Ultimate guide to hairloss treatment
Hair loss in Men: Your Ultimate Guide to its causes, prevention, and treatment in 2024
Are you starting to notice thinning hair?
You're not alone. Hair loss is very common and affects more than half of all men. It can have a profound impact on a guy's self-image, self-esteem, and psychological well-being.
But there's good news: the great majority of hair loss in men—95% of it—is treatable.
In this ultimate guide, we want to provide you with everything you need to know about hair loss in men. We'll cover the causes of hair loss, what you can do to prevent it, and which of the various treatment options are effective.
We'll cover:
- Hair loss: A brief introduction
- What causes androgenic alopecia in men?
- What are the signs of hair loss?
- Hair loss prevention
- Evidence-based hair loss treatments
- Alternative Hair loss treatments
- When should I treat hair loss
- Conclusion: There are effective hair loss treatments for men
Hair loss: A brief introduction
So what causes hair loss?
There are many different types of hair loss, and each of them has a different cause. It's important to know which kind of hair loss you're experiencing so that you can get appropriate treatment for it. Here are some of the major types.
Androgenic alopecia
Often called “male pattern hair loss” or “male pattern balding”, this is the most common type of hair loss in men. It is usually characterised by gradually thinning hair on the crown of the head and a receding hairline. It's caused by androgen hormones that cause hair follicles to miniaturise and eventually die.
Alopecia areata
This is a disease where the body's immune system begins to attack hair follicles causing hair loss. It's characterised by hair loss anywhere on the body, often in patches.
Telogen effluvium
This type of hair loss is associated with a sudden bodily change like severe stress, serious illness, crash dieting, and anaesthesia. It is usually temporary.
Drugs and hair loss
Other possible causes of hair loss include pharmaceutical medications and drugs. Anabolic steroids have been found to be a cause of hair loss in men. Other medications that may contribute to hair loss include anti-hypertensives, antiarrhythmics, statins, antimetabolites, psychotropic agents, anticonvulsants, anticoagulants, and antiretrovirals.
Supplements and hair loss
Over supplementing certain vitamins and minerals—such as vitamin A and selenium—can cause hair loss. Some research suggests that dietary supplements that contain food contaminants like heavy metals and chemical ingredients can also be a cause of hair loss in men.
Creatine, often used to enhance athletic performance, is rumoured to cause hair loss by the fitness crowd. However, the evidence linking creatine to hair loss is still limited and inconclusive.
Foods that cause hair loss
Do some foods cause hair loss?
Not usually. It's true that hair cells need various vitamins and minerals to function properly. People with inadequate protein intake—like those with anorexia—may experience hair loss. Others that have a deficiency in vitamins or minerals may also experience some hair loss. But we're not aware of any evidence that supports the claim that certain foods cause hair loss in men or women.
So should you choose or avoid certain foods to prevent hair loss?
Well, you should try to eat a healthy, balanced diet when you can. This will ensure you have the nutrients that your body needs to create healthy hair. But don't worry too much about specific foods that cause hair loss—there probably aren't any.
Other causes of hair loss
Hair loss can also be caused by a number of other things like chemotherapy and radiation treatments for cancer, damaging hair products, hairstyles that create excessive tension on the scalp, scalp infections, and scarring.
What causes androgenic alopecia in men?
While there are several different types of hair loss, the focus of this article will be on the most common one: Androgenic alopecia. Androgenic alopecia is also known as “male pattern baldness” or “male pattern hair loss”. It's also sometimes called “androgenetic alopecia”. These all refer to the same condition.
The primary cause of androgenic alopecia is DHT. DHT is a substance that is made when testosterone is broken down in the body. DHT causes hair follicles to shrink and eventually die. Several of the effective hair loss treatments that are currently available work by reducing DHT to keep hair follicles healthy.
What are the signs of hair loss?
