Men's hair loss treatment: finasteride, minoxidil, and what's next

Short answer: Most men's hair loss is male pattern hair loss (androgenetic alopecia), driven largely by a hormone called DHT shrinking sensitive follicles over time. The two most studied medical treatments are finasteride and minoxidil, used alone or together, in oral or topical forms. New options are moving through trials in 2026. Treatment slows loss and can support growth for many men, but results take months and vary from person to person. Individual results vary.

Finasteride blocks the 5-alpha reductase enzyme, which lowers DHT levels at the scalp. Less DHT means less of the squeeze that miniaturizes follicles. It is an oral tablet that is FDA-approved for male pattern hair loss, and it mostly works by slowing or stopping further loss, with some men also seeing growth over time. Your clinician sets whether it fits you and at what dose.

With finasteride, oral is the long-studied, FDA-approved route for male pattern hair loss. Topical finasteride is used to try to reduce how much drug reaches the rest of the body, keeping more of it at the scalp. That sounds appealing, but it comes with real caveats we cover in the safety section, including an FDA alert about compounded topical versions. Changing the format does not change the underlying medication; it changes the on-ramp and the exposure pattern.

Direct answer: In April 2025 the FDA issued an alert about compounded topical finasteride products. It noted 32 adverse-event reports from 2019 to 2024, including erectile dysfunction, anxiety, suicidal ideation, and brain fog, plus a risk of transferring the product to others. The agency stressed there are no FDA-approved topical finasteride products and that quality can vary.

PP405. Pelage reported a phase 2a study in June 2025 involving 78 participants. Hair-growth findings were exploratory; the report described further studies as planned. A development plan is not proof that a later trial started or that treatment is available. ¹¹.