Finasteride ranks as the most effective medical treatment for androgenetic alopecia, halting further loss in 80 to 90% of men who take it. Androgenetic alopecia affects roughly 50% of men by age 50, driven by a combination of genetic predisposition and the hormone dihydrotestosterone (DHT). The condition follows predictable patterns mapped by the Norwood scale guide, and treatments vary significantly in their ability to slow, stop, or reverse it.
This article is for informational purposes only and does not constitute medical advice.
Tier 1: Prescription Medications
Prescription medications form the foundation of any androgenetic alopecia treatment plan. They target the hormonal mechanisms driving follicle miniaturization.
1. Finasteride (Oral, 1mg Daily)
Finasteride blocks the enzyme 5-alpha reductase, reducing DHT levels by approximately 70%. Clinical trials consistently show it halts hair loss in 80 to 90% of men, with roughly 65% experiencing measurable regrowth. Results become visible at 3 to 6 months and peak around 12 to 24 months.
Cost runs $10 to $30 per month for generic, making it one of the most cost-effective treatments available. Side effects affect 2 to 4% of users and may include decreased libido, which typically resolves after discontinuation.
2. Dutasteride (Oral, 0.5mg Daily)
Dutasteride inhibits both type I and type II 5-alpha reductase, reducing DHT by over 90%. Studies suggest it produces slightly better hair count increases than finasteride, particularly at the vertex. It is FDA-approved for BPH but prescribed off-label for hair loss in many countries.
Side effect profiles are similar to finasteride. Cost is typically $15 to $50 per month for generic versions.
3. Topical Finasteride
Topical formulations deliver finasteride directly to the scalp, aiming to reduce systemic absorption and side effects. Early clinical data suggests comparable efficacy to oral finasteride with lower serum DHT suppression. Compounded versions cost $40 to $80 per month.
Tier 2: Over-the-Counter Medical Treatments
4. Minoxidil (Topical or Oral)
Minoxidil prolongs the anagen (growth) phase of the hair cycle and increases blood flow to follicles. Applied topically twice daily (5% solution for men), it produces visible regrowth in 40 to 60% of users. Oral low-dose minoxidil (2.5 to 5mg) is gaining traction among dermatologists for its convenience and possibly superior results.
Cost is $10 to $25 per month for over-the-counter liquid or foam. The primary limitation is that it does not address DHT, so it works best when paired with finasteride.
5. Ketoconazole Shampoo (2%)
Ketoconazole has mild anti-androgenic properties when used as a shampoo. It reduces scalp inflammation and may inhibit localized DHT. Used 2 to 3 times per week, it serves as a supporting treatment rather than a standalone therapy. Cost is $8 to $20 per bottle.
Tier 3: In-Clinic Procedures
6. PRP (Platelet-Rich Plasma) Therapy
PRP involves drawing the patient's blood, concentrating the platelets, and injecting the solution into the scalp. Studies report 30 to 40% improvement in hair density after a series of 3 to 4 sessions. Maintenance sessions every 6 to 12 months are recommended.
Cost ranges from $500 to $1,500 per session. PRP works best for early to moderate androgenetic alopecia and is often combined with medication.
7. Low-Level Laser Therapy (LLLT)
FDA-cleared laser devices (caps, combs, helmets) stimulate cellular metabolism in hair follicles. Clinical data shows modest improvements in hair count, typically 10 to 20% above baseline. Treatment requires consistent use of 3 to 4 sessions per week over at least 6 months.
Devices range from $200 to $1,200 as a one-time purchase. Results are subtle and best suited as an adjunct to medication.
Tier 4: Surgical Restoration
8. FUE Hair Transplant
Follicular Unit Extraction removes individual follicular units from the donor area and implants them into thinning zones. Graft survival rates reach 90 to 95% in skilled hands. FUE leaves no linear scar and offers a shorter recovery period compared to FUT.
Cost ranges from $4,000 to $15,000 depending on graft count and geography. See the FUE vs FUT comparison for a detailed breakdown of both surgical approaches.
9. FUT Hair Transplant
Follicular Unit Transplantation removes a strip of donor tissue, which is then dissected into individual grafts. Graft survival rates are comparable to FUE at 90 to 95%. FUT can yield higher graft counts in a single session but leaves a linear scar.
Cost is generally $4,000 to $12,000. FUT may be preferred when maximum graft yield from one session is a priority.
Tier 5: Supporting Treatments
10. Supplements and Lifestyle
Biotin, saw palmetto, zinc, and iron supplementation have limited clinical evidence for androgenetic alopecia. Saw palmetto may mildly inhibit 5-alpha reductase, but its effect is far weaker than finasteride. These supplements address deficiency-related shedding rather than hormonal hair loss.
Lifestyle modifications including stress management, balanced nutrition, adequate sleep, and avoiding harsh chemical treatments support overall hair health but do not reverse androgenetic alopecia on their own.
Building a Treatment Stack
The most effective approach combines treatments from multiple tiers. A typical evidence-based protocol includes finasteride (Tier 1), minoxidil (Tier 2), and ketoconazole shampoo (Tier 2) as a baseline. Patients with moderate to advanced loss add PRP (Tier 3) or a hair transplant (Tier 4) for restoration.
Starting treatment early produces the best outcomes. The sooner DHT-mediated miniaturization is halted, the more follicles remain viable for regrowth or transplantation.
Get a free AI analysis of your hair loss pattern and personalized treatment recommendations at myhairline.ai/analyze.