Male Pattern Hair Loss

£195  I Consultation

Hamilton-Norwood Scale - Male Pattern Hair Loss

Male Pattern Hair Loss is common with increasing age, and most men in their 50s and 60s will have a receding hairline. However, Male Pattern Hair Loss may develop as early as in the 20s and 30s and can cause great distress. It often starts with thinning of the hair at the temples and front of the scalp. As it progresses, hair also becomes thin and sparse on the vertex (top) of the scalp. 

The first step in treating any form of hair loss is an accurate diagnosis by a Dermatologist or a Trichologist. Most of the time, the diagnosis of Male Pattern Hair Loss can be made on clinical examination alone. Blood tests may be recommended to look for underlying reasons for hair loss. Rarely, a biopsy of the scalp is necessary to determine the cause of the hair loss.

Treatments are aimed at preventing further hair loss and, if treatment is started early enough, to reverse some of the hair loss.


Currently, there are 2 Licensed treatments in the UK for Male Pattern Hair Loss. Topical Minoxidil (Regaine) comes in a lotion or a foam preparation which is applied to the scalp once a day. There may be an initial hair shedding phase for about 4 weeks, before things settle down. People usually start to notice an improvement in their hair after about 6 months of use. Sometimes Topical Minoxidil can cause scalp irritation with redness, soreness and itching, or the hair becomes dry and frizzy.

Finasteride 1mg daily is a tablet that reduces the activity of an enzyme called 5 alpha-reductase, which is responsible for converting Testosterone to the more potent androgen called Dihydrotestosterone. For some men, reducing the level of Dihydrotestosterone may slow hair loss and possibly help regrowth of hair. Continuous use for 3 to 6 months is required before a benefit is usually seen. A very small number of men may experience decreased libido and erectile problems as a side-effect of taking this treatment (1.5%). Finasteride is harmful to the unborn baby and precautions should be taken to avoid pregnancy in the female partner. Finasteride may be taken in combination with topical or low dose oral Minoxidil. 

Dutasteride is a more potent inhibitor of the enzyme 5 alpha-reductase

Low dose oral Minoxidil is an unlicensed treatment for Hair Loss in the UK. Minoxidil is an old-fashioned treatment for raised Blood Pressure (hypertension), for which a dose of 10-40mg daily is typical. In Male Pattern Hair Loss, low doses of oral Minoxidil are taken, usually starting at a dose of 0.625mg, and increasing over several months to 5mg for Males. Recent scientific publications confirm the efficacy of this treatment and highlight the safety profile of taking low dose oral Minoxidil. A worldwide, multi-centre study of 1404 patients found that the most common side-effect was hypertrichosis or excessive hair growth on the body (15%) which led to 14 people stopping the treatment (0.5%). Other side-effects included lightheadedness, fluid retention, tachycardia, headache, periorbital oedema and insomnia, leading to a further 29 people stopping the treatment (1.2%). Low dose oral Minoxidil may be combined with Finasteride in men.

To begin with, most people are asked to try Topical Minoxidil to see if it prevents progression of the hair loss. If it doesn't help, or if the side-effects are too severe, they may need to consider alternative treatments for the hair loss.

Dermatologists are able to recommend treatments such as oral Finasteride or low dose oral Minoxidil for hair loss. The choice of drug depends on the individual's circumstances and health status. Each drug has potential side-effects and people need to be closely monitored whilst taking the medication with regular clinic visits and blood tests. Pregnancy in the female partner should be avoided whilst taking any of these medications.

The Hair Loss Consultation includes an examination of the scalp to help make a diagnosis, and advice on any necessary tests or investigations. In addition, the Consultation covers the use of cosmeceuticals and nutraceuticals in the management of hair loss, including advice on products that help to volumise hair, and those that camouflage bald or thin areas. Prescriptions are only issued where it is safe to do so, and depends on clinical need. The fee for blood tests and biopsies are in addition to the consultation fee.