Androgenic Alopecia

Seeing more hair in the shower or on your pillow is stressful. Androgenic alopecia — often called male- or female-pattern hair loss — is the most common reason. It’s driven by genes and androgens (male hormones). That means hair follicles slowly shrink under the influence of DHT, producing thinner hair until growth stops. The good news: there are clear, practical steps that help many people slow or reverse the process.

How it works and who gets it

Follicles are sensitive to dihydrotestosterone (DHT). If your follicles inherit that sensitivity, hair thins in predictable patterns: a receding hairline and crown thinning in men, diffuse thinning at the top in women. It usually starts in your 20s–40s, but timing varies. Doctors diagnose it by looking at the pattern and history; blood tests or scalp biopsy are rarely needed unless another cause is suspected.

Risk factors that speed things up: family history, male hormones, smoking, poor nutrition, and chronic stress. Some medications or medical problems can mimic pattern loss, so a quick check with a dermatologist can rule out treatable causes like thyroid issues or iron deficiency.

Treatments that work — what to try first

Start with the two treatments backed by the most evidence: topical minoxidil and oral finasteride (for men). Minoxidil is over-the-counter, applied to the scalp daily. It can thicken hair and keep hair you still have. Expect 3–6 months to see results, and you must keep using it or gains fade.

Finasteride is a prescription pill that lowers DHT. Many men see slowed loss and new growth after several months. Be aware of side effects — some men report lowered libido or erectile issues. Talk to your doctor before starting and revisit treatment regularly.

For women, oral anti-androgens like spironolactone or combined oral contraceptives help when androgens play a role. Pregnant women should avoid certain medications. Topical minoxidil is safe for many women and often the first step.

If meds aren’t enough, procedures can help: hair transplant surgery moves healthy follicles into thinning areas; platelet-rich plasma (PRP) injections stimulate growth in some people; low-level laser devices can give modest benefit. These cost more and results vary — ask a specialist for realistic expectations.

Small changes help too: treat your scalp gently, avoid tight hairstyles, quit smoking, eat a protein-rich diet with enough iron and vitamin D, and manage stress and sleep. Supplements like biotin only help if you’re deficient; they aren’t magic fixes.

If you notice sudden or patchy hair loss, rapid shedding, or other symptoms (scalp pain, scaling), see a doctor fast. For slow pattern loss, expect to test a treatment for at least 6 months before judging success. Keep photos to track progress — they show changes you might miss day to day.