Only two non-surgical treatments have real regulatory approval and decades of studies backing partial efficacy: topical minoxidil and oral finasteride. Everything else — from PRP to low-level laser — has more limited or preliminary evidence. And no product, approved or not, reactivates a follicle that has already stopped producing hair.
Minoxidil — the most studied
Topical minoxidil (solution or foam, typically 5%) is the most studied non-surgical treatment for androgenetic alopecia, FDA-approved since 1988. It prolongs the follicle's growth phase and can thicken hair that's already miniaturised.
Its limit is clear: the effect only lasts as long as treatment continues, and it doesn't work on follicles that have already stopped producing visible hair. See our full guide on minoxidil and hair transplants.
Finasteride — acts on the hormonal cause
Oral finasteride reduces DHT levels, the hormone responsible for follicular miniaturisation in male androgenetic alopecia. Unlike minoxidil, it acts on the hormonal mechanism, not just the follicle. It's restricted to men and requires medical follow-up given its side-effect profile, which should be discussed with a professional before starting.
More detail in finasteride before and after a transplant.
PRP — real evidence, but more moderate
Platelet-rich plasma (PRP) injected into the scalp shows promising results in several studies, particularly in early-stage hair loss, but the evidence is less robust and less standardised than for minoxidil or finasteride. It's typically used as an add-on rather than a standalone treatment. See PRP vs. hair transplant — where to start.
Ketoconazole shampoos
2% ketoconazole shampoo has mild anti-inflammatory and anti-androgenic properties. Studies suggest a modest benefit as a complement to minoxidil or finasteride, but not as a standalone treatment for genetic baldness.
Low-level laser therapy (LLLT)
Low-level laser devices (combs, helmets) carry FDA clearance as a low-risk device, and some studies show modest density improvements. The evidence is positive but less conclusive than for pharmacological treatments, and results vary considerably between studies and manufacturers.
Biotin and supplements — the most overrated
Biotin is by far the most heavily marketed product for hair loss, and also the one with the least support in people without a genuine deficiency. If there's no real biotin deficiency — fairly uncommon — the evidence that supplementing improves genetic baldness is very limited. A blood test can confirm whether a real deficiency worth correcting exists.
What no product does
No topical, oral or injectable product reactivates a follicle that has already stopped producing visible hair. That's the key difference between "slowing progression" and "reversing baldness." Once miniaturisation has reached that point, the only way to bring hair back to that area is moving follicles from a genetically insensitive donor area — in other words, a hair transplant.
How to decide what to use
| Situation | Reasonable option |
|---|---|
| Early thinning, follicles still present | Minoxidil and/or finasteride, with medical follow-up |
| Want to complement pharmacological treatment | PRP or low-level laser, as an add-on — not a replacement |
| Areas already fully bald | No product recovers them — evaluate for a transplant |
| No clear diagnosis of the cause | Blood test and medical evaluation before any product |