Zoom on baldness treatment

Baldness is treated in most articles as one condition with a menu of solutions. It is nearer to four different conditions that happen to look alike from a distance, and the treatment that transforms one of them does nothing at all for another.

What counts as baldness, and what does not

Baldness is not heavy shedding, it is hair that stops being replaced. A scalp carries somewhere around 100,000 hairs, of which roughly 85 to 90% are actively growing at any moment and 10 to 15% are resting before they let go. The NHS puts normal daily loss at 50 to 100 hairs, and almost nobody notices them.

What changes in baldness is the replacement, not the loss. Follicles either shrink until the hair they produce is too fine and short to cover anything, or they stop producing altogether. That distinction explains why counting hairs in the plughole tells you far less than looking at your parting in a mirror once a month.

Four patterns, four different outcomes

Androgenetic, the common one

This is pattern hair loss, and it accounts for the large majority of cases in both men and women. A combination of genetic and hormonal factors, with dihydrotestosterone progressively miniaturising the follicle, makes each successive hair finer until the follicle stops. Prevalence figures collected in clinical reviews put it at roughly 50% of men by 50 and around 80% by 70, with Caucasian populations most affected, then Asian and African American, then Native American and Inuit.

It can start any time after puberty, and around a quarter of men notice the first signs before 21. In men it shows at the temples and crown; in women it is more diffuse, widening the parting rather than creating a bald patch, and it becomes markedly more common after the menopause.

Diffuse, spread across the whole scalp

Diffuse shedding is usually telogen effluvium, and it is the one that most often reverses. Something pushes a large batch of follicles into the resting phase at once, and they release together two to three months later. Childbirth, surgery, a high fever, thyroid disorders, iron deficiency, crash dieting and severe emotional stress are the recognised triggers. It commonly settles within six to twelve months once the underlying cause is addressed, and the hair regrows.

Patchy, in defined circles

Coin-sized bald patches with normal skin underneath are alopecia areata, an autoimmune condition where the immune system attacks the follicle. The prognosis is far better than most people assume: the British Association of Dermatologists states that four out of five affected people see complete regrowth within a year without any treatment, though those who lose more than half their hair at the outset have roughly a one in ten chance of full recovery.

Two points worth correcting here. About two in ten people affected have a family history, so genetics matter more than is usually said. And stress, routinely named as the main cause, is described by the BAD as one theory among several, with the association possibly coincidental, since no trigger can be identified in many people at all.

Congenital, the rare one

Congenital hair loss is by far the rarest form and is present from the start of life, with follicles that are absent or abnormally formed rather than damaged later. Because there is nothing to reactivate, the treatments that work on the other three patterns have no target. It affects women and men alike.

Which treatment matches which pattern

Minoxidil is a topical solution or foam, licensed at 5% for men and at 2% for women, and it needs at least six months of continuous use before it can be judged. Finasteride is a 1 mg daily tablet for men that lowers dihydrotestosterone; the BAD puts the time to a visible benefit at up to fourteen months and lists reduced libido and erectile problems in approximately 2% of men. It is not licensed for women, and anti-androgens are avoided in pregnancy because of the risk of feminising a male foetus. Both work only while they are being taken.

PRP, correctly platelet-rich plasma, involves injecting a concentrate of your own platelets into the scalp under local anaesthetic. Low level laser therapy, sold as LLLT or sometimes LLT, applies red light to thinning areas. Both are widely offered privately in the UK, and the British Association of Dermatologists describes the research behind platelet-rich plasma as limited and states that low level laser light requires further research. Microneedling, often bundled with them, has very little research behind it.

For alopecia areata the picture is genuinely different. Intralesional corticosteroid injections into the patch remain standard, and because the follicle is dormant rather than destroyed the results can be excellent. Severe cases now have oral JAK inhibitors such as ritlecitinib and baricitinib, which are a real change from where this article stood a few years ago.

Three things worth saying plainly

• Neither minoxidil nor finasteride is generally available on the NHS for pattern hair loss, and nor are transplants. That is a cost to plan for, not a detail to discover later.
• A private clinic has no way of finding a thyroid problem or low ferritin. The NHS advises seeing a GP to establish the cause before going to a commercial hair clinic, and that order matters.
• Stopping a source of stress will not reverse androgenetic hair loss. It may help a diffuse shed. Conflating the two is how people spend a year on the wrong problem.

The version of this article that stood here before treated baldness as a single misfortune with a shopping list attached. It is not. It is four different situations with four different honest answers, and in two of the four the answer involves waiting rather than buying. If you are at the earlier stage of working out what you are dealing with, the companion piece on which anti hair loss treatments have evidence behind them goes through the products themselves in more detail.

Updated 13 August 2026. General health information only, not a diagnosis or a personalised treatment recommendation. Hair loss can indicate an underlying medical condition, so speak to your GP or a dermatologist before starting or stopping any treatment.

Sources: NHS, hair loss guidance; British Association of Dermatologists patient information leaflets on male pattern hair loss, female pattern hair loss, telogen effluvium and alopecia areata, produced in consensus with the British Hair and Nail Society; StatPearls, Androgenetic Alopecia, for prevalence by age and population.