Topical Treatments for Hair Loss

  • Best Results4-6 months
  • Treatment RecoveryNA
  • Procedure TimeNA
  • Skin SpecialistMedical Dermatologist
  • Duration of ResultsDecades
  • AnaestheticNA
  • Back to WorkNA
  • Cost$

Topical Treatments for Hair Loss

Simple topical treatments such as minoxidil can markedly slow down hair loss in men & women. In many cases hair regrowth can be seen within 4- 6 months of therapy. This is a cost-effective alopecia treatment. Topicals can be used pre & post follicular unit extraction & hair transplantation. Topicals can also be used with lasers & PRP to improve hair density.

FactsFacts on Topical Treatment for Hair Loss

  • Minoxidil is an over-the-counter lotion or foam for male/female pattern hair loss
  • The 5% concentration is better than 2%
  • Minoxidil works best for early stage hair loss
  • Other topicals include finasteride & dutasteride lotion
  • Shampoos include topical ketoconazole
  • Minoxidil with finasteride topically is a promising combination for male & in some cases female pattern hair loss
  • Topical treatments are best combined with medical therapy including PRP, low level lasers & fractional thulium
  • Advanced cases are treated with follicular unit extraction & transplantation

What types of hair loss are amenable to topicals?

Topicals work best for early-stage androgenetic alopecia or male/female pattern baldness. The most widely used & studied topical is minoxidil, also known as Regaine or Rogaine.

Minoxidil is best used to slow down hair loss, however up to 40% of uses will obtain regrowth. This regrowth is best seen in the vertex or crown areas. Topicals are less effective for growing hair in the hairline or sides.

What is minoxidil & does it work?

Minoxidil is a hair loss treatment approved by the FDA since 1988. It comes as a liquid or foam applied to the scalp twice a day to slow or stop the progression of male & female pattern baldness. 

To maintain results, it must be used continuously — if you stop using the medication, the new hair growth may reverse, and hair loss will continue.

Minoxidil tends to work best in early stage androgenetic alopecia (balding). Once hair loss spreads over a large area and has persisted for a long time, minoxidil is less likely to produce benefits. Basically, the younger you are, and the sooner you start minoxidil, the better the results tend to be.

The effects of minoxidil can be compounded with supplementation, oral medications, as well as procedures such as PRP, & lasers.

How does minoxidil work?

Minoxidil was initially prescribed as an oral medication to treat high blood pressure. By coincidence researchers discovered that some patients developed hair regrowth. The use of topical minoxidil was approved in 1988. Fast forward to 2021, minoxidil is now trending as an oral medical treat yet again (The Hairy Pill).

Minoxidil seems to work as a peripheral vasodilator. That means it helps improve blood flow to the hair follicles. This provides nutrients to the hair follicles, stimulating hair growth.

Unlike finasteride—which works by suppressing the androgen DHT, which can attack hair follicles—minoxidil has no effect on hormones. 

Clinically minoxidil increases the hair’s growth cycle (anagen) & reduces the hair’s sleeping cycle (telogen). This results in thicker hair follicles with less miniature follicles per square area.

How long does it take for topicals to take effect?

4 to 6 months. This applies to minoxidil as well as combinations with finasteride. The 5% formulation works faster than 2%.

Some people may experience paradoxical hair loss when they first start using minoxidil. This is normal and is a result of the hair follicles shifting from the resting to the growth phase.

If your hair loss hasn’t slowed after several months of using minoxidil, it’s a good idea to consult a medical dermatologist. Ideally topicals should be combined with medical therapy. 

What does a basic hair loss topical routine look like?

This guide refers to male/female pattern androgenetic alopecia. 

Stage 1: Minoxidil 5% once to twice a day. Supplement with saw palmetto. Shampoo with Nizoral 3-5 times per week. You can obtain this from any pharmacy.

Stage 2: As above. Option to add minoxidil 1-2 mg orally. Men: option for finasteride/dutasteride. Women: option for cyproterone acetate / spironolactone.   

Stage 3: As above. Option to add PRP monthly for 3 months, followed by 6 mth PRP. Option to add low level lasers or thulium fractional laser. 

Stage 4: As above. Option for FUE- follicular unit extraction

Davin’s Viewpoint on Topical Hair Loss Treatments

Topicals for hair loss are akin to sunscreen for skin. Prevention is the aim of treatment.

The human scalp contains approximately 100,000 follicles. In time this number decreases. Over 80% of men, & 24% of women will experience clinically evident balding. Slowing down the progression of hair follicle miniaturization early in the process is the most effective & cost-effective way to treat hair loss. This applies to early-stage alopecia all the way to post hair transplant maintenance.

If there is a family history of hair loss, especially in males, start topical treatments early. This may be as early as in the late teens to early 20s. A simple routine is once daily 5% minoxidil to the vertex or crown areas, & if indicated to the frontal hairline & sides (frontoparietal areas). Remember, the aim is to slow down the progression of hair loss. In 40% of cases, hair may re-grow. This is usually in the vertex area.

From there add supplementation with saw palmetto, obtained from any pharmacy. If there is progression of hair loss, you may benefit from medical intervention from a dermatologist. Oral medications for men include 5 alpha reductase blockers. These tablets block the formation of dihydrotesterone or DHT. For females, anti-androgens can be used, including cyproterone acetate, spironolactone & newer analogues of flutamide.

Physical modalities such as low-level laser, platelet rich plasma & fractional thulium laser can preserve the hairline, & in most cases regrow hair. Follicular unit extraction is the end treatment. Even after FUE, topicals are paramount in preserving the remaining follicles.

Join the conversation

Join Dr Davin Lim on Instagram to stay up to date

@drdavinlim

Enquire now!

Get In Touch

Quick Contact

Dr Lim has unparalleled experience in dermatology. Fill in the form below and he will get back to you with your query