Male pattern baldness (androgenetic alopecia) is the most common form of hair loss in men, driven by genetics and the hormone dihydrotestosterone (DHT). It follows a characteristic pattern: recession at the temples, thinning at the crown, and gradual merging of these areas over time.
In the UK, around 50% of men are affected by age 50. It can begin as early as the late teens, though it most commonly becomes noticeable in the mid-20s to 30s. The Hamilton-Norwood scale classifies hair loss into seven stages, guiding treatment decisions.
MHRA-Approved Medical Treatments
Two treatments have strong clinical evidence and regulatory approval in the UK:
- Finasteride 1 mg (oral): A prescription-only DHT blocker that reduces hair loss in over 80% of men and promotes regrowth in around 65%. Taken as a daily tablet.
- Minoxidil 5% (topical): An over-the-counter vasodilator applied to the scalp twice daily. Stimulates growth and extends the hair cycle's anagen phase.
Using both together is widely considered the gold standard for non-surgical hair loss treatment, with clinical trials confirming superior results from combination therapy.
Off-Label Options
Dutasteride 0.5 mg is a more potent DHT blocker licensed for prostate enlargement but prescribed off-label by some UK clinicians for hair loss. It reduces DHT by approximately 90% compared to finasteride's 60–70%. It is typically considered for men who have not responded adequately to finasteride.
⚠ Important: Dutasteride is not licensed by the MHRA for hair loss in the UK. Any use for this purpose is off-label and at the prescriber’s clinical discretion. Discuss the risks and benefits with your GP or specialist.
Surgical Hair Restoration
For men with more advanced hair loss (Norwood stages 5–7), hair transplant surgery may be appropriate. The two main techniques are:
- FUE (Follicular Unit Extraction): Individual follicles extracted and transplanted — £3,000 to £10,000 per session
- FUT (Follicular Unit Transplantation): A strip of scalp removed and follicles dissected — £3,000 to £7,000 per session
Even after a transplant, ongoing medical treatment with finasteride or minoxidil is usually recommended to protect non-transplanted hair.
Complementary Approaches
Low-level laser therapy (LLLT) devices and dermarolling (microneedling) have some emerging evidence but are not considered first-line treatments. A balanced diet rich in iron, zinc, biotin, and vitamin D supports healthy hair growth but will not reverse androgenetic alopecia on its own.
When to Act
Early intervention produces the best outcomes. It is far easier to maintain existing hair than to regrow what has been lost. If you are noticing thinning or recession, speak to your GP or a GPhC-registered pharmacist for a personalised assessment of your options.