Topical minoxidil |
Strong, multiple RCTs |
Unlikely, scalp irritation |
Rare, dizziness, cardiac arrhythmia |
Low to moderate |
$ |
$$ |
Hair growth in undesired locations. May leave residue on hair which interferes with styling. |
Topical finasteride |
Weak |
Unlikely, skin erythema, contact dermatitis |
Rare |
High |
$ |
$$ |
May be used as a maintenance therapy |
Oral finasteride |
Strong, multiple RCTs |
Uncommon |
Post‐finasteride syndrome |
High |
$ |
$$ |
Avoid in females of childbearing potential |
Oral minoxidil |
Moderate, mainly retrospective case reviews |
Unlikely |
Rare, unless patients with cardiovascular comorbidities. Weight gain |
High |
$ |
$$ |
Hair growth in undesired locations |
Spironolactone |
Weak, but commonly used by clinicians |
Rare, possible SE include postal hypotension, electrolytic disturbance |
Rare, unless patients with renal failure. |
High |
$$ |
$$ |
Contraindicated in males, pregnant females, and individuals with renal failure |
Flutamide & bicalutamide |
Weak |
Hepatic injury |
Flutamide has black box warning of hepatic failure |
Moderate to high |
$ |
$$ |
Potential interaction with other medications |
Platelet‐rich plasma |
Strong |
Unlikely, scalp pain |
Rare |
Moderate |
$$ |
$$$$ |
Avoid in patients with bleeding disorder, lack of standardized protocol |
Exosomes |
Moderate |
Unlikely, scalp pain |
Rare |
Moderate |
$$$ |
? |
Lack of standardized protocol |
Microneedling |
Weak to moderate |
Unlikely, scalp pain |
Rare |
Moderate |
$$ |
$$$ |
Lack of standardized protocol |
Oral nutraceutical supplement containing Synergen Complex®
|
Moderate |
Unlikely |
Rare |
PO BID, high compliance |
$ |
$$$ |
Four capsules daily |
Marine complex supplement |
Moderate |
Unlikely |
Rare |
PO BID, high compliance |
$ |
$$$ |
Fishy taste for oral supplement |
Serenoa repens |
Weak |
Unlikely |
Rare |
PO BID, high compliance |
$ |
$$$ |
Possibility of missing early detection of prostatic cancer |
Light devices |
Strong |
Unlikely |
Rare |
Daily, high compliance |
$$ |
$$ or $$$ |
Noninvasive, convenient to use at home |
Hair transplant |
Strong |
Infection, scarring, pain, itching, swelling, bleeding |
Rare |
Permanent, one‐time treatment |
$$$$ |
? |
May need concurrent medical treatment |