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All about hair loss
2m - By Dr. Earim Chaudry
A word from our medical director
In this video, Dr. Earim Chaudry talks about the causes of hair loss, what can reverse it, and how our treatments and offering can help.

What causes hair loss

Hormonal effects (DHT)

Hair loss is caused by Dihydrotestosterone (DHT), a hormone derived from testosterone that shrinks your hair follicles.

Genetic factors

Inheriting hair loss genes from your family will increase the chances of losing your hair.

Lack of nutrients

Vitamin D, Selenium and Zinc all play an important part in the maintenance of healthy hair.
By Dr. Earim Chaudry
Manual Medical Director

Our solutions can help with

Receding hairlines

Often an early sign of hair loss that needs treating to prevent further hairline recession.

Thinning at the crown

One of the most common and recognisable signs of male pattern baldness.

Thinning all over

A gradual process where hair can start to feel less thick and more of the scalp can be seen.

How will medication help?

Blocking DHT
By inhibiting the production of DHT, hair loss can be completely stopped with regrowth also possible.
Stimulating hair follicles
By increasing oxygen-rich blood flow to your hair follicles, thicker, stronger hair growth is promoted.
The science behind hair loss
Dr. Earim Chaudry, Medical Director
94% of men who used Finasteride and Minoxidil combined showed an improvement in their hair loss.¹

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“Like many I was sceptical, but after a year on the daily tablets, all bald areas are fully recovered. Thanks to manual I have my hair back which I didn't think was possible”

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Choose a hair loss plan

Our plans are created by our medical team to offer the most effective combination of treatments

The Complete Hair Loss plan

Combines Finasteride & Minoxidil to increase hair growth & prevent hair loss
Best combo for maximum results
The science
Finasteride blocks hair loss, Minoxidil stimulates hair regrowth
In 3-6 months
Tablet (once daily), Spray (twice daily)
Delivery frequency:
1 month
Save 30%
3 months
“Strongly recommend a 3 month order as first results take time”
Earim Chaudry, Medical Director
£60 for the first 3 months
You already have a product that requires a prescription. You'll have to submit different orders for separate prescription medicine. Please proceed to your cart
Cancel-any-time subscription
Find out more

Finasteride Hair Loss plan

Blocks the enzyme that produces DHT to prevent hair loss and promote growth
Shields against hair loss
The science
Finasteride blocks hair loss
In 3-6 months
Tablet (once daily)
Delivery frequency:
1 month
Save 17%
3 months
“Strongly recommend a 3 month order as first results take time”
Earim Chaudry, Medical Director
£45 for the first 3 months
You already have a product that requires a prescription. You'll have to submit different orders for separate prescription medicine. Please proceed to your cart
Cancel-any-time subscription
Find out more

Minoxidil Hair Loss plan

Increases blood flow to follicles to promote growth and longer, thicker hair
Stimulates hair regrowth
The science
Stimulates hair follicles to promote growth
In 3-6 months
Spray (twice daily)
Delivery frequency:
1 month
Save 40%
3 months
“Strongly recommend a 3 month order as first results take time”
Earim Chaudry, Medical Director
£52 for the first 3 months
You already have a product that requires a prescription. You'll have to submit different orders for separate prescription medicine. Please proceed to your cart
Cancel-any-time subscription
Find out more
Other Treatments
Not sure which plan is right for you?

Answer a few questions about your hair and get recommended the best treatments for you, by UK prescribers.

180 day money back guarantee

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Personalised recommendations
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What to expect

1-2 months

There will likely be no visible change in the first two months. Though some people may shed more fine hairs than before. This is temporary and normal.

3-6 months

At this point, it may become noticeable that hair loss has slowed, stopped, or in some cases maybe even reversed. Take a photo to track your progress.

6 months

By now, hair loss may have considerably slowed or stopped, and some people may see signs of regrowth, usually at the crown of the head.
Results guaranteed
We're confident you'll love the results. Just follow your treatment plan and if you're not satisfied after 180 days, we'll give you your money back. See full terms

How it works

Online prescription

We’ll ask you a couple of quick medical questions. Tick the boxes and a clinician will review your answers and issue you a prescription.

Free next-day delivery

Your selected treatment will be delivered for free, with discreet packaging and instructions on how to use it.

