Hair Loss Treatments: Minoxidil, Finasteride and What Actually Works

Hair loss is extremely common, and for many people it affects confidence more than they admit. A small number of treatments have good evidence, but they take months to work and only continue working while you use them.

Imagine noticing more scalp in photos, more hair in the shower drain and a widening parting. You see adverts promising miracle shampoos and supplements. What actually works, and what is a waste of money?

Common types of hair loss

• Male and female pattern hair loss (androgenetic alopecia): gradual thinning linked to genes and hormones; the most common cause
• Telogen effluvium: temporary shedding a few months after illness, childbirth, surgery, stress or crash dieting
• Alopecia areata: round patches of hair loss caused by the immune system
• Traction alopecia: from tight hairstyles, braids or extensions
• Hair loss from medical conditions: such as thyroid problems or iron deficiency

When to see a healthcare provider

• Sudden or patchy hair loss
• Hair loss with an itchy, painful or scaly scalp
• Hair loss with other symptoms, such as tiredness, weight change or irregular periods
• Hair loss in children
• If you are distressed by it

Minoxidil

Minoxidil is applied to the scalp as a solution or foam, usually once or twice a day. It is available without a prescription in many countries for both men and women. It prolongs the growth phase of hair follicles and can slow hair loss and regrow some hair.,Results take at least three to six months to appear, and shedding can temporarily increase in the first few weeks. If you stop, any gained hair is usually lost within months. Side effects include scalp irritation and, rarely, unwanted hair growth on the face. Low-dose oral minoxidil is also used by some specialists, but it needs medical supervision because it can affect blood pressure and heart rate.

Finasteride

Finasteride is a tablet that blocks the conversion of testosterone to dihydrotestosterone (DHT), the hormone that shrinks hair follicles in male pattern hair loss. It is prescribed for men. It can slow hair loss in most men and regrow some hair in many.,Like minoxidil, it takes several months to work, and benefits stop when you stop taking it. Possible side effects include reduced sex drive, erectile problems and changes in mood. Regulators have added warnings about depression and suicidal thoughts, and reports of sexual side effects that persist after stopping. Discuss these carefully with your healthcare provider before starting.,Finasteride must not be taken by women who are or may become pregnant, and they should avoid handling crushed or broken tablets, because it can harm a male baby.

Options for women

Topical minoxidil is the main evidence-based treatment for female pattern hair loss. Some women with signs of high androgens, such as irregular periods, acne or excess facial hair, may benefit from treatments that block androgens, such as spironolactone, under specialist supervision. These are not suitable in pregnancy.,Checking for iron deficiency, thyroid problems and other causes is important, because treating these can improve shedding.

Other treatments

• Hair transplant surgery for suitable people with stable hair loss
• Low-level laser devices, with mixed evidence
• Platelet-rich plasma (PRP) injections, with limited and variable evidence
• Steroid injections or creams for alopecia areata
• Newer JAK inhibitor medicines for severe alopecia areata, under specialist care

Be cautious about

• Shampoos, serums and supplements with bold claims but little evidence
• Biotin supplements, which rarely help unless you are deficient and can interfere with blood tests
• Buying prescription medicines from unregulated online sellers
• Very expensive clinic packages without clear evidence

Looking after your hair

• Avoid tight hairstyles that pull on the scalp, and give your hair breaks from braids and extensions
• Limit harsh chemical treatments and high heat
• Eat a balanced diet with enough protein and iron
• Be patient with any treatment: give it at least six months

Frequently asked questions

Is hair loss after having a baby permanent?

Usually not. Shedding often peaks around three to four months after birth and recovers within a year.

Does stress cause hair loss?

Severe stress can trigger temporary shedding (telogen effluvium), which usually recovers.

Do I have to use minoxidil forever?

To keep the benefit, yes. Hair gained usually falls out within months of stopping.

But will I look silly if it does not work?

Not every treatment works for everyone. A dermatologist can help you choose realistic options, and many people find a new haircut or accepting the change just as good for confidence.

Related: Thyroid symptoms

Sources: British Association of Dermatologists, American Academy of Dermatology, UK Medicines and Healthcare products Regulatory Agency, US Food and Drug Administration.