Thinning hair in men: what causes it and what can you do about it?

Thinning hair in men: What are the causes and what can be done about it?

Short answer: Thinning hair in men is usually caused by genetic predisposition and the hormone DHT, which causes the hair follicles to gradually shrink. Proven treatments such as finasteride and minoxidil can halt hair loss and, in many cases, restore hair growth.

Many men realise at some point that their hair is thinning. Sometimes it starts at the crown or the temples; sometimes it spreads across the whole head. This can lead to a lack of confidence, but thinning hair is perfectly normal and – as fewer people realise – often easily treatable. This article explains how thinning hair develops, which treatments really work and when it makes most sense to seek treatment.

How does thinning hair develop?

Thinning hair in men is almost always caused by the hormone dihydrotestosterone, better known as DHT. DHT is a by-product of testosterone and binds to receptors in the hair follicles. This causes the hair follicles to gradually shrink – a process known as hair follicle miniaturisation. The hairs become finer, shorter and less visible until the hair cycle comes to a complete standstill.

Genetic predisposition plays a key role in determining how sensitive your hair follicles are to DHT, and this predisposition can be inherited from either side of the family.

A recent review shows that the shrinkage of hair follicles begins long before it can be detected with the naked eye. Age accelerates the process, but genetic sensitivity to DHT is the most important determining factor. Hormones, stress and nutrient deficiencies play a contributing role, but are rarely the sole cause.

What are the first signs of thinning hair?

The earliest signs are barely noticeable. You may notice more hair on your pillow, in the shower drain or on your hairbrush. Your parting seems to be widening, or you can see your scalp through your hair in bright light.

Another classic sign is a gradually receding hairline. This is how many men describe their experiences when they look back on how it all began.

A review study concludes that early intervention yields the best results, as treatments can preserve existing hair, but lost hair is difficult to fully restore. Are you unsure whether what you’re seeing is normal hair shedding or the onset of hair loss? An initial online consultation with Fellos will quickly provide clarity.

What are the main causes of thinning hair in men?

Hereditary hair loss, also known as androgenetic alopecia, is by far the most common cause. It is estimated that more than half of men over 50 are affected, though hair loss can begin as early as around the age of 20 or 30. The causes of hair loss and how to prevent it are described in the Norwood Scale, a seven-stage classification system that maps the progression of hair loss from mild receding hairline to complete baldness at the crown.

As well as a genetic predisposition, other factors can also play a role. Hormonal changes caused by thyroid disorders or increased stress levels can disrupt the hair growth cycle. A deficiency in zinc, vitamin D or iron can have a negative impact on hair growth. These factors exacerbate an existing predisposition, but are rarely the sole cause of structurally thinning hair.

Which treatments really help with thinning hair?

Two active ingredients have been scientifically proven to be effective: finasteride and minoxidil. Finasteride acts as a 5-alpha-reductase inhibitor, blocking the conversion of testosterone into DHT. A daily oral dose of 1 mg is sufficient to significantly reduce DHT levels. Studies show that finasteride halts hair loss in 83% of men, with visible hair volume increasing by +10% after less than a year and by +24% after more than a year.

Minoxidil works differently: it is a topical vasodilator that improves blood flow to the hair follicles and reactivates dormant follicles. The standard dosage is 1 ml of the 5 per cent solution applied to the dry scalp twice daily. According to the Medicines Information Bank (CBG-MEB), Minoxidil Biorga 5 per cent is an authorised medicine for treating male pattern hair loss. A comparative review shows that 73 per cent of users benefit from minoxidil.

The combination of both treatments has been shown to be most effective. Studies show that hair loss is halted in 94 per cent of men who combine finasteride and minoxidil. Fellos works exclusively with authorised prescription-only medicines, which are prescribed following an assessment by a Dutch doctor.

Side effects are a reality and should be clearly stated. Finasteride may cause loss of libido, erectile dysfunction, reduced semen volume and depressive moods. In rare cases, more serious side effects have been reported, including suicidal thoughts, breast cancer in men and what is known as post-finasteride syndrome, in which symptoms persist after stopping the medication.

With minoxidil, temporary hair loss sometimes occurs in the initial phase: increased hair shedding in the first few weeks. This is a normal sign that the treatment is working and is no reason to stop the treatment. Localised skin irritation is another known side effect.

How quickly do you see results from treatment?

Hair regrowth takes time. This is also described in ‘How Minoxidil Stimulates Hair Growth’: the first visible effects appear after around four months. Finasteride takes three to six months for visible changes to occur, but the maximum results from both treatments are only achieved after two years.

Consistent use is essential. If you stop treatment with minoxidil, hair loss will return within three to four months, as the treatment does not eliminate the cause but merely inhibits the process. The same applies to finasteride: as soon as you stop taking it, DHT levels rise again and hair loss resumes. Treatment is therefore a long-term commitment and not a short-term cure.

What can you do yourself to keep your hair healthy?

A healthy lifestyle supports hair growth but is no substitute for medical treatment. Avoid hairstyles that pull the scalp too tightly, such as tight plaits or ponytails, as prolonged tension can damage the hair follicles. Harsh hair colouring or frequent heat styling makes the hair more brittle. Certain hairstyles for thinning hair can also make your hair appear fuller whilst your treatment takes effect.

A varied diet with sufficient protein, zinc and iron provides a good foundation for hair growth. Sleep and stress management have a direct influence on the hair cycle. Whilst these measures are beneficial, they do not alter the underlying effect of DHT in cases of hereditary hair loss.

How does Fellos help with thinning hair?

Fellos offers a treatment programme carried out entirely online: you start with an initial consultation, during which a Dutch doctor assesses your situation and draws up a personalised treatment plan. Prescription medication is delivered discreetly to your home, without having to visit a pharmacy or clinic. Fellos then supports you with aftercare and medical advice should you have any questions about side effects or how to use the treatment.

Ready to get started? Find out how you can treat hair loss with Fellos and book your online initial consultation.

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