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Erfelijke aanleg voor kaalheid (Alopecia androgenetica) bij mannen

Hair loss in men

Do you, as a man, suffer from hair loss or thinning hair?

You can prevent hair loss and baldness by taking timely action. Let our specialists advise you.

Are you curious whether something can be done about hair loss in men?

Did you know that almost 70% of all men will sooner or later experience thinning hair or hair loss, ranging from a mild form to complete baldness?
Heredity is one of the most common causes, but extreme stress situations or diseases can also affect your hair growth.

Although male pattern baldness is socially accepted and some men accept their own baldness, that doesn't mean you have to do the same. After all, your hair plays an important role in your identity and well-being.
Do you notice that your hair loss bothers you, do you experience it as a problem? Don't you want to put up with increasingly thinning hair, inlets, a balding crown, or impending baldness? We can advise you on treatment methods.
Fortunately, hair loss and baldness can be prevented in many cases.


A good diagnosis is essential to choose the right treatment and estimate the expected treatment result. Specialized dermatologists at the Intermedica Kliniek are ready to advise you about hair loss and inform you about the treatment options.

Would you like a personal consultation about your hair problem? Then simply make an appointment with us. We are happy to help you.


The most common causes for excessive hair loss in men are:

Hereditary predisposition to baldness in men
Androgenetic alopecia

Habitual, or classic, baldness is a form of hair loss in men.

Androgenetic alopecia, also known as common or classical baldness, is a form of hair loss in men that is influenced by heredity, race, gender and age.
It usually manifests itself at the temples and the crown, where the hair becomes thinner and a connection gradually develops between the balding temples (coves) and the crown. It is a common form of hair loss in men.

Although it is a process that occurs in many men, it can be experienced as disturbing or problematic for some. Fortunately, there are several treatment options available to reduce or stabilize hair loss due to androgenetic alopecia, such as medication or a combination of a hair transplant and medication.

  • What causes androgenetic alopecia?
    Each hair follicle can produce a hair approximately 20 times per lifetime, after which it dies. Because each hair remains in the hair follicle for three to five years, a person would only experience baldness after 60 to 90 years. Baldness at a young age with a hereditary cause is caused by the degree of sensitivity of certain hair follicles to the hormone dihydrotestosterone (DHT). This DHT is formed from the hormone testosterone under the influence of an enzyme (5-alpha-reductase, types I and II). The DHT binds to the androgen receptor (a 'biological magnet') of the hair follicle, which therefore has less blood flow. The growth phase of the hair is therefore shortened from three to five years to just a few months. The affected hairs become finer and shorter with each hair cycle and the hair follicle eventually dies at an accelerated rate. If this process occurs in many hair follicles, the hair becomes thinner. The number of androgen receptors a person has is genetically determined and that explains why some people go bald and others do not.
  • What treatment options are there for androgenetic alopecia?
