Many men hesitate for months, sometimes years, about whether they should see their GP about hair loss. It feels like something trivial. Something vain, perhaps. And somewhere you read that the GP won't do anything about it anyway.
That last part is only half true. An appointment about hair loss can be very useful, provided you know what to expect and what not. In this blog, you will read how such a conversation usually goes, why some GPs are cautious about prescribing medication, what it costs, and how to prepare so that you come away with a clear plan.
Should you actually go to the GP for hair loss?
Hereditary hair loss is not a disease. It says nothing about your health, and for many men, it is simply a part of aging. So, you don't have to go. But there are good reasons to do so anyway.
Thuisarts.nl, the patient website of the Dutch College of General Practitioners (NHG), mentions a few situations where an appointment is sensible:
- you are losing significantly more hair than normal
- your hair is visibly thinning
- you are developing sudden bald patches
- you are worried about it, or it is making you feel insecure or depressed
The latter point is often forgotten. You don't need a medical reason to go. If it bothers you, that is reason enough. Are you still doubting whether what you see is actually hair loss? Then read about early signs of hair loss and how much hair loss per day is normal first.
What the GP does during the consultation
A regular consultation lasts about ten minutes. That is short, so it helps to know how it usually proceeds.
- Asking questions. Since when have you noticed it? Is it gradual or sudden? Does baldness run in your family? Do you use medication or supplements, or have you been ill recently, experienced a lot of stress, or lost weight quickly?
- Examination. The GP will examine the pattern. Receding hairlines at the temples and thinning at the crown are typical of hereditary hair loss. Round bald patches, a red or flaky scalp, or hair thinning everywhere at once point to something else.
- Conclusion and options. With a typical pattern, the GP usually makes the diagnosis by sight. Then, he or she will discuss what you can do and whether it is worth it for you.
Blood tests are by no means always part of it. With the classic male pattern, it adds little, because the cause is primarily hereditary sensitivity to DHT and not an abnormal blood value. If you are losing a lot of hair everywhere at once, or if you have other symptoms such as fatigue, a blood test is more logical. Think of iron or your thyroid. We wrote about this earlier in iron and hair loss and thyroid and hair loss.
Why the GP is sometimes hesitant
This is the part where many men get frustrated. They go with a clear request, for example for finasteride, and return with advice to mainly accept it.
That is not due to unwillingness. GPs work with NHG guidelines, which are cautious when it comes to hair loss. The starting point is that baldness does not need to be treated. Medication mainly comes into the picture if you are truly suffering from it. The reasoning behind this:
- The treatments only work as long as you use them. If you stop taking finasteride, the effect is gone after nine to twelve months according to the Farmacotherapeutisch Kompas.
- Not everyone responds. According to Apotheek.nl, Minoxidil on the skin helps about one-third of users achieve visible hair growth.
- Finasteride can have side effects, including sexual ones. For most men, this is not the case, but a GP will factor that risk in. More about this in persistent side effects of finasteride.
It also varies from GP to GP. One will prescribe finasteride without much discussion, the other prefers not to. Both fall within what the guideline allows. It therefore helps to clearly explain why it is important to you. "I am 26, my father and grandfather were bald early, and I notice that it makes me feel insecure" gives the GP much more to work with than "Can I get finasteride?"
Which treatments may be on the table
For hereditary hair loss in men, there are two treatments that the GP will discuss.
The first is minoxidil for the skin. You do not need a prescription for this; you can buy it at the pharmacy or drugstore. The GP can explain how to use it and what to expect. Thuisarts.nl mentions applying it to the bald spots twice a day, and you will only see if it does anything after about six months. You can read more extensively about this in minoxidil for hair loss.
The second is finasteride 1 mg, a prescription tablet. It inhibits the conversion of testosterone into DHT, the hormone that causes hair follicles to shrink in sensitive men. According to Thuisarts.nl, you should discuss how it is going with your GP two to four weeks after starting and whether you have any side effects. Everything about this medication is in finasteride for hair loss.
Other options, such as oral minoxidil, dutasteride, or topical finasteride, are not standard treatment for most GPs. These are more likely to be prescribed via a dermatologist or a specialized clinic.
What it costs and what insurance covers
The consultation with the GP is free. It does not fall under your deductible. The medication is a different story.
- Finasteride 1 mg for hair loss is not covered by basic insurance. You pay for it yourself.
- Minoxidil lotion is an over-the-counter product and you pay for it yourself.
- Some supplementary insurance policies have a provision. Check your policy or call your insurer before assuming.
- If you are referred to a dermatologist, that will come out of your deductible.
Keep in mind that you will be using these products for years if you want to maintain the effect. A few tens of euros a month seems little, but do the math over five or ten years.
When you are referred to the dermatologist
With regular hereditary hair loss, a referral is usually not necessary. The GP can make the diagnosis themselves and prescribe or advise on the common remedies.
