Pattern hair loss: the options side by side
Five options, the same questions for each. Nothing is hidden: choose one to bring it forward, and the rest stay on the page.
How long before you can judge it
One figure = one month.
- Minoxidil6months
- Finasteride12months
- Red light6months
- Microneedling3–6months
Overprinted on minoxidil: the two are usually used together.
- PRP injectionsNo agreed timeline
All options stay on the page. Choose one to bring it forward.
| — | Minoxidil | Finasteride | Red light | Microneedling | PRP injections |
|---|---|---|---|---|---|
| How you use it | Lotion or foam on the thinning area, once or twice a day. | One tablet a day. | A cap, helmet or comb at home, several short sessions a week. | A roller or pen on the scalp, usually together with minoxidil, or sessions at a clinic. | Injections of your own blood plasma into the scalp, in a course of clinic sessions. |
| How it works | Keeps follicles in the growing phase longer. Exactly how is not fully understood. | Blocks the enzyme that turns testosterone into DHT, the hormone that shrinks follicles. | Red light on the scalp. How it works is not fully understood. | Tiny wounds that may prompt the scalp to respond. | Growth factors from your platelets may support follicles. |
| When you can judge it | Early shedding is possible in the first 8 weeks. Judge at 6 months. | An early check at 6 months, a fair verdict at 12. | Judge at about 6 months. | Judge after 3 to 6 months, alongside minoxidil. | No agreed timeline. |
| How sure we can be | Good: several large trials. Recommended for men and women by the 2017 European guideline. | Good: several large trials. Recommended for men by the 2017 European guideline. | Some: smaller or fewer trials. Suggested as an add-on by the 2017 European guideline; trials are small. | Some: smaller or fewer trials. Pooled small trials look positive; larger trials are needed. | Little: weak or mixed trials. Pooled trials are low quality and vary a lot. The 2017 European guideline makes no recommendation. |
| Common downsides | Scalp irritation; unwanted hair elsewhere; the gain fades within months if you stop. | Sexual side effects in some men; mood changes, now listed by the EMA. Not for anyone who is or may become pregnant. | Time and routine; the device costs money up front. | Scalp soreness; infection risk if the tool is not clean. | Injection pain; results vary; courses are repeated. |
| Where you get it | Pharmacy, no prescription. | Prescription only. | Buy a device. | Device, or clinic. | Clinic. |
| How you pay | Small monthly cost, for as long as you use it. | Small monthly cost, plus doctor visits. | One-off purchase. | Cheap device, or paid clinic sessions. | Paid clinic sessions; the most costly option here. |
| Read the guide | Minoxidil | Finasteride | Red light | Microneedling | Covered in this table |
Where this comes from
Numbered in the order the guide first cites them.
- 1
The 2017 European guideline recommends topical minoxidil for women and men and finasteride 1 mg for men, suggests low-level laser as an add-on, makes no recommendation on PRP, and advises judging results at 6 months. Its own expiry date was June 2020, and we found no newer version.
Kanti V, Messenger A, Dobos G, et al. (2017). S3 – European Dermatology Forum Guideline for the Treatment of Androgenetic Alopecia in Women and in Men. European Dermatology Forum, S3 guideline (literature to Oct 2015, expiry 06/2020)
- 2
In 393 men over 48 weeks, minoxidil 5% gave 45% more regrowth than 2%, with more scalp itching and irritation.
Olsen EA, Dunlap FE, Funicella T, et al. (2002). A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2002;47(3):377–385
- 3
Across trials in women, minoxidil nearly doubled the chance of moderate or marked regrowth compared with placebo, 2% and 5% did about the same, and finasteride 1 mg did no better than placebo.
van Zuuren EJ, Fedorowicz Z, Schoones J (2016). Interventions for female pattern hair loss. Cochrane Database Syst Rev 2016;(5):CD007628
- 4
In 1553 men, finasteride 1 mg gave about 107 more hairs than placebo at 1 year and 138 more at 2 years in a 5.1 cm² crown area, while hair loss kept getting worse on placebo.
Kaufman KD, Olsen EA, Whiting D, et al. (1998). Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol 1998;39(4 Pt 1):578–589
- 5
The EU regulator confirmed suicidal thoughts as a side effect of finasteride tablets with unknown frequency, added a patient card to 1 mg packs, found no link for finasteride skin spray, and judged that benefits still outweigh risks.
European Medicines Agency (2025). Measures to minimise risk of suicidal thoughts with finasteride and dutasteride medicines. EMA/142716/2025, 8 May 2025
- 6
In four sham-controlled trials, laser combs added about 18 to 26 terminal hairs/cm² in men and about 20 in women over 26 weeks, against about 2 to 9 with sham devices.
Jimenez JJ, Wikramanayake TC, Bergfeld W, et al. (2014). Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study. Am J Clin Dermatol 2014;15(2):115–127
- 7
In 41 men, a red-light laser helmet used every other day for 16 weeks gave 39% more hair growth than a placebo helmet, with no side effects reported.
Lanzafame RJ, Blanche RR, Bodian AB, et al. (2013). The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers Surg Med 2013;45(8):487–495
- 8
In 42 women, the same red-light helmet gave 37% more hair growth than a sham device over 16 weeks, with no side effects reported.
Lanzafame RJ, Blanche RR, Chiacchierini RP, et al. (2014). The growth of human scalp hair in females using visible red light laser and LED sources. Lasers Surg Med 2014;46(8):601–607
- 9
Pooling 12 trials with 631 patients, microneedling plus minoxidil raised hair counts more than minoxidil alone, but results varied widely and side effects, mostly mild, were more common.
Ahmed KMA, Kozaa YA, Abuawwad MT, et al. (2025). Evaluating the efficacy and safety of combined microneedling therapy versus topical Minoxidil in androgenetic alopecia: a systematic review and meta-analysis. Arch Dermatol Res 2025;317(1):528
- 10
In a small 12-week pilot in 100 men, weekly microneedling plus minoxidil 5% raised hair counts much more than minoxidil alone (91.4 against 22.2 hairs in the target area).
Dhurat R, Sukesh M, Avhad G, et al. (2013). A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology 2013;5(1):6–11
- 11
Pooling 14 trials with 431 patients, PRP added about 28 hairs/cm² over placebo, but the authors rate the evidence as low quality and highly inconsistent.
Kieling L, Konzen AT, Zanella RK, et al. (2024). Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials. An Bras Dermatol 2024;99(6):847–862