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Androgenetic Alopecia: Causes & Treatment Options

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Grace Gallagher

Published 04/21/2021

Updated 05/03/2024

If you’re reading this because you’re losing your hair, you’re not alone — hair loss is a common issue affecting more than half of men by the time they’re in their forties. The most common type of hair loss is androgenetic alopecia, or androgenic alopecia. This condition is also referred to as male pattern baldness when it occurs in men and female pattern hair loss when it occurs in — you guessed it — women.

Symptoms of androgenetic alopecia may include a receding hairline, thinning hair, and hair loss that affects the crown (or vertex) of your head.

Below, we’ve explained how and why androgenetic alopecia develops, as well as effective treatment options for androgenetic alopecia.

Androgenetic alopecia, or pattern hair loss, is a form of hair loss that’s caused by a mix of genetic and hormonal factors.

Here’s a little cheat sheet on androgenetic alopecia:

  • If you have androgenetic alopecia, you may notice your hairline receding and developing an “M” shape. You may also develop thinning or total hair loss on your scalp, particularly at your crown.

  • Dihydrotestosterone, or DHT, is the hormone responsible for androgenetic alopecia.

  • Androgenetic alopecia is treatable. Right now, several medications are available to slow down, stop, or even reverse this form of hair loss, including FDA-approved treatments like finasteride and minoxidil.

  • Hair loss from androgenetic alopecia tends to get worse over time and with age, making it important to take action and start treatment as soon as you notice symptoms.

If you’re wondering about alopecia vs. male pattern baldness, know that alopecia is just an umbrella term for all types of hair loss.

There are different types of alopecia, including an autoimmune disorder known as alopecia areata, alopecia univeralis (when hair falls out all over the body), and telogen effluvium, which occurs when hair loss falls out after an illness or stressful event. But for this article, we’re focusing on androgenetic alopecia.

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Androgenetic alopecia is caused by a combination of factors including genetic predisposition and the effects of male sex hormones called androgens.

More specifically, androgenetic alopecia is caused by a genetic sensitivity to an androgen called DHT.

Your body creates DHT as a byproduct of testosterone, the main androgen hormone in the male body. You need DHT to develop male features before birth and during adolescence, such as your external genitals, facial hair, and prostate gland.

However, as you get older, your body’s relationship with DHT sours. DHT can damage your hair follicles, causing miniaturization, and hairs affected by DHT become thinner and shorter with a more fragile shaft, and ultimately stop producing new hair.

Plus, DHT also shortens the anagen (growth) phase of the hair growth cycle, which means the hair isn’t given as much opportunity to grow, so the length of each hair shaft is reduced.

It’s also worth noting that some men are more sensitive to DHT than others — which is primarily where genetics comes into play when it comes to balding. If you’re more sensitive to DHT, you can start losing your hair as early as your teens and twenties.

If you’re not sensitive to it, you might not start seeing thinning until much later.

Research shows that men with hair loss tend to have higher levels of DHT than their peers, as well as a greater number of androgen receptors in the scalp.

Is There a Male Baldness Gene?

Research has found that variations in the AR gene on the X chromosome, which instructs the body about how to create androgen receptors, may contribute to androgenetic alopecia.

Contrary to popular belief, while there’s definitely a strong genetic component to baldness, there’s no evidence that androgenetic alopecia is inherited from your mother’s father or any other specific family member.

There’s also no science behind the idea that male pattern baldness skips a generation — it can sometimes, but doesn’t follow any pattern.

The most common, obvious symptom of androgenetic alopecia is a pattern of hair loss, particularly that which develops in a specific pattern (typically in the M shape we mentioned above). Other signs of androgenetic alopecia include thinning hair and a receding hairline.

It’s normal to shed between 50 and 100 hairs per day. These hairs fall out as a natural result of your hair growth process, during which your hair grows to its normal length, rests and eventually sheds as new hair takes its place.

Symptoms can also vary depending on how severe your balding is. While some men develop total baldness, others only lose a small amount of hair around the hairline or crown.

Male pattern baldness is like height in that it’s coded into your DNA from birth, and there’s not much you can do to change that. Research done on twins have found that genetic factors account for about 80 percent of the baldness equation. The other 20 percent of the pathogenesis is a mix of hormones, lifestyle and environmental factors.

