This article will explain what causes the most common hair loss in men – Androgenetic Alopecia (or male pattern baldness). It is hair loss unrelated to the rare cases where the cause may be attributed to an unrelated medical condition or side effects to certain medication.

Androgenetic Alopecia commonly shows itself up by way of diffuse thinning from the hairline all the way back to the crown of the head. There is no common pattern – as in some people the hair loss may begin at the front and on others, the loss may be more prominent at the top.

The gradual (or sometimes quick) progression takes place until the worst case scenario where the entire front and top is devoid of hair, leading to baldness rated a 7 on the Norwood Scale, a chart showing different stages of hair loss in men.

Can male pattern baldness be treated?

Yes. But how well it can be treated may depend on the individual and, more importantly, how much the hair loss has progressed. The sooner it is diagnosed and treated the more likely it is that a full head of hair may be retained. It is our view that a general medical practitioner e.g. a physician is not always the best option when seeking advice about genetic hair loss, so it might be better to see a hair loss specialist seek out the correct diagnosis.

Correct diagnosis will ensure it is related to Androgenetic Alopecia. If it is not the case then a completely different treatment, or none at all, maybe the best option.

Provided it is determined that it is Androgenetic Alopecia the next best solution to seek is to see how aggressively it needs to be tackled.

What causes hair loss

Let’s begin with what is responsible.

An enzyme called 5-alpha-reductase converts testosterone in men into a hormone called dihydrotestosterone, an androgen, which gives men their male characteristics but can cause hair growth phase to shorten after it binds to hair follicles.

Given this, to tackle hair loss caused by DHT (dihydrotestosterone), it makes sense to either block its production or cause a reduction in its binding to follicles.


These two require different treatments. To stop the production of DHT, Propecia, which contains 1mg Finasteride, has proven to successfully stop hair loss.

Finasteride, like Minoxidil, came about to be a viable hair loss treatment more by accident than design. While using Finasteride to treat men with an enlarged prostate, a side effect was increased hair growth. Eventually, it was trialed for hair loss.

1mg Finasteride is the active ingredient in Propecia and is widely considered to be the most effective way to stop DHT getting into the bloodstream and has been used many people and in many cases with effective results.

In many of the participants during the trial phase, the cessation of hair loss began to take hold only a few months in. Not only that but there was increased hair count and general thickness after it was continued for longer. The best results were seen around the two-year mark. It is believed the two-year mark possibly represents the point of optimal results.

One major drawback to Propecia is that it can cause nasty side effects in some of those taking it. The side effects are not minor. Decreased libido and other sexual dysfunction are a side effect experienced by some, and long-term adverse effects from taking it over many years aren’t known. These points can put people off from starting with Propecia.

Still, the number of of those suffering these side effects during the trial phase were relatively small in number. The trial also showed participants who discontinued taking it saw side effects dissipate.

A second solution would be to actually to use something that triggers hair growth (regrowth).

Anyone whose hair loss has progressed considerably and showing visible thinning or baldness would also likely need to add something that triggers or stimulates hair to regrow.

This is where Minoxidil comes in. Minoxidil is the active ingredient in Rogaine, a hair loss product designed to regrow hair in men. It was the first hair loss product given clearance by the Food and Drug Administration (FDA) as a viable treatment for hair loss. To get a better understanding of this product, please see our article on Rogaine Questions & Answers.

Finasteride 1mgMinoxidil 5%
Stops hair loss
May grow hair
Regrows hair
Thickens thinning hair
Decreased libido
Erectyle dysfunction
Testicular pains
Itchy scalp

Rare: Increased heart rate
Chest pains

Real world performance of Propecia and Rogaine

We must stress, not everyone derives the same level of results from either Propecia or Rogaine.

It appears from considerable anecdotal research, that Propecia possibly does a better job in its function of slowing and stopping hair loss than rogaine does at regrowing hair.

While some people react very positively to Rogaine others complain of seeing either frustratingly slow regrowth or experience barely visible progress at all, causing some of them to quit.

There is a natural tendency for people to see Rogaine as the go-to product because of its known capability to induce regrowth of hair, while others are quite rightly apprehensive about Propecia because of the documented side effects, though, in truth, Propecia, or any other product known to inhibit DHT, would be the ideal place to begin. If the root cause of the problem is not tackled, then regrowth of hair will only provide a temporary solution.

The extra thickness and density of Rogaine that could initially lead to greater hair count and thickness versus not using it at all will eventually subside as the loss will outweigh any regrowth over time, so any good hair loss regimen should ideally consist of something that will stop hair loss as well as something that will trigger hair growth.

Side effects of Rogaine

Side effects from Rogaine are generally very mild and not that common. Getting an itchy scalp is quite common but nothing to worry about. But few also experience worse side effects, such as faster heart rate and chest pains. In the event of chest pains or irregular heartbeats following Rogaine application, it is recommended to stop and consult a doctor.

Although it is Recommended rogaine is stopped following these more severe side effects, many tend to continue with it as generally the side effects subside within days or weeks. This is a matter for the user of what course of action to take, though it is recommended to stop it.

Other Treatments besides Propecia & Rogaine

These are both proven treatments to tackle hair loss, but are there other cheaper or safer options? To be fair, Rogaine is fairly affordable today at around $30 a month and there are even cheaper generic options available, such as Kirkland’s 5% strength Minoxidil, which works out to an only few dollars for a month’s supply when bought in larger quantity.

With Propecia, there is the cheaper generic version in the form of generic Finasteride available, although it is suggested a great deal of care taken when buying generic Finasteride online. Generic Finasteride often comes from overseas, where regulatory practices aren’t likely to be as stringent as those in developed countries such as the USA or UK.

Aside from Propecia and Rogaine, there aren’t many hair loss treatments available that would be considered as either proven or have any considerable level of efficacy behind them.

There is one vague study suggesting Saw Palmetto may have a weak form of DHT inhibiting qualities after it helped to increase the hair count in a small number of the participants. It functions similarly to Propecia, although of the natural variety. However, it is not really proven to any great measure as further studies haven’t been conducted.

There are also various hair loss products containing Minoxidil 5% and since they have this proven ingredient, judging by what seems to be genuine customer feedback, have proved to be successful in many cases.

These treatments usually a concoction of Minoxidil 5% and various other ingredients that may or may not actually help. These extra ingredients usually are said to act as a means to combat DHT, so you are getting both the minoxidil to trigger growth and the anti-DHT properties, in one. Examples of products are Lipogaine and Provillus.

But when it comes to proven alternative treatments then laser comb is one which actually has been backed by FDA. In trials, it has shown to increase the hair count in participants and thicken the diameter of the hair shaft, albeit not as nearly convincingly as Finasteride and Minoxidil. And going by a lot of anecdotal evidence, it appears to be a very much hit and miss, with many actually saying it didn’t help them any.

All in all, it may be best for anyone aiming to tackle male pattern baldness to have an all-encompassing regimen, consisting of a DHT inhibitor, something that stops DHT binding from to follicles, and something that stimulates growth, and if they can afford to, maybe even a laser comb.

Food and Drug Administration



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