Male hair loss

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

Overview of male pattern hair loss

Male pattern hair loss is the most common type of hair loss in men. It is due to a combination of factors including genetics and hormones (androgens), hence the name ‘androgenic alopecia’.

Men usually notice a gradually receding hairline with hair loss at the front and sides (temples), and an area on the top (vertex) of the head. This is a natural ageing process and not due to ill health. Approximately 60% of men notice some hair loss by 50 years of age. Early onset male pattern hair loss can affect men as early as their mid-20s and several family generations may be affected.

Male pattern hair loss is due to increased scalp sensitivity to the male hormone dihydrotestosterone (DHT) which causes the hair follicles to shrink. New hair becomes thinner and falls out more quickly, eventually not growing enough to break the surface of the scalp leading to balding.

Treatments available for male pattern hair loss

• Propecia/finasteride 1mg tablets.
• Minoxidil 5%: Regaine solution/foam, or SONs solution.
• Dr Fox Hair Growth Spray: finasteride 0.3% and Minoxidil 5% plus tretinoin 0.01%.

Propecia/finasteride 1mg (tablets) can be taken at the same time as using Regaine Extra Strength OR Sons Minoxidil 5%.

When can I expect to see results when using male hair growth treatments

Positive changes may be seen as early as 3 months of treatment. After 6 months of treatment excess hair loss has usually stopped and changes are more obvious. Maximum benefit is usually seen at 1-2 years of treatment. Continued treatment is required to maintain the benefits. If treatment is stopped, pre-treatment appearance will likely return within 6 months. In the event your hair loss continues after 12 months you are likely to be a ‘non-responder’ and should stop treatment.

Please note: When using hair growth treatments a temporary increase in hair loss over the first 2-6 weeks of treatment is NORMAL and should be expected. Treatment moves hairs from the resting phase into the growth phase of the hair growth cycle which causes shedding of old hairs.

Who CAN use male hair growth treatments

• Adults (aged 18+).
• Assigned male at birth.
• Affected by male pattern hair loss.

Who should NOT use male hair growth treatments?

• Rapid hair loss (within 12 months). This is not likely due to male ‘pattern’ hair loss and may indicate an underlying medical condition.
• Patchy hair loss, hair loss in clumps, scalp redness, soreness, itching, or pustules. These symptoms may indicate an underlying skin condition.
• Hair loss following chemotherapy, hair loss affecting the entire body (total alopecia), or hair loss at the site of trauma.
• Women - please see the FAQ What is female pattern hair loss?

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Propecia/finasteride 1mg

• Finasteride 1mg is a prescription-only medication taken once daily to treat male pattern hair loss in men.
• Finasteride reduces the amount of testosterone converted to dihydrotestosterone (DHT) which results in hair regrowth and renewed hair thickness in most men.
• After 5 years of taking finasteride 1mg, 90% of men have more or the same amount of hair than they started with.
• Finasteride can also be used to treat benign prostate enlargement, but with a different dose of 5mg daily.

Cautions for Propecia/finasteride use

• Women who are pregnant or could become pregnant should not come into contact with Propecia/finasteride tablets. It may affect the baby’s genital development.
• Finasteride is excreted in semen. Use of a condom is recommended if your sexual partner is or may become pregnant.
• If you are to have a prostate-specific antigen (PSA) test you must inform your GP as the reference values for the PSA test may need adjustment.

Dr Fox is unable to supply Propecia/finasteride if you have the following, or a history of the following, conditions:

• Difficulty passing urine (either starting or slow flow).
• Prostate cancer.
• Depression, or a history of severe depression and/or suicidal thoughts (symptom monitoring is required after starting treatment).
• Liver disease (as removal of finasteride from the body may be affected).
• Male breast enlargement (gynaecomastia).

Possible side effects of Propecia/finasteride

Uncommon:

• Reduced libido (sex drive) and/or erectile dysfunction. These will usually reverse on stopping treatment.
• Depression/low mood.

