Male-pattern hair loss

What it is

Male-pattern hair loss (androgenetic alopecia) is gradual thinning at the temples and crown driven by genetics and hormones. It is very common and can start in the late teens.

How it works

In male-pattern hair loss, a hormone called DHT shrinks genetically sensitive follicles at the temples and crown. Each hair cycle produces a thinner, shorter hair until the follicle goes quiet.

Why it matters on darker skin

It affects men of all backgrounds. In men of African descent it can be confused with traction loss from tight locs or close-shave folliculitis, so getting the right diagnosis matters.

Causes and triggers

Family history, age and androgen sensitivity. Sudden patchy loss, scaly scalp or loss with illness suggests a different cause.

What helps — and why it works

Treatments with good evidence are available from a doctor or pharmacist, including topical and tablet options; they work best when started early and are needed long term. Many men also choose to keep hair short or shaved, which is a perfectly healthy option. Topical minoxidil, after speaking to a pharmacist or doctor: prolongs the growth phase and enlarges follicles. Expected timeline: shedding may increase at first; results in 4–6 months; continued use needed. Doctor-prescribed options: some tablets block DHT; they need medical discussion. Expected timeline: 6–12 months.

What to avoid and why

Avoid unregulated "hair growth" oils and supplements that promise quick results, and sharing medicines without advice.

Common mistakes

• Buying unregulated 'growth oils' with no evidence.
• Stopping treatment and losing the gains.
• Assuming all hair loss is genetic.

Handling textured hair gently

Coily and curly hair is naturally the most fragile hair type because each bend in the strand is a weak point and natural oils travel down it slowly. That makes handling — how often and how firmly hair is combed, styled and pulled — as important as which products you buy. Detangle only when hair is wet and coated in conditioner, working in sections from the ends towards the roots with fingers or a wide-tooth comb. Keep heat to the lowest effective setting and always use a heat protectant. Sleep on satin or silk, or wear a satin bonnet, to reduce friction. Between wash days, a water-based leave-in followed by a light oil or cream helps hold moisture. Give the scalp attention too: it is skin, and needs regular cleansing, especially under wigs, weaves and braids, to prevent build-up, itch and infection. Any style that hurts, causes bumps or leaves the scalp tender is too tight and should be loosened. Hair grows about one centimetre a month, so changes in care take two to three months to show in length and thickness.

Scalp health and product choice

Choose a shampoo that suits the scalp and a conditioner that suits the lengths: the scalp may need cleansing or a medicated shampoo while the ends need moisture. Fragrance, essential oils and heavy waxes can irritate a sensitive scalp or cause build-up, and heavy oils on the scalp may worsen dandruff. Look for a clear ingredient list and a NAFDAC number, and patch-test new dyes and relaxers 48 hours before every use. Products that promise dramatic growth are usually untested; the treatments with the best evidence for pattern hair loss are medicines such as minoxidil, which should be started only after speaking to a pharmacist or doctor. Signs that you need medical advice rather than a new product include patches of hair loss, scarring or shiny skin, pain, pus, or shedding that continues for more than six months.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.