A review of the treatment of male pattern hair loss
February 2020
in “Expert Opinion on Pharmacotherapy”

TLDR
Finasteride and minoxidil work best together for hair loss.
This document is a compilation of reviews and studies on treatments for male pattern hair loss. The most effective options are hormonal treatments like finasteride and minoxidil, which can partially regrow hair and stop the progression of the disease. Non-pharmacologic treatments like platelet-rich plasma and micro-needling can also be considered. Combination therapy with both finasteride and minoxidil is recommended for best results. Other potential treatments include dutasteride, topical finasteride, low-level laser therapy, and bimatoprost-sensitive prostamide receptors, but more research is needed to confirm their effectiveness.
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Cited in this study

research Effectiveness and safety of low-dose oral minoxidil in male androgenetic alopecia
Low-dose oral minoxidil effectively improves male hair loss with mild side effects.

research A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia
Laser and minoxidil combo promotes better hair growth than minoxidil alone, safely.

research Treatment of male pattern alopecia with platelet-rich plasma: A double-blind controlled study with analysis of platelet number and growth factor levels
Platelet-rich plasma treatment can significantly increase hair count and density in men with pattern baldness, and these improvements can last up to 3 months.

research A randomized, double-blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil vs. 3% minoxidil solution in the treatment of male androgenetic alopecia
Finasteride and minoxidil mix works better for hair growth than minoxidil alone, with similar safety.

research Low-dose daily aspirin reduces topical minoxidil efficacy in androgenetic alopecia patients
Daily low-dose aspirin lowers minoxidil's effectiveness for hair loss treatment.

research Efficacy of 1,550-nm Erbium-Glass Fractional Laser Treatment and Its Effect on the Expression of Insulin-Like Growth Factor 1 and Wnt/β-Catenin in Androgenetic Alopecia
Laser treatment improves hair density and increases growth factors in androgenetic alopecia.

research Microneedling for the treatment of hair loss?
Microneedling can help stimulate hair growth, especially when used with other treatments, but it's not better than existing therapies.

research A preliminary study on topical cetirizine in the therapeutic management of androgenetic alopecia
Topical cetirizine improves hair density and thickness in androgenetic alopecia, but more research is needed.

research Platelet-rich plasma for androgenetic alopecia: Does it work? Evidence from meta analysis
PRP treatment may increase hair density and reduce hair loss, but more research is needed.
research Efficacy of fractional lasers in treating alopecia: a literature review
research Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study
Dutasteride is more effective than finasteride at increasing hair count and reversing hair thinning in men with hair loss, but both have similar side effects.

research A Mechanistic Model of Platelet-Rich Plasma Treatment for Androgenetic Alopecia
PRP treatment may stimulate hair growth by promoting blood vessel formation, increasing growth factors, and preventing cell death.

research Long-term safety and efficacy of dutasteride in the treatment of male patients with androgenetic alopecia
Dutasteride safely promotes hair growth and reduces hair loss, with mild side effects.
research The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial
Platelet-rich plasma injections significantly improved hair regrowth and thickness in patients with hair loss.

research Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients
Finasteride and minoxidil together work best for male hair loss.

research Evaluation of DNA Variants Associated with Androgenetic Alopecia and Their Potential to Predict Male Pattern Baldness
DNA variants can predict male pattern baldness, with higher risk scores increasing baldness likelihood.

research Clinical utility and validity of minoxidil response testing in androgenetic alopecia
Minoxidil response testing helps treat hair loss effectively and safely.

research Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride
Dutasteride helps hair growth in those unresponsive to finasteride, but may cause more sexual dysfunction.

research Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia
Sulfotransferase in hair follicles helps predict how well minoxidil works for female hair loss.

research Topical valproic acid increases the hair count in male patients with androgenetic alopecia: A randomized, comparative, clinical feasibility study using phototrichogram analysis
Valproic acid increases hair count in men with hair loss.

research The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit–risk assessment of finasteride and dutasteride
Finasteride and dutasteride effectively treat hair loss, but may cause side effects like sexual dysfunction and depression.

research A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study

research Persistent Sexual Side Effects of Finasteride: Could They Be Permanent?
Finasteride may cause long-lasting sexual side effects.

research Comparitive Effectiveness and Finasteride Vs Serenoa Repens in Male Androgenetic Alopecia: A Two-Year Study
Finasteride works better than Serenoa repens for male hair loss.
research Depressive Symptoms and Suicidal Thoughts Among Former Users of Finasteride With Persistent Sexual Side Effects
Former finasteride users with persistent sexual side effects have higher rates of depression and suicidal thoughts.

research Characteristics of Androgenetic Alopecia in Asian
Asian hair loss differs from Europeans; consider individual needs and psychological well-being for treatment.

research A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia
Latanoprost 0.1% may effectively treat hair loss.

research Prostaglandin D 2 Inhibits Hair Growth and Is Elevated in Bald Scalp of Men with Androgenetic Alopecia
PGD2 stops hair growth and is higher in bald men with AGA.

research Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men
Use minoxidil for hair loss; finasteride and dutasteride for men, dutasteride for women.

research Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up
Finasteride effectively increases hair growth in men with AGA, works better for those over 30, and may cause some side effects.