The not-great news is that there’s no known way to prevent male pattern baldness. But the better news is that there are things you can do to slow its progression.

If you’re noticing hair thinning or you come from a long line of strapping bald men, the best thing you can do to prevent baldness is to start treatment of androgenetic alopecia early.

It’s typically much easier to hold on to the hair you have than it is to regrow hair that’s already been lost, as hair loss treatments primarily help prevent further hair loss. While they can and may regrow some of what you’ve lost, it’s not a horse you should bet the farm on.

You don’t need a formal diagnosis for androgenetic alopecia to start treating it. And unfortunately, even if a dermatologist confirms that you have male pattern baldness, it doesn’t mean that insurance is any more likely to cover hair loss medications or procedures.

That said, here’s how androgenetic alopecia is generally diagnosed in the dermatology field.

  • You will be asked about your specific hair loss, including when it began and any family history of baldness.

  • Your healthcare provider may take a hair sample to send to a lab.

  • Some dermatologists use the Norwood scale, a classification system that measures the extent of male pattern baldness.

  • Your healthcare provider may perform a hair pull test, where they test 20 to 60 close to the base of your scalp. They’ll gently tug on the hairs and if more than 10 percent of the strands come loose from your scalp, it’s generally considered a sign that your hair loss is beyond typical shedding.

  •  A scalp biopsy usually isn’t required, but one may be performed if there’s some confusion about what type of hair loss you have.

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Androgenetic alopecia isn’t preventable, but it is treatable. By acting quickly and seeking treatment as soon as you start to notice your hair shedding, you can usually slow down or stop any further hair loss.

In some cases, it may also be possible to regrow hair along your hairline, near your crown or in other areas with noticeable thinning.

Currently, the most effective treatments for androgenetic alopecia are the medications minoxidil and finasteride. We’ve explained how these medications work below.

Minoxidil

Minoxidil is a medication that stimulates hair growth. While its precise mechanism of action is still unknown, the most popular theory is that it forces hair to enter the anagen phase (the growth portion) of the hair growth cycle and stimulates blood flow to the scalp (and the hair follicles on it).

Research shows that minoxidil helps to treat androgenetic alopecia. In a large-scale study, 84.3 percent of men with androgenetic alopecia who were treated with minoxidil for 12 months rated it as either very effective, effective or moderately effective at stimulating hair regrowth.

We offer minoxidil online as a topical solution in two formulations — a topical minoxidil foam and a liquid solution (both at 5% strength). They work the same way but have unique benefits. Some people with longer hair think the liquid solution is easier to apply since it has a dropper that gets past the hair. The foam doesn’t drip and is basically mess-free to apply.

More recently, for people who aren’t keen on the clean-up of applying minoxidil topically, minoxidil has become available as an oral medication. While it hasn’t yet gained FDA approval, the research available for it shows it works comparably effectively to topical minoxidil.

We offer oral minoxidil as part of our Minoxidil + Supplement Blend daily chew, which includes 3mg minoxidil and is meant to be taken daily.

Our guide to applying minoxidil explains how you can use this medication to prevent and reverse androgenetic alopecia hair loss.

Finasteride

Finasteride is a medication that reduces your body’s production of DHT, the hormone that causes androgenetic alopecia. If you’re into medical terminology, it’s a type of medication called a 5-alpha reductase inhibitor. In simpler terms, finasteride works by blocking DHT, which helps to slow down or stop the DHT-related damage to your hair follicles that causes hair loss.

Research shows that finasteride can slow down, stop and even reverse hair loss. For example, two one-year trials found that men with androgenetic alopecia who took finasteride daily saw a measurable improvement in hair growth (the men who took a placebo continued to lose hair throughout the study).

Topical finasteride is also quickly picking up speed as a hair loss treatment, as well. Like oral minoxidil, topical finasteride isn’t yet approved for use as a hair loss treatment by the FDA, but the research we have so far indicates that it’s a comparable alternative to oral finasteride.

For instance, one 2018 analysis of more than 440 patients compared the efficacy of topical finasteride vs oral finasteride and found that the spray significantly improved overall hair count at the end of 24 weeks, but les of an impact on serum DHT levels in the body.

