Treatment for Patterned Hair Loss
Start with topical minoxidil 5% applied 1 mL twice daily to the scalp, which is the FDA-approved first-line treatment for androgenetic alopecia. 1, 2, 3
Initial Treatment Approach
Apply minoxidil 5% topical solution directly to the scalp twice daily (morning and evening), ensuring the medication reaches the scalp surface rather than just coating the hair. 1, 3
Expect to wait 4-6 months before seeing visible results, as hair grows only 1/2 to 1 inch per month; some patients may notice improvement as early as 2 months. 3, 1
Do not be alarmed if hair loss temporarily increases during the first 2 weeks of treatment—this represents shedding of old hairs to make way for new growth. 3
Combination Therapy for Superior Results
The most effective evidence-based approach combines minoxidil 5% with platelet-rich plasma (PRP) injections, which increases hair density by 1.74 times and hair diameter by 14.3 times compared to minoxidil alone. 4, 1, 2
PRP Treatment Protocol
Receive PRP injections every 3-6 months (typically 3 sessions spaced 1 month apart initially, then maintenance every 3-6 months) while continuing daily minoxidil application. 4, 2
PRP combined with minoxidil is significantly more effective than either treatment alone and represents the best therapeutic option for androgenetic alopecia. 4, 1, 2
Be aware that PRP injections cause more pain than topical minoxidil, though the superior results may justify the discomfort. 4
Alternative Option: Oral Minoxidil
If you cannot tolerate or comply with twice-daily topical application, consider oral minoxidil 1 mg daily, which is as effective as topical 5% minoxidil. 2, 5, 6
Important Cardiovascular Screening Required
Before starting oral minoxidil, you must undergo cardiovascular screening including assessment for orthostatic symptoms, edema, tachycardia, and pre-existing heart conditions. 2
Oral minoxidil is contraindicated if you have cardiovascular disease, and monitoring for rare but serious effects like pericardial effusion is necessary. 2
Critical Treatment Principles
Continue treatment indefinitely—all hair regrowth will be lost within months after stopping, as no treatment alters the underlying course of androgenetic alopecia. 2
Early intervention is crucial; recent and limited hair loss responds much better than extensive and prolonged cases. 1
Minoxidil works best for hair loss on the vertex (top/crown) of the scalp, not for frontal baldness or receding hairline. 3
What NOT to Expect
Do not expect to regrow all lost hair—the amount of regrowth varies significantly between individuals, and some men may not respond at all. 3
If you see no improvement after 4 months of consistent twice-daily use, stop treatment as you are likely a non-responder. 3
Initial regrowth will appear as soft, downy, colorless "peach fuzz" hairs before potentially developing into terminal hairs. 3
Common Pitfalls to Avoid
Ensure the medication reaches your scalp, not just your hair—this is the most common reason for treatment failure. 3
Do not skip applications; inconsistent use dramatically reduces effectiveness. 1, 3
Do not give up before 4-6 months; premature discontinuation prevents you from seeing potential results. 3, 1