Q&A: Heather Woolery-Lloyd, MD, FAAD, on the Biology of Hair Thinning in Older Male Patients

As hair thinning in male patients increasingly becomes a topic of discussion in dermatology clinics, age-specific biology is emerging as a key factor in treatment planning—particularly for patients over 50. In this Q&A, Heather Woolery-Lloyd, MD, FAAD, a board-certified dermatologist, founder of DermFriends, and Chief Medical Advisor at Nutrafol, explores how hair loss in older men differs from early-onset androgenetic alopecia and why management often requires a broader, multi-factorial approach. She discusses the biologic shifts that accompany aging, the rationale behind Nutrafol’s newest launch, Men 50+, and how dermatologists can integrate targeted nutraceutical support alongside other therapeutic options while counseling patients who may feel it is “too late” to intervene.

Dermatology Times: What age-specific considerations should dermatologists be aware of when treating a 50+ year old man with hair loss versus a younger patient?

Woolery-Lloyd: Younger men who seek treatment for hair thinning often have a family history of male pattern hair loss and they are interested in preventing or treating androgenetic alopecia. In contrast, older men tend to have additional factors that can contribute to hair thinning. Although older men can present with androgenetic alopecia, this can be compounded by age-related thinning. As men age, there are unique biological changes that can contribute to hair thinning: hormone balance shifts, cellular turnover slows, oxidative stress and inflammation increase, collagen production declines, and nutrient absorption may become less efficient.

Hair thinning after 50 is often more complex and cumulative, which is why a whole-body, inside-out approach can be helpful. Nutrafol Men 50+ focuses on supporting the biological environment that allows hair to grow. By addressing factors like oxidative stress, nutrient delivery, and scalp health, the formula helps create more favorable conditions for healthier-looking hair. Nutrafol Men 50+ was designed specifically around the biological shifts that occur after age 50.

Dermatology Times: How do the key ingredients of Saw Palmetto, Moldavian Dragonhead, and Spermidine work together in Nutrafol Men 50+?

Woolery-Lloyd: The key ingredients in Nutrafol Men 50+ are designed to work synergistically to address several of the primary biological drivers of hair thinning in men over 50. Saw Palmetto helps reduce the conversion of testosterone to DHT, a hormone that can shrink hair follicles and contribute to thinning, supporting a healthier environment for hair growth. Moldavian Dragonhead promotes the body’s natural collagen production, helping maintain hair strength and scalp health as collagen levels decline with age. Spermidine supports cellular health, helping counteract age-related changes like cellular senescence that can impact the hair growth cycle and follicle function. Together, these ingredients, along with the 16 other ingredients, take a multi-targeted approach that is particularly relevant for men 50 and older. This kind of comprehensive, root-cause strategy is important in dermatology because hair thinning at this stage of life is rarely driven by just one factor.

Dermatology Times: How does this formula differ from the original Men’s one? What other treatments or procedures for hair thinning can this new supplement be combined with?

Woolery-Lloyd: Men 50+ was designed specifically around the biological shifts that occur after age 50. The original Nutrafol Men formula is intended for men ages 18–49 and focuses more heavily on root causes like hormones, stress, and lifestyle. While both formulas contain ingredients to support healthy hair growth, Men 50+ was developed and evaluated with the needs of a mature population in mind. I typically recommend patients choose the product aligned with their age for the most targeted benefit. Nutrafol is tolerated well alongside other hair thinning treatments, and because hair thinning is often multifactorial, a combination approach can be very helpful.

Dermatology Times: How should clinicians recommend this product and approach conversations with male patients who may believe it’s “too late” to treat their hair loss?

Woolery-Lloyd: It’s important to set realistic expectations: Nutrafol Men 50+ is not designed to regrow hair in fully bald areas where follicles may no longer be active. However, for older men who are concerned about hair thinning or are interested in maintaining the hair they have, this formula can help support and maintain hair quality over time.

Dermatology Times: Is there anything else you’d like to share with our audience today?

Woolery-Lloyd: As a dermatologist, I always make sure that when I recommend a supplement, it’s backed by clinical studies and credible third-party reviews for safety. Nutrafol Men 50+ is unique because it is NSF Certified for Sport, which is one of the highest standards for independent safety and quality testing in supplements. NSF is a third-party organization that independently tests to confirm the ingredients that are listed on the label. NSF Certified for Sport is the highest tier of NSF certification and screens for over 290 substances banned by major athletic organizations. This level of rigor in safety and quality gives me confidence in recommending Nutrafol to patients looking for science-backed solutions for hair thinning.