What Are the Treatment Options for Androgenetic Alopecia?

Androgenetic alopecia is commonly referred to as male- or female-pattern baldness. It’s by far the most common type of hair loss, and the condition is responsible for 95 percent of hair loss in men, according to the American Hair Loss Association. Women also commonly experience androgenetic alopecia, commonly misspelled as “androgenic” alopecia.

This type of hair loss is largely due to genetics and is more common with age, according to the National Library of Medicine. If you have a variation of a specific gene, your hair follicles are sensitive to the effects of dihydrotestosterone (DHT), a derivative of testosterone. As a result, the hair follicles begin to shrink, or miniaturize, leading to thinning, explains Shoshana Marmon, MD, PhD, a fellow of the American Academy of Dermatology and an assistant professor and director of clinical research in the department of dermatology at New York Medical College in New York City. The role of androgens in women’s hair loss is less well known, she adds.

Unfortunately, scientists and doctors don’t know how much hair an individual with androgenetic alopecia will lose, so if you’re facing this condition, it’s hard to know what the fate of your hair will be, notes StatPearls.

Regardless, for both men and women, hair loss can be difficult to endure psychologically. Androgenetic alopecia has been linked to depression and anxiety in women, research shows. Men may also be extremely unhappy with their hair loss and less accepting of the changes than people may assume them to be, according to the American Hair Loss Association. All around, hair loss can affect your personal and professional life.

That’s why early, proper treatment is so important. There are a number of different therapies that can help stimulate hair regrowth, although certain approaches may be more effective for you than others. Below, find topicals, medications, and noninvasive and surgical treatments to talk to your doctor about for androgenetic alopecia.

“Treatments may vary depending on the severity of hair loss,” Dr. Marmon says. One first-line treatment for androgenetic alopecia, especially during early hair loss, is topical minoxidil, which is commonly known by the brand name Rogaine.

Minoxidil works by stimulating hair growth and preventing new hair loss, according to the American Academy of Dermatology (AAD). You’ll have to use it consistently for three to six months before seeing the benefits. Even when your hair grows back, you’ll still have to apply minoxidil daily as directed, otherwise it will begin to thin again.

John Browning, MD, a fellow of the American Academy of Dermatology and a dermatologist with Texas Dermatology and Laser Specialists in San Antonio, recommends applying minoxidil twice a day to a dry scalp. Available over the counter, minoxidil comes in versions designed for men or women. Dr. Browning recommends using a 5 percent formula; lower-strength ones won’t be enough, he says. When using it at home, avoid getting it on your forehead or above your lips — and anywhere else you don’t want hair to grow — he advises.

The good thing about topical minoxidil is that it is available over the counter and is therefore very accessible. However, not everyone likes how the topical feels, as it can be sticky and uncomfortable. Another option? “A low dose of oral minoxidil is a great option for men and women,” says Browning. Taking minoxidil by mouth requires an off-label prescription, as oral minoxidil isn’t actually approved by the U.S. Food and Drug Administration (FDA) to treat hair loss. Instead, it is approved for treating high blood pressure (although it’s only used in severe cases, per the American Heart Association).

For off-label prescriptions of oral minoxidil, women are typically prescribed one-quarter to one-half of the dose men would get, taken twice a day, Browning says.

This treatment tends to be effective, and it’s often combined with topical formulations for even better results. “When used early on, you can do wonders with oral minoxidil, with or without topicals,” Browning says.

Another oral option that is more tried and true than oral minoxidil is finasteride, known by the brand name Propecia, which is approved by the FDA for hair loss treatment in men. This medication can cause birth defects, so it may be considered for postmenopausal women, Browning points out. In the latter case, Propecia is offered as an off-label prescription, just like oral minoxidil is for hair loss in general.

For women, another oral medication called spironolactone may be an option, as research shows that this drug blocks androgens, which can help with hair regrowth and improve its density. Dermatologists also prescribe this med for acne in women, making it a potential two-in-one treatment, if you have both of those conditions.

Low-level laser therapy (LLLT) is a type of laser treatment that stimulates hair follicles and prolongs their growth phase, resulting in thicker hair, more hair growth, and greater scalp coverage, according to one review. The researchers found that compared to sham treatment, LLLT is a safe and effective approach to hair loss for men and women, when done for more than 16 weeks.

LLLT devices often look like helmets or caps that are worn on the head, and there are various such devices available to buy and use in your own home. Talk to your dermatologist about the options that may be best for you. LLLT can also be used in combination with other treatments, such as minoxidil, and research has shown that dual treatment may be more effective than each one alone. One downside is that purchasing a helmet/cap can cost hundreds of dollars.

This treatment involves using tiny needles on the scalp to stimulate hair growth, notes the AAD. The needles, which are arranged on a roller or in a pen-like device, puncture the skin to reach the dermis, triggering inflammation that stimulates collagen production and promotes hair growth, as one study explains. (More research needs to be done to establish the best protocols for using microneedling for hair growth.) Some research shows that using microneedling alongside topical minoxidil can improve hair growth and thickness better than using minoxidil alone. Microneedling can also be used with platelet-rich plasma therapy, as explained below.

During this short procedure, called platelet-rich plasma therapy, or PRP, a dermatologist will inject the parts of your scalp where the hair is thinning with plasma from your blood. This needs to be done in a series of procedures and then maintained regularly to slow hair loss, according to the AAD. Platelet-rich plasma therapy is not approved by the FDA as a treatment for hair loss, Browning points out, but it is used off label, and it may work by increasing blood flow to hair follicles and decreasing inflammation. “PRP has shown some promise, but there is definitely less hard data available to support its use,” Marmon adds.

There is a surgical option for androgenetic alopecia. “During a hair transplant, the surgeon takes the hairs on the back of the head and moves them to the top of the head,” explains Browning. “The hairs located on the back of the head are more resistant to the effects of DHT,” he says. The catch is that hair transplant surgery is expensive and is not covered by health insurance. Browning points out that it can cost thousands or even tens of thousands of dollars. When searching online, the common price range for hair transplant surgery is $2,000 to $20,000.

The American Society for Dermatologic Surgery says that it can take several months to heal after the surgery, and while it is typically successful, several surgeries are often needed for the desired result.

People who are best suited for hair transplant surgery are those who have lost 50 to 75 percent of the hair on top of their head (or all of it), says Browning.

The sooner you can get help for hair loss, the better. “Especially if begun early, treatment can be very effective,” says Marmon. “Unfortunately, if the follicle goes for too long without undergoing a growth cycle and gets smaller and smaller, it can become too damaged to produce a normal hair shaft,” she explains.

While you can access some hair loss treatments over the counter, such as topical minoxidil, other treatments will require a visit to the dermatologist, whether that’s for a prescription for an oral medication or to talk about options, such as laser therapies or surgery.

If you have androgenetic alopecia, or male- or female-pattern hair loss, there are a variety of treatments available to you, including topicals, oral medications, laser therapy, PRP, and surgery. Starting treatment early is the most effective way to regrow hair using less invasive options, so talk to your primary care provider and a board-certified dermatologist about your options as soon as possible.