Treatment Based on the Cause of Hair Loss Starts with the Right Medication Selection Hair Loss Medication (Oral Drugs & Topical Agents)

Finasteride inhibits only type 2 5-alpha reductase, partially reducing DHT, while dutasteride inhibits both type 1 and type 2, resulting in a stronger DHT reduction effect. Dutasteride is more effective at suppressing hair loss, but may also have a higher potential for hormonal side effects. The appropriate choice depends on hair loss stage, age, and side effect history.

Side effects such as sexual dysfunction from finasteride and dutasteride are reported in about 1–5% of clinical cases, and are usually reversible after stopping the medication. If side effects are a concern, hair loss progression can also be slowed using minimized medication strategies such as topical minoxidil, alfatradiol, and follicle-strengthening injections. Recently, topical finasteride has also been introduced as an alternative. It is important to determine the appropriate treatment intensity based on follicle condition and progression speed with a specialist.

DHT inhibitors often require long-term use because stopping them leads to a rise in DHT levels and recurrence of hair loss. However, duration and dosage can be adjusted depending on progression and side effects. If long-term medication is burdensome, a combined approach with injections or procedures and reduced dosage can be discussed with a specialist.

Oral minoxidil is systemically absorbed and improves overall scalp blood flow, and is increasingly used at low doses due to its effectiveness. Typical starting doses are 1.25–2.5 mg for women and 2.5–5 mg for men. Topical minoxidil is applied directly to the scalp, producing localized vasodilation with a lower risk of systemic side effects. Rather than combining both immediately, it is common to start with one and adjust based on follicle condition and side effects.

Finasteride and dutasteride are generally not recommended for women of reproductive age due to the risk of fetal abnormalities. For female hair loss, alternatives such as spironolactone (androgen receptor blocker), topical minoxidil, and alfatradiol are used. Spironolactone also requires caution and contraception in women of reproductive age. Since female hair loss is often multifactorial, evaluation of hormones, thyroid function, and anemia is necessary before selecting a treatment plan.

If the hair loss was temporary, stopping minoxidil will not cause additional shedding. However, in ongoing hair loss conditions (such as androgenetic alopecia), stopping minoxidil leads to a gradual loss of the maintained effect, and hair that was being sustained may slowly shed. It does not make hair loss worse than before starting the treatment.

Nutritional components such as biotin, amino acids, and keratin support hair structure and follicle metabolism, but have limited ability to directly stop ongoing hair loss. Hair loss medications (such as finasteride and minoxidil) directly target causes like DHT and blood flow. Nutrients are most effective as supportive therapy when used alongside medications and injections to support the follicle environment.

The cost varies depending on the type and combination of prescribed medications, treatment duration, and whether combined therapies are included. In general, prescription medications such as finasteride and dutasteride are not covered by insurance in many cases, so costs may apply. Exact prescriptions and pricing are provided after an in-person consultation.