    There are quite a few products and treatments that claim to have an effect on stopping hair loss due to androgenetic alopecia (hereditary baldness). Every two months a new shampoo, lotion or nutritional supplement comes onto the market with claimed effectiveness. Unfortunately, these claims are usually empty promises and the effect cannot be scientifically proven. However, there are also plenty of options whose effectiveness has been proven in scientific studies. Below is an overview of the treatment options used at Intermedica. The effectiveness of the products can be expressed as a percentage of full effectiveness, where hair loss is completely normalized. The effectiveness of the products for which scientific evidence is available is as follows (estimates): Minoxidil lotion: 25% Diane pill, Yasmin pill or Yaz pill: 25% Trix Basic Alpha + Trix Basic Beta: 25% Aminexil: 20% Androcur: 20% Other nutritional supplements: 0-10% Shampoos with Aminexil: 5% Other shampoos and lotions: 0-2% The effectiveness of the various products should not be added together. However, the effectiveness of one product can be improved slightly if another product is used. In addition, treatments are offered for which there is also only weak evidence that they inhibit the process of hair loss due to androgenetic alopecia. Examples of such treatments are light and laser treatments and the injection of vitamins and minerals into the scalp (PRP, mesotherapy). These are not carried out at Intermedica.
  • What about finasteride and dutasteride for women?
    The drugs finasteride and dutasteride have been prescribed for a long time and with good clinical results to women with hair loss due to androgenetic alopecia by the dermatologists of the Intermedica Clinic. These medicines are prescribed off-label. Off-label use of medicines means that they are prescribed for a purpose or in a different way than that for which they were approved. This is done based on a doctor's professional assessment. This is legally permitted. Finasteride and dutasteride were originally approved and prescribed for the treatment of prostate problems, but in low doses they also appear to be effective in preventing hair loss due to androgenetic alopecia, a so-called positive side effect. Finasteride and dutasteride affect the amount of dihydrotestosterone (DHT) in your blood. DHT is an important substance in the development of the male genitalia. This development starts in the womb and continues in men until the end of puberty. To prevent any risk (however small it may be!) of a genital abnormality in a male fetus, the prescription of finasteride and dutasteride is subject to strict rules.* The Intermedica clinic can prescribe finasteride or dutasteride to women under certain conditions. These conditions are: there is infertility (post-menopausal, sterilization) or finasteride or dutasteride is the only possible treatment in your situation (other treatments have proven to be ineffective or insufficiently effective) and you have been fully informed about the advantages and disadvantages of finasteride/dutasteride and you sign a statement about this (“informed consent”) and consultation has taken place with the pharmacy that supplies the medicine. It is solely the dermatologist who assesses and decides on each patient and circumstance. By the dermatologists of the Intermedica Clinic in 2013 in collaboration with internationally renowned trichologists conducted a retrospective study on the effectiveness of finasteride and dutasteride when used by women with androgenetic alopecia. You can read the results of this research here or download it in PDF format below. PDF scientific publication: “The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia”. Ids H. Boersma, Arnold P. Oranje, Ramon Grimalt, Matilde Iorizzo, Bianca M. Piraccini, Emiel H. Verdonschot *The Lareb side effects center received ten reports of possible side effects of finasteride/dutasteride in women in the period between 2005 and 2014. Two of these reports concerned the use of finasteride during pregnancy. On this basis, pharmacies are advised not to supply finasteride and dutasteride to fertile women. You can find Lareb's full message here.
The effect of using dutasteride.

