Minoxidil is an over-the-counter medication approved by the FDA for the treatment of hair loss. It’s most well-known by the brand name Rogaine. Minoxidil is a vasodilator, and while its exact mechanism of action in treating hair loss is not entirely clear, scientists believe that Minoxidil stimulates hair follicles by prolonging the anagen (growth) phase and shortening the telogen (resting) phase. Both men and women can safely use minoxidil. To learn more about minoxidil, click here.
Finasteride is a prescription medication that’s approved by the FDA for the treatment of hair loss in men. It works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), which is the hormone largely responsible for male pattern baldness. While it’s usually taken orally, it can also be used topically, especially for men who want to have the benefits of finasteride but have experienced systemic side effects from the oral version. Finasteride is not recommended for people who are pregnant or may become pregnant due to the risk of serious birth defects.
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Spironolactone is a medication that’s typically used to treat high blood pressure and fluid retention. It also has anti-androgen effects, and it’s sometimes prescribed in an oral pill for off-label use to treat hair loss in women, especially in cases where hair loss is related to a condition like polycystic ovary syndrome (PCOS).
In 2023, a review analyzed the effectiveness and safety of using spironolactone, either orally or topically, for treating androgenic alopecia (AGA), also known as pattern hair loss (PHL). The analysis included seven studies totaling 618 hair loss patients, with 414 of them receiving spironolactone. Across the studies, oral spironolactone doses varied between 25mg and 200mg per day, while topical spironolactone was applied as a 1% gel or 5% solution, twice daily. Both oral and topical spironolactone were found to be effective in stimulating hair regrowth in hair loss patients, but topical use had fewer side effects and was suitable for any gender. Combining spironolactone with other treatments, such as minoxidil, produced better outcomes compared to using spironolactone alone.
Melatonin is a hormone that regulates sleep-wake cycles. Topical melatonin has been studied for its potential to promote hair growth. Research shows compelling evidence to support the effectiveness and safety of using topical melatonin for treating hair loss, particularly in the preliminary stages of pattern hair loss (PHL). While the exact mechanism of how melatonin works for hair loss is not fully understood, researchers believe that its ability to stimulate hair growth may be due to its interaction with specific receptors in the scalp. These receptors are thought to have antiandrogenic (reducing the effects of androgens, which contribute to hair loss) and antioxidative properties.
The melatonin solutions used in the studies were generally well-tolerated, with patients experiencing only mild and infrequent side effects. Based on the positive outcomes observed in the studies, topical melatonin shows promise as a potential option for managing hair loss in both men and women.
Tretinoin, also known as Retin-A, is primarily used as a treatment for acne and skin aging. It’s not FDA-approved for the treatment of hair loss, but some research suggests it may help promote hair growth when used in combination with minoxidil, potentially by increasing the absorption of minoxidil into the scalp. This theory makes sense in principle because tretinoin works by speeding up the skin’s cell turnover process, which helps unclog pores, reduce the formation of acne lesions, and promote the growth of new skin cells. Recent studies are just starting to scratch the surface on the potential for tretinoin for hair loss.
Latanoprost is a medication used in the treatment of glaucoma and ocular hypertension and is typically administered as eye drops. Given that a known, common side effect of latanoprost is eyelash hypertrichosis (an increase in thickness, length, and number of eyelashes) researchers have been eager to prove that the solution, when applied to the scalp, might regrow hair in the same way.
A 2022 study showed promise for latanoprost in the treatment of a less-common form of hair loss, alopecia areata (AA), which is an autoimmune disorder that affects hair follicles, usually resulting in patchy hair loss on the scalp or other areas of the body. The study involved thirty participants with scalp AA who were randomly assigned to receive either a topical latanoprost 0.005% solution or a placebo for a period of 12 weeks. The study showed that latanoprost significantly increased hair density and regrowth compared to the control group and suggests that latanoprost solution may be a safe and effective option for increasing hair density and promoting regrowth in individuals with scalp alopecia areata.