What is hair loss?
Male pattern hair loss (androgenetic alopecia) affects about half of men by age 50. It's genetic and driven by dihydrotestosterone (DHT) acting on susceptible hair follicles — temples recede, crown thins, eventually leaving a "horseshoe" pattern.
Female pattern hair loss affects women too, typically as diffuse thinning across the top of the scalp rather than receding hairline.
Other causes include telogen effluvium (stress, post-pregnancy, illness — usually temporary), alopecia areata (autoimmune — patchy bald spots), traction alopecia (tight hairstyles), and medication side effects.
Proven treatments: finasteride (blocks DHT production), minoxidil (stimulates hair growth via unclear mechanism — both topical and oral), dutasteride (stronger DHT blocker), and procedural options like PRP and hair transplant. Earlier treatment works better.
Do I have hair loss? Common signs
If most of these describe what you're experiencing, telehealth is a reasonable next step:
What causes it
Androgenetic alopecia is genetic — sensitivity of follicles to DHT, a testosterone metabolite. Other causes: thyroid disease, iron deficiency, autoimmune (alopecia areata), medications, severe stress or illness (telogen effluvium), pregnancy-related changes, scalp infections, and certain hair styling practices.
Is it contagious?
No.
Hair you keep is hair you don't have to grow back — early treatment preserves what's there.
Can it be treated online?
Hair loss evaluation works extremely well by telehealth. A clinician reviews your history (pattern, duration, family history, medications, recent illnesses), looks at photos of the affected area, screens for non-pattern causes, considers labs when indicated, and prescribes treatment.
In-person evaluation may be needed for: patchy hair loss that may be alopecia areata, scarring alopecia, suspected scalp infection, or comprehensive workup of female hair loss when other causes are suspected.
How hair loss is treated
Finasteride: 1 mg daily oral — blocks 5-alpha reductase, lowering DHT. About 80% of men see stabilization or improvement over 6–12 months. Continued treatment is needed — stopping reverses gains within months.
Minoxidil: topical 5% solution or foam twice daily; or low-dose oral minoxidil (off-label, increasingly used) — stimulates hair growth. Works for both men and women.
Combination: finasteride + minoxidil is more effective than either alone for many men.
Dutasteride: stronger 5-alpha reductase inhibitor; sometimes used when finasteride alone isn't enough.
For women: minoxidil, spironolactone (anti-androgen), and oral contraceptives can help in selected cases.
Procedural: PRP (platelet-rich plasma), low-level laser therapy, hair transplantation — generally not first-line.
Self-care while you wait
- Be gentle with hair — avoid tight ponytails, harsh styling, frequent chemical treatments
- Use a wide-tooth comb on wet hair
- Mild shampoo
- Adequate protein intake
- Address iron deficiency, thyroid issues, vitamin D deficiency if present
- Manage stress
- Set realistic expectations — treatments slow progression and partially restore, but rarely fully reverse
- Be patient — most treatments take 3–6 months to show visible results
How long does it last?
Pattern hair loss is progressive and lifelong without treatment. With treatment, most men maintain or improve their hair over years to decades. Stopping treatment leads to loss of gained hair within 3–12 months — treatment is generally lifelong.
Frequently asked questions
Does finasteride cause sexual side effects?
A small percentage of men report sexual side effects (reduced libido, ED, ejaculatory issues). In clinical trials these rates are low and often resolve with continued use or discontinuation. Discuss any concerns with the clinician — sometimes lower doses or topical formulations are options.
Does minoxidil work for receding hairlines?
Minoxidil works best for thinning at the crown and is less effective for frontal hairline recession. Finasteride may help frontal areas more.
How long until I see results?
Typically 3–6 months on consistent treatment. Some men see early shedding ("dread shed") in the first few weeks of minoxidil as resting hairs are pushed out by new growth — this passes.
Is it worth doing PRP or laser?
Evidence for PRP and low-level laser is more limited than for finasteride/minoxidil. They're generally considered after maximizing medical therapy or in patients who can't tolerate medications.
Should I consider hair transplant?
Hair transplant can be excellent for the right candidate — typically after maximizing medical therapy, with stable hair loss pattern, sufficient donor hair, realistic expectations. Combining with medical therapy is usual.