This analysis also hypothesized that because serum DHT levels weren’t as highly affected by topical finasteride, some of oral finasteride’s more troublesome side effects — like sexual dysfunction, for instance — may be less pronounced.

We offer finasteride online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate. Finasteride is FDA-approved to treat male androgenetic alopecia but not female pattern baldness.

Finasteride & Minoxidil Together

You don’t have to choose one or the other when it comes to finasteride and minoxidil. In fact, research shows that finasteride and minoxidil are actually most effective at treating androgenetic alopecia when used together.

You can buy the two together in our Hair Power Pack, which contains oral finasteride and topical minoxidil, or in our topical finasteride & minoxidil spray where they’re combined into one product.

In some cases, other medications like spironolactone may be prescribed off-label for hair loss. This is typically only used in women and not in men, because in men it can lead to gynecomastia (growth of breast tissue).

Low-Level Light Therapy

There isn’t much research on the efficacy of low-level light therapy for hair loss, but the research we do have is promising, and there appear to be few risk factors.

A meta-analysis of several different hair loss treatments found low-level light therapy to be effective at promoting hair growth in men with androgenetic alopecia.

Done in-office or at home wearing a lighted cap, LLLT stimulates hair follicles to re-enter the anagen phase.

Platelet-rich plasma

Platelet-rich plasma (PRP) therapy is when a healthcare provider injects your own blood into your scalp. More research is needed on PRP and male pattern baldness specifically, but a 2019 review of clinical studies found that PRP treatment prolonged the anagen phase, which could be helpful as androgenetic alopecia causes hair to exit the anagen phase prematurely.

Hair Transplant Surgery

A hair transplant surgery involves transplanting DHT-resistant hairs from the sides and back of your scalp to areas with hair loss, such as your hairline and crown.

It doesn’t actually regrow new hair (and it can be very expensive), but when performed correctly, it can produce a convincing, natural-looking result. There are several different types including stem cell hair transplants and synthetic hair transplants.

Want to learn more? Check out our guide, Hair Transplants: Cost, Time and Side Effects.

Hair Care Products & Habits

Because androgenetic alopecia is caused by genetic and hormonal factors, making changes to your habits won’t completely stop your hair loss. But there are certainly lifestyle tweaks that can help you manage hair loss, especially when these changes are combined with treatments like minoxidil and finasteride. Here are some things you can do at home:

  • Use a hair loss prevention shampoo. Shampoos containing ingredients such as saw palmetto and ketoconazole may help to slow down and prevent hair loss. Our Thick Fix Shampoo is designed to promote volume and moisture while reducing scalp buildup.

  • Eat a balanced diet. Although there’s no food that can prevent androgenetic alopecia, many foods are rich in vitamins and minerals that can stimulate growth and keep your hair healthy.

  • Avoid overly tight hairstyles. Hairstyles that put pressure on your hair, like dreadlocks or braids, can damage the hair follicles and cause traction alopecia, a type of hair loss most common in people with tight, spiraling hair. It’s different from androgenetic alopecia but often produces similar symptoms.

Our guide to how to make hair grow faster for men offers more information about proven habits that you can implement to keep your hair healthy.

Male Pattern Baldness is usually permanent and tends to worsen over time. Still, there are things you can do to slow its progression or even stop it in its tracks.

And remember: male pattern baldness is not a medical disorder, and so if it does not bother you, there’s nothing you need or should do (except please wear sunscreen on your scalp).

Hair loss may affect confidence or cause anxiety in some people. In fact, according to one study, some of the psychological factors associated with hair loss, like anxiety, depression, decreased confidence and social withdrawal are also seen in people with severe life-threatening diseases. So, while hair loss itself is not a medical disorder, it can have debilitating side effects.

While androgenetic alopecia is not preventable, you don’t have to live with the psychological consequences of hair loss. It can be helpful to see a counselor or join a support group if hair loss is negatively impacting your life in any way.

Interestingly, androgenetic alopecia is associated with several other men’s health issues, some of which may be influenced by DHT.

For example, research has found that androgenetic alopecia is linked to cardiovascular diseases like coronary heart disease. It’s also associated with issues such as benign prostatic hyperplasia (BPH), diabetes, high blood pressure (hypertension), obesity and prostate cancer.

One study examined data from over 30,000 participants and found that male pattern hair loss was associated with an increased risk of certain skin cancers.

