HAIR LOSS
Hair loss: the basics
The short answer
Most adult hair loss is slow pattern loss (gradual thinning in a typical pattern), and some medicines have trial results behind them. This is not medical advice, just handy to know. Talk to a doctor if you want to explore this option further.
See how it works
Do this
- 1Photograph your hairline and crown every 3 months, same light.
- 2Shedding 50-150 hairs a day is normal; thinning you can see is not.
- 3Stop tight styles that pull on the hairline.
- 4Skip biotin and 'detox' products unless a doctor finds a deficiency.
- 5Medicines in trials take months to show results, and gains fade if stopped.
- 6Talk to a doctor early, and fast for patches, sudden shedding or scalp pain.
The numbers behind it
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50%
Of men are affected by pattern hair loss by age 50 (genetics study of about 70,000 men).
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26.3%
Hair density lost over 5 years by men on placebo (239 hairs in the test area). 75% looked worse on photos.
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45% more
Regrowth with 5% minoxidil lotion (a medicine) was 45% higher than with 2% after 48 weeks, in 393 men.
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107 hairs
Extra hairs versus placebo after 1 year on finasteride, a prescription pill (1,553 men; counted in a 5.1 cm2 crown patch).
For your hair
Men (Norwood scale)
The hairline recedes at the temples, then the crown thins. Stages run I to VII.
Women (Ludwig scale)
The part widens and thinning spreads over the crown. The front hairline usually stays.
Sudden or patchy loss
Shedding over weeks, round patches or a sore scalp are not pattern loss. See a doctor.
Myths to ignore
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Myth A receding temple means you are going bald.
Truth Some temple recession is near-universal in adults: 98.6% of men and 64.4% of women in one Australian town survey, and none of 140 children.
Gan 2005 ↗ -
Myth Washing your hair often makes it fall out.
Truth The drain hairs were already shed: about 28 per wash in people without hair loss, 52 with pattern loss. Pattern loss itself comes from hairs thinning.
Li 2022 ↗ -
Myth Biotin and hair vitamins regrow hair.
Truth A 2024 systematic review found no high-quality support for biotin as a hair supplement. A true deficiency is a different matter; ask a doctor.
Yelich 2024 ↗ -
Myth Cosmetic serums work like medicines.
Truth Adenosine, the best studied, was positive in all 7 trials, but certainty ranges from very low to moderate. Pooled lotion results for density were not significant.
Szendzielorz 2025 ↗
Made for this
Go deeper
- MinoxidilThe most widely used hair-growth treatment, available as a cheap over-the-counter lotion or foam and as a prescription tablet, with a mechanism that is still only partly understood.
- FinasterideA prescription pill (and in some countries a scalp spray) that lowers DHT and is the best-proven drug for stopping male pattern hair loss.
- DutasterideA stronger cousin of finasteride that blocks both forms of the DHT-making enzyme and grew more hair than finasteride in head-to-head trials.
- ClascoteroneA topical androgen blocker already approved as an acne cream whose 5% scalp solution reported positive phase 3 results in men; it is not yet approved for hair.
- PyrilutamideA topical androgen blocker from the Chinese company Kintor that reported positive pivotal results in China; no peer-reviewed efficacy paper yet.
- RU58841A topical androgen blocker from the 1990s that grew hair in animal and graft models but has no human efficacy trial and is sold online as a research chemical.
- Antiandrogen comparison for hair lossA side-by-side of the drugs, topicals and supplements that work on the androgen pathway, with who they were studied in and how strong the evidence is.
- DHT and pattern hair lossPattern hair loss happens when genetically sensitive scalp follicles respond to the hormone DHT by shrinking a little more with every hair cycle.
- Hair loss treatment ladderAn evidence-ranked ladder of options for pattern hair loss in men and in women, with doses as studied and links to the studies, plus where to go for other causes of hair loss.
