Androgenetic Alopecia: The Evidence-Based Approach
Dermatologist Samantha Ellis's evidence-based approach to pattern hair loss (androgenetic alopecia): topical over-the-counter minoxidil 5% is the well-supported first-line option that needs no prescription; oral or topical finasteride has stronger evidence in men but is prescription-only and physician-required; expect a realistic timeline of 4 to 6 months minimum before you can judge whether either is working; and most 'hair vitamin' products lack randomized trial support unless you have a documented deficiency. Disclosed: Dr. Ellis founded Prequel, a skincare (not hair-loss-specific) brand; nothing on this page requires buying it.
Apply topical minoxidil 5% as a first-line option Per product label, typically applied to the scalp; consistent daily use matters more than any other single factor
Topical minoxidil has the strongest accessible evidence base for androgenetic alopecia per AAD/JAAD consensus reviews, and it is available over the counter.
Expect a minimum of 4 to 6 months of consistent use before judging whether minoxidil or finasteride is working n/a, patience is the dose
Hair growth cycles are slow; trials showing benefit for both minoxidil and finasteride measured outcomes at several months, not weeks, so stopping early is the most common reason people conclude "it does not work."
Ask a physician about oral or topical finasteride if minoxidil alone is not enough, especially in men No dose given here; finasteride is prescription-only and a physician decision, including discussing sexual-side-effect risk
Finasteride has stronger trial evidence than minoxidil in men specifically, per AAD/JAAD consensus, but it is Rx-only and carries a real, if uncommon, side-effect profile that a physician needs to weigh with you.
Do not expect biotin or most "hair growth" gummy/vitamin products to regrow hair unless you have a documented deficiency n/a
Biotin and similar single-ingredient supplements meaningfully help hair growth mainly when correcting an actual deficiency, which is uncommon in otherwise healthy adults; marketing claims for these products generally outrun the trial evidence.
Topical minoxidil and finasteride are the two treatments with the strongest evidence base for androgenetic alopecia per American Academy of Dermatology and JAAD consensus reviews.
View sources
Dr. Sam Ellis, hair loss and hair care channel
Hair loss: Diagnosis and treatment
Not medical advice. This page is for education only and is not a substitute for professional medical care. Consult a qualified clinician before changing your health routine.
Independent curation. YourProtocol is an independent platform. This protocol is based on the publicly available work of Samantha Ellis, MD and is not created, reviewed, endorsed by, or affiliated with Samantha Ellis, MD or Potozkin Ellis Dermatology, Danville, CA.
Is this for you
- Anyone noticing pattern thinning who wants the evidence-graded options, not marketing claims
- People deciding between OTC minoxidil and asking a physician about finasteride
- Anyone tempted by a "hair vitamin" who wants an honest read first
Cautions
- Informational only, not a diagnosis; a dermatologist can rule out other causes of hair loss (thyroid, iron, autoimmune)
- Finasteride is prescription-only; do not self-source it
- Disclosed: Dr. Ellis founded Prequel, a skincare brand not required or recommended on this page
Common questions
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