Hair Loss Treatment

Understanding age-related hair loss in men 

Male pattern baldness

Male pattern baldness (sometimes called Androgenetic or Androgenic Alopecia) affects up to 80% of men, and usually starts between 20-25 years old. Hair usually thins in a predictable pattern and is influenced by both genetics and hormones.

The root of male pattern baldness

Male pattern baldness is usually inherited. It happens when hair follicles become sensitive to a hormone called dihydrotestosterone (DHT), which is made from testosterone. Over time, DHT causes these hair follicles to shrink. The hair grows back finer and shorter, until eventually it stops growing.

Key causes of male pattern baldness include:

• Genetics: Hair loss genes can be inherited from either parent, not just the mother's side as commonly believed
• DHT sensitivity: This testosterone-based hormone binds to receptors in hair follicles, causing them to miniaturise
• Ageing: Hair becomes more sensitive to DHT as you get older
• Hormonal changes Changes in androgen levels may speed up hair loss in those already genetically predisposed

The Norwood Scale

Male pattern baldness typically progresses through predictable stages, though the rate of progression varies significantly between individuals. This is known as the Norwood Scale and has 3 distinct stages – Early, Moderate and Advanced. Explore our FAQs for more information on each stage.

Good to know

We’ve helped thousands of people manage hair loss with expert advice and access to licensed and unlicensed treatments.

Our prescription treatments include generic Finasteride or branded Propecia, which can slow, stop or even reverse hair loss and is currently 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 also not available on the NHS.

Our non-prescription treatments include generic Minoxidil spray or branded Regaine for Men, and Alpecin Caffeine Shampoo and Liquid.

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.

Understanding age-related hair loss in women 

Female pattern hair loss

Female pattern hair loss (FPHL), also known as Androgenetic Alopecia in women, can affect around 50% of women. Unlike men, women usually notice more general thinning rather than a receding hairline. It can take longer to spot and often feels emotionally difficult to manage.

Detangling female pattern hair loss

Like in men, FPHL is often genetic. But it’s also influenced by other factors such as hormone changes and age. Some women’s hair follicles are more sensitive to even normal levels of androgens.

Common causes include:

• Genetic predisposition: As with men, hereditary factors from both maternal and paternal sides influence susceptibility
• Hormonal changes: Fluctuations during menopause, pregnancy, or thyroid disorders can trigger or accelerate hair loss
• Aging processes: Natural aging reduces hair follicle size and growth phase duration
• Androgen sensitivity: Some women have hair follicles particularly responsive to androgens
• Underlying health conditions: Polycystic ovary syndrome (PCOS), insulin resistance, and chronic inflammation can contribute to hair loss

The Ludwig Scale

Female pattern hair loss typically follows the Ludwig Scale and can progress more subtly than male pattern baldness tends to. It has 3 key stages – Minimal, Moderate and Intense/Severe. Explore our FAQs for more information on each stage.

Good to know

Our team understands how emotional hair loss can feel. We offer advice and non-prescription options that can help support hair health. These include Florisene hair loss tablets, Regaine for Women 2% Minoxidil solution, Regaine for Women extra strength foam and Nourkin Woman tablets.

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.

Finding the right treatment option for you

Discover a range of hair loss treatments and understand which might be most suitable for you. Remember, some options are prescription-only and will need to be approved by our clinical team once your order is placed.

Oral options for men and those AMAB

Finasteride tablets

• Works by blocking the conversion of testosterone to dihydrotestosterone (DHT), which shrinks hair follicles 
• Usually taken as a 1mg daily tablet 
• Results typically appear after 3-6 months of consistent use 
• Stops hair loss in about 80% of men; stimulates regrowth in about 60% 
• Potential side effects include mood changes, reduced libido and erectile dysfunction in a small percentage of users

Dutasteride capsules

• Second stage treatment where Finasteride hasn’t been successful
• More potent than Finasteride tablets

Minoxidil tablets

• Works by increasing blood flow to hair follicles and prolonging the growth phase of hair 
• Usually prescribed at doses of 2.5mg daily for hair loss 
• Results typically appear after 3-6 months 
• Side effects may include fluid retention, rapid heartbeat, or unwanted body hair growth

Oral options for women

Florisene tablets

• A nutritional supplement containing iron, vitamin C, and lysine 
• Addresses hair loss related to iron deficiency, which is common in women 
• Most effective for non-hereditary diffuse hair loss 
• Results may take 3-6 months to become noticeable 
• Generally well-tolerated with minimal side effects

Nourkin tablets

• Contains marine protein complex with specific amino acids that support the hair growth cycle 
• Particularly useful for hair thinning during menopause 
• Recommended course is typically 6 months 
• Results typically begin to show after 2-3 months 
• Few side effects, though some may experience mild digestive discomfort

Topical options for men and women

Minoxidil solution/Regaine foam

• Available in different strengths (2% often recommended for women, 5% for men)
• Works by increasing blood flow to hair follicles and prolonging the growth phase
• Applied directly to the scalp once or twice daily
• Results typically appear after 4 months of consistent use
• About 60% of users see reduced hair loss; about 40% experience regrowth
• Side effects may include scalp irritation or unwanted hair growth on adjacent skin

Alpecin caffeine shampoo

• Contains caffeine which may help counter the effects of testosterone on hair follicles
• Used as a regular shampoo, left on for 2 minutes to allow absorption
• Less robust clinical evidence than minoxidil or finasteride
• May complement other treatments
• Very few side effects; mainly scalp irritation in sensitive individuals

FAQs

Not sure which hair loss option is right for you or want to understand more about hair loss? Explore some of our most-asked hair loss questions.

