The other main hair-loss treatment that was recommended by all four dermatologists I interviewed is finasteride, often called by its brand name Propecia. This FDA-approved medication is only available with a prescription, but these days, it’s found as a generic and ordered online after a virtual consultation, through start-ups like Hims, Keeps, and Lemonaid.
"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.

There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice.

Hi, great article. I have an aggressive form of MPB. I am 23 year old with a NW2 hairline, diffuse thinning over the top and crown. Been on 5% Minoxidil and 2% Keto for about 9 months. Went through a period of shedding which has reduced somewhat in the last couple of months. I don’t see any appreciable increase in density anywhere but I do see plenty of thin vellus hair at my hairline. I am waiting for the 1 year mark to see the full effect of this regime. Is there like a test you can do to assess hairfall? Or do we just have to count the hair lost in the shower? Do you reckon I should start the Fin to hold on the the hair I have? Like most guys (actually a bit more than most guys seeing that I am young) I worry a lot about being in the 2% who experience disastrous sides from Fin. I do plan to check my DHT levels before I start, if I do at all, to see if I naturally have high/low DHT. That should tell me what to expect, to an extent.
In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."
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