Androgenetic hair loss

Options that make thinning less visible without medicine, such as hair fibers, tinted sprays or powders, volumizing cuts, wigs or hairpieces, and scalp micropigmentation (a tattoo-like technique).

Often considered when someone wants a quick change in appearance, is waiting to see if a treatment works, or prefers not to use medicine.

Less suitable when the scalp is irritated or has open sores, or when a product has caused a reaction before. Wigs, glue, or tight attachments may not suit areas where hair is also breaking from traction.

Scalp irritation or allergy to fibers, sprays, or adhesives. Tight wigs or clips can pull on hair. Micropigmentation is long lasting and may look different as hair changes.

Results are immediate, but products wash out or need upkeep.

• Which camouflage options might suit my hair type and skin tone?
• Are any of my current hair or styling habits adding to breakage?
• Where can I find a trained provider for scalp micropigmentation or a medical wig?

A liquid or foam applied to the scalp that is sold without a prescription in many places. It is thought to lengthen the growth phase of hair. It is used by both men and women.

Often considered as a first step for pattern thinning in men and women, alone or together with other treatments.

May be less suitable during pregnancy or breastfeeding, so this is worth discussing first. May not suit people with scalp skin disease or past reactions to it. It is not meant for sudden or patchy hair loss.

Scalp itching, dryness, or irritation. Unwanted hair on the face or neck if product runs or touches skin. A temporary increase in shedding early on is common. Rarely, lightheadedness or a fast heartbeat. Hair gained is usually lost again if it is stopped.

Often 4 to 6 months or more to judge. It works only while it is used.

• Is minoxidil a reasonable fit for my pattern of loss?
• How should I think about pregnancy plans or breastfeeding with this?
• What should I expect in the first few months, including shedding?

Home or clinic devices that shine red light on the scalp. Some are cleared by the FDA as devices, which is not the same as being proven as strongly as a medicine.

Often considered by people who want a non-drug option or who add it to other treatments.

Less suitable when someone is expecting a major change, or when cost is a concern, since devices can be expensive and results vary. Not meant for sudden or scarring hair loss.

Mild warmth, dryness, or scalp irritation. Quality differs between devices. Evidence is mixed and studies are often small, so results are uncertain.

Often 6 months or more of regular use to judge.

• Is there good evidence for this for my type of hair loss?
• Which devices, if any, are worth considering and which claims are marketing?
• How would it fit alongside other treatments?

A procedure where a small amount of your blood is spun to concentrate platelets and then injected into the scalp. The idea is that growth signals in platelets may help follicles.

Sometimes considered as an add-on in a clinic, for people who want to try a procedure and understand the evidence is still developing.

Less suitable with blood disorders, blood thinners, active scalp infection, or when someone expects a sure result. It is not standardized, and clinics differ in method, number of sessions, and cost, which is often not covered by insurance.

Pain, swelling, headache, or bruising at the injection sites. Rarely infection. Studies have shown some benefit, but they vary a lot, so the honest answer is that evidence is limited and results are uncertain.

Repeated sessions are common, and results are often judged after several months.

• How strong is the evidence for PRP in my situation?
• What would it cost, how many sessions, and what are realistic results?
• Should I try a proven treatment first?

A surgical procedure that moves hair from areas that keep growing, usually the back and sides of the scalp, to thinning areas.

Often considered when pattern loss is stable enough to plan, there is enough donor hair, and the person wants a long lasting change.

Less suitable when hair loss is still changing quickly, donor hair is limited, or the cause is not yet clear, such as scarring hair loss or active scalp disease. Tight coily hair and a tendency to form raised scars (keloids) call for an experienced surgeon.

Swelling, scabbing, numbness, infection, scarring, and uneven or unnatural results. Transplanted hair keeps growing, but untreated native hair may continue to thin around it. Cost is high and is usually not covered by insurance.

Growth appears over many months, and full results may take a year or more.