Clinician support

Chat with your clinician anytime through your Manual account for any questions you may have, or updating your treatment.

Frequently asked

Why are there different types of treatments for the plan I want?
Different people have different needs. That's why we've developed a range of different treatment options, designed to give you the best possible results whilst fitting your specific needs.

Treatments in our plans come as pills, sprays or a combination of both, with dozens of combinations available to best suit you.
Which type of treatment should I choose?
Our team will assess the information you provide and based on this, give you their clinical recommendation on the best options to suit your needs and give you the best chance of getting the results you hope to achieve. The answers you give may mean that in certain circumstances, one type of treatment may be better for you than another.

Please read the 'learn more' if you would like to switch your recommended treatment as part of your plan.
Can I change treatment type?
Yes. We're committed to giving you the best chance of keeping your hair, so if your current treatment is not working as expected, you can change it - at any time - to any of the others recommended.
Will I be charged more if I change treatment type?
No, all types of treatments in a plan cost the same. We're committed to providing you with the best treatment for your lifestyle, at a price that is affordable and gives you the best value.
How long will it take to see results?
There’s no overnight cure for hair loss, but over time, medication has been shown to work for many men. As with any long-term treatments, it’s important to be patient, consistent and not to lose hope - treating hair loss just takes time. This does also mean, that the earlier you start, the more chance you have of saving your hair.

The time it takes to see results will differ by treatment type, broadly best results are seen at 12 months for combination plans. To better understand each plan's timeline, you can learn more on each treatment type page.
What are the side effects?
It's totally normal to be concerned about side effects. They are important to take into account when picking the right treatment for you.

Like all medicines, hair loss treatments carry the potential for unwanted side effects. The good news is that possible side effects should be uncommon, and usually reversible once you stop taking the medication.

We offer a range of formats, providing you with ways to help reduce your chances of specific side effects. The type of side effects and the likelihood you may experience them will differ by treatment type. Please read the learn more about each format for a detailed description of their specific potential side effects.
I'm not sure i'm ready to buy this plan
Not a problem! If you have a clinical question, but you're not quite ready to complete a consultation yet, you can sign up for an account and send a message to one of our clinicians.