While these links are interesting, it’s important to understand that losing your hair doesn’t mean that you’ll necessarily develop any of these conditions or vice-versa. Balding is simply an (imperfect) indication that you could be at a higher risk for certain diseases.

Hair loss treatments, delivered

What is androgenic alopecia? Hopefully, you now have a better understanding of this type of hair loss, which goes by many names, including male pattern baldness, pattern alopecia and androgenetic alopecia. Here are the cliff notes on the most common cause of hair loss.

  • Androgenetic alopecia, or male pattern baldness, is a common form of hair loss that can occur in your 20s, 30s, 40s or later in your life Over time, this hair loss may cause your frontal hairline to take on an M-shaped appearance, with more skin visible in the areas near your temples.

  • If you’re affected by androgenetic alopecia, hair loss treatments such as minoxidil and finasteride can prevent this form of hair loss from becoming worse over time.

  • Medical treatments like low-level light therapy, platelet-rich plasma or hair transplants can also help slow or reverse balding.

Want to learn more? Our guide to the early signs of baldness explains the symptoms you may notice if you’re losing your hair, as well as the proven steps that you can take to stop hair loss.

22 Sources

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  2. Ho CH, Sood T, Zito PM. Androgenetic Alopecia. [Updated 2020 Sep 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430924/
  3. Kinter, K.J. & Anekar, A.A. (2021, March 13). Biochemistry, Dihydrotestosterone. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK557634/
  4. Ho, C.H., Sood, T. & Zito, P.M. (2020, September 29). Androgenetic Alopecia. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430924/
  5. Androgenetic alopecia. (2020, August 18). Retrieved from https://medlineplus.gov/genetics/condition/androgenetic-alopecia/
  6. AAD. (n.d.) Do you have hair loss or hair shedding? Retrieved from https://www.aad.org/public/diseases/hair-loss/insider/shedding
  7. Badri, T., Nessel, T.A. & Kumar, D.D. (2020, May 4). Minoxidil. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482378/
  8. Rundegren, J. (2004, March 1). A one-year observational study with minoxidil 5% solution in Germany: results of independent efficacy evaluation by physicians and patients. Journal of the American Academy of Dermatology. 50 (3), 91. Retrieved from https://www.jaad.org/article/S0190-9622(03)03692-2/fulltext
  9. Kaufman, K.D., et al. (1998, October). Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. Journal of the American Academy of Dermatology. 39 (4 Pt 1), 578-89. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9777765/
  10. Hu, R., et al. (2015, June 2). Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients. Dermatologic Therapy. 28 (5), 303-308. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/dth.12246
  11. Zito PM, Raggio BS. Hair Transplantation. [Updated 2021 Mar 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547740/
  12. Ustuner, E. T. (2013). Cause of Androgenic Alopecia: Crux of the Matter. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4174066/
  13. Asfour, L., Cranwell, W., Sinclair, R. (Updated 2023, Jan).Male Androgenetic Alopecia. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK278957/
  14. Hagenaars, S. P., Hill, W. D., Harris, S. E., Ritchie, S. J., Davies, G., Liewald, D. C., Gale, C. R., Porteous, D. J., Deary, I. J., & Marioni, R. E. (2017). Genetic prediction of male pattern baldness. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308812
  15. Trüeb, R. M. (2021). Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719969/
  16. AAD. (n.d.) What is male pattern hair loss, and can it be treated? https://www.aad.org/public/diseases/hair-loss/treatment/male-pattern-hair-loss-treatment
  17. Dhurat, R., Saraogi, P. (2009). Hair Evaluation Methods: Merits and Demerits. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938572/
  18. Avci, P., Gupta, G. K., Clark, J., Wikonkal, N., & Hamblin, M. R. (2014). Low-Level Laser (Light) Therapy (LLLT) for Treatment of Hair Loss. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944668/
  19. Stevens, J., & Khetarpal, S. (2019). Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374694/
  20. Pulickal JK, Kaliyadan F. Traction Alopecia. [Updated 2023 Aug] StatPearls [Internet]. StatPearls Publishing; 2021 Jan. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK470434
  21. Dhami, L. (2021). Psychology of Hair Loss Patients and Importance of Counseling. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719979/
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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