Not every case of hair loss needs surgery straight away. For many people it starts with a drug, the right one, at the right dose, properly monitored. Dr Sussan Rosenthal puts every treatment plan together herself.
Medication halts the loss and thickens the hair you have. It does not create new follicles. That is why it always starts with a diagnosis, and an honest account of what is achievable.
Trichoscopy, medical history and, where needed, blood work. Only once the cause is clear do we discuss a drug, not the other way round.
A regimen that fits your diagnosis, your routine and your plans. The one you can sustain beats the one that is strongest on paper.
Standardised progress photographs and follow-up appointments. At twelve months we assess honestly whether the treatment is doing what it should.
Select a drug, how it works, how it is used, the evidence and the safety profile appear immediately.
A potassium channel opener: it increases blood flow to the scalp and extends the hair's growth phase. The longest-documented drug for hereditary hair loss, and approved for both sexes.
A type II 5-alpha-reductase inhibitor. It lowers DHT in the scalp and in serum, acting on the real cause: the hormonally driven shrinking of the follicle. Prescription only, and for men only.
Low-dose oral minoxidil, under 5 mg a day, an option where the topical form is not tolerated or simply cannot be kept up. It acts systemically, so it requires cardiac assessment and ongoing monitoring.
Finasteride 0.25% as a spray. A chitosan carrier deposits the drug around the hair bulb, where it inhibits 5-alpha-reductase, with a far lower systemic load than the tablet.
Originally an antifungal, used in hair medicine for its anti-inflammatory effect on the scalp and a mild anti-androgenic action. Not a lead player, but a useful supporting one, particularly with a seborrhoeic scalp.
17-alpha-estradiol as a topical solution. It inhibits 5-alpha-reductase locally without meaningful systemic oestrogenic effect. In German-speaking countries it is used mainly in women when minoxidil is unsuitable or not tolerated.
Dr Rosenthal looks first at locally acting options: PRP, SeffiHair®, polynucleotides or dutasteride mesotherapy. They work where the problem is, and avoid the systemic load oral drugs can bring. Only after that do we discuss tablets.
Generally yes. The effect lasts as long as the drug is used. Once you stop, over the following months things return to the course they would have taken untreated. Which is why a regimen you can actually keep up matters more than the theoretically strongest option.
Three to four months at the earliest, and reliably at twelve. Shedding can even increase in the first few weeks, as resting hairs move into the new growth phase together. This is well recognised and not a sign the treatment is failing.
Yes, and often that is exactly the sensible route. The mechanisms complement each other: drugs address the hormonal or vascular cause, regenerative treatments the environment around the follicle. We agree the right combination at the consultation.
No. Medication preserves and thickens existing hair; it does not create new follicles in bald areas. Equally, a transplant does not remove the need to protect your own hair with medication. In practice the two work together.
We look at your diagnosis and tell you honestly which drug suits you, and whether you need one at all.
Sources. Olsen EA et al., J Am Acad Dermatol 2002;47:377–85. · Lucky AW et al., J Am Acad Dermatol 2004;50:541–53. · Kaufman KD et al., J Am Acad Dermatol 1998;39:578–89. · Kaufman KD et al., Eur J Dermatol 2008;18:400–6. · Piraccini BM et al., J Eur Acad Dermatol Venereol 2022;36:286–94. · Randolph M, Tosti A, Skin Appendage Disord 2022;8:355–62. · Vañó-Galván S et al., Dermatol Ther 2020;33:e14106. · Piérard-Franchimont C et al., Dermatology 1998;196:474–7.
Please note. This page is for general information and does not replace medical advice. The drugs named are prescription-only or require a medical indication; some uses are off-label. Individual results vary.