Wondering if you're seeing male pattern hair loss? Here are some early warning signs that you should watch out for:
- Gradual thinning of the hair on the top of the head
- Noticeable changes in the hairline
- Patchy or circular bald spots
- Loosening of hair
- Excessive hair loss after brushing or showering
If you experience any of these symptoms, consult a hair loss expert to find out your treatment options.
Hair loss at 20?
When do guys usually start losing hair?
We typically associate hair loss with older men, and hair loss certainly does become more common as you age. But it can also happen early. As many as 25% of guys begin losing their hair by the age of 30. Some guys even start experiencing hair loss in their early 20s.
In general, hair loss is proportional to your age: the older you are, the more likely you'll experience hair loss, and the more advanced it could be. By age 50, 85% of men experience thinning hair.
Hair loss prevention for men
Can you prevent hair loss?
At least some of the cause of male pattern hair loss is baked into your genetics—and you can't do much about that. But there are lifestyle decisions that you can make that will help with hair loss prevention.
- Treat your hair well. You can make sure you shampoo your hair regularly, avoid hair products with harmful ingredients, and keep your hair out of the sun.
- Maintain a healthy weight. Obesity can influence your hormones and ultimately contribute to thinner, weaker hair.
- Avoid smoking. Smoking can restrict blood flow throughout the body, including to the hair follicles in your scalp. This can hinder hair growth.
- Avoid alcohol. Some research has found that alcohol consumption has been associated with increased hair loss in the temples and crown.
- Limit stress. Stress has been associated with hair loss. Finding ways to limit stressors and cope with them in a healthy way may help you prevent hair loss.
While doing these things may not completely prevent hair loss, they may help you at least slow down the rate of hair loss.
What's the best way to prevent hair loss? Starting treatment early. Your best bet is to see your hair loss specialist and get one of the several hair loss treatment options available.
Evidence-based hair loss treatments for men
There are several hair loss treatments that have been shown to work in rigorous scientific studies. These include finasteride, dutasteride, minoxidil, hair transplant surgery, low-level laser light therapy, and platelet-rich plasma therapy.
1. Finasteride
What is finasteride?
The most common hair loss treatment for men in Canada and the United States is generic finasteride and its brand name Propecia. These medications work by blocking the 5α-reductase enzyme that breaks testosterone down into DHT. Reducing the amount of DHT helps keep hair follicles healthy.
Finasteride prescriptions are very common; in 2021, finasteride was the 88th most commonly prescribed medication in the United States with over 2 million users.
Finasteride uses
Finasteride is used at 1 mg daily for male pattern hair loss. In 5 mg pills, finasteride is often prescribed as a treatment for an enlarged prostate.
Topical finasteride is also available for hair loss. Rather than being taken as a pill, this version is applied in a liquid or gel directly to the scalp.
Finasteride results
Finasteride is a very effective hair loss treatment. Clinical studies have found that finasteride can stop hair loss in 90% of cases. It has been found to actually reverse hair loss and increase hair growth in a further 65% of cases.
Several systematic reviews and meta-analyses have corroborated these findings, concluding that finasteride results in significantly improved hair growth outcomes.
Finasteride side effects
The research consistently shows that finasteride is safe and well-tolerated by most men. However, some users may experience finasteride side effects. The likelihood and type of possible side effects depend to some extent on whether it is taken orally or used topically.
Oral finasteride. Oral finasteride side effects include:
- Erectile dysfunction
- Decreased libido
- Ejaculatory disorder
- Gynaecomastia
Oral finasteride has also been linked to prostate cancer. While it seems to decrease the risk of a prostate cancer diagnosis, in those individuals who have prostate cancer, it may increase the chance that the cancer is considered “high grade”.
While these side effects can occur, they are relatively uncommon. It's estimated that only between 3.8% of users will experience these finasteride side effects. Side effects usually stop when treatment stops, although they may persist in a very small number of patients.
Topical finasteride. There has been less research conducted on the side effects of topical finasteride compared to the oral version. The research so far shows that topical finasteride is safe with no serious side effects. Minor side effects include:
- Scalp irritation
- Erythema
- contact dermatitis
Again, though, this research is limited. Further high-quality studies will be needed to confirm the long-term safety of topical finasteride.
