Understanding Male Pattern Hair Loss: Causes, Treatments, and Prevention

Ever wondered why so many South Asian men are losing hair? Why have they got the bald crown at such young ages? Is it stress? Is it genetics? Is there anything I can do?

This post explores hair loss further. The reasons why it seems to happen to us. We will focus on men only here. Provide sound evidence and reasonable options for what you can do. Remember, as always, our blogs are written by doctors who use evidence and experience to provide their thoughts. It is not intended for medical advice and we recommend you speak to a doctor for more personalised advice.

It was sometime in year 3 of medical school that I came across a small section on male pattern hair loss in our enormous (over 1,000 pages) textbook. Or, to be more precise, androgenetic alopecia. As a young, 20-something Indian man, I thought, “That’s what my dad has, and my uncle. And actually, pretty much every male family member I know.” But I figured I was fine—I had long hair. Twenty years later, I’m not so sure I’ll be okay.

And the science is pretty grim. Some studies have suggested that almost 63% of South Asian men have some element of male pattern hair loss. More concerning is that it usually starts in the third and fourth decade of life.

So, what is it

In a nut shell, it is receding hair line and thinning of the crown. You begin to notice the hair starts to slowly get thinner, shortly after puberty, and simply continues to do so.

This is a question that so many patients have asked me: What is available? I don’t want to be bald. I’m too young. Sadly, doctors with too little time sometimes dismiss the impact hair loss has on a man, regardless of their culture. It can be disempowering, make you feel less masculine, and affect your self-esteem and mood. Dismissing the issue is not helpful.

But there are options and below is a collection of medically proven options which work for South Asian men.

Medical Treatments for Male Pattern Hair Loss:

1. Finasteride (Oral)

• How It Works: Finasteride is a prescription medication that blocks the conversion of testosterone to dihydrotestosterone (DHT), a hormone linked to hair loss.

• Effectiveness: It has been shown to slow hair loss and, in some cases, stimulate new hair growth. Studies suggest that about 66% of men experience hair regrowth or stabilization within a year.

• Side Effects: Possible side effects include reduced libido, erectile dysfunction, and a small risk of depression.

2. Minoxidil (Topical)

• How It Works: Minoxidil is a topical solution or foam that increases blood flow to hair follicles, prolonging the growth phase of hair.

• Effectiveness: It is effective for about 40-60% of men, helping to slow hair loss and stimulate regrowth, particularly when used consistently over several months.

• Side Effects: Scalp irritation and unwanted facial hair growth in some cases.

3. Low-Level Laser Therapy (LLLT)

• How It Works: LLLT devices, like laser combs and helmets, use light to stimulate hair follicles.

• Effectiveness: Some studies show modest improvement in hair density, especially when used as part of a combination therapy.

• Side Effects: Generally well tolerated, but effectiveness varies.

4. Dutasteride (Oral)

• How It Works: Similar to finasteride but blocks more of the DHT enzyme.

• Effectiveness: Potentially more effective than finasteride, but with a similar side effect profile.

• Side Effects: May include sexual dysfunction and mood changes.

5. Hair Transplant Surgery

• How It Works: Involves moving hair follicles from one part of the scalp to areas affected by hair loss.

• Effectiveness: Offers permanent results with high success rates, but it’s expensive and requires a recovery period.

• Side Effects: Scarring, infection, and the possibility of unnatural-looking hair growth if not done properly.

6. Platelet-Rich Plasma (PRP) Therapy

• How It Works: Involves injecting your own blood plasma, rich in growth factors, into the scalp.

• Effectiveness: Some studies suggest improvement in hair density and thickness, but more research is needed.

• Side Effects: Minimal, but it can be costly and requires repeated treatments.

It’s great that we have options. Our ancestors didn’t. But there are things you should always know and understand prior to considering the above options.

Medication and topical treatment:

These are the most common choices for men, and they are effective at keeping hair loss at bay, slowing down the progression. But they are not a cure. This means that once you stop the treatment, hair loss will continue as it did before. It’s best to think of it this way. And why is that important? Because you need to consider how much it will cost to maintain these treatments potentially for years.

Transplant surgery

This is effective and there are a number of reputable providers in the UK. Some people even travel abroad for this (Turkey is getting more popular) but as always, please do your research. This, again, is not cheap.

Doing nothing and letting nature take its course

This is the mantra taught in the NHS: the idea that hair loss is not a disease and that treatment is considered “cosmetic.” That’s why these treatments are not available on the NHS. This stance remains controversial, as there is a clear psychological impact on men, and these decisions disproportionately affect South Asian men in particular, as well as men in general.

But the truth is, at some point, unless you decide to undergo a hair transplant, you will have to accept it. It may not be today or tomorrow, but eventually, you will need to come to terms with it. Otherwise, it can weigh heavily on you. In the meantime, you can consider some of the treatment options mentioned above.