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6 min readA DECADE AGO, my buddies and I would get together every weekend to line up at the bar and passionately grunt at each other about whatever game was on. Now that we’re all in our thirties, we have a new routine. We meet up somewhere much quieter and inevitably start checking each other’s crowns for bald spots like a pack of gorillas fishing for insects. What is often lost during our paranoid expeditions for signs of aging is that not all hair loss is created equal.
The two main versions of it are thinning and breakage, and whichever you’re facing will determine the hair loss treatment you enlist. For some, thickening shampoos will suffice. For others, a stronger foam or hair growth device may be necessary. In either case, all that drinking in our twenties didn’t do us any favors, so I reached out to a trio of doctors to determine what type of hair loss we may be facing, and crucially, how to reverse it.
Difference Between Hair Thinning and Breakage
According to dermatologist Dr. Ariel Ostad, MD, the main difference between hair thinning and breakage comes down to where the issue originates. There are two primary areas of concern: the hair follicle, which is the living structure in the skin that produces hair, and the hair shaft, which is the visible, non-living strand that grows out of it.
In short, the hair follicle is closer to the root, and the shafts are the more visible strands. Hair thinning occurs at the follicle level, as it begins producing fewer, finer hairs or stops producing hair altogether, Dr. Ostad says. Breakage, on the other hand, is a shaft problem. Here, the hair grows normally from the scalp but breaks along its length.
The most common cause of shedding is genetic hair loss, known as androgenetic alopecia or, more commonly, male pattern baldness. Other triggers include telogen effluvium, which can happen after stress, illness, or weight loss, Dr. Ostad says. Breakage typically results from physical or chemical damage, such as over-processing with bleach or color, excessive heat styling, tight hairstyles (think man bun), harsh brushing, or poor moisture and protein balance. While the follicle remains healthy, the hair fiber itself becomes weak and prone to damage, he says.
Dermatologist Dr. Marisa Garshick, MD, adds that hair thinning reflects a decrease in the number or thickness of hairs growing from the scalp, while hair breakage occurs when the hair shaft snaps after it has already formed. When examining the situation, thinning will appear as reduced hair density with a more visible scalp, while breakage will show uneven length, although the number of follicles remains normal, she says.
Scalp health also directly impacts hair thinning, as inflammation, clogged follicles, and poor circulation can disrupt normal hair growth, Dr. Ostad says. In contrast, breakage mainly affects the hair shaft, so the focus shifts to protecting and repairing damaged strands. Stress can contribute to both, most commonly triggering shedding (usually telogen effluvium) and sometimes worsening breakage through inflammation or damaging hair habits.
How to Tell at Home
Founder of DandRX, Dr. Deepak Khanna, DO, says most people first notice hair changes as thinning when they look in the mirror and see either a more visible scalp, bald spot emerging, or receding hair line. Before that, they may also notice more hair on their comb or in the shower drain, a wider part line, or a more visible scalp, as these are all common signs of thinning. With breakage, it’s not as clear-cut. The hair often feels rough when you run your hands through it because it is uneven, so your barber or hairdresser might be the first to spot it, he says.
Dr. Ostad says if you see long hair with a white bulb at the end, the hair is shedding from the root. If you find short, uneven pieces without a bulb, the hair is breaking. This is because thinning causes overall loss of volume, while breakage leads to frizz, flyaways, and uneven lengths. You can also tell thinning and breakage apart by how the hair looks. Thinning makes the scalp more visible, while breakage keeps the overall thickness but makes the hair look rough, frizzy, and unable to grow longer, he says.
How to Treat
Hair loss treatment is one of those things that sees a lot of misinformation getting passed around and blindly accepted, especially if you spend any time on Instagram or TikTok. In many cases, these trends aren’t entirely without any merit, but they’re more band-aids or small boosts, rather than full treatments. For example, Dr. Garshick says that many thickening shampoos can make hair look fuller for a short time, but they do not treat hair loss. Similarly, hair oils and serums can add shine, but they will not stop shedding from the root.
However, these products can still help because hair regrowth takes time, and they can make the hair look healthier while other treatments start to work, she says. Still, some lean closer to snake oil. Dr. Ostad adds that one of the internet’s favorite hair loss aids, biotin, is rarely effective. It will only help if someone is biotin deficient, which is uncommon, he says. Instead, focus on over-the-counter treatments for thinning that target the follicle, with topical minoxidil as the most effective option.
For breakage, choose treatments that strengthen and protect the hair shaft using bond-repair formulas, deep conditioning, and heat protection, Dr. Ostad says. This will include shampoos and conditioners featuring proteins, ceramides, fatty acids, amino acids, or panthenol. For thinning, look for products with minoxidil, caffeine, niacinamide, ketoconazole, or peptides that support scalp health, he says.
Dr. Garshick’s number one recommendation for thinning is Rogaine 5% Minoxidil Foam. She says this formula helps to prolong the growth phase while reducing thinning. She also backs Nutrafol Men’s Hair Growth Supplement, which addresses internal drivers like stress, inflammation, and micronutrient gaps to support growth from within. For breakage, Dr. Garshick points to Olaplex No. 3 Hair Protector, which helps rebuild bonds in the hair to make it stronger, or K18 Leave-In Molecular Repair Hair Mask, which works deep inside the hair to improve elasticity and resilience.
There has also been a recent surge of hair growth devices, with a couple of standouts. Men’s Health contributor Bob Gearing found the Rogaine foam irritating to his scalp, so he turned to the HigherDOSE Red Light Hat. After a year of use, he saw a noticeable improvement in the thickness and prevalence of his hair.
Then there’s the FDA-cleared iRestore Essential Laser Hair Growth System, our best overall tested hair growth device. This helmet combines both LLLT and LED technology, blending the gentleness of LEDs with the intensity of lasers in one FDA-cleared device with convenient 25-minute sessions a few times a week. It offers a hands-free, easy-to-use option that may help address alopecia symptoms like thinning, balding, and a receding hairline.
Look, there is no cure for hair loss—at least not one that doesn’t involve a lengthy trip to Turkey. But there are plenty of effective options to postpone further thinning or breaking; you just need to know the right products.
Everything You Need to Treat Hair Loss
Nutrafol Men’s Hair Growth Supplement,
K18 Leave-In Molecular Hair Mask
HigherDOSE Red Light Hat
iRestore Essential Laser Hair Growth System
Meet the Experts
- Dr. Marisa Garshick, MD, board-certified dermatologist with RoyceDerm.
- Dr. Ariel Ostad, MD, board-certified dermatologist and facial cosmetic surgeon based in New York City.
- Dr. Deepak Khanna, DO, physician, hospitalist at the University of Pennsylvania, and founder of DandRX.
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Sean Zucker is the Grooming and Reviews Editor at Men's Health. He brings over half a decade of experience covering health, wellness, and lifestyle. When Sean's not writing about hair products, you can find him running for exercise, or toward the nearest food truck.
Christian is the Style and Reviews Director at Men's Health and Women’s Health, where he oversees shopping and style content for both brands. He started his magazine career as an accessories assistant at Vogue, and has since held editorial roles at Tatler Asia and The Manual. When he’s not online shopping, you can find him on long walks with his two corgis.