Rare/frequency not known:

• Reduced male infertility: advise stop treatment 3 months before planned pregnancy.
• Suicidal thoughts: advise stop treatment immediately and seek GP review, or if there is concern for safety attend the emergency department.
• Rarely male breast cancer has been reported. Any changes in breast tissue, enlargement (gynecomastia) or nipple discharge should be reported to your GP.

Read the Patient information leaflet (PIL) for the full list of side effects.

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Regaine/Sons Minoxidil 5% topical treatment

• Regaine/minoxidil is applied twice daily directly to the scalp.
• Minoxidil widens the small blood vessels in the scalp allowing more blood to reach the hair follicles.
• Hair follicles are boosted by the extra oxygen and nutrients which results in less hair loss and stimulates hair growth.
• Studies have shown 9 out of 10 men report no further hair loss and hair regrowth is reported in 4 out of 5 men with regular use.

Available products

• Regaine Extra Strength foam: minoxidil 5% topical foam.
• Regaine Extra Strength spray: minoxidil 5% topical solution.
• Sons: Minoxidil 5% topical solution.

One pack is one month’s supply, applying minoxidil twice daily to the scalp. Using more than the standard dose does not provide better results and increases the risk of side effects.

Who can use minoxidil?

• Minoxidil foam is licensed for use in males aged 18 to 49 years.
• Minoxidil spray is licensed for use in males aged 18 to 65 years.
• If you are over these ages, Dr Fox can provide these products ‘off label’. Both products have been used safely beyond the licensed ages.

Cautions for minoxidil use

It is recommended to discuss use of topical minoxidil with your usual GP if you have been diagnosed with any of the following conditions:

• Heart disease or an irregular heart beat.
• Angina/chest pains.
• High blood pressure (treated or untreated).

Possible side effects of minoxidil

Only a very small amount of minoxidil is absorbed into the blood stream therefore side effects are unlikely. You should however stop using minoxidil if you develop:

• Skin irritation
• Symptoms of low blood pressure (dizziness or light-headedness)

Please read the patient information leaflets for the full list of cautions and side effects.

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Dr Fox Hair Growth Spray for men

• Dr Fox Hair Growth Spray contains finasteride 0.3%, minoxidil 5%, and tretinoin 0.01%.
• Finasteride and minoxidil are two ingredients that are proven to treat male pattern hair loss.
• Tretinoin comes from vitamin A and promotes hair growth by increasing minoxidil uptake.
• Topical finasteride has been shown to be as effective as oral finasteride in recent studies but has less side effects.
• Minoxidil alone is used twice daily, but combined with tretinoin can be used once daily.
• Supplied on prescription as an off label ‘special’ medicine.

Cautions and possible side effects of Dr Fox Hair Growth Spray

Dr Fox Hair Growth Spray contains both minoxidil and finasteride so the cautions and side effects are the same as for both finasteride and minoxidil (see above). As the active ingredients are delivered directly to the scalp, side effects are less likely with the spray compared to taking finasteride tablets.

Tretinoin can cause skin irritation or increase the risk of sunburn.

For the full list of cautions and potential side effects read the Product information leaflet (PIL).

NOTE: We are unable to supply Dr Fox Hair Growth Spray at the same time as Propecia/finasteride tablets or any of the minoxidil products as they contain the same active ingredients and are not to be used together. There has been no evidence that duplicating treatments increases hair growth but can increase your risk of side effects.

Buy treatment

Dr Fox supplies treatment for hair loss on prescription - you are required to answer a short medical assessment before your order can be completed.

Product leaflets

Report side effects via the MHRA Yellow Card Scheme

Report side effects online at MHRA Yellow Card scheme or using the Yellow Card app. The app is available from the Apple App Store, or Google Play Store and you can use your Yellow Card website account details on the app to report.

1. Medical questions
2. Choose treatment
3. Complete order

Answer medical questions to order(male pattern hair loss)

Honest & accurate responses are necessary for safe medical assessment