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

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

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

Many men notice 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 cause self-consciousness, 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 the most sense to take action.

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 gradually causes the hair follicles to shrink, a process known as hair follicle miniaturisation. The hairs become finer, shorter and less visible, until the hair growth cycle stops completely.

Genetic predisposition largely determines how sensitive your hair follicles are to DHT, and this predisposition can come from either side of the family.

A recent review shows that the shrinking of the hair follicles begins long before it is visible to the naked eye. Age accelerates the process, but genetic sensitivity to DHT is the most important determining factor. Hormones, stress and nutritional deficiencies play a supporting role, but are rarely the sole cause.

What are the first signs of thinning hair?

The earliest signs are subtle. You notice more hair on your pillow, in the shower drain or on your brush. Your parting seems to be getting wider, or you can see your scalp through your hair in bright light.

Receding hairlines that gradually deepen are another classic sign. This is how many men describe their experience when looking back on how it began.

A review concludes that early intervention yields the best results, as treatments can preserve existing hair but find it difficult to fully restore hair that has been lost. Are you unsure whether what you’re seeing is normal hair shedding or the start of hair loss? An online consultation with Fellos provides quick 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 to affect more than half of men over the age of fifty, but can begin as early as your twenties or thirties. The causes of hair loss and how to prevent it are described in the Norwood scale, a seven-stage classification system that charts the progression of hair loss from mild receding hairline to complete baldness on the crown.

As well as a genetic predisposition, other factors may also play a role. Hormonal changes caused by thyroid disorders or increased stress levels can disrupt the hair cycle. A deficiency in zinc, vitamin D or iron can negatively affect 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 treatments have been scientifically proven to be effective: finasteride and minoxidil. Finasteride acts as a 5-alpha-reductase inhibitor, blocking the conversion of testosterone to DHT. Taking 1 mg orally every day is sufficient to significantly reduce DHT levels. Research shows that in 83% of men, hair loss stops with finasteride, with a visible increase in hair of +10% after less than a year and +24% after more than a year’s use.

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

The combination of both treatments has been shown to be the most effective. Research emphasises that hair loss stops in 94% of men who combine finasteride and minoxidil. Fellos works exclusively with registered prescription-only medicines, prescribed following assessment by a Dutch doctor.

Side effects are a real possibility and should be clearly stated. Finasteride may cause loss of libido, erectile dysfunction, reduced semen volume and feelings of depression. 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 treatment.

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

How soon will you see results from treatment?

Hair regrowth takes time. This is also described in how minoxidil stimulates hair growth: the first visible effect occurs after around four months. Finasteride takes three to six months to produce visible changes, but the maximum results from both treatments are only achieved after two years.

Consistent use is essential. If you stop using minoxidil, hair loss will return within three to four months, as the treatment does not eliminate the cause but merely slows down the process. The same applies to finasteride: as soon as you stop, DHT levels rise again and hair loss resumes. Treatment is therefore a long-term commitment, 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 tightly on the scalp, 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. Hairstyles designed for thinning hair can also make it look fuller whilst your treatment takes effect.

A varied diet containing sufficient protein, zinc and iron lays a good foundation for hair growth. Sleep and stress management have a direct impact on the hair cycle. These measures are beneficial, but in cases of hereditary hair loss, they do not alter the underlying effects of DHT.

How does Fellos help with thinning hair?

Fellos offers a fully online programme: you start with an initial assessment, during which a Dutch doctor evaluates your situation and draws up a personalised treatment plan. Prescription medication is discreetly delivered to your home, without the need to visit a pharmacy or clinic. Fellos then supports you with follow-up care and medical advice should you have any questions about side effects or usage.

Ready to get started? Find out how you can treat hair loss with Fellos and complete the online assessment.