How do I buy finasteride in Canada and the United States?
Finasteride is only available in Canada and the United States with a prescription. You can obtain a finasteride prescription through your doctor or buy finasteride online through Essential Clinic after a medical review.
2. Dutasteride
What is dutasteride
Dutasteride, the generic version of Avodart, is another effective pharmaceutical medication used to treat hair loss. Like finasteride, dutasteride inhibits 5α-reductase so that less testosterone is broken down into DHT. Less DHT means less hair loss.
Dutasteride is less commonly prescribed for hair loss in the United States and Canada, but it is the preferred treatment for hair loss in other countries like Japan and Korea.
Dutasteride uses
Dutasteride is taken daily as an oral tablet. In Canada and the United States, dutasteride is usually prescribed to treat individuals with enlarged prostates. It is also prescribed off-label for hair loss in more advanced cases.
Dutasteride results
Like finasteride, dutasteride results in significantly improved hair growth outcomes. In fact, several studies have found that dutasteride is actually more effective than finasteride for treating hair loss. The conclusions of these individual studies have been corroborated by a review of several studies conducted between 1990 and 2018, in which researchers concluded that dutasteride is more effective than finasteride.
Dutasteride side effects
So it works… but Is dutasteride safe?
Yes. Study after study has found that dutasteride is safe and well-tolerated by most users. It has been found to have a similar safety profile as finasteride.
But there are some side effects that you should be aware of:
- Erectile dysfunction
- Decreased libido
- Ejaculatory disorder
- Gynaecomastia
These effects are experienced by between 1% and 7% of users. As with finasteride, these side effects almost always subside after you stop taking the medication, although it can take 4-6 months for dutasteride to completely leave your system.
How do I buy dutasteride in Canada and the United States?
Like finasteride, you need a prescription from a doctor in both the United States and Canada to purchase dutasteride. You can buy dutasteride online from Essential Clinic after completing a medical review.
3. Minoxidil
What is minoxidil?
Minoxidil, better known by its trade name Rogaine, is a treatment for hair loss that was developed in the 1980s. It works by dilating the blood vessels in the scalp, allowing more blood flow and nutrients to get to the hair follicles. It also helps reduce cellular build-up.
Minoxidil uses
Minoxidil is used to treat hair loss in men as well as in women. It comes in a liquid, cream, gel, or foam solution that is applied topically to the scalp—usually twice a day. You can also find minoxidil shampoos although these are less common. In addition to topical forms, minoxidil is also available as an oral medication. Oral minoxidil was originally used to treat high blood pressure, but at lower doses, it has been found effective in treating hair loss.
Minoxidil results
Minoxidil has been around for so long because it works. Studies consistently find that minoxidil can slow down hair loss and can promote hair growth.
However, in comparison studies, both finasteride and dutasteride have been found to be more effective than minoxidil. Using topical minoxidil and finasteride together is currently the Health Canada authorised and FDA approved hair loss treatment in Canada and the United States.
Note that minoxidil shampoos are not as effective as liquids, creams, and gels. This is because minoxidil needs time to permeate the scalp. Since shampoos are quickly washed off, they do not usually have enough time to adequately get into the scalp and make a meaningful change to hair loss outcomes.
While oral minoxidil can be an effective option for hair loss, it is also associated with more serious side effects compared to its topical counterpart. Oral minoxidil can lead to systemic effects such as changes in blood pressure, heart rate alterations, and fluid retention, among others. Due to these potential risks, topical minoxidil is still the recommended form of minoxidil for most patients.
Topical minoxidil side effects
Topical minoxidil has been consistently found to be safe and well-tolerated by users. Some minoxidil side effects include:
- Allergic contact dermatitis
- Hypertrichosis
- Irritation
- Eczema
- Shedding
How do I buy minoxidil in Canada and the United States?
