Reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Androgenetic alopecia, or male pattern baldness, is an all-too-common problem for men. In fact, an estimated 50 percent of men develop some signs of hair loss, such as a receding hairline or thinning around the crown, by the age of 50.
While hair loss might seem straightforward, there’s far more to going bald than simply losing hair over the course of a few years or decades.
One key aspect of hair loss is hair miniaturization -- a process in which your hair follicles slowly become smaller and less capable of producing new hairs. Over time, miniaturization can affect your hair density, causing everything from mild hair shedding to near-total, severe hair loss.
The symptoms of hair miniaturization are fairly self explanatory: smaller, thinner and more brittle hair that makes for a weakened coif, and one that generally requires more attention and gentler handling to keep intact, even as additional hair loss sets in.
The good news is that if you’re starting to experience hair loss, there are several things that you can do to stop the hair miniaturization process and maintain healthy hair growth.
Below, we’ve listed the causes of hair follicle miniaturization, as well as the symptoms you might notice if your hair follicles gradually begin to shrink.
We’ve also shared the most effective treatments for thinning hair and miniaturized follicles, from hair loss medications such as finasteride to procedures such as hair transplant surgery.
Hair follicle miniaturization is exactly what it sounds like -- a process in which your hair follicles gradually constrict, affecting your ability to maintain normal hair growth.
Your hair follicles are tiny, tunnel-like structures located throughout your body, including on your scalp, face and body. Hair grows from your follicles as part of a multi-phase hair cycle, referred to as the hair growth cycle.
During this cycle, your hair passes through distinct stages as it grows to its full length, becomes dormant and eventually detaches from your scalp, allowing a new hair to take its place.
Miniaturization occurs when some of your hair follicles become physically smaller, causing new hairs to lose part of their hair shaft thickness and grow less effectively.
Put simply, the miniaturization of hair follicles shrinks and weakens your hair, eventually leading to hair that’s incapable of penetrating through your scalp.
Hair follicle miniaturization is extremely common, and progressive miniaturization is considered a hallmark of several common types of hair loss.
These include male pattern baldness, female pattern hair loss and alopecia areata (AA), a form of hair loss caused by an autoimmune reaction within your body.
The process of how miniaturized hairs develop is long and complicated, involving both genetic factors and certain hormones that are produced by your body. Here’s a quick-hit version of how it works:
Over time, just about everyone experiences some amount of pattern hair loss, or androgenetic alopecia. For some men, this process starts early in life, while for others, hair loss may remain virtually invisible under their 50s, 60s or even 70s.
This type of hair loss occurs when a hormone called dihydrotestosterone (DHT) attaches itself to receptors throughout your scalp and causes your hair follicles to shrink.
DHT is created inside your body as a key byproduct of testosterone. It’s an important hormone early in your life, as it plays a major role in the development of secondary sex characteristics in men, such as your voice and body hair.
As an adult, DHT can damage your hair follicles, causing them to gradually shrink in size and stop producing terminal hairs -- the thick, pigmented hairs that account for the majority of your scalp hair.
It can also lead to the development of vellus hairs -- thin, lightly-colored hairs that are smaller than terminal hairs and difficult to see.
The final result of this is that areas of your scalp that were previously full of coarse, lush, thick hairs can become noticeably thin, with finer, lighter-colored hairs that don’t provide very much scalp coverage.
In addition to exposure to DHT, other factors can also cause your hair follicles to gradually get smaller and produce thinner, finer hairs.
For example, another cause of hair miniaturization is alopecia areata. This form of hair loss is caused by your immune system attacking your hair follicles, causing them to gradually shrink and stop producing healthy hairs.
Miniaturization from alopecia areata generally affects the hair follicles on your scalp and face, causing small patches of hair loss.
The most common symptom of hair miniaturization is hair loss, which could develop near your hairline, around your crown (the area at the top of your scalp), or in the form of diffuse thinning that affects your entire scalp.
If you’re starting to develop hair loss due to hair miniaturization, you may notice the corners of your hairline slowly moving upwards, creating a more pronounced V or M shape.
You may also notice that your hair seems to shed more easily than before, especially when it’s brushed or washed. For example, you might notice more hairs on your pillow, in your shower’s drain catch, or in your hair brush than you did a few years ago.
Our guide to the early signs of baldness goes into more detail about these symptoms and how they can manifest as your hair follicles miniaturize.
Over time, hair miniaturization can have a noticeable impact on your hair, causing anything from a mild decrease in hair density and hair thinning to an obvious pattern of hair loss.
The good news is that there are proven options available for either slowing down or stopping the hair miniaturization process, allowing you to maintain your hair and, in some cases, even regrow hair that’s starting to thin and fall out.
Finasteride is an FDA-approved prescription medication for male pattern baldness. It works by preventing your body from converting testosterone into DHT, the hormone that can miniaturize your hair follicles.
Research shows that finasteride reduces DHT levels by approximately 70 percent on average, which is enough to either slow down, stop or reverse hair loss in men.
By reducing DHT levels, finasteride can prevent DHT from harming your hair and causing your follicles to miniaturize. This can lead to thicker hair in your frontal scalp, crown and other areas that are often affected by male pattern baldness.
For example, one study published in the journal Dermatologic Therapy found that 80.5 percent of balding men showed improvements after taking finasteride for 12 months.
We offer finasteride online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate.
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Minoxidil is a topical, over-the-counter hair loss medication. Although it doesn’t block DHT and prevent hair follicle miniaturization directly, it can reduce many forms of hair loss by increasing the speed of your hair follicle cycling process and putting your hair in a growth phase.
Minoxidil may also increase blood flow to your scalp, ensuring your hair follicles have access to the nutrients required for consistent growth.
Research shows that minoxidil is effective on its own, but it’s especially effective when it’s used with finasteride. In the same study linked above, more than 94 percent of balding men showed improvements after using finasteride and minoxidil for one year.
Hair transplant surgery, or surgical hair restoration, is a surgical procedure that involves moving healthy hair follicles from the back and sides of your scalp to your hairline, crown or other areas with significant follicular miniaturization.
Although getting a hair transplant won’t stop the miniaturization process, it can “replace” follicles that have been damaged by DHT with healthy hair follicles from elsewhere on your scalp.
This can provide additional coverage and create the appearance of a thicker head of hair if you have thinning around your hairline or crown.
Our guide to hair transplants provides more information about this type of procedure, as well as its costs, potential complications and more.
Generic for Rogaine®, this FDA-approved over-the-counter version of topical minoxidil is used for regrowth on the crown of the head.
This is the FDA-approved dynamic duo. When used together, men saw better results in clinical trials compared to using either alone.
If you’re looking for something effective but don’t want too many steps in your routine, this once-a-day pill could be right for you.
Clinically proven to regrow hair in 3-6 months, no pills required.
If you’ve recently started to notice signs of hair follicle miniaturization, it’s best to take action as soon as you can to prevent it from getting worse.
Our range of hair loss products includes proven, FDA-approved options for preventing follicular miniaturization from progressing, including medications such as finasteride that block DHT and shield your hair follicles from damage.
Want to find out more before you get started? Our guide to the best treatments for thinning hair goes into more detail about how medications like finasteride work, as well as your other options for protecting your hair follicles from the miniaturization process.