A dermatologist is more likely to be involved if:
- the pattern does not match hereditary baldness
- there are round, smooth bald patches that appear quickly, such as with alopecia areata
- the scalp is inflamed, painful, or scarred
- previous treatments are not working and you are suffering greatly from the hair loss
On forums, you sometimes read that men ask for a referral themselves if their GP won't cooperate. You can always discuss that. Do know that the GP must also find a referral worthwhile, and that you often have to deal with a waiting list at the dermatologist.
How to prepare for the conversation
Ten minutes goes by fast. With a little preparation, you will get much more out of it.
- Bring photos. Preferably from a few months or years ago and from now, under similar light. This shows at a glance that something is changing.
- Know your family. How is it with your father, grandfathers, and uncles? On which side is the baldness? See also heredity and hair loss.
- Write down what you use. Medicines, supplements, testosterone, or other products from the gym. Be honest about this, because it could be the cause.
- Know what you want. Do you mainly want to know if it is hereditary? Do you want to consider medication? Say that at the beginning, not in the last minute.
- Tell them how much it bothers you. That is not exaggerating. It is information the GP needs to make a decision.
It also helps to know what stage you are in. With the Norwood scale, you can estimate that yourself beforehand.
And if you don't want to go to the GP?
That is also possible, of course. Online, there are providers where you can have finasteride prescribed after a questionnaire. That is easy, but no one looks at your scalp. If your hair loss has a different cause than you think, you will miss that. If you choose that, do it at least with a party where a registered doctor is looking along.
Other men, certainly in the beginning, do not want medication and start with scalp care. A serum with ingredients such as Redensyl, Procapil, and Baicapil works differently than finasteride or minoxidil, and you do not need a prescription for it. The Hairborn Growth Serum is an example of this. Some men combine it with a derma roller. Don't expect miracles and give it at least three to six months. The honest trade-off between these two routes is in serum or medication for early hair loss.
Whatever you choose: the conversation with the GP does not exclude anything. You can go first to hear what is going on and then decide for yourself what to do about it. That is perhaps the greatest gain of such an appointment.
Frequently Asked Questions
Is it weird to go to the GP with hair loss?
No, GPs see this regularly and it is a normal reason for an appointment. Thuisarts.nl mentions worry or insecurity due to hair loss itself as a reason to go. So, you don't have to apologize. Just tell them what you see, since when, and how much it bothers you. The more concrete you are, the better the GP can help you.
Does the GP perform a standard blood test for hair loss?
No, with the typical male pattern of receding hairlines and a thinning crown, blood tests are usually not necessary. The diagnosis is then made by sight. If you lose a lot of hair everywhere at once, or if you also have symptoms such as fatigue, the GP can have blood drawn, for example for iron or the thyroid.
Can the GP refuse to prescribe finasteride?
Yes, the GP decides for themselves whether a medication is wise for you. The guideline for GPs is cautious and advises medication mainly if you are suffering greatly. Therefore, explain well why it is important to you. If the GP remains in doubt, you can ask whether consultation with or a referral to a dermatologist is an option.
Is finasteride for hair loss covered by insurance?
No, finasteride 1 mg for hair loss is not covered by basic insurance. You pay for it yourself at the pharmacy. Some supplementary insurance policies have a provision, but that varies per policy. Check this with your insurer before you start, because you usually use the medication for years.
Do I need a prescription for minoxidil?
No, minoxidil lotion for the scalp is available without a prescription at the pharmacy and drugstore. So, you can start with it yourself. It can still be useful to discuss it with your GP first, especially if you are not sure whether your hair loss is hereditary or if you use other medications.
Does an appointment with the GP about hair loss cost money?
No, a consultation with the GP is free and does not come out of your deductible. Costs only arise for medication, blood tests in a lab, or a referral to the dermatologist. Care through the hospital and the dermatologist falls under your deductible. You usually pay for medication for hair loss yourself.
When does the GP refer to a dermatologist?
Usually only if the diagnosis is not clear or if something else is going on than hereditary baldness. Think of sudden round bald patches, an inflamed or painful scalp, or scars. Also, if treatments do not work and you are suffering greatly, a referral can be discussed. For regular hereditary hair loss, that is rarely necessary.
What do I bring to the appointment?
The most useful things are photos from before and now, a list of medications and supplements you use, and what you know about baldness in your family. Also, consider beforehand what you want: a diagnosis, advice on medication, or both. This is how you make the best use of the short consultation time.
Do I have to go back to the GP if I start taking finasteride?
Yes, according to Thuisarts.nl, you should discuss how it is going two to four weeks after starting and whether you have any side effects. After that, it is sensible to see after six months to a year whether the medication is doing anything. Photos under the same light help with this, because you see change poorly yourself in the mirror.
Is an online doctor a good alternative to the GP?
That is possible, but you miss the physical examination. An online doctor usually works with a questionnaire and does not see your scalp. If your hair loss has a different cause, such as alopecia areata or a deficiency, that could be missed. If you doubt the cause, go to your own GP first.
