Male pattern baldness treatment: an evidence-based overview

Male pattern baldness, also called androgenetic alopecia, is the most common type of hair loss in men. A European guideline notes that it affects up to 80% of Caucasian men over their lifetime ¹. A Canadian consensus puts the figure at 40% to 50% of men and women by age 50 ². The NHS explains that it usually runs in families ³.

The good news is that it is one of the best-studied types of hair loss. The less good news is that the NHS is clear: no treatment is 100% effective, and the main medicines only work for as long as they are used ³.

How it shows

Pattern hair loss usually starts with a receding hairline at the temples, thinning at the crown, or both. It develops slowly over years. Because other conditions can look similar, it is worth getting a diagnosis first. See what to do when you first notice hair loss.

The main medicines

The NHS describes finasteride and minoxidil as the main treatments for male pattern baldness ³.

• Topical minoxidil is applied to the scalp. MedlinePlus says it must be used for at least 4 months, and possibly up to a year, before any effect is seen ⁴. See minoxidil for hair loss.
• Finasteride is a tablet that lowers a hormone involved in pattern hair loss. It needs a prescription in many places. See finasteride for hair loss.
• Using both together is common. See minoxidil and finasteride together.

A 2017 systematic review and meta-analysis found that 5% minoxidil, 2% minoxidil, 1 mg finasteride and low-level laser therapy all worked better than placebo in men, although the studies differed a lot from each other ⁵.

What a recent expert consensus recommends

In 2025, a panel of 11 Canadian physicians reviewed 45 treatments for pattern hair loss in adults using a structured consensus method ². Several panel members are affiliated with a cosmetics company, which readers may wish to bear in mind ².

• Recommended: oral dutasteride, oral finasteride, topical finasteride, topical minoxidil, oral minoxidil, platelet-rich plasma (PRP) and microneedling ².
• Recommended with near consensus: dutasteride injected into the scalp, ketoconazole shampoo, low-level laser therapy and aminexil, as part of a regimen ².
• Not recommended: 17 options, including caffeine and topical herbal formulations ².

Some of these, such as oral minoxidil and dutasteride, are used off-label for hair loss and need a doctor's supervision. See dutasteride for hair loss and PRP for hair loss.

Hair transplant

A hair transplant moves follicles from the back of the head to thinning areas. The NHS says results may show after about 4 months, with full results taking 10 to 18 months ⁶. It also warns that there is a small risk the transplanted hair will not take, and that hair may continue to thin around the transplanted area ⁶. That is why many people continue medicine after surgery. See FUE vs FUT.

Camouflage and other options

The NHS also mentions options such as scalp micropigmentation and wigs ³. Hair fibres, concealers and a shorter haircut can also reduce how noticeable thinning is. See hair loss camouflage options.

Setting realistic expectations

• Start early if you want to act. Treatments generally work better at holding on to existing hair than at bringing back long-bald areas.
• Be patient. Give a treatment at least several months before judging it ⁴.
• Expect to continue. Benefits usually fade if you stop ³.
• Watch for side effects. Ask your doctor what to look out for with each medicine.
• Track progress with photos taken in the same light every few months.
• Be wary of big promises. No one can promise a full head of hair.

Choosing whether to treat

Treatment is optional. Many men choose not to treat pattern hair loss at all, and that is a valid choice. The NHS notes that hair loss can be upsetting and that counselling or support groups may help ³.

If you decide to treat, a GP, pharmacist or dermatologist can confirm the diagnosis, explain the options and check whether a medicine is suitable for you. The NHS advises seeing a GP before going to a commercial hair clinic ³.

Frequently asked questions

What are the main treatments for male pattern baldness?

The NHS names finasteride and minoxidil as the main treatments ³.

How long before minoxidil works?

MedlinePlus says at least 4 months, and possibly up to a year ⁴.

Do I have to keep using treatment?

Yes. The NHS says these treatments only work for as long as they are used ³.

Does a hair transplant stop further hair loss?

No. The NHS warns hair may continue to thin around the transplanted area ⁶.

Educational content. Not medical advice.