Hair loss (androgenetic alopecia) affects over 80 million Americans, primarily driven by genetic sensitivity to DHT. Modern science provides targeted solutions at every stage of progression. This guide compares FDA-approved drugs, compounded topicals, and OTC/device-based options based on proven efficacy and safety profiles.
Core Mechanism: How DHT Triggers Hair Loss
Genetic sensitivity determines progression speed. Early intervention is key to preserving existing follicles and slowing miniaturization.
Prescription Pharmaceuticals (Highest Efficacy)
1. 5a-Reductase Inhibitors
Medication |
Formulation |
Key Benefit |
Best For |
Finasteride |
Oral tablet (1mg daily) |
Reduces scalp DHT by 60–70% |
Men with vertex/crown thinning |
Dutasteride |
Oral capsule (0.5mg daily) |
Blocks 90%+ DHT (all 3 isoforms) |
Men with aggressive loss |
Propecia® |
Branded finasteride |
Same efficacy as generic |
Patients preferring brand assurance |
Prescription Required: Not for premenopausal women. Reported side effects <2% (reversible upon discontinuation).
2. Anti-Androgens (Women-Specific)
- Spironolactone: Oral anti-androgen (50–200mg/day)
- Topical Finasteride: Compounded formulas minimize systemic absorption
- Oral Minoxidil: Low-dose (0.25–1.25mg) enhances growth phase
Compounded Formulations (Precision Topicals)
Custom solutions that deliver actives directly to follicles while minimizing systemic exposure.
Product |
Active Ingredients |
Clinical Advantage |
Mens Hair TriGro |
Minoxidil 5% + Finasteride 0.1% + Tretinoin 0.01% |
Combats DHT + enhances absorption |
Womens Hair TriGro Ageless |
Minoxidil 2% + Spironolactone 1% + Biotin 0.5% |
Anti-androgen + follicle nutrition |
Womens Hair TriGro Vibrant |
Minoxidil 5% + Finasteride 0.025% + Melatonin 0.1% |
Nighttime growth stimulation |
2024 JAMA Study: Topical finasteride reduced serum DHT by only 24% vs. 70% with oral therapy.
Realistic Treatment Timeline
- + Months 1–3: Reduced shedding
- + Months 4–6: Vellus hair emergence
- + Months 8–12: Visible density improvement
- - Full results require 18–24 months
Tip: Switch protocols at 6 months if no reduction in shedding is observed.
When to Consult a Specialist
Seek Doctor evaluation for:
- Sudden patchy loss (possible alopecia areata)
- Scalp inflammation or pain (possible scarring alopecia)
- Treatment resistance after 12 consistent months
- Women with PCOS symptoms (acne + hair loss)