as many as eighty percent.


How does it work? When applied directly to the scalp, Minoxidil stops further hair loss and encouraging growth, but it’s not known how! It may be something to do with activating potassium pathways. What is known is that in clinical trials 85% of men who applied 5% minoxidil two times a day had increased their hair count after 4 months. The new hair is downy initially, but it improves – and be ready to experience some extra hair loss in the first few weeks.

An alternative to Minoxidil is Finasteride, which has been used in the States for hair growth in the name of Propecia since 1997. During tests, Merck decided that a 1mg dose was enough to grow hair. Some of the side effects, including erectile dysfunction, libido and ejaculation disorders, can put men off, but here are millions of men taking the drug with no detrimental side effects

Does Propecia work?

Finasteride is the active component of Propecia. Finasteride works by preventing an enzyme named 5-alpha-reductase converting testosterone into dihydrotestosterone, the androgen that has a negative effect on hair growth.

By using Propecia, the levels of the dihydrotestosterone hormone are reduced, and a beneficial effect can be seen on hair quality and hair growth is improved for men who suffer from hair loss.

How long do you have to wait for results?

With regular treatment you may begin to see an improvement within months, but it could take up to 12 months to notice a real impact. But it is vital that you persevere with the treatment long enough to see the results, as the improvement won't happen quickly.

If you haven't experienced any changes after using Propecia for a year or more, more treatment is not likely to benefit you and it’s best to end the treatment.

If you do decide to end the treatment, you will lose any hair gained during the treatment, so it’s recommended that you talk to your GP about your options.

No other medications for male pattern hair loss are licensed by the FDA or its European equivalent, the European Medicines Agency.