Finasteride and minoxidil together halt androgenetic alopecia progression in the majority of men and can produce visible regrowth without any surgical procedure. Androgenetic alopecia affects 50% of men by age 50, but catching it early and treating it with proven non-surgical methods can preserve most of your hair for decades. The key is starting before too many follicles have permanently miniaturized.
This article is for informational purposes only and does not constitute medical advice.
FDA-Approved Medications
Two medications carry FDA approval specifically for treating male pattern hair loss. They form the core of any non-surgical treatment plan.
Finasteride (Propecia, Generic)
Finasteride inhibits the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). Since DHT is the primary hormone responsible for follicle miniaturization in androgenetic alopecia, blocking its production addresses the root cause of the condition.
At 1mg daily, finasteride reduces scalp DHT by approximately 70%. Clinical trials spanning 5 years demonstrate that 80 to 90% of men halt further loss and 65% experience measurable regrowth. The medication costs $10 to $30 per month for generic versions.
Side effects occur in 2 to 4% of users and may include reduced libido or erectile changes. These effects are reversible upon discontinuation in the vast majority of cases.
Minoxidil (Rogaine, Generic)
Minoxidil works through a different mechanism than finasteride. It extends the anagen (growth) phase of the hair cycle and improves blood flow to follicles. Applied as a 5% topical solution or foam twice daily, it produces visible regrowth in 40 to 60% of men.
Results appear at 4 to 6 months of consistent use. The medication costs $10 to $25 per month over the counter. Common side effects include scalp irritation and, in some cases, increased facial hair growth.
Oral minoxidil at low doses (2.5 to 5mg daily) is increasingly prescribed off-label by dermatologists. Early data suggests comparable or superior efficacy to topical application with better compliance, though it requires medical supervision for cardiovascular monitoring.
Combining Finasteride and Minoxidil
Using both medications together produces significantly better results than either alone. Finasteride stops the hormonal cause of loss while minoxidil directly stimulates regrowth. Studies show combination therapy outperforms monotherapy in both hair count increases and patient satisfaction scores.
Off-Label Prescription Options
Dutasteride
Dutasteride blocks both type I and type II 5-alpha reductase, reducing DHT by over 90% compared to finasteride's 70%. Research indicates slightly superior hair count improvements, particularly at the vertex. It is FDA-approved for prostate enlargement but prescribed off-label for hair loss.
Topical Finasteride
Compounded topical finasteride delivers the active ingredient directly to the scalp, potentially reducing systemic side effects. Clinical data is still emerging, but initial studies show comparable scalp DHT reduction with lower serum DHT suppression. Cost runs $40 to $80 per month through compounding pharmacies.
Oral Minoxidil
Low-dose oral minoxidil (1.25 to 5mg daily) bypasses the compliance issues of topical application. A growing body of evidence supports its use for androgenetic alopecia, though patients require blood pressure monitoring and cardiac screening before starting.
In-Clinic Non-Surgical Procedures
PRP (Platelet-Rich Plasma) Therapy
PRP concentrates growth factors from the patient's own blood and injects them into the scalp. The growth factors stimulate dormant follicles and increase the density and diameter of existing hairs. Clinical studies report 30 to 40% improvement in hair density after 3 to 4 sessions.
Treatment sessions cost $500 to $1,500 each. Maintenance injections every 6 to 12 months sustain results. PRP is most effective for early to moderate androgenetic alopecia and pairs well with medication therapy.
Low-Level Laser Therapy (LLLT)
FDA-cleared laser devices (caps, helmets, combs) emit low-level light that stimulates cellular activity in hair follicles. Clinical data shows modest improvements of 10 to 20% in hair density. Devices cost $200 to $1,200 as a one-time purchase and require 3 to 4 sessions per week.
LLLT is best positioned as an adjunct treatment rather than a standalone therapy. It adds incremental benefit on top of finasteride and minoxidil.
Supporting Treatments
Ketoconazole Shampoo
Ketoconazole (2%) has mild anti-androgenic and anti-inflammatory properties. Used 2 to 3 times per week, it reduces scalp inflammation associated with androgenetic alopecia and may inhibit localized DHT activity. It costs $8 to $20 per bottle and serves as a low-risk addition to any treatment stack.
Microneedling
Derma rolling or microneedling the scalp at 1.0 to 1.5mm depth creates controlled micro-injuries that trigger a wound healing response and increase topical treatment absorption. Studies combining microneedling with minoxidil show significantly greater hair count increases than minoxidil alone.
Sessions can be done at home with a derma roller ($15 to $30) or professionally ($100 to $300 per session). Treatment is typically performed once per week.
When Non-Surgical Treatment Is Not Enough
Non-surgical options work best for early to moderate androgenetic alopecia (Norwood 2 to 4 on the Norwood scale). Men with advanced loss at Norwood 5 and above typically need surgical restoration to achieve meaningful coverage. See the FUE vs FUT surgical options guide if medication alone is not meeting your goals.
Assess your current stage and get personalized treatment recommendations with a free AI analysis at myhairline.ai/analyze.