Hair loss is four different problems wearing the same jacket

"Hair loss" is a single phrase covering at least four unrelated problems. They look similar in a mirror and they are treated completely differently, which is why so many men spend a year on a product that was never going to work for them.

Here is how to tell them apart.

1 · Male pattern baldness

The most common cause worldwide, and the one most treatments are designed for. It is driven by genetics and DHT, a testosterone by-product that gradually shrinks follicles until they stop producing visible hair.

What it looks like: the M-shape. Corners pushing back first, often with the crown thinning independently, and the two eventually meeting.

What matters about it: it is slow, progressive, and genuinely treatable — but treatment maintains and regrows, it does not cure. Stop and the loss resumes. The men who do well are the ones who start early and stay consistent rather than the ones who find a better product.

2 · Traction alopecia

The one our community carries far more of than anyone else, and the one nobody gets warned about until it has already happened.

It is caused by pulling. Braids and cornrows worn tight, locs carrying weight, durags tied like tourniquets, and years of tight fades all put steady tension on the follicle. Aggressive brushing for waves does it too.

What it looks like: thinning at the edges and temples first, in a band that follows wherever the tension sits. Often with small bumps early on.

What matters about it: caught early the follicle is stressed rather than dead, and hair usually returns once the pulling stops. Left alone, the follicle scars — and a scarred follicle does not come back. The window is real and it closes.

3 · CCCA

Central centrifugal cicatricial alopecia is a scarring alopecia that starts at the crown and spreads outward, and it disproportionately affects people of African descent.

What it looks like: thinning that begins at the crown centre, frequently with tenderness, burning or persistent itch. That combination is the tell.

What matters about it: this is the one that needs a dermatologist rather than a product, and it needs one promptly. Early treatment can stop it. Late treatment cannot undo scarring. If you take one thing from this article, take this one.

4 · Everything else

A smaller group, but worth ruling in or out before you commit to a plan.

• Stress shedding — telogen effluvium. Sudden, diffuse shedding six to twelve weeks after a hard season. Usually recovers on its own.
• Patchy circular loss — alopecia areata, autoimmune. Needs a dermatologist.
• Nutrition gaps — iron, vitamin D and protein deficiencies are common and fixable, and worth checking at your next physical rather than guessing.
• Medication side effects — worth reviewing anything you started in the year before the shedding did.

The quick self-check

| What you see | Most likely | |---|---| | M-shaped corners, crown thinning, family history | Pattern baldness | | Edges and temples thinning, history of tight styles | Traction alopecia | | Crown centre thinning with tenderness or itch | CCCA — see a dermatologist promptly | | Sudden shedding everywhere after a stressful season | Stress shedding |

Why this matters more than the product you pick

Minoxidil is excellent for pattern baldness and helps traction recovery. It does nothing for a scarring alopecia that needs a prescription anti-inflammatory, and it will not fix an iron deficiency.

Six months on the wrong treatment is not just six wasted months. In traction and CCCA it is six months of a closing window. Work out which problem you have first — everything else is downstream of that.