How long should I wait to see if Alfatradiol is working for me?

Alfatradiol, also known as 17α-estradiol, is a topical treatment mainly used in Europe and Latin America to address androgenetic alopecia, especially in women. Unlike conventional estradiol (17β-estradiol), alfatradiol has very low systemic estrogenic activity, making it a safe option for direct application to the scalp without causing broader hormonal effects. When starting topical alfatradiol treatment—usually in the form of a scalp solution applied once a day—it’s important to understand that results are not immediate. Several clinical studies have established that it takes at least 3 to 6 months of continuous use to notice visible stabilization in hair loss. Unlike treatments such as minoxidil, which promote new hair growth, alfatradiol primarily works to slow or stop the progression of hair loss. This makes it especially helpful in the early stages of androgenetic alopecia.

A 2007 study by Blume-Peytavi et al., published in the Journal der Deutschen Dermatologischen Gesellschaft, compared the effectiveness of alfatradiol and minoxidil in women with androgenetic alopecia. This clinical trial included a female human population and lasted six months. Results were measured using standardized photographic analysis and hair density counts. While minoxidil showed improvement in hair thickness and density, alfatradiol was effective in reducing hair shedding. However, the study was limited by its small sample size (34 participants) and lack of long-term follow-up. Another observational retrospective study published by MedCrave in 2020 evaluated the use of alfatradiol over 12 months in women with androgenetic alopecia. The study included 59 participants. Effectiveness was assessed through clinical interviews and patient self-evaluation. After one year, over 70% of the participants reported a noticeable reduction in daily hair shedding. **Although the study lacked a control group and was open-label (not blinded), it supports the idea that alfatradiol’s stabilizing effect becomes apparent after several months of consistent use. **

User Experiences

Users on Tressless have shared a range of feedback regarding their experience with Alfatradiol, especially in terms of how long it takes to assess its effectiveness. One common theme is that Alfatradiol often results in modest improvements or stabilization, rather than dramatic regrowth. This aligns with clinical data suggesting it works primarily by slowing hair loss rather than reversing it. Some users reported initial shedding, similar to what occurs with minoxidil. In one post, a user described a noticeable drop in hair density after starting Alfatradiol, which they had added to an existing finasteride regimen. Another commenter explained that this type of shedding is sometimes expected at the start of a new treatment, suggesting that users should not panic too early and give the product time to work.

In terms of timeline, multiple users suggest that visible effects—or at least an absence of further loss—can take 3 to 6 months to become apparent. This is consistent with broader clinical guidance for topical hair loss treatments. For instance, a user combining Alfatradiol with Fluridil debated adding topical finasteride but was already seeing enough improvement in shedding and scalp condition to hesitate. Another user mentioned reduced scalp itching and oiliness within the first month, even if cosmetic hair gains were minimal. However, some feedback is less optimistic. Several users noted no noticeable changes even after several months, and one user discussed switching away from Alfatradiol due to side effects like nausea and headaches. **Another comment reflected that Alfatradiol might be more useful as a supplementary product in a broader stack rather than a standalone treatment. ** In a longer discussion on Alfatradiol (Pantostin/Ell-Cranell), users questioned why the treatment isn't more popular, with some citing its mild anti-androgenic effect and minimal side effects as positives, while others felt it lacked the potency of finasteride or minoxidil. One user mentioned that in Germany, where Alfatradiol is more widely available, dermatologists often recommend it as a first-line treatment for early-stage androgenic alopecia, especially in women.

In summary, based on user comments, the general consensus is to wait at least 3 to 6 months before judging the effectiveness of Alfatradiol. The product may be best used to stabilize hair loss rather than to regrow hair, and its role is often as a low-side-effect addition to a more aggressive treatment stack.

Why doesn’t it work immediately?

The human hair cycle has three phases: anagen (growth), catagen (transition), and telogen (rest/shedding). Any topical or systemic treatment like alfatradiol must go through at least one of these cycles before changes become visible. **Considering that the anagen phase can last for years, treatments affecting this process—such as alfatradiol—take time to show results. It’s not uncommon for people to see a reduction in shedding only after the third or fourth month of regular use. Currently, alfatradiol is only available in topical formulations approved for use in humans. There is no oral version of this compound for treating androgenetic alopecia. **

Alfatradiol was specifically developed to reduce systemic hormonal effects, which is why it is not prescribed in oral form. If an oral treatment targeting the same hormonal pathway (the conversion of testosterone into dihydrotestosterone, or DHT) is required, doctors may prescribe medications like finasteride or dutasteride, both of which have a more systemic impact and require a medical prescription. Topical alfatradiol is sold under brand names like Pantostin and Ell-Cranell in Europe. In some Latin American countries, it can be purchased at specialized pharmacies. However, depending on the country and a patient's medical history, a prescription may be required, especially if alfatradiol is combined with other treatments.

Is it worth continuing if I don’t see quick changes?

Yes—but with the right expectations. The key is to understand that alfatradiol is not a rapid rescue treatment. Its most well-documented benefit is stabilizing hair loss, which already represents a significant improvement for many individuals. While new hair growth may not be visible, stopping the progression of follicular miniaturization is crucial to maintaining existing hair density. Furthermore, there is evidence suggesting that when combined with other treatments like minoxidil, alfatradiol can provide better long-term results.

Sources

Blume-Peytavi, U., Hillmann, K., Dietz, E., Canfield, D., Garcia Bartels, N., & Hoffmann, R. (2007). Comparison of the efficacy and safety of topical minoxidil and topical alfatradiol in the treatment of androgenetic alopecia in women. Journal der Deutschen Dermatologischen Gesellschaft, 5(5), 391–395. https://pubmed.ncbi.nlm.nih.gov/17451383/

MedCrave Online. (2020). Addressing androgenetic alopecia–a complex disorder–with a multilateral treatment strategy. MOJ Bioequivalence & Bioavailability. https://medcraveonline.com/MOJBB/addressing-androgenetic-alopeciandasha-complex-disorderndashwith-a-multilateral-treatment-strategy.html

Tressless. (2025, April 7). Alfatradiol!!! Does anyone use this as part of their stack and can actually comment on its effectiveness? Reddit. https://reddit.com/r/tressless/comments/1jtfzyf/alfatradiol_does_anyone_use_this_as_part_of_their/

Tressless. (2025, February 3). Alfatradiol causing shedding? Reddit. https://reddit.com/r/tressless/comments/1ih0v2c/alfatradiol_causing_shedding/

Tressless. (2024, October 2). Why is no one talking about alfatradiol? Reddit. https://reddit.com/r/tressless/comments/1fumy8j/why_is_no_one_talking_about_alfatradiol/

Tressless. (2024, April 17). Alfatradiol and Fluridil enough? Thoughs on topical fin? Reddit. https://reddit.com/r/tressless/comments/1c6c66c/alfatradiol_and_fluridil_enough_thoughs_on/

Tressless. (2023, November 14). Alfatradiol/pantostin - anyone notice shedding in first month of use? Reddit. https://reddit.com/r/tressless/comments/17uwsyt/alfatradiolpantostin_anyone_notice_shedding_in/

Tressless. (2023, May 7). Alfatradiol (Pantostin/Ell Cranell) - does anybody here use this as part of their stack? Does it help? Reddit. https://reddit.com/r/tressless/comments/13agm6t/alfatradiol_pantostinell_cranell_does_anybody/