Androgenetic alopecia: treatments compared

Androgenetic alopecia, or pattern hair loss, is the most common type of hair loss in both men and women. Under the influence of hormones and genes, follicles gradually shrink and produce thinner, shorter hair. Treatment aims to stop that shrinking and thicken the hair that remains; surgery can redistribute hair once the pattern is stable.

Which medicines are used?

Topical minoxidil and oral finasteride are the most established medicines, and low-level light therapy is also used. A 2021 review in the Journal of Cosmetic Dermatology compared these and other options on efficacy, side effects, adherence and cost, and pointed out that the lack of standardised grading makes direct comparison difficult. Medical treatment generally needs to be continued to keep its effect.

Which procedures can help?

• PRP delivers growth factors from the patient's own blood. In a 40-patient trial led by Professor Nilforoushzadeh, both PRP injection and PRP microneedling increased hair count and thickness, with no significant difference between the two methods.
• Erbium lasers improved density, growth rate and thickness across 12 studies in a 2025 systematic review, especially when combined with minoxidil or PRP.

When is a hair transplant considered?

A hair transplant moves follicles from the back of the scalp, which resist the hormonal process, to thinning areas. It is usually considered once loss has been stabilised and the donor area is adequate. Medical treatment often continues afterwards, because a transplant does not protect the native hair around the grafts.

Is it different in women?

Pattern hair loss in women usually thins the top of the scalp while keeping the front hairline. The same families of treatment are used, but choices and medicine safety differ, for example around pregnancy. This is one reason the diagnosis and plan should come from a dermatologist; the hair restoration guide gives the overview.