This image shows the effect of using dutasteride. Dutasteride inhibits the conversion of testosterone to DHT (dihydrotestosterone). This inhibition normalizes the accelerated thinning and loss of hair and allows thin hair to become thicker, longer and darker again. Our experienced doctors can advise you on this treatment option to combat hair loss due to hereditary causes.

Hair loss due to 'stress'
Telogen effluvium

Hair loss in men due to 'stress'  (Telogen effluvium).

Telogen effluvium is a form of hair loss in which there is a temporary disruption of the hair cycle.
Normally, hair goes through a cycle of growth (anagen phase), rest (telogen phase) and shedding (exogenous phase).
With telogen effluvium, a large number of hairs enter the telogen phase at the same time, causing them to loosen and fall out. This can lead to noticeable hair loss and thinning hair.
Telogen effluvium can be caused by various factors, such as stress, illness, hormonal changes, medication use, nutritional deficiencies or physical trauma.
Fortunately, telogen effluvium is usually temporary and hair will heal itself after a few months.
A correct diagnosis helps to address the cause of a telogen effluvium and support the natural recovery of the hair as much as possible.

  • What causes androgenetic alopecia?
    Each hair follicle can produce a hair approximately 20 times per lifetime, after which it dies. Because each hair remains in the hair follicle for three to five years, a person would only experience baldness after 60 to 90 years. Baldness at a young age with a hereditary cause is caused by the degree of sensitivity of certain hair follicles to the hormone dihydrotestosterone (DHT). This DHT is formed from the hormone testosterone under the influence of an enzyme (5-alpha-reductase, types I and II). The DHT binds to the androgen receptor (a 'biological magnet') of the hair follicle, which therefore has less blood flow. The growth phase of the hair is therefore shortened from three to five years to just a few months. The affected hairs become finer and shorter with each hair cycle and the hair follicle eventually dies at an accelerated rate. If this process occurs in many hair follicles, the hair becomes thinner. The number of androgen receptors a person has is genetically determined and that explains why some people go bald and others do not.
  • What treatment options are there for androgenetic alopecia?
    There are quite a few products and treatments that claim to have an effect on stopping hair loss due to androgenetic alopecia (hereditary baldness). Every two months a new shampoo, lotion or nutritional supplement comes onto the market with claimed effectiveness. Unfortunately, these claims are usually empty promises and the effect cannot be scientifically proven. However, there are also plenty of options whose effectiveness has been proven in scientific studies. Below is an overview of the treatment options used at Intermedica. The effectiveness of the products can be expressed as a percentage of full effectiveness, where hair loss is completely normalized. The effectiveness of the products for which scientific evidence is available is as follows (estimates): Minoxidil lotion: 25% Diane pill, Yasmin pill or Yaz pill: 25% Trix Basic Alpha + Trix Basic Beta: 25% Aminexil: 20% Androcur: 20% Other nutritional supplements: 0-10% Shampoos with Aminexil: 5% Other shampoos and lotions: 0-2% The effectiveness of the various products should not be added together. However, the effectiveness of one product can be improved slightly if another product is used. In addition, treatments are offered for which there is also only weak evidence that they inhibit the process of hair loss due to androgenetic alopecia. Examples of such treatments are light and laser treatments and the injection of vitamins and minerals into the scalp (PRP, mesotherapy). These are not carried out at Intermedica.
  • What about finasteride and dutasteride for women?
    The drugs finasteride and dutasteride have been prescribed for a long time and with good clinical results to women with hair loss due to androgenetic alopecia by the dermatologists of the Intermedica Clinic. These medicines are prescribed off-label. Off-label use of medicines means that they are prescribed for a purpose or in a different way than that for which they were approved. This is done based on a doctor's professional assessment. This is legally permitted. Finasteride and dutasteride were originally approved and prescribed for the treatment of prostate problems, but in low doses they also appear to be effective in preventing hair loss due to androgenetic alopecia, a so-called positive side effect. Finasteride and dutasteride affect the amount of dihydrotestosterone (DHT) in your blood. DHT is an important substance in the development of the male genitalia. This development starts in the womb and continues in men until the end of puberty. To prevent any risk (however small it may be!) of a genital abnormality in a male fetus, the prescription of finasteride and dutasteride is subject to strict rules.* The Intermedica clinic can prescribe finasteride or dutasteride to women under certain conditions. These conditions are: there is infertility (post-menopausal, sterilization) or finasteride or dutasteride is the only possible treatment in your situation (other treatments have proven to be ineffective or insufficiently effective) and you have been fully informed about the advantages and disadvantages of finasteride/dutasteride and you sign a statement about this (“informed consent”) and consultation has taken place with the pharmacy that supplies the medicine. It is solely the dermatologist who assesses and decides on each patient and circumstance. By the dermatologists of the Intermedica Clinic in 2013 in collaboration with internationally renowned trichologists conducted a retrospective study on the effectiveness of finasteride and dutasteride when used by women with androgenetic alopecia. You can read the results of this research here or download it in PDF format below. PDF scientific publication: “The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia”. Ids H. Boersma, Arnold P. Oranje, Ramon Grimalt, Matilde Iorizzo, Bianca M. Piraccini, Emiel H. Verdonschot *The Lareb side effects center received ten reports of possible side effects of finasteride/dutasteride in women in the period between 2005 and 2014. Two of these reports concerned the use of finasteride during pregnancy. On this basis, pharmacies are advised not to supply finasteride and dutasteride to fertile women. You can find Lareb's full message here.

Patchy baldness
Alopecia areata

Man with patchy baldness.
Men with alopecia areata

Hair loss occurs in the form of round or oval patches, there is patchy baldness (alopecia areata), where the skin does not scar. This form of baldness is caused by a malfunction in the immune system. The progression of spot baldness is not predictable. Any hairy area of the skin can be affected, with the exception of gray hair. The course is unpredictable.

 

The clinical picture does not cause any physical complaints but often leads to concern and fear among the patient and the family. The round spots can become larger, but also smaller. The bald spots can become completely covered with hair again, but partial thin growth is also possible. If the bald spots disappear, they may remain gone for a long period of years, but they can also return after a few months.

