Although androgenetic alopecia (which refers to hair loss that is closely linked to genetic factors) does not require treatment, some people may want to use hair loss medications to reduce hair loss.
All prices are taken from Optum Perks, a free search engine that provides coupons to reduce the cost of your medications.
minoxidil
Price: Starting at $26.49 Type: Nonprescription Topical Brand Name: Rogaine
Minoxidil is a topical product that is applied to the scalp. Also available in stores.
Doctors initially prescribed minoxidil for severe high blood pressure, but the oral version was found to cause excessive hair growth in 20% of users. Scientists developed a topical version specifically for male androgenic alopecia in 1987, and later developed a version specifically for female pattern hair loss (FPHL).
Minoxidil is approved by the Food and Drug Administration (FDA) to treat male pattern baldness. However, scientists do not fully understand how it works. Experts believe this shortens the hair’s resting phase, called telogen, and lengthens the growth phase, called anagen.
Side effects and warnings
You may notice results within 8 weeks. However, there are some side effects to be aware of. These include:
It is also not suitable for people who are pregnant or breastfeeding. If you don’t know the cause of your hair loss, you should not use minoxidil.
Minoxidil may be more effective when combined with other hair loss treatments. For example, an older study found that women who took 0.25 milligrams (mg) of oral minoxidil and 25 mg of spironolactone as a daily capsule improved their FPHL.
spironolactone
Price: From $3.92 Format: Prescription Oral Tablet Brand Name: Aldactone
This drug is approved by the FDA for the treatment and management of heart failure and high blood pressure. However, your doctor may also prescribe it for FPHL if other treatments have not worked.
The British Association of Dermatologists says it can take up to six months for spironolactone to start working.
Several studies have revealed positive results of spironolactone for FPHL. A 2015 study found that almost 75% of study participants with FPHL experienced improved or stable hair loss.
A 2017 pilot study in 100 women with hair loss concluded that the combination of spironolactone and minoxidil may be a safe and effective treatment for FPHL. Study participants experienced increased hair growth and decreased hair loss. However, this study has some limitations and further research is needed to confirm its results.
Side effects and warnings
The AAD recommends avoiding the use of spironolactone during pregnancy as it can cause birth defects. If you want to take spironolactone, you must use contraception to prevent pregnancy.
Side effects that spironolactone can cause include:
dutasteride
Price: Starting at $8.50 Type: Prescription Oral Tablet Brand Name: Avodart
It may take 3-6 months to start seeing results.
An older study found that dutasteride 0.5 mg given for 6 months could improve hair growth in MPHL patients.
In another 2017 study, researchers looked at the effects of dutasteride and finasteride in men with androgenetic alopecia. They found that dutasteride was more effective, but its side effects were similar to finasteride. However, this study had a small sample size and short duration, so more research is needed to confirm the results in a broader population.
A larger meta-analysis in 2019 compared dutasteride and finasteride as treatments for MPHL. The authors found that dutasteride significantly increased hair number, increased efficacy, and caused similar side effects compared to finasteride. They also wrote that participants tolerated both treatments well. However, further studies are needed to confirm these findings.
Side effects and warnings
Dutasteride can cause side effects such as:
finasteride
Price: Starting at $3.93 Type: Prescription Topical or Oral Tablet Brand Name: Proscar, Propecia
It works by binding to the 5-alpha reductase enzyme and blocking the conversion of testosterone to DHT. This can slow down hair loss, but it cannot stop it completely.
According to the AAD, a person should take one tablet of finasteride every day. Results may take up to 4 months.
A 2018 study found that over 85% of participants saw improvement after using finasteride for five years, making it a good option for people looking for long-term support.
A 2022 paper states that some people may prefer using topical finasteride over oral agents because topical medications may have a reduced risk of sexual dysfunction. However, topical dosage forms can cause irritation, burning, or contact dermatitis at the treated area.
Side effects and warnings
Finasteride is not safe for pregnant or breastfeeding people, women of childbearing age, or children.
Additionally, finasteride can cause side effects such as:
