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Before anything else
Most people notice something months before they say it out loud. These four questions are the ones a provider ends up asking anyway, so answering them here makes the rest of it quicker.
01 · Four questions
None of these is a test.
Hairline, crown, or the amount in the drain.
Pattern loss at the crown and a receding hairline point at the hormonal driver, which is finasteride's territory. Diffuse thinning across the whole scalp often points somewhere else, and a provider will say so rather than sell you a capsule.
Roughly how long. A guess is fine.
Hair grows about 1 centimetre a month, so recent change has more to work with than something that has been running for a decade. Knowing the timeline is how you avoid being disappointed at week four by a plan that reads at month twelve.
Current medicines, blood pressure, pregnancy plans.
Blood pressure rules how a provider approaches oral minoxidil. A possible pregnancy changes how finasteride is handled. This is the part of the questionnaire that does the most work.
Something you would still be doing in month nine.
The same two medicines come as a capsule, a tablet and a spray. The best option is the one still happening in month nine, so the routine matters as much as the ingredient.
02 · When it is not this
Sudden loss in patches, loss with a rash, pain or scaling, or hair coming out in handfuls over days is worth an in-person appointment before any prescription for pattern hair loss. A provider reviewing your questionnaire will say the same thing, and saying it here saves you the wait.
03 · When you are ready
Finasteride and minoxidil, alone or together, as a capsule, a tablet or a spray, at $65 to $85 per month.
Safety information
A once-daily tablet that blocks the enzyme converting testosterone to DHT, the androgen associated with pattern hair loss.
Not for
Handling
Common effects
Serious effects
Get medical help if
Tell your provider
Sources
Finasteride delivered onto the scalp rather than swallowed. Some of it is still absorbed, so the systemic cautions for the tablet apply.
Not for
Handling
Common effects
Serious effects
Get medical help if
Tell your provider
Sources
A solution applied to the scalp. Topical minoxidil is sold over the counter for hair regrowth, which is the wording of its approved labeling.
Not for
Handling
Common effects
Serious effects
Get medical help if
Tell your provider
Sources
A tablet that widens blood vessels. In hair follicles it is understood to lengthen the growing phase.
Minoxidil tablets are approved to treat severe high blood pressure, not hair loss. Prescribing them for hair loss is off-label. A provider may do that, and should tell you why.
Boxed warning. Minoxidil tablets carry an FDA boxed warning. Fluid can collect around the heart and, in some cases, compress it (pericardial effusion progressing to tamponade). Chest pain from angina can get worse. The tablets can cause salt and water retention that leads to heart failure. In the approved use they are given under close supervision, usually alongside a medicine to slow the heart and a diuretic.
Not for
Common effects
Serious effects
Get medical help if
Tell your provider
Sources
A B vitamin used in keratin production. Evidence that supplementing it improves hair growth in people who are not deficient is limited.
Common effects
Serious effects
Tell your provider
Sources
