What AGA and FAGA treatment can and cannot do. Medication aims to "slow the progression"

AGA (male pattern hair loss) and FAGA (female pattern hair loss) treatment primarily works by using medication to slow the progression of hair thinning and to regrow thinned hair[1]. Medication works only while you continue taking it, and you must continue long-term to maintain the effect. The response varies from person to person[2][3].

Why does AGA and FAGA cause hair to thin?

Due to inherited body constitution and the effects of male hormones, the hair follicles that produce hair gradually become smaller. Hair becomes thinner and shorter, and the scalp gradually becomes more visible[4][1].

This is hair loss that leaves no scarring and occurs in both men and women[4]. Although the pattern of thinning differs between men and women, men can develop female-type thinning and women can develop male-type thinning[5].

What medications are used for male AGA?

The main treatments are the topical medication minoxidil and finasteride, an oral medication that weakens the effects of male hormones. These are the two medications approved in the United States[1].

Minoxidil has been reported to enlarge hair follicles and increase the proportion of hairs in the growth phase[6]. Dutasteride oral medication (0.5 mg) is approved for male AGA in Japan and Korea[7]. In reports comparing the strength of effectiveness, dutasteride was superior to finasteride 1 mg[7].

What is different about FAGA treatment in women?

The center of treatment in women is minoxidil[4]. Because facial and body hair may become darker or thicker, it is recommended to receive an explanation before starting treatment[8].

Finasteride is not indicated for women, and because it may affect the developing baby, contraception is necessary for those who might become pregnant[4][9]. A study in 137 postmenopausal women using 1 mg for 12 months showed no clear improvement[9].

For women with high levels of male hormones, medications such as spironolactone may be used[2].

When will the effect be seen? What happens if you stop?

It takes time to assess effectiveness. For FAGA medications, it is said that you must continue for at least 6–12 months before assessing the effect[9].

Approved treatments are premised on continuing long-term to maintain the effect[2]. This tends to become lifelong treatment, and you must also consider the cost and side effects[1]. Also, it has been reported that even when using finasteride, 30–50% of people showed no clear improvement[3]. This is a ratio of approximately 3–5 people per 10.

What are the side effect risks? What should you be careful about?

With oral minoxidil, darkening of body hair and symptoms affecting the heart and blood vessels become more likely depending on the dose[7]. With finasteride and dutasteride, decreased sexual function and mood changes have been reported[7].

Dutasteride is a medication that persists in the body for a long time[7]. If used by women, it is recommended to continue contraception for at least 6 months after stopping[9]. If you notice any concerning symptoms, do not stop on your own—consult the doctor who prescribed the medication.

What cannot medication do? What are other options?

The goal of treatment is to stop the process of hair becoming thinner[1]. This is not a treatment that restores hair to its original state in a single procedure.

PRP (treatment using components from your own blood) is positioned as a supplement to medication rather than a standalone treatment[8]. For those who meet the criteria, hair transplantation is also an option[5].

Three things to confirm before proceeding: whether the cause of hair thinning is truly AGA or FAGA, that the medications available change depending on sex and pregnancy plans[4][9], and when to assess effectiveness and how long to continue treatment[9][2]. The condition of the scalp and hair cannot be determined from an article, so confirm it during consultation.