FTM hair loss

Did you know that part of FTM people faces hair loss, following T therapy? What are the main reasons? How does an FTM person feel about this? What can be done to avoid balding? Let’s discuss these and some more questions in the following parts of this article.

FTM balding

This is not a secret, the start of balding is closely related to the start of T therapy. Usually, balding starts slowly and almost imperceptibly, especially when a trans man has lush hair on his head. Why testosterone is responsible for hair loss? Hair loss is known as androgenetic alopecia. For a transgender man, this unpleasant change usually starts following hormone replacement therapy (HRT). Taking testosterone is the most popular treatment to achieve a masculine body and transit yourself into men. Unfortunately, so desirable changes may bring unpleasant effects such as hair loss, as well. Interested why this happens? The main reason and perpetrator is DHT (dihydrotestosterone) – a hormone, created from testosterone, which is linked to male pattern baldness and hair loss. DHT affects the hair follicles and harms them. As a result – hair follicles start
Of course, not every trans man who starts using testosterone faces side effects such as hair loss. Androgenetic alopecia is a possibility, but not a necessity. And you can never know how much T will affect your hair.

Stages of FTM male pattern baldness

Androgenetic alopecia or male pattern baldness (MPB) is classified into 7 stages. These stages are also known as the Norwood Hamilton scale (picture below).

FTM male pattern baldness
The Norwood scale helps to determine the condition of trans men’s hair thinning or loss. The earlier stage is, the easier reverse your hair fall is. Let’s find out how exactly each stage on the Norwood scale looks like and what can be done not to reach the following scale step and prevent further hair loss.

Stage 1 (Norwood Type 1)

Hair thinning in the first stage of MPB is almost unnoticeable. It means, that that there are no obvious changes, and the first early balding signs are missed by the transgender people. 

Treatment. Is it possible to treat something you don’t know it should be treated? I guess the answer is no. The best what you can do is to make an investigation about your family and the hair they own. Are there any bald family members, are anybody of your relatives facing hair thinning or even loss? This could help you to pay more attention to your scalp situation and notice the first changes around the forehead and the temples.

Stage 2 (Norwood Type 2)

In this stage hair thinning becomes visible, especially on the forehead (V or M-shaped hairline). It could be called the early stage of male pattern baldness. 


The mild hair loss stage is the best time to take the first action against further hair loss. You can start using some natural methods as herbs to prevent hair loss, or even take medications such as minoxidil (stimulates hair growth and is responsible for hair restoration) or finasteride (reduces DHT levels). 

Stage 3 (Norwood Type 3)

If your hair thinning becomes more visible and you can notice clear M, U, or V shapes of your forehead – this is stage 3. It is complicated to hide the hair loss and you should start the treatment as soon as possible. 


In stage 3 natural methods of treatment are no longer helpful. It is time to start taking minoxidil and finasteride. Besides, hair transplantation could be a very effective hair restoration method. 

Stage 4 (Norwood Type 4)

Unfortunately, stage 4 means that you have faced massive hair loss on the crown of your head. Massive hair loss brings so much stress. It is not possible to hide baldness anymore. 


First, it is necessary to the reduce body’s DHT levels. A simple diet, quitting smoking, active lifestyle – that’s the most effective way how to do that. Finasteride is another way on reducing DHT levels. Other methods, such as sleep, resting, dry derma roller massage of the scalp, are important in fighting hair loss and baldness. 

Stage 5 (Norwood Type 5)

Stage 5 and stage 4 are quite similar, but hair loss is more severe in stage 5. The hairline is in the progress of moving toward the back of the head. It becomes a challenge to treat male pattern baldness in this stage.


It’s a correct decision to continue using treatment methods of the previous stages. Besides, it’s time to think about hair transplants as an option. Or you can always choose to use micro-pigmentation to hide the bald spots on your head.  

Stage 6 (Norwood Type 6)

In this stage, FTM people face with almost bald front and top of the head. The rest hair becomes thin, and the scalp is even more visible than ever.  


In stage 6 it is recommended to get a scalp reduction procedure. If you combine scalp reduction and hair transplant procedures – the result should make you happy, because your scalp will look fuller with hair. 

Stage 7 (Norwood Type 7)

Stage 7 means that a person almost lost all his hair. There may be some hair left on the sides of the head. Unfortunately, there is a big chance the balding will continue. Existing hair and newly growing hair are thin and weak. 


The level of hair loss is the highest and most complicated in this stage. The best option of treatment – getting a hair transplant. FTM (female to male) patient should visit his doctor first. Usually, it takes some time to discuss all the questions related to hair restoration and transplantation. In most cases, surgeons recommend using head hair and facial hair for transplantation. A talented specialist can create a miracle on the patient‘s head.

FTM balding

Trans men hair loss

Facing hair thinning or even loss usually is a stressful experience. Thick and healthy hair brings self-confidence, which is so necessary to each of us, especially to FTM people who often might have gender dysphoria, mixed thoughts about themselves, fair to come out, and much more negative, and complicated feelings and emotions. Besides, male pattern baldness is responsible for the acuting condition of gender dysphoria. As you can understand, this is a serious issue which can’t be left without fixing it as soon as possible.  

The family and friend support, therapeutic intervention, a medical team of amazing aesthetic specialists – this is the key to successful treatment. Never forget that you are not alone in this battle! There are plenty of FTM people who have faced the same problems and you are always welcome to find their stories online or even contact these people. Male pattern baldness is not only a question of look, but it is directly related to mental health, as well. Not losing hair is an important part of a successful FTM transition journey. 

You are welcome to visit the related blog posts on the Emisil website:

To learn more about FTM facial hair - click here.

To learn more about testosterone and hair growth - click here.

To learn more about FTM hairstyles - click here.

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