Medical Treatment
Medical treatment is the quiet partner in hair restoration, and it does a great deal of the work. Two drugs have solid evidence behind them. Finasteride blocks the hormone that drives male pattern loss, and minoxidil prolongs the growth phase of the follicles you still have. The other treatments on offer range from reasonable adjuncts to options with little evidence behind them.
They do a different job from a transplant. They do not move hair into a bald area, and no drug regrows a follicle that has been gone for years. What they do is protect the hair you have, and in many people recover some of what was recently lost.
That is a powerful thing. A transplant places permanent hair where it is needed, and medication keeps the hair around it in step. Together they give a result that can look right for decades, which is why I treat them as two halves of the same plan.
Who medical treatment is for
Anyone with androgenetic hair loss who wants to keep what they have, which is almost everyone reading this. The best time to start is early, because both drugs are far better at holding hair than at bringing it back.
Anyone planning a transplant should be on something first, ideally with a year or two of stability behind them. Most careful surgeons ask for it, because it leads to a better plan and a longer-lasting result.
The exceptions are real. Finasteride is not appropriate in pregnancy or for anyone who may become pregnant, and it needs a proper conversation about side effects so you can decide on the numbers. Minoxidil suits almost everyone but has to be continued indefinitely. Loss that is not androgenetic, such as alopecia areata, scarring alopecias or thyroid-driven shedding, needs a dermatologist rather than a hair loss clinic.
Trans women on oestrogen and an androgen blocker are often already receiving most of what finasteride would do, and should ask their prescriber rather than adding to it independently.
Before you start anything
Take a proper set of baseline photographs, four angles in flat daylight, before your first dose. Both drugs work slowly and mostly invisibly, and without a before you will spend a year unable to tell whether anything is happening.
Choosing between them
Finasteride is the one that changes the trajectory, because it addresses the cause. If you are going to take one thing, take that, assuming you have weighed the side effect conversation properly.
Minoxidil is the one that adds visible thickness, works anywhere on the scalp, and carries far less baggage. It is the obvious starting point for anyone who does not want a systemic drug, and the obvious addition for anyone already on finasteride.
Taking both is standard and they work on different mechanisms, so the combination does more than either alone. Most dermatologists would start there for someone with active loss who wants to keep their hair.
Everything else is a longer conversation. PRP and the rest covers platelet-rich plasma, microneedling, ketoconazole shampoo, dutasteride, oral minoxidil and the supplement aisle, which range from reasonable adjuncts to options with little evidence.
Where practitioners genuinely disagree is on oral minoxidil and on dutasteride, both of which are used off-label, both of which are more potent than the standard option, and both of which need a prescriber who will monitor you rather than a website that will post it.
At your first appointment
Ask the prescriber to talk you through the side effect profile in numbers rather than reassurance. It is your decision to make, and making it on actual figures is the only way to be comfortable with it years later.
Guides
The pages below cover each treatment in turn: what it does, what the evidence actually shows, what it costs and what it asks of you. Read finasteride and minoxidil first. They have the strongest evidence, and they are the two your surgeon will ask about.
The last page covers life after a transplant: how to keep the result looking its best for years.
Finasteride
The only widely available drug that addresses the cause rather than the symptom. It holds hair for as long as you take it, and its side effects are worth understanding in numbers.
Minoxidil
The one you can buy over the counter. It thickens the hair you have, pairs well with finasteride, and keeps working for as long as you use it.
PRP and the Rest
The treatments offered alongside finasteride and minoxidil. Some make reasonable adjuncts, and knowing which helps you spend well.
Keeping a Transplant
How to keep a transplant looking great for years: medication, the first year month by month, second sessions and everyday care.
Medical treatment recovery
Nothing here has a recovery in the surgical sense, but everything has a timetable, and it is slower than people expect.
Both drugs go through a shedding phase in the first two to three months, where hairs in a resting phase are pushed out as new growth starts underneath. It can look like the treatment is making things worse. It is not, and staying with it through that phase is how you get to the results.
Visible change takes six to twelve months, and the first result is often that the loss has slowed or held steady, which photographs show far better than a mirror. Full effect is judged at a year.
The benefit lasts for as long as you take it. Stopping returns you, over six to twelve months, to roughly where you would have been had you never started, so it works best as a long-term part of your routine.
Medical treatment cost
Cheap, relative to everything else on this site, and permanent. Generic finasteride costs a few pounds or dollars a month; minoxidil is similar. Over thirty years that adds up to a meaningful figure, and it is still a fraction of one transplant.
Subscription services charge several times the generic price for the same molecules with better packaging. I have never seen a good clinical argument for paying it. There is nothing wrong with the convenience if you value it, and there is no clinical difference.
The costs to actually watch for are the ones around the edges. PRP courses run to four figures a year in some clinics, laser caps are sold at a few hundred, and the supplement market is essentially unregulated. None of that is where your money does most work.
Where it fits
Medication comes first, before any surgical plan, and continues afterwards indefinitely. If you take one thing from this site, take that.
Start with finasteride if you are going to use it, give it twelve months, and photograph the result. Add or start minoxidil at any point. Only then should a transplant be planned, on a head where the loss is documented as stable.
After surgery, everything continues. Some surgeons pause minoxidil for a couple of weeks around the operation and most continue finasteride throughout. Follow their protocol, then go back to the long-term routine and stay on it.
Eligibility
Anyone can buy minoxidil over the counter almost everywhere. Finasteride requires a prescription in most countries, which is appropriate, and it is widely available through general practice and online prescribers.
The thing worth saying is that a proper diagnosis comes first. Androgenetic loss looks different from telogen effluvium, from alopecia areata and from scarring alopecias, and the treatments are entirely different. If your loss is patchy, sudden, itchy, painful or accompanied by scaling, see a dermatologist before you buy anything. The eligibility pages go into who each treatment actually suits.
Clinics that do medical treatment
Frequently asked questions
Do I have to take it forever?
For as long as you want the benefit. Stopping returns you to roughly where you would have been within six to twelve months. See recovery.
Which works better, finasteride or minoxidil?
Finasteride addresses the cause and changes the trajectory; minoxidil adds visible thickness. Most people with active loss use both. See choosing between them.
Will my hair fall out when I start?
Often, for two to three months. It is resting hairs being pushed out by new growth, and a sign the treatment is starting to work.
Can I just have a transplant instead?
A transplant and medication do different jobs. The transplant moves permanent hair; medication protects the hair around it, so the result keeps looking natural. See sequence.
Does PRP work?
The evidence is mixed and protocols vary between clinics. It can be a reasonable adjunct alongside medication. See PRP and the rest.
Thinking about a transplant?
The Start Here guide shows you the order that gets the best result: what is causing your loss, how medication protects your hair, how much donor hair you have, and where a transplant makes the biggest difference.
start here →