research Evidence of increased DNA methylation of the androgen receptor gene in occipital hair follicles from men with androgenetic alopecia
Men with hair loss have more DNA changes in back-of-head hair follicles, possibly protecting them from thinning.

research Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss
Finasteride for hair loss can cause long-lasting sexual side effects like low libido and erectile dysfunction.

research Fractional Photothermolysis Laser Treatment of Male Pattern Hair Loss
Laser treatment can stimulate hair growth for male pattern hair loss.

research Efficacy and Safety of Finasteride Therapy for Androgenetic Alopecia
Finasteride helps hair growth but may cause sexual side effects.

research A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men
New 5% minoxidil foam effectively promotes hair growth and is safe for use.
research Effect of 1 mg/day finasteride on concentrations of serum prostate-specific antigen in men with androgenic alopecia: a randomised controlled trial

research Finasteride induced depression: a prospective study
Finasteride may cause slight depression and anxiety.
research K channel therapeutics at the bedside

research Minoxidil: mechanisms of action on hair growth
Minoxidil boosts hair growth by opening potassium channels and increasing cell activity.

research An Open, Randomized, Comparative Study of Oral Finasteride and 5% Topical Minoxidil in Male Androgenetic Alopecia
Oral finasteride works better than topical minoxidil for hair growth, both are safe.

research Androgenetic alopecia in men aged 40-69 years: prevalence and risk factors
Hair loss increases with age; alcohol raises risk, more female partners lowers it.

research Minoxidil vs Finasteride in the Treatment of Men With Androgenetic Alopecia
Finasteride slightly better long-term, minoxidil faster initial results, but stopping minoxidil may cause hair loss.

research A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men
5% minoxidil works better for hair growth and density, with minor irritation.

research Comparative Efficacy of Various Treatment Regimens for Androgenetic Alopecia in Men
Best hair growth results from combining finasteride and minoxidil.

research A Randomized, Double-Blind, Placebo-Controlled Trial to Determine the Effectiveness of Botanically Derived Inhibitors of 5-α-Reductase in the Treatment of Androgenetic Alopecia
Natural 5AR inhibitors effectively improve mild to moderate hair loss in men.

research Minoxidil-Induced Hair Growth is Mediated by Adenosine in Cultured Dermal Papilla Cells: Possible Involvement of Sulfonylurea Receptor 2B as a Target of Minoxidil
Minoxidil boosts hair growth by targeting adenosine and possibly sulfonylurea receptor 2B.

research The prevalence and types of androgenetic alopecia in Korean men and women
AGA more common in men, Koreans have lower rates and unique patterns.

research Finasteride in the treatment of men with frontal male pattern hair loss
Finasteride effectively treats frontal hair loss with few side effects.

research Prevalence of Male Pattern Hair Loss in 18–49 Year Old Men
Hair loss is more common in men aged 18-49 and increases with age.

research Finasteride in the treatment of men with androgenetic alopecia
Finasteride safely and effectively treats male pattern hair loss, but may cause reversible sexual issues and harm male fetuses.

research Allergic contact dermatitis from minoxidil
Minoxidil can cause allergic reactions, but testing helps identify the cause.

research The psychological effects of androgenetic alopecia in men
Hair loss can cause low self-esteem, anxiety, and depression in men.

research Minoxidil Stimulates Mouse Vibrissae Follicles in Organ Culture
Minoxidil can help grow hair in mice by making cells grow and improving hair quality. More research needed.

research Topical minoxidil in male pattern baldness: Effects of discontinuation of treatment
Stopping minoxidil treatment resumes balding; continuous use needed for results.
research Topical Minoxidil Therapy in Hereditary Androgenetic Alopecia
Using minoxidil on the scalp can help grow hair for people with hereditary baldness.

research Reversal of Baldness in Patient Receiving Minoxidil for Hypertension
Minoxidil helped bald patient regrow hair.
Related
research Pharmacological therapeutics in androgenetic alopecia

research A review of the treatment of male pattern hair loss
Finasteride and minoxidil work best together for hair loss.

research A randomized, double-blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil vs. 3% minoxidil solution in the treatment of male androgenetic alopecia
Finasteride and minoxidil mix works better for hair growth than minoxidil alone, with similar safety.
research Androgenetic alopecia and its remedies – a review

research Potential targets in the discovery of new hair growth promoters for androgenic alopecia
The document concludes that targeting 5α-reductase, the androgen receptor, and hair growth genes, along with using compounds with anti-androgenic properties, could lead to more effective hair loss treatments.
research Minoxidil to Treat Androgenetic Alopecia in Men and Women: What is It & How does It Work?
Minoxidil, originally a blood pressure medication, is effective in treating hair loss in men and women, with different strengths recommended for each.
research Effective treatment of female androgenic alopecia with dutasteride.
Dutasteride successfully treated a woman's hair loss when other treatments failed.

research Finasteride Treatment of Patterned Hair Loss in Normoandrogenic Postmenopausal Women
Finasteride can slow hair loss and promote growth in postmenopausal women.
research Current management of androgenetic alopecia in men.
Minoxidil and finasteride are promising drugs that can prevent hair loss and promote new growth in people with common hair loss condition.