Topical minoxidil is sold over the counter in Canada and the United States—you don't need a prescription. You can also buy minoxidil online directly from online hair loss clinics like Essential Clinic.
4. Hair transplant surgery
Treating hair loss with hair transplantation surgery is gaining popularity. With a hair transplant, a surgeon takes hair from the back of your scalp where hair is more resistant to balding, and moves it to areas with thinner hair or that are bald.
Hair transplant results
The effectiveness of hair transplants largely depends on several factors, including the skill of the surgeon, the quality of the donor hair, and the patient's own hair characteristics. Most patients see a significant improvement in hair density and a natural blend with existing hair. Since the transplanted hair comes from areas genetically resistant to balding, results are typically permanent, making hair transplants a long term solution compared to other treatments that might require ongoing usage.
Along with a hair transplant, most doctors will still prescribe finasteride or minoxidil to ensure that the hair around the transplanted area remains full and healthy. Otherwise hair loss will progress and more hair transplants will be needed down the road.
However, results can vary, and the procedure does have limitations. Hair transplants redistribute existing hair—they do not create new hair. Thus, individuals with advanced balding and limited donor hair may not achieve full coverage. For some, multiple sessions may be necessary to reach desired density. Despite these drawbacks, many patients report a boost in self-esteem and confidence following the procedure.
Hair transplant side effects
A hair transplant is a kind of surgery, so it is relatively invasive. Side effects can include:
- Scarring
- Scalp pain and itching
- Infections of the scalp
- Swelling
- Bleeding
- Inflammation of the hair follicles
- Hair that doesn't match surrounding areas.
How do I get a hair transplant in Canada or the United States?
Talk with your doctor or a hair transplant surgeon. Make sure you select only a certified and licensed surgeon. You can find one through the Canadian Society of Plastic Surgeons or the American Academy of Plastic Surgeons.
Some of the most popular hair transplant surgeons in Canada include Dr. Rahal and Hassan & Wong.
5. Low-level laser light therapy
Low-level laser light therapy (LLLT), also known as red light therapy, is a relatively new hair loss treatment for men. It works by improving circulation and stimulating the hair follicles to grow hair.
This therapy is painless and noninvasive. But it is relatively time-consuming and expensive. Providers generally suggest that you must continue to have the therapy over the course of your life for it to continue to have an effect.
Laser therapy results
Because it's still a relatively new hair loss treatment, there's not as much research available on LLLT as there is for other treatments. But the research that exists looks promising.
One small study from 2013 found that laser therapy resulted in a 39% improvement in hair growth over 16 weeks. Another study from 2014 found that it was safe and effective for both men and women. It also appears to increase the strength of hair. One meta-analysis of studies on LLLT concluded that it was effective in promoting hair growth in men with androgenic alopecia. Another even suggests it may be the most effective of non-surgical treatments for androgenic alopecia.
While LLLT seems to work quite well with men who still have some hair, it may not be as effective for individuals in the more advanced stages of hair loss.
Laser therapy side effects
There do not seem to be any side effects for this treatment, although the long term safety of LLLT has not yet been adequately studied.
Where can I get laser therapy in Canada and the United States?
Laser therapy is typically provided by hair restoration clinics as part of their treatment options for hair loss.
6. Platelet-rich plasma therapy
Platelet-rich plasma therapy (PRP) is a very new hair loss treatment. It consists of a three-step process:
- First, your blood is drawn, usually from your arm.
- That blood is then put into a centrifuge, which separates it into three substances: platelet-rich plasma, platelet-poor plasma, and red blood cells.
- Finally, the platelet-rich plasma is injected into your scalp in areas with thinning hair.
PRP normally requires three treatments 4 to 6 weeks apart, and then maintenance treatments about every 4 to 6 months. It can be fairly expensive, depending on your provider and location.
PRP results
Because it's such a new hair loss treatment, there hasn't been as much research on PRP as other hair loss treatments. However, the results do look promising.