  • What causes androgenetic alopecia?
    Each hair follicle can produce a hair approximately 20 times per lifetime, after which it dies. Because each hair remains in the hair follicle for three to five years, a person would only experience baldness after 60 to 90 years. Baldness at a young age with a hereditary cause is caused by the degree of sensitivity of certain hair follicles to the hormone dihydrotestosterone (DHT). This DHT is formed from the hormone testosterone under the influence of an enzyme (5-alpha-reductase, types I and II). The DHT binds to the androgen receptor (a 'biological magnet') of the hair follicle, which therefore has less blood flow. The growth phase of the hair is therefore shortened from three to five years to just a few months. The affected hairs become finer and shorter with each hair cycle and the hair follicle eventually dies at an accelerated rate. If this process occurs in many hair follicles, the hair becomes thinner. The number of androgen receptors a person has is genetically determined and that explains why some people go bald and others do not.
  • What treatment options are there for androgenetic alopecia?
    There are quite a few products and treatments that claim to have an effect on stopping hair loss due to androgenetic alopecia (hereditary baldness). Every two months a new shampoo, lotion or nutritional supplement comes onto the market with claimed effectiveness. Unfortunately, these claims are usually empty promises and the effect cannot be scientifically proven. However, there are also plenty of options whose effectiveness has been proven in scientific studies. Below is an overview of the treatment options used at Intermedica. The effectiveness of the products can be expressed as a percentage of full effectiveness, where hair loss is completely normalized. The effectiveness of the products for which scientific evidence is available is as follows (estimates): Minoxidil lotion: 25% Diane pill, Yasmin pill or Yaz pill: 25% Trix Basic Alpha + Trix Basic Beta: 25% Aminexil: 20% Androcur: 20% Other nutritional supplements: 0-10% Shampoos with Aminexil: 5% Other shampoos and lotions: 0-2% The effectiveness of the various products should not be added together. However, the effectiveness of one product can be improved slightly if another product is used. In addition, treatments are offered for which there is also only weak evidence that they inhibit the process of hair loss due to androgenetic alopecia. Examples of such treatments are light and laser treatments and the injection of vitamins and minerals into the scalp (PRP, mesotherapy). These are not carried out at Intermedica.
  • What about finasteride and dutasteride for women?
    The drugs finasteride and dutasteride have been prescribed for a long time and with good clinical results to women with hair loss due to androgenetic alopecia by the dermatologists of the Intermedica Clinic. These medicines are prescribed off-label. Off-label use of medicines means that they are prescribed for a purpose or in a different way than that for which they were approved. This is done based on a doctor's professional assessment. This is legally permitted. Finasteride and dutasteride were originally approved and prescribed for the treatment of prostate problems, but in low doses they also appear to be effective in preventing hair loss due to androgenetic alopecia, a so-called positive side effect. Finasteride and dutasteride affect the amount of dihydrotestosterone (DHT) in your blood. DHT is an important substance in the development of the male genitalia. This development starts in the womb and continues in men until the end of puberty. To prevent any risk (however small it may be!) of a genital abnormality in a male fetus, the prescription of finasteride and dutasteride is subject to strict rules.* The Intermedica clinic can prescribe finasteride or dutasteride to women under certain conditions. These conditions are: there is infertility (post-menopausal, sterilization) or finasteride or dutasteride is the only possible treatment in your situation (other treatments have proven to be ineffective or insufficiently effective) and you have been fully informed about the advantages and disadvantages of finasteride/dutasteride and you sign a statement about this (“informed consent”) and consultation has taken place with the pharmacy that supplies the medicine. It is solely the dermatologist who assesses and decides on each patient and circumstance. By the dermatologists of the Intermedica Clinic in 2013 in collaboration with internationally renowned trichologists conducted a retrospective study on the effectiveness of finasteride and dutasteride when used by women with androgenetic alopecia. You can read the results of this research here or download it in PDF format below. PDF scientific publication: “The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia”. Ids H. Boersma, Arnold P. Oranje, Ramon Grimalt, Matilde Iorizzo, Bianca M. Piraccini, Emiel H. Verdonschot *The Lareb side effects center received ten reports of possible side effects of finasteride/dutasteride in women in the period between 2005 and 2014. Two of these reports concerned the use of finasteride during pregnancy. On this basis, pharmacies are advised not to supply finasteride and dutasteride to fertile women. You can find Lareb's full message here.

Baldness due to scarring (Cicatricial alopecia)

Cicatricial alopecia in men.

Cicatricial alopecia is a form of hair loss in which scarring occurs in the hair follicles, permanently disrupting hair growth. This can have various causes, such as inflammation, infections, injuries or autoimmune diseases. The result is permanent hair loss where the scars are located, as the hair follicles are replaced by scar tissue.

Cicatricial alopecia may be accompanied by symptoms such as itching, pain or a burning sensation on the scalp. The condition is often progressive and usually not reversible, which can have an emotional and psychological impact on those affected.
Treatment options for cicatricial alopecia focus on controlling symptoms and preventing further scarring. It is important to seek timely medical attention if you suspect that you are suffering from cicatricial alopecia, to minimize the progression of hair loss and prevent possible complications.