Alternatively, if you have a general question, you can email us at
Meet our medical team
Enabling the mission of revolutionising how men approach health, they are at the core of the men’s wellness platform.
Earim Chaudry, MD
Medical Director
Eve Agwuncha
Pharmacist, Ind. Prescriber
Bentley Ifediora-Ezike
Pharmacist, Ind. Prescriber
Male Hair Loss: Everything You Need to Know
Curated by Dr. Earim Chaudry, Manual Medical Director
Male pattern baldness (MPB) is common – and probably more common than you think. 30% of men aged 30 have it to some degree. By the age of 70, that proportion is 70%. While some of us can even see it in our 20s, others can hold out until their older years. The chances are that you will almost certainly see some degree of thinning.
But what are the common causes of hair loss? And is it treatable? Read on to find out more.
The Causes of MPB and Other Hair Loss
In 90% of cases, though, male hair loss is caused by MPB (also known as androgenic alopecia). This is a result of your hormones and genes – and your follicles’ sensitivity to dihydrotestosterone (DHT). DHT is a male hormone that gives your male characteristics when young, but it impacts hair growth as you age.
DHT binds to hair follicles on your scalp, and causes them to shrink, weaken, and stop producing healthy hair. It also affects your hair growth cycle, meaning that your follicles are in their resting phase for longer and stay in the growth phase (or anagen phase) for a shorter time. MPB is treatable and even reversible.
There are other reasons why you can lose your hair – and, unfortunately, not all of them are treatable. Alopecia areata is one possibility, caused by autoimmune disease, in which hair falls out in clumps. Another cause is traction alopecia, where hair falls out due to tension at the root. This is usually the result of wearing a tight-fitting helmet for too long, or wearing hairstyles such as braids, cornrows, or hairpieces too tightly. It’s usually accompanied by itchiness and redness on the scalp.
Trichotillomania, or obsessive hair pulling, is another of the types of hair loss, caused by physically pulling out hair from the scalp or eyebrows. Meanwhile, telogen effluvium is the name of hair loss caused by stress. Other medical conditions and treatments – including fungal infection and chemotherapy – can also cause hair loss. Consult your GP or a dermatologist before treatment.
Is my hair loss treatable?
If you’re male and in the 90% of hair loss cases, take a deep breath. It’s okay. MPB is easily treated using widely approved treatments.
You’ll be able to recognise if you have MPB. It first affects either the hair above your temples or on your crown. You’ll see your hairline receding into a “widow’s peak”, a v-shaped hairline at the front of your head. Elsewhere, thinning hair will be seen across the top of the head. Importantly, it won’t fall out suddenly or in clumps, and it won’t leave behind a rash.
There are two effective and approved treatments for a receding hairline. Known as Finasteride (often sold as Propecia) and Minoxidil (Rogaine or Regaine).
The first, Finasteride, tackles the root cause of MPB by blocking the production of the hormone DHT. Effective in 90% of men and usually taken orally as a daily pill, Finasteride intervenes to prevent the shrinkage of hair follicles before they become permanently damaged.
Minoxidil, meanwhile, is applied topically as a spray. It’s a “vasodilator”, widening blood vessels on the scalp to facilitate the transport of nutrients and oxygen. Use the spray twice daily – and it’s shown to help regrowth in two thirds of men. We recommend that men use both of these treatments together.
Note: Many men report that topical Minoxidil has not worked for them because they lack the SULT1A1 sulfotransferase enzyme in their hair follicles to activate the topical Minoxidil to the active form Minoxidil Sulphate. Studies show oral Minoxidil (a tablet form) is more effective as it utilises the sulfotransferase enzyme present in the liver, and is not reliant on it being present in the scalp.
What are the side effects of the treatments?
Finasteride and Minoxidil are licensed as effective treatments for hair loss. Like all medications, they can have side effects. However, the good news is that these side effects are rare, and the vast majority of people do not experience them.
The side effects of Minoxidil usually come as a result of overapplication. They include dizziness and drowsiness – as the increased blood flow lowers your blood pressure slightly – as well as irritation in the area of your scalp where it has been applied. Other side effects may include hypertrichosis (abnormal amount of hair growth), changes in hair colour, headaches, fast heartbeat, fluid retention (swelling) in the hands, feet or legs, shortness of breath, and low blood pressure. More serious side effects – including chest pain, heart palpitations, nausea, and changes to your vision – are very rare.
Over 98% of men experienced no serious side effects of Finasteride in clinical trials. However, weight loss and weight gain, skin rashes, tenderness around the nipples or lumps, dizziness and weakness, erectile dysfunction, testicular pain, poor seminal quality / infertility, ejaculation disorders, decreased libido and changes in mood or depression have all been reported as side effects. If your partner is pregnant, conservative advice is to use a condom.
Unreported side effects may also occur. Any questions, just reach out to us via direct messaging through your account, WhatsApp, phone or book via this link to schedule a call with one of our clinicians.
Why wouldn’t I have a hair transplant?
Hair transplants are not quite as permanent as they may seem. As MPB is a progressive condition, there’s no guarantee that your hair loss won’t continue post-op. And, as a result, you might find yourself saving up for a second or a third transplant.
Hair transplants are also accompanied by treatment with Finasteride and Minoxidil. These drugs tackle the root cause of hair loss, where hair transplants only manage the symptoms. You’re increasing the chances of further hair loss if you don’t follow surgery with these treatments. You’re the best judge of what you need, but if you’re getting a transplant, you’ll be taking these medications afterwards anyway.
Can a shampoo treat my hair loss?
Yes, it’s true. Shampoos can be effectively used to treat hair loss. However, with many duff products on the market, it’s important that you know what you are looking for.
Manual’s Power Shampoo includes ingredients known to encourage healthy hair. Caffeine is known to stimulate hair follicle activity. Biotin is an essential vitamin for hair health, as it plays a role in the production of keratin, the protein of which hair is made. Meanwhile, saw palmetto is thought to reduce the amount of DHT in the body, too. But Finasteride and Minoxidil are the only proven treatments.
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This has honestly revived my hair. I was going bald from the age of 19 and by 21 my hairline was completely gone. I’ve been taking this for 6 months and my hair line has grown back completely to how it was.
Alex. Trustpilot
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