What does male pattern baldness look like?

Male pattern baldness is assessed using the Norwood Scale and has 3 distinct stages – Early, Moderate and Advanced.

Early stage (Norwood Scale 1-2)

• Slight recession of the hairline at the temples, creating an "M" shape
• Gradual thinning at the crown that may initially go unnoticed
• Hair quality changes, becoming finer and shorter in affected areas

Moderate stage (Norwood Scale 3-4)

• Deeper recession of the hairline, creating a more pronounced "M" pattern
• Noticeable thinning at the crown, forming a small bald spot
• Widening of the part line, especially toward the crown
• Connection beginning to form between the receding hairline and thinning crown

Advanced stage (Norwood Scale 5-7)

• Significant hair loss with only a narrow band of hair connecting the sides
• Large bald areas merging between the crown and frontal regions
• Remaining hair often becomes finer and less dense
• Hairline may recede completely to the middle or back of the scalp

What does female pattern hair loss look like?

Female pattern hair loss is assessed using the Ludwig Scale and has 3 key stages – Minimal, Moderate and Intense/Severe.

Minimal stage (Ludwig Scale I)

• Minimal thinning beginning at the part line, often most noticeable on the crown
• Gradual widening of the centre part
• No significant recession of the frontal hairline
• Overall hair volume reduction that might only be noticeable when styling

Moderate stage (Ludwig Scale II)

• Pronounced widening of the part throughout the top of the scalp
• Increased visibility of the scalp through thinning hair
• Noticeable decrease in ponytail thickness or diameter
• More difficulty achieving volume when styling
• Possible slight recession of the frontal hairline, particularly at the temples

Intense/Severe stage (Ludwig Scale III)

• Diffuse thinning across the entire top of the scalp
• Significantly visible scalp through remaining hair
• Thin, wispy quality to remaining hair strands
• The frontal hairline may remain relatively preserved compared to men, even with extensive crown thinning

For some women, a different pattern emerges (Christmas Tree Pattern or Frontal Accentuation):

• Thinning that forms a triangular shape with the wider part toward the front hairline
• Progressive hair loss that widens from the centre part outward

Where can I buy hair loss treatments? 

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.

What options are available for hair loss?

There are a range of hair loss options available depending on your biological sex and how advanced your hair loss has become. There are both oral and topical options available. This means tablets, shampoos, foams and liquid solutions for hair loss. Some oral and topical treatments can be combined to boost results.

How do I know if I'm a suitable candidate for prescription treatments like Finasteride or Minoxidil?

You're likely suitable for Finasteride if you're a male over 18 with male pattern baldness and no liver problems. Minoxidil foam or liquid suits both men and women with early to moderate hair loss.

Are all hair loss treatments licenced for hair loss?

Some hair loss treatments available at Oxford Online Pharmacy are prescribed off-label, which means they are not licensed in the UK for treating hair loss, but may be used at our prescriber’s discretion where clinically appropriate.

This is a common and accepted practice in UK medicine, where the prescriber is experienced and the patient is fully informed. All off-licence prescribing at OOP is supported by our pharmacist-led service and follows MHRA and GPhC guidance.

How long should I try medications before expecting to see results?

Patience is often one of the most frustrating things about hair loss medications. Typically, you should commit to at least 6 months of consistent use before assessing how treatment is working. Full results generally take 12-18 months. Many people experience initial shedding in the first few weeks, which is actually a sign treatment is working.

Why is starting with medication recommended before considering hair transplant surgery?

Medicines can stabilise hair loss and may even regrow hair without the need for surgery. Medication is often less invasive and more affordable than surgery, and can even improve transplant results if you choose to have one later. It’s recommend maintaining a medication regimen for 12-18 months to assess its effectiveness before pursuing surgical options, as surgery without addressing the underlying causes can lead to continued hair loss around the transplanted areas.

What alternative options exist for severe hair loss when medications aren't effective?

For severe hair loss, high-quality hair systems (modern wigs or hairpieces) offer an excellent non-surgical alternative. Unlike older wigs, today's hair systems use medical-grade adhesives and breathable materials that create a natural-looking hairline. They can be custom-made to match your hair colour, texture, and desired style, with options ranging from partial coverage to full systems. Many specialist hairdressers and clinics offer these solutions, with professional fitting, styling and maintenance services. Hair systems allow immediate results without recovery time and can be especially appropriate for those with extensive hair loss patterns not suitable for transplantation or responsive to medications.

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).
6. NICE. 
7. NICE. 
8. Cleveland Clinic. Hair Loss in Women | Cleveland Clinic [Internet]. Cleveland Clinic. 2018.