Inherited hair loss can be treated with medicines or hair transplant surgery. Other types of hair loss are treated by dealing directly with the cause. Finasteride is only effective for hair loss caused by androgenetic alopecia (AA), which is also known as male-pattern or female-pattern hair loss. 

Medications

Options for treatment with medication include:

1. Finasteride: Oral pill taken once daily, more effective than minoxidil alone
2. Minoxidil: Topical, used twice daily, not as effective as finasteride
3. Combo of finasteride + Minoxidil: This is the gold standard for hair loss treatment and over 90% effective!

Finasteride

Also known by its brand name Propecia® or Proscar®, is used to help hair growth in people assigned male at birth (AMAB). It may take three months to see the full effect. It decreases the production of DHT, the hormone that causes hair loss in AMAB people.

Finasteride Dosing

• Tablet may be taken with or without food.
• If you miss a dose, take the tablet as soon as you remember. If it is less than 12 hours till your next dose, skip the dose and resume your usual dosing time. Do not double dose.

Finasteride Side effects / Safety Considerations:

• Less than 2% of people experience side effects including sexual side effects (decreased libido, erectile dysfunction), swelling to hand and feet, and light-headedness. Side effects are reversible when medication stopped.
• Finasteride has been found to decrease your overall chances of acquiring prostate cancer. However, in the case that you do acquire it, it may increase the risk of forming a more aggressive form of prostate cancer by 0.5%.
• Rare, but may have a potential to increased suicidal ideation (suicidal thoughts). Stop medication and seek Emergency Care if this occurs.
• Might take up to three to four months to notice results. Continue for at least 12 months to assess full effect; continued daily use is required to sustain benefit.
• 90% effective at stopping hair loss.
• Can affect fertility and should be avoided in men interested in conceiving.
• If showing positive results, continue medication for as long as new hair growth is wanted.
• Hair loss may reoccur once medication is stopped.
• If you have not seen positive results after one year of continuous use, finasteride will likely not be effective for you.
• Pills should never be handled by people who are or may be pregnant.

Minoxidil Topical

Also known as Rogaine®. How this medication works is not well understood, but topical minoxidil stops hair from thinning and stimulates new hair growth.

Minoxidil Dosing

• Available as liquid or foam
• Apply directly to scalp, not just hair
• Apply twice per day for best results

Minoxidil Side effects/ Safety Considerations:

• Side effects are rare but may include scalp redness and irritation and the growth of facial hair.
• Can take up to three to four months to notice results. Continue for at least 12 months to assess full effect; continued daily use is required to see ongoing effect (hair loss will return when stopped).
• If showing positive results, continue medication for as long as new hair growth is wanted.
• Hair loss may reoccur once medication stopped.
• You may notice increased shedding of hair in the first couple months of use - this is only temporary and usually a good sign the medication will work!
• Minoxidil 5% has been shown to be more effective than a 2% concentration.
• Minoxidil seems to be most effective for men under 40 who have been balding for 5 years or less and do not have large areas of baldness.