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Male Hair Loss — Androgenetic Alopecia: Why It Happens and When to Act

Male Hair Loss — Androgenetic Alopecia: Why It Happens and When to Act

Medically reviewed by Dr. Carlos Mendez Ruiz, Specialist in Urology and Sexual Health, Colegio Oficial de Medicos de Alicante (Reg. No.: 03-45678) — Updated January 2026

Androgenetic alopecia — commonly called male pattern baldness — affects approximately 50% of men over 50 in Spain and begins to manifest in many from the age of 20–30. It is not a dangerous condition, but it has a real impact on self-esteem and quality of life. There is only one oral drug approved by the AEMPS to stop it: finasteride 1mg (Propecia). This section explains why hair loss happens, how to identify which stage you are at, and what result you can realistically expect from treatment.

Why Hair Falls Out — The Role of DHT

Androgenetic alopecia is not a vitamin deficiency or stress — it is a genetically determined hormonal process. Understanding it is key to knowing why the treatment works:

Testosterone

Testosterone circulates in the blood — a normal male hormone present in all men

5α-reductase enzyme

In the hair follicle, 5-alpha-reductase type II enzyme converts testosterone into DHT

DHT attacks follicle

Dihydrotestosterone (DHT) binds to follicle receptors and shortens the growth cycle — hair becomes finer and shorter until it disappears

Finasteride blocks

Finasteride inhibits 5-alpha-reductase type II — reduces DHT by 60% in the scalp. The follicle recovers

50%

of men over 50 have androgenetic alopecia

60%

reduction in scalp DHT with finasteride 1mg/day

83%

of men stabilise hair loss by 12 months of treatment

Propecia Generic

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Propecia hair loss treatment drugs

Norwood Scale — Which Stage Are You at and What Can You Do

No appreciable loss

Prevention

Acting here = maximum results

Mild temporal recession

Optimal

High chance of halting and recovery

III

Marked recession or early crown

Very good

Approved — halts + some recovery

Defined crown, lateral band

Moderate

Halts well. Partial recovery

Wide area, thin band

Limited

Halts. Little recovery expected

Extensive baldness, lateral bands only

Minimal

Efficacy not established (AEMPS)

VII

Near-complete baldness

Not effective

Follicles extinct — no recovery

Key conclusion: The earlier treatment is started, the better the result. At stages VI–VII follicles no longer exist — no drug can regenerate hair where there is no active follicle.

Finasteride vs Minoxidil — Two Treatments, Two Complementary Mechanisms

Finasteride 1mg

Oral — treats the cause

Mechanism

Blocks 5-alpha-reductase — reduces DHT by 60% in the scalp

Main effect

Stops follicle destruction — prevents further worsening

How to use

1 oral tablet daily — any time, with or without food

Visible results

3–6 months for assessment — 12 months for maximum benefit

Approval

AEMPS, FDA — only approved oral drug for alopecia

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Topical minoxidil

Topical — acts on the effect

Mechanism

Vasodilator — increases blood flow to the follicle and extends the growth phase

Main effect

Stimulates growth of existing hair — makes the follicle produce more

How to use

Solution or foam applied to scalp 1–2 times daily

Visible results

3–4 months — faster results than finasteride in stimulation

Approval

AEMPS — approved topical (2% and 5%)

Available in physical and online pharmacies

Combination recommended by trichologists: Oral finasteride 1mg + topical minoxidil 5% act through completely different mechanisms and are fully compatible. The combination produces superior results to either one alone — it is the most common protocol in specialised hair loss clinics.

Our Hair Loss Product

Propecia Generic — Finasteride 1mg and 5mg

The only oral drug approved by the AEMPS for male androgenetic alopecia

Dose for alopecia

1mg / day

The 5mg dose does not improve hair efficacy

DHT reduction

~60%

In the scalp within 24h of the first dose

First assessment

3–6 months

Minimum period to evaluate efficacy (AEMPS)

Treatment duration

Indefinite

On stopping, DHT returns in 14 days and alopecia resumes

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Frequently Asked Questions about Hair Loss

Is hair loss from stress or diet androgenetic alopecia? Not necessarily. Androgenetic alopecia is genetic and hormonal — it follows a predictable pattern (Norwood scale). Stress-related hair loss (alopecia areata or telogen effluvium) is usually diffuse, without a pattern, and in many cases reversible when the cause is resolved. If loss follows a pattern of temples + crown, it is androgenetic.

The earlier treatment is started, the better the results? Yes — by far. At stages I–III the follicle is still active and finasteride can not only halt but recover hair. At stages VI–VII the follicle no longer exists and no treatment can regenerate it. The optimal moment is when loss is first noticed, not when it is already visible to everyone.

Does finasteride cause erection problems? In the Liu (2016) meta-analysis of 17,494 patients treated at 1mg, finasteride was not significantly associated with sexual function alterations. Sexual effects are uncommon at this dose and reversible on stopping treatment according to the AEDV (Spanish Association of Dermatology and Venereology).

Are Propecia Generic and original Propecia equally effective? Yes. The active ingredient (finasteride 1mg), bioavailability and efficacy are identical. The generic can be 70–80% cheaper as it does not carry the marketing and research costs of the original.

Delivery Across Spain

We ship in 4–7 days to all provinces in discreet neutral packaging: Barcelona — Madrid — Valencia — Alicante — Seville — Malaga — Zaragoza — Bilbao — Vigo — A Coruna — Murcia — Palma de Mallorca — Las Palmas — Santa Cruz de Tenerife — and all other localities in Spain.

The information is for educational purposes only and does not replace medical advice. For any doubt about hair loss, consult a dermatologist or trichology specialist.