Hair Loss Treatment

UK Specialist for Hair Loss Treatments and Medications

Hair loss caused by Male Pattern Baldness (also called Androgenetic Alopecia or Androgenic Alopecia) affects up to 80% of men in their lives, with most men beginning to experience hair loss between 20 and 25 years old.^1.

Often not taken seriously, hair loss can dramatically affect a person’s self-esteem.

This review paper, written about the psychological consequences of Androgenetic Alopecia and published in the Journal of Cosmetic Dermatology, gathers information from 13 studies that assess the psychological effects of hair loss.

The authors found that many of those affected by androgenetic alopecia suffer from feelings of anxiousness, helplessness, and low self-esteem.

The study participants also reported feeling preoccupied with the fear of their hair loss worsening and their colleagues, friends and family noticing.

Oxford Online Pharmacy has provided expert advice, prescription-only and over-the-counter treatments for hair loss to tens of thousands of men and people assigned male at birth.

Our prescription treatments include generic Finasteride or branded Propecia, which can slow, stop or even reverse hair loss and is unavailable on the NHS.

We are also one of the only online services to prescribe oral Minoxidil or Dutasteride for hair loss when appropriate, treatments which are also not available on the NHS.

Our over-the-counter treatments include generic Minoxidil liquid or branded Regaine for Men and Alpecin Caffeine Shampoo and Liquid.

Common Signs of Hair Loss

Hair loss in men with male pattern baldness often starts with one of these common signs;

A receding hairline - this is where the hair at the temples (the hairline on the sides of the forehead above the eyebrows) begins to thin.

Starting to see or feel thinning hair or a bald spot at the crown of the head. The crown is on the top of the head, slightly towards the back, on the opposite side of the head from the chin.

Thinning of hair across the entire head. This can be more noticeable when the hair is wet or after a haircut.

These patterns and how severe the hair loss is are often measured using something called The Norwood Scale.

Hair loss can be caused by other conditions as well as male pattern baldness.

You should see your doctor if your hair is falling out quickly or suddenly, if your eyelash or eyebrow hairs are falling out, if you have redness, swelling or spots on your scalp or if you have started or changed any medicine.

You can also see a skin and hair specialist called a Dermatologist, they are experts in diagnosing hair loss and counselling patients on what may help them regrow their hair.

What Causes Hair Loss?

Androgenetic alopecia is caused by a combination of genetics and hormones called androgens, which are male sex hormones.

The androgens responsible for hair loss are Testosterone and Dihydrotestosterone (referred to as DHT).

Testosterone is an androgen made naturally in the body. In scalp hair follicles, testosterone is turned into DHT by another naturally produced substance, the enzyme 5-alpha reductase.

We know that there is more of this 5-alpha reductase in the follicles of balding men, and that it seems more active than in a non-balding person.²

We also know that there is a higher level of DHT and more receptors for DHT in the follicles on a balding scalp.

When we block the action of this 5-alpha reductase, we see hair loss slow, stop and occasionally reverse.

Androgenetic Alopecia is unusual because it commonly only affects hair on the head, men can experience hair loss from the head but have no lessening in eyebrow, beard or body hair.

Where Can I Buy Hair Loss Treatment?

You can access hair loss treatments from online providers, like us, or privately through your GP or a dermatologist.
When seeking treatment online, you can add over-the-counter products straight into your basket or begin a hair loss consultation, enabling us to prescribe treatments like Finasteride or Minoxidil if safe and appropriate.

The consultation takes around 5 minutes and, if appropriate, we can prescribe and ship your treatment on the same day.

Treatment for hair loss caused by Androgenetic Alopecia is unavailable on the NHS.

Can I Buy Prescription Hair Loss Treatments Online?

Yes, prescription treatments for hair loss caused by Androgenetic Alopecia can be bought online from reputable clinics and pharmacies, if appropriate, following a consultation.

Prescription-only treatments include Finasteride, Oral Minoxidil and Dutasteride.

Can I Get Hair Loss Tablets on the NHS?

Treatment for Androgenetic Alopecia is not available on the NHS.

Other conditions can cause hair loss, some of which can be treated on the NHS. If you are unsure what is causing your hair loss, you should see your GP or dermatologist.

Which Hair Loss Medications Are Available Over the Counter?

Over-the-counter treatments for male pattern hair loss include 5% strength Minoxidil, which increases blood flow to the hair follicles and can result in up to 84.3% improved hair growth³. Minoxidil 5% is available as a liquid or a foam and is also sold under the brand name Regaine.

Another non-prescription treatment is a caffeine shampoo made by a brand called Alpecin. Aplecin also makes a liquid caffeine treatment that is applied and left on the scalp.

These products can be added straight to your basket without a Pharmacist or Doctor’s consultation.

Hair Loss Tablets

There are several tablets and capsules available to treat hair loss caused by Androgenetic Alopecia.