  • What causes androgenetic alopecia?
    Each hair follicle can produce a hair approximately 20 times per lifetime, after which it dies. Because each hair remains in the hair follicle for three to five years, a person would only experience baldness after 60 to 90 years. Baldness at a young age with a hereditary cause is caused by the degree of sensitivity of certain hair follicles to the hormone dihydrotestosterone (DHT). This DHT is formed from the hormone testosterone under the influence of an enzyme (5-alpha-reductase, types I and II). The DHT binds to the androgen receptor (a 'biological magnet') of the hair follicle, which therefore has less blood flow. The growth phase of the hair is therefore shortened from three to five years to just a few months. The affected hairs become finer and shorter with each hair cycle and the hair follicle eventually dies at an accelerated rate. If this process occurs in many hair follicles, the hair becomes thinner. The number of androgen receptors a person has is genetically determined and that explains why some people go bald and others do not.
  • What treatment options are there for androgenetic alopecia?
    There are quite a few products and treatments that claim to have an effect on stopping hair loss due to androgenetic alopecia (hereditary baldness). Every two months a new shampoo, lotion or nutritional supplement comes onto the market with claimed effectiveness. Unfortunately, these claims are usually empty promises and the effect cannot be scientifically proven. However, there are also plenty of options whose effectiveness has been proven in scientific studies. Below is an overview of the treatment options used at Intermedica. The effectiveness of the products can be expressed as a percentage of full effectiveness, where hair loss is completely normalized. The effectiveness of the products for which scientific evidence is available is as follows (estimates): Minoxidil lotion: 25% Diane pill, Yasmin pill or Yaz pill: 25% Trix Basic Alpha + Trix Basic Beta: 25% Aminexil: 20% Androcur: 20% Other nutritional supplements: 0-10% Shampoos with Aminexil: 5% Other shampoos and lotions: 0-2% The effectiveness of the various products should not be added together. However, the effectiveness of one product can be improved slightly if another product is used. In addition, treatments are offered for which there is also only weak evidence that they inhibit the process of hair loss due to androgenetic alopecia. Examples of such treatments are light and laser treatments and the injection of vitamins and minerals into the scalp (PRP, mesotherapy). These are not carried out at Intermedica.
  • What about finasteride and dutasteride for women?
    The drugs finasteride and dutasteride have been prescribed for a long time and with good clinical results to women with hair loss due to androgenetic alopecia by the dermatologists of the Intermedica Clinic. These medicines are prescribed off-label. Off-label use of medicines means that they are prescribed for a purpose or in a different way than that for which they were approved. This is done based on a doctor's professional assessment. This is legally permitted. Finasteride and dutasteride were originally approved and prescribed for the treatment of prostate problems, but in low doses they also appear to be effective in preventing hair loss due to androgenetic alopecia, a so-called positive side effect. Finasteride and dutasteride affect the amount of dihydrotestosterone (DHT) in your blood. DHT is an important substance in the development of the male genitalia. This development starts in the womb and continues in men until the end of puberty. To prevent any risk (however small it may be!) of a genital abnormality in a male fetus, the prescription of finasteride and dutasteride is subject to strict rules.* The Intermedica clinic can prescribe finasteride or dutasteride to women under certain conditions. These conditions are: there is infertility (post-menopausal, sterilization) or finasteride or dutasteride is the only possible treatment in your situation (other treatments have proven to be ineffective or insufficiently effective) and you have been fully informed about the advantages and disadvantages of finasteride/dutasteride and you sign a statement about this (“informed consent”) and consultation has taken place with the pharmacy that supplies the medicine. It is solely the dermatologist who assesses and decides on each patient and circumstance. By the dermatologists of the Intermedica Clinic in 2013 in collaboration with internationally renowned trichologists conducted a retrospective study on the effectiveness of finasteride and dutasteride when used by women with androgenetic alopecia. You can read the results of this research here or download it in PDF format below. PDF scientific publication: “The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia”. Ids H. Boersma, Arnold P. Oranje, Ramon Grimalt, Matilde Iorizzo, Bianca M. Piraccini, Emiel H. Verdonschot *The Lareb side effects center received ten reports of possible side effects of finasteride/dutasteride in women in the period between 2005 and 2014. Two of these reports concerned the use of finasteride during pregnancy. On this basis, pharmacies are advised not to supply finasteride and dutasteride to fertile women. You can find Lareb's full message here.

Are you worried about your hair?
We can help!

Do you notice that your hair is getting thinner? Are you losing more hair than normal? Has your hairline changed compared to the past? Are you concerned about your hair or scalp and want to know what you can do?

Our dermatologists are experts in the field of hair problems.

During a consultation, a thorough diagnosis is made and the treatment options are discussed with you in detail, together with what you can expect. We understand that hair loss can have an emotional impact and our team of professionals are ready to support you and provide the best possible solutions.

About Intermedica kliniek

The Intermedica Kliniek is the leading expertise center for hair problems in the Netherlands. General practitioners, dermatologists and (university) hospitals refer patients with hair diseases, excessive hair loss or thinning hair to the Intermedica Clinic.

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