Oral Medication for Hair Loss
Stabilize hair loss and promote hair growth
Oral medications play a key role in any complete hair restoration strategy for men suffering from androgenic alopecia (also known as male pattern baldness). While the primary role of oral medications is to stabilize hair loss, some men may experience increased hair growth with improved hair counts and thickness while on treatment. Commonly used prescription medications fall into two categories:
5a-Reductase Inhibitors - Androgenic alopecia is largely driven by the effect of the hormone dihydrotestosterone (DHT) on hair follicles in men with a genetic predisposition for hair loss. 5a-reductase inhibitors block the conversion of testosterone to DHT within the hair follicle, halting hair loss in around 90% of men and producing increased hair counts in 60-80% of men. Finasteride is the only 5a-reductase inhibitor approved for androgenic alopecia. Another 5a-reductase inhibitor, dutasteride, is not yet FDA-approved but is often prescribed off-label based on studies showing increased hair counts compared to finasteride. Patience is key with either medication as it will take months before any results are first noted.
Minoxidil (Rogaine): Minoxidil is an over-the-counter (OTC) medication available in both liquid and foam formulations. Foam is generally preferred as a component of liquid minoxidil may cause scalp irritation and itching. Although the precise mechanism of action is unknown, minoxidil has been shown to stabilize hair loss by prolonging the growth phase of the hair cycle (called anagen).
Topical Finasteride: Finasteride works by blocking the conversion of testosterone to DHT, the hormone primarily responsible for androgenic alopecia. While oral finasteride is FDA-approved for male pattern baldness and is proven to be highly effective, there has been growing interest in a topical form of the medication. This interest has been driven primarily by concerns about rare systemic side effects of the oral medication. The topical form is not yet FDA-approved for hair loss. While the topical form can directly block the conversion of testosterone to DHT within the scalp and hair follicles, systemic absorption still occurs.