- The hair growth cycleEvery scalp follicle cycles through growth, shutdown, rest and release on its own clock, which explains normal shedding, seasonal changes, maximum length and how pattern hair loss works.
- Hair loss scales, hairlines and how to classify your own hair lossThe Norwood, Ludwig, Sinclair and BASP scales describe pattern hair loss in broad bands, and this page explains how reliable they are, how well people can stage themselves and how to tell a mature hairline from a receding one.
- Minoxidil forms comparedSolution, foam, oral tablets, sublingual and extended-release minoxidil deliver the same drug in different ways; this page compares them.
- When to see a dermatologistMost gradual thinning is pattern loss you can start treating yourself, but scarring signs, scalp symptoms, patches or sudden shedding should go to a clinician quickly because delay can cost permanent hair.
- Androgenetic alopecia (male and female pattern hair loss)The most common cause of hair loss is an inherited, slowly progressive shrinking of scalp follicles; it cannot be cured, but finasteride, minoxidil and transplants slow, partly reverse or camouflage it.
- Telogen effluviumA temporary burst of diffuse shedding that starts 2 to 3 months after a physical or emotional shock and usually settles within 6 months once the trigger is gone; it does not cause bald patches.
All studies in this guide (9)
Pirastu N et al. GWAS for male-pattern baldness identifies 71 susceptibility loci in 2 UK cohorts. Nat Commun. 2017
Tested: genome-wide association study
Result: 71 loci explaining about 38% of risk; about 50% of men are affected by age 50.
Read the study ↗Kaufman KD et al. Progression of hair loss in men with androgenetic alopecia (male pattern hair loss): long-term (5-year) controlled observational data in placebo-treated patients. Eur J Dermatol. 2008
Tested: no treatment (placebo)
Result: Untreated men lost about 239 hairs (26.3% of density) in the target area over 5 years, and 75% looked worse on photos.
Read the study ↗Olsen EA et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002
Tested: 5% vs 2% topical minoxidil solution vs placebo, twice daily
Result: 5% was superior to 2% and placebo, with about 45% more regrowth than 2% at week 48 and faster onset; itch and irritation were more common with 5%.
Read the study ↗Kaufman KD et al. Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol. 1998
Tested: finasteride 1 mg/day vs placebo
Result: Finasteride grew about 107 more hairs than placebo at 1 year and about 138 more at 2 years in a 5.1 cm2 vertex circle (baseline about 876); placebo men kept losing hair.
Read the study ↗Gan DC, Sinclair RD. Prevalence of male and female pattern hair loss in Maryborough. J Investig Dermatol Symp Proc. 2005
Result: In an Australian town survey, bitemporal recession was present in 98.6% of adult men and 64.4% of adult women, and in none of 140 children.
Read the study ↗Li X et al. Hair Shedding Evaluation for Alopecia: A Refined Wash Test. Clin Cosmet Investig Dermatol. 2022
Result: About 28 shed hairs per wash was normal.
Read the study ↗Ishino A, et al. Contribution of hair density and hair diameter to the appearance and progression of androgenetic alopecia in Japanese men. Br J Dermatol. 2014
Result: In Japanese men aged 25 or older, pattern loss showed up as fewer thick hairs (over 80 micrometres) and more vellus hairs, with density similar to men without loss.
Read the study ↗Yelich A et al. Biotin for Hair Loss: Teasing Out the Evidence. 2024
Result: The utility of biotin as a hair supplement is not supported by high-quality studies.
Read the study ↗Szendzielorz E, Spiewak R. Adenosine as an active ingredient in topical preparations against hair loss: a systematic review and meta-analysis of published clinical trials. Biomolecules. 2025
Tested: adenosine products, mostly 0.75% lotion
Result: All 7 trials were positive but certainty was very low to moderate; pooling 3 trials of the lotion at 6 months was not significant for density (OR 1.03) or thick hairs (OR 1.4).
Read the study ↗