Finasteride and minoxidil remain the two most effective, FDA-approved medications for treating hair loss in 2026. This list covers every major prescription and over-the-counter option available, organized by strength of clinical evidence, so you can have an informed conversation with your doctor.
This article is for informational purposes only and does not constitute medical advice. Consult a licensed physician before starting any medication.
FDA-Approved Hair Loss Medications
These medications have completed rigorous clinical trials and hold specific FDA approval for treating androgenetic alopecia (pattern hair loss).
1. Finasteride (Propecia, generic)
Finasteride is a 5-alpha-reductase inhibitor that blocks the conversion of testosterone to DHT, the hormone primarily responsible for miniaturizing hair follicles in androgenetic alopecia.
- Dosage: 1mg daily (oral)
- Effectiveness: Stops further hair loss in 83-90% of men. Regrows visible hair in approximately 66% of users after 2 years.
- Cost: $10-30/month for generic, $60-90/month for brand-name Propecia. See our finasteride cost breakdown for a full pricing comparison.
- Side effects: Sexual side effects (decreased libido, erectile dysfunction) occur in 1-2% of users and are typically reversible upon discontinuation.
- Who it works for: Men with androgenetic alopecia. Not FDA-approved for women due to risk of birth defects.
2. Minoxidil (Rogaine, generic)
Minoxidil is a vasodilator that stimulates blood flow to hair follicles and extends the anagen (growth) phase of the hair cycle. It is available over the counter and works for both men and women.
- Dosage: 5% topical solution or foam applied twice daily (men). 2% solution for women. Low-dose oral (2.5-5mg) increasingly prescribed off-label.
- Effectiveness: Produces moderate to dense regrowth in 40-60% of users after 12 months of consistent use.
- Cost: $15-40/month for topical. See our minoxidil cost guide for brand comparisons.
- Side effects: Scalp irritation, initial shedding (weeks 2-8), unwanted facial hair growth (especially oral formulations), and rare cardiovascular effects with oral use.
- Who it works for: Men and women with androgenetic alopecia. Also used to improve results after hair transplant surgery.
3. Low-Dose Oral Minoxidil
Oral minoxidil at low doses (0.625-5mg daily) has become a widely prescribed off-label treatment in recent years. Dermatologists favor it for patients who find topical application inconvenient or experience scalp irritation.
- Dosage: 2.5mg daily is the most common starting dose for men. Women typically start at 0.625-1.25mg.
- Effectiveness: Comparable to topical 5% minoxidil in clinical studies, with some evidence suggesting superior results.
- Cost: $5-15/month (generic oral tablets).
- Side effects: Hypertrichosis (excess body hair growth) is the most common side effect. Fluid retention, dizziness, and rapid heart rate are possible at higher doses. Requires blood pressure monitoring.
Prescription Medications Used Off-Label
These medications are FDA-approved for other conditions but are prescribed off-label by dermatologists for hair loss based on clinical evidence.
4. Dutasteride (Avodart)
Dutasteride is a dual 5-alpha-reductase inhibitor (blocks both type I and type II enzymes) originally approved for benign prostatic hyperplasia. It reduces DHT levels by over 90%, compared to finasteride's 70%.
- Dosage: 0.5mg daily (oral)
- Effectiveness: Multiple studies show dutasteride produces superior hair count increases compared to finasteride 1mg. A 2014 study found 12.2% greater hair count improvement versus finasteride at 24 weeks.
- Cost: $15-50/month (generic).
- Side effects: Similar to finasteride but potentially higher incidence of sexual side effects due to more complete DHT suppression.
5. Topical Finasteride
Topical finasteride formulations deliver the active ingredient directly to the scalp, reducing systemic DHT suppression while still lowering scalp DHT levels.
- Dosage: 0.1-0.25% solution applied once daily.
- Effectiveness: Reduces scalp DHT by 30-50% with minimal systemic absorption. Clinical results appear comparable to oral finasteride for many patients.
- Cost: $40-90/month from compounding pharmacies or telehealth platforms.
6. Spironolactone
Spironolactone is an antiandrogen prescribed for women with androgenetic alopecia. It is not used in men due to feminizing side effects.
- Dosage: 100-200mg daily (oral)
- Effectiveness: Slows hair loss and promotes regrowth in approximately 70-80% of women after 6-12 months.
- Cost: $10-25/month (generic).
- Side effects: Breast tenderness, menstrual irregularity, dizziness, potassium elevation (requires periodic blood tests).
Over-the-Counter and Supplement Options
These treatments do not require a prescription. Evidence levels vary significantly.
7. Ketoconazole Shampoo (Nizoral)
Ketoconazole is an antifungal that also has mild anti-androgenic properties. Used as a 1-2% shampoo, it reduces scalp inflammation and may lower local DHT levels.
- Dosage: 1% (OTC) or 2% (prescription) shampoo used 2-3 times per week.
- Evidence level: Moderate. A small study showed ketoconazole 2% produced hair density improvements comparable to minoxidil 2%.
- Cost: $10-20/month.
8. Saw Palmetto
Saw palmetto is a plant extract that acts as a weak 5-alpha-reductase inhibitor. Some studies suggest modest benefit for hair retention, but the evidence base is limited compared to pharmaceutical options.
- Dosage: 320mg daily (standardized extract)
- Evidence level: Weak to moderate. A 2020 systematic review found some positive effects but noted small sample sizes and study design limitations.
- Cost: $10-25/month.
9. Biotin (Vitamin B7)
Biotin supplementation at 2.5-5mg daily is one of the most popular hair growth supplements, but clinical evidence supporting its use is limited to patients with actual biotin deficiency. Most healthy adults consuming a normal diet are not biotin deficient.
- Dosage: 2.5-5mg daily
- Evidence level: Limited. Beneficial only in cases of confirmed biotin deficiency. No strong evidence that supplementation helps hair growth in non-deficient individuals.
- Cost: $5-15/month.
10. LLLT (Low-Level Laser Therapy)
FDA-cleared laser caps and combs deliver red light at 650-670nm wavelength to stimulate cellular activity in hair follicles. Results are modest and require consistent use.
- Dosage: 20-30 minute sessions, 3 times per week.
- Evidence level: Moderate. FDA-cleared for both men and women. Clinical trials show statistically significant but modest improvements in hair count.
- Cost: $200-3,000 for devices (one-time purchase).
Medications in Clinical Trials
Several new treatments are progressing through clinical development:
- Clascoterone (topical antiandrogen): FDA-approved for acne, currently being studied at higher concentrations for androgenetic alopecia
- Pyrilutamide (KX-826): A topical androgen receptor antagonist in Phase III trials showing promising results with minimal systemic absorption
- CTP-543 (ritlecitinib): A JAK inhibitor FDA-approved for alopecia areata, with research expanding into androgenetic alopecia
How to Choose the Right Treatment
The best approach depends on your stage of hair loss, tolerance for side effects, and budget. Most dermatologists recommend starting with finasteride plus minoxidil as the foundation. Additional treatments like ketoconazole shampoo or LLLT can supplement but should not replace proven medications.
Upload a photo at myhairline.ai/analyze to identify your current Norwood stage and get treatment recommendations matched to your pattern.