• Am I a good candidate, and is my hair loss stable enough?
• How should medicine be used before or after surgery to protect my existing hair?
• How do I choose a qualified, board-certified surgeon and review real results on my hair type?

Prescription pills that lower the amount of DHT, the hormone that shrinks follicles in pattern loss. Finasteride is approved for male pattern hair loss in the US. Dutasteride is used for hair loss as an off-label choice, meaning it is approved for another condition.

Often considered for men with pattern loss, alone or with minoxidil, when someone wants to slow progression.

Not suitable for people who are or may become pregnant, because these medicines can harm a developing male baby. Pregnant women should not handle crushed or broken tablets. Their use in women is limited and specialist-guided. Not suitable for people with liver disease, or when future fertility or sexual side effects are a major concern, without discussion.

Some people notice lower sex drive, trouble with erections, or changes in ejaculation. These often improve over time or after stopping, but some people report that they continue. Mood changes, including low mood, and breast tenderness or lumps have been reported and should be reported to a doctor. These medicines can lower PSA blood test results, so tell any doctor who orders one.

Often 6 to 12 months to judge. Benefit is kept only while taking it.

• What are the sexual, mood, and fertility side effects, in honest terms, and how common are they?
• Would this fit my situation if I may have a child in the future or have a partner who is pregnant or planning pregnancy?
• How would this affect my PSA tests or other monitoring?

A class of prescription pills that block the effect of androgens. They are sometimes used off-label in women with pattern hair loss, often for those who also have acne, extra facial hair, or irregular periods.

Often considered for women with pattern loss, sometimes with minoxidil, especially when hormone-related signs are present.

Not suitable in pregnancy, because they can affect the development of a male baby, so reliable birth control is usually discussed. May be less suitable with kidney problems or certain heart or blood pressure situations. Not used in men for hair loss in this way because of effects on the body.

Irregular periods, breast tenderness, dizziness, frequent urination, and changes in blood potassium, so blood tests may be arranged. Not all antiandrogens have the same cautions.

Often 6 to 12 months to judge. Benefit lasts only while it is taken.

• Is an antiandrogen reasonable for me, and what are the alternatives?
• What contraception or pregnancy planning would I need, and what monitoring would be done?
• Should hormone-related causes such as PCOS be checked first?

Minoxidil taken as a pill, in very small amounts, is used by some clinicians as an off-label option for pattern hair loss. It was first made as a blood pressure medicine.

Often considered when topical minoxidil is hard to use, causes scalp irritation, or has not been enough, and when a clinician feels it is safe for the person.

Less suitable with heart disease, low blood pressure, kidney problems, or fluid retention, and not usually used in pregnancy or breastfeeding. Medicine and heart history matter.

Extra hair growth on the face or body, swelling in the ankles, dizziness, fast heartbeat, or headache. Because it is off-label, it should be started and followed by a clinician.

Often 6 months or more to judge. Benefit lasts only while it is taken.

• Is oral minoxidil an option for me given my health history and medicines?
• What symptoms mean I should call right away?
• What follow up would be needed?

Over-the-counter vitamins and hair supplements, such as biotin, are widely marketed for hair growth.

Sometimes considered when a doctor finds a true shortage, such as low iron or vitamin D, based on testing.

Less suitable when taken without a known need. Biotin has little proof for pattern hair loss in people who are not deficient. High-dose supplements can interfere with some lab tests, including thyroid and heart tests, so tell your care team. Some supplements can be harmful in large amounts or interact with medicines.

Possible interference with blood tests, stomach upset, or skin breakouts with some products. Supplements are not regulated like medicines, so contents may vary.

If a true shortage is found and corrected, shedding may improve over several months. It will not reverse genetic pattern loss.

• Should I have any blood tests before taking supplements?
• Is my biotin or multivitamin affecting any lab tests?
• Is there a shortage that could be adding to my shedding?