Hair Loss Medications

Androgenetic alopecia — the most common form of hair loss — is driven by dihydrotestosterone (DHT), a potent androgen that binds to follicle receptors and progressively miniaturizes the hair shaft over time. Left untreated, this process continues unabated. Medical therapy interrupts it at the hormonal level, giving your follicles — and your transplant — the best possible environment to thrive.

At Crown Hair Institute, Dr. Truesdale and Dr. Drummond prescribe hair loss medications as part of a comprehensive medical protocol tailored to your specific hair loss pattern, bloodwork, age, and goals. Options include oral finasteride and dutasteride (5-alpha reductase inhibitors that block DHT production), topical and oral minoxidil (which prolongs the growth phase of the hair cycle), and targeted nutritional supplementation.

Medications are most powerful when started early — before significant miniaturization has occurred — but they offer meaningful benefit at any stage. For transplant patients, medical therapy protects the non-transplanted native hair surrounding the grafts, preserving the naturalness of the result over time.

Finasteride (Propecia, Proscar) — Dihydrotestosterone (DHT) shrinks hair follicles and makes it difficult for healthy hair to survive. Finasteride inhibits the enzyme 5-alpha reductase in the hair follicle, which inhibits the production of DHT. Finasteride was first marketed under the brand name Proscar as a 5mg tablet to treat the prostate gland. In 1998, a lower dosage pill (1mg) with the brand name Propecia entered the market as the first pill approved by the FDA for men’s hair loss. Finasteride works well in the treatment of hair loss by triggering hair regrowth for men and women. However, women should not take it if they are pregnant, and should not get pregnant while on the drug because of the risk of birth defects in a male infant. Oral finasteride is a prescription medication for men who have male pattern hair loss, or androgenetic alopecia. Finasteride slows the rate of hair loss and stimulates new hair growth by inhibiting the body’s production of DHT, a hormone that destroys hair follicles.

Minoxidil (Rogaine) — Minoxidil was first used in tablet form as a medicine to treat high blood pressure. Patients being treated with minoxidil for blood pressure often reported excessive hair growth as a side effect. Further research showed that applying a solution of minoxidil directly to the scalp could also stimulate hair growth. Oral minoxidil taken in a tablet (either 2.5mg or 5mg) once daily is much more effective than topical due to absorption. Available topically in generic versions and under the brand name Rogaine, minoxidil is more effective in women (compared to men) suffering from diffuse androgenetic alopecia. The FDA recommends that women use the 2% concentration of minoxidil, not 5%, as the higher dose has not been officially approved for use in women. Topical minoxidil stimulates the hair follicles to enter the anagen (growth) phase and prolongs the anagen phase. The foam formulation tends to produce better results than the liquid. This medication can help people with many different types of hair loss, including male and female pattern hair loss, alopecia areata, and other causes.

Antiandrogens — Antiandrogens are medications that inhibit androgens (sex hormones that damage or destroy hair follicles) and are commonly used in female pattern baldness (androgenetic alopecia). Antiandrogen medications are available by prescription only and include spironolactone and oral contraceptives, or birth control pills, that contain estrogen. Antiandrogens usually start to work after four months. Long-term treatment is sometimes necessary to prevent hair loss from recurring.

Corticosteroids — Some types of hair loss are caused by an autoimmune disease, where the body starts to attack normal healthy hair follicles. Corticosteroid medications can be used to treat people with this type of hair loss, including alopecia areata, lichen planopilaris, and discoid lupus erythematosus. Steroids are immune system suppressors that can counteract the effects of an autoimmune disease, allowing hair to grow. Steroids are available as topical solutions or injections, and all require a prescription. At Crown, our hair restoration surgeons may first recommend a biopsy, or sampling of the skin in the scalp, to correctly diagnose the cause of your hair loss. Upon diagnosis, we can help determine which type of treatment is most appropriate based on your age and severity of symptoms.

Antifungal Medications — If a fungal infection such as tinea capitis (scalp ringworm) is identified as the cause of your hair loss, our physicians may prescribe an antifungal medication to be taken by mouth daily. Often, it takes one or two months before you can see results, and treatment usually lasts for several months in order to fully eliminate the fungus. If treatment begins soon after symptoms appear, most patients see excellent hair regrowth.