One meta-analysis of several studies found that PRP significantly increased the hair count by 14.38 per square centimeter. Another meta-analysis found similarly promising results, but noted the quality of the existing evidence was “very low”. In other words, it looks like PRP is effective, but we need more evidence to be sure.
PRP side effects
There are few side effects of this treatment because it essentially uses your own blood as the active ingredient. However, there are some possible side effects that come with any injections:
- Injury to nerves or blood vessels
- Infections
- Scar tissue
Where can I get PRP in Canada and the United States?
PRP for hair loss is typically offered at hair restoration clinics in both Canada and the United States.
Alternative Hair loss treatments for men
In addition to those proven treatments, there are a variety of natural hair loss remedies and alternative treatments that some people say are effective. Let's take a quick look at those and the evidence for their effectiveness.
1. Hair loss shampoos?
Hair loss shampoos are among the numerous hair loss products aimed at guys with male pattern baldness. Depending on their ingredients, these shampoos may fight hair loss in different ways—if they fight it at all.
Hair loss shampoo results
There is relatively little research on hair loss shampoos. Some pilot studies have found promising results for shampoos that contain one particular ingredient: ketoconazole. However, the majority of hair loss shampoo products have not been rigorously tested. It's not clear whether they work or not and so they are not recommended as a primary hair loss treatment.
Hair loss shampoo side effects
There do not seem to be any side effects of hair loss shampoos, but there has been little long-term safety research conducted on them.
2. Hair loss vitamins?
Can you take vitamins for hair loss?
It's true that vitamins and minerals are essential for hair cells to function. And being deficient in certain vitamins and minerals may contribute to hair loss. Some research has found that supplementing vitamin D and iron for individuals who are deficient in those nutrients can improve hair loss symptoms.
At present, though, there isn't enough research to support taking most other vitamins for hair loss, including zinc, riboflavin, folic acid, vitamin B12, vitamin E, or biotin. Unless you're deficient in these, they probably won't help you prevent hair loss. Preliminary research even suggests that too much of certain vitamins—like vitamin A or selenium—can actually contribute to hair loss.
So, by all means, eat a healthy balanced diet to ensure you are not vitamin deficient. But most people can skip hair loss vitamins. You'll have more success by obtaining a proven treatment option.
3. Natural hair loss remedies
As you've searched around the internet looking for hair loss solutions, you might have heard about several natural hair loss remedies. Some of these may have included cod liver oil, eggs, ginseng, aloe vera, coconut oil, and onion juice.
Unfortunately, there's no evidence that these are effective. While these may make your hair look healthier, it's probably not doing anything to actually inhibit DHT or reduce hair loss. If you're looking for hair loss solutions, your best bet is to go for one that has been shown to actually work.
When should I treat hair loss?
You should treat hair loss as early as possible. DHT will eventually miniaturise and kill your hair follicles—and once they're dead, you can't bring them back. But that process takes some time. The earlier you start hair loss treatment, and the more hair you have to begin with, the more successful your treatment will be.
Start your online hair loss consultation to get an evaluation by a hair loss expert and understand your options.
Conclusion: There are several effective hair loss treatment options for men
What we hope you take away from this article is that most men will experience hair loss at some point. Making healthy lifestyle changes may help slow your hair loss, but it probably won't completely prevent it.
Luckily, there are some very effective hair loss treatments for men. The most common are finasteride, dutasteride, and minoxidil, although there are also some newer treatments like laser therapy and PRP that are becoming more popular. Hair transplants, while costly and invasive, may also be appropriate for some people.
Hair loss shampoos, vitamins, and natural hair loss remedies aren't supported by evidence. If you really want to prevent your hair loss, those likely aren't your best bet.
The last takeaway is that you should look into your hair loss early. The earlier you start your treatment, the more successful it will be.
You've got lots of options. Get started with a hair loss expert as soon as you notice thinning hair for the best results:
- Canadians can easily get an online hair loss consultation now.
- If you're in the United States, you can visit Plush Care.
- Visitors from the UK can get a free consultation from Boots pharmacy.
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.