From the Guidelines
The first-line option for treating hair loss is typically minoxidil (Rogaine), which is available over-the-counter in 2% and 5% solutions or foam. For men, the recommended regimen is applying 5% minoxidil to the scalp twice daily, while women can use either 2% twice daily or 5% once daily 1. Results typically take 3-6 months to become noticeable, and continued use is necessary to maintain benefits.
Key Considerations
- For men, oral finasteride (Propecia) at 1mg daily is another effective first-line treatment that can be used alone or combined with minoxidil for enhanced results 1.
- Finasteride works by blocking the conversion of testosterone to dihydrotestosterone (DHT), which is responsible for miniaturizing hair follicles in male pattern baldness.
- Both treatments are most effective when started early, as they work better at maintaining existing hair than regrowing lost hair.
- Side effects of minoxidil include scalp irritation and unwanted hair growth elsewhere, while finasteride may cause sexual side effects in a small percentage of men.
- Although PRP and PRF have shown promise in treating hair loss, the evidence is still controversial and more research is needed to standardize their use 1.
Additional Recommendations
- Addressing underlying causes like nutritional deficiencies, stress, or hormonal imbalances is also important for comprehensive hair loss management.
- A complex combined therapy protocol, including minoxidil and finasteride, may be more effective than a single treatment approach, especially when started early 1.
From the FDA Drug Label
Minoxidil topical solution 5% is a clear, light amber liquid medication containing 5% minoxidil for use only on the scalp to help regrow hair in men. Minoxidil topical solution 5% is for use only by men Minoxidil topical solution 5% may be appropriate for you if you are a male at least 18 years old and experiencing gradually thinning hair or gradual hair loss on the top of the scalp (vertex only, as shown).
First line option for hair loss: Minoxidil topical solution 5% is a first line option for hair loss in men, particularly for those experiencing gradually thinning hair or gradual hair loss on the top of the scalp (vertex only) 2, 2.
- Key points:
- For use by men only
- Apply twice a day, every day
- Results may be seen as early as 2 months with twice daily use
- Not intended for frontal baldness or receding hairline
- May not work for all men
- The amount of hair regrowth is different for each person.
From the Research
Hair Loss Treatment Options
- Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women, with various treatment options available 3.
- Traditional first-line treatments for AGA include topical minoxidil and oral finasteride, which have shown mixed results 3, 4.
Efficacy of Treatments
- A systematic review and meta-analysis found that minoxidil, finasteride, and low-level laser light therapy are effective for promoting hair growth in men with androgenetic alopecia, and minoxidil is effective in women with androgenetic alopecia 4.
- Oral minoxidil has been proposed as a safe alternative to topical minoxidil, with studies showing its efficacy and safety in treating hair loss 5.
- Platelet-rich plasma (PRP) and photobiomodulation are also being used as minimally invasive treatment options for AGA, with positive results 6, 7.
Treatment Considerations
- The quality of evidence for various treatments varies greatly, and there is still a need for randomized double-blinded clinical trials to assess their efficacy 3.
- Clinicians and patients must weigh the benefits and risks of each treatment option for AGA, considering factors such as efficacy, safety, and individual patient needs 3, 7.
- Hair transplantation is also an effective option for eligible individuals, using healthy follicular units to restore hair-bearing areas 7.