Finasteride tablets block the production of a chemical called DHT (dihydrotestosterone) in the scalp. People with higher levels of DHT in the scalp experience more hair loss⁴, blocking it from working can slow, stop and sometimes reverse hair loss.

Dutasteride capsules work in the same way but are more potent, we only prescribe Dutasteride for people who have not had success with Finasteride before.

Minoxidil tablets work differently to Finasteride and Dutasteride, instead increasing the blood flow to the scalp. Studies show that about a third of men taking Minoxidil tablets experience reduced shedding and another third experience improved growth by around six months of treatment.

These treatments are all prescription-only, and a consultation must be completed to assess suitability.

How Do Hair Loss Tablets Work?

Finasteride and Dutasteride are from the same group of medicines and work in the same way. They block the enzyme 5-alpha reductase which turns testosterone into DHT in scalp follicles.

This has been shown to slow, stop or even reverse hair loss caused by Androgenetic Alopecia.

Oral Minoxidil tablets work by increasing blood flow to the hair roots, this enables hairs to grow for longer and new hairs to grow more quickly.⁵

How Quickly Do Hair Loss Tablets Work?

All Hair Loss treatments take 6-12 months to reach full effectiveness, with most users seeing a difference from around four months.

How Do You Take Hair Loss Tablets?

Finasteride tablets or Dutasteride capsules should be taken once a day at any time. They can be taken with or without food.

The dose for Minoxidil tablets is half a tablet each day for the first two weeks of treatment. After the two weeks, the dose is one tablet daily.

Minoxidil capsules cannot be broken in half, so a person should take one capsule every other day for the first two weeks of treatment and then increase to one capsule daily.

Hair Loss Tablets Side Effects

Potential side effects of Finasteride and Dutasteride include a rash, reduced sex drive, low mood, erection problems or tenderness on or around the nipples.
Occasionally these side effects can be permanent and remain after stopping treatment.

Potential side effects for Oral Minoxidil include increased hair growth on other areas of the body, low blood pressure and/or feeling lightheaded.

See the individual product side effect tabs for full details on side effects.

Topical Solutions for Hair Loss

Alpecin Caffeine Solution, like their shampoo, uses caffeine to promote hair growth and prevent further loss.
The treatment is a water-based formula, allowing easy application and absorption into the scalp without leaving a greasy residue. Users report that the solution doesn’t weigh down the hair or leave it feeling crunchy or oily.

Side Effects of Hair Loss Shampoo

Hair loss shampoos don’t tend to cause problems. Like all products, some people may experience side effects or sensitivities. It's important to note that reactions can vary from person to person. Potential side effects associated with the use of hair loss shampoos include;

Scalp Irritation - Some people may develop irritation, redness, or itching on the scalp as a reaction to certain ingredients in the shampoo. Dryness or Flakiness - Certain formulations may lead to dryness or flakiness of the scalp. This is usually due to ingredients that can strip away natural oils. This can also happen if hair is washed too often.

Allergic Reactions - Individuals with allergies to specific ingredients in the shampoo may experience allergic reactions, such as a rash or swelling.

Changes in Hair Texture - Some users report changes in the texture of their hair, such as increased dryness or brittleness. This can be caused by certain ingredients in the shampoo.

Unwanted Hair Color Changes - In rare cases, hair loss shampoos with certain chemicals may lead to changes in hair colour, especially for those with colour-treated hair.

Eye Irritation - Shampoo runoff during rinsing can potentially cause eye irritation. Avoid direct contact with the eyes and rinse thoroughly.

Always follow the product instructions and perform a patch test before regular application to ensure you get on with your new product. If you experience persistent side effects, discontinue use and consult with a healthcare professional or dermatologist.
Additionally, if you have pre-existing skin conditions or allergies, seek advice before using any new hair care product.

Further Reading on Hair Loss

NHS Hair Loss
Alopecia UK Hair Loss
Wikipedia article on the Hamilton-Norwood Scale

References

1. Piraccini, B. M. & Alessandrini, A. Androgenetic alopecia. G. Ital. Dermatol. Venereol. 149, 15–24 (2014).
2. Sawaya, M. E. & Price, V. H. Different levels of 5alpha-reductase type I and II, aromatase, and androgen receptor in hair follicles of women and men with androgenetic alopecia. J. Invest. Dermatol. 109, 296–300 (1997).
3. Rundegren, J. A one-year observational study with minoxidil 5% solution in Germany: results of independent efficacy evaluation by physicians and patients. J. Am. Acad. Dermatol. 50, P91 (2004).
4. Ho, C. H., Sood, T. & Zito, P. M. Androgenetic Alopecia. (StatPearls Publishing, 2022).
5. Sharma, A. N., Michelle, L., Juhasz, M., Muller Ramos, P. & Atanaskova Mesinkovska, N. Low-dose oral minoxidil as treatment for non-scarring alopecia: a systematic review. Int. J. Dermatol. 59, 1013–1019 (2020).