Understanding Hair Loss: Causes, Treatments, and What Really Works

Hair loss is one of the most common concerns seen in dermatology practices. Whether you are noticing increased shedding in the shower, a widening part, thinning at the crown, or a receding hairline, it can be frustrating and emotionally challenging. The good news is that there are more effective treatment options available today than ever before.  

Why Does Hair Loss Happen?

Hair loss is not a single condition. Common causes include:

• Androgenetic alopecia (pattern hair loss) – the most common cause in both men and women.

• Telogen effluvium – excessive shedding often triggered by illness, stress, surgery, medications, or hormonal changes.

• Alopecia areata – an autoimmune condition that causes patchy hair loss.

• Inflammatory forms of alopecia – conditions that can damage hair follicles and lead to thinning.  

Because different types of hair loss require different treatments, an accurate diagnosis is the most important first step.

The Most Proven Hair Loss Treatments

Topical Minoxidil (Rogaine®)

Minoxidil is one of the most extensively studied hair loss treatments and is FDA-approved for pattern hair loss in both men and women. It works by increasing blood flow to hair follicles, helping prevent follicle shrinkage while promoting thicker, healthier hair growth. It is available over-the-counter as a liquid or foam. Most patients need to use it consistently for 6+ months before noticing improvement. Side effects are generally limited to mild scalp irritation.  

Finasteride (Propecia®)

Finasteride is an FDA-approved oral medication for male pattern hair loss. It works by reducing the effects of dihydrotestosterone (DHT), a hormone that contributes to follicle miniaturization and hair thinning. Finasteride can be very effective for slowing hair loss and preserving existing hair, but it must be taken long-term to maintain results. Potential side effects include sexual dysfunction and mood changes in a small percentage of patients. It should not be used by premenopausal women because of the risk of birth defects.  

Prescription Treatments Used “Off Label” for Hair Loss

Oral Minoxidil

Originally developed as a blood pressure medication, low-dose oral minoxidil has gained popularity as a hair loss treatment. Studies have shown meaningful improvements in hair growth in several forms of alopecia when used at low doses. Some patients may notice increased hair growth in areas other than the scalp, such as the face.  

Spironolactone

Spironolactone is commonly used in women with hormonally influenced hair loss. It blocks the effects of androgen hormones within hair follicles and may help slow female pattern hair loss. It has also been used for decades to treat acne and excessive facial hair. Possible side effects include menstrual irregularities, low blood pressure, and changes in potassium levels.  

Dutasteride

Dutasteride is similar to finasteride but blocks DHT more broadly and may be more potent for some patients. While studies have produced mixed results regarding superiority over finasteride, it remains an important option for certain patients with pattern hair loss. Like finasteride, it can cause sexual side effects and is generally reserved for men and postmenopausal women.  

Additional Treatments That May Help Hair Loss

Hair Growth Supplements

Several supplements, including products such as Viviscal®, contain marine collagen-derived peptides and other ingredients that may support hair growth. Research suggests these supplements may improve hair thickness and overall hair quality. While results vary between individuals, supplements are generally safe, can be combined with other therapies, and may be a reasonable addition to a comprehensive treatment plan. Patients with seafood allergies should avoid marine-derived products.  

Red Light Therapy

Low-level light therapy has emerged as a non-drug treatment option for hair loss. Devices such as the Revian® Hair Growth System use specific wavelengths of red and orange light that may improve scalp blood flow, reduce inflammation, and counteract some hormonal effects that contribute to hair loss. Treatment is painless and typically involves wearing a light-emitting cap for a few minutes each day.  

Interested patients of Northeast Dermatology can go to www.revian.com and use the promo code: nedermhair to get $550 off the cost of the device

Platelet-Rich Plasma (PRP)

PRP therapy uses a patient’s own blood to create a concentrated solution rich in platelets and growth factors. These growth factors are injected into the scalp to stimulate hair follicles, improve circulation, and encourage healthier hair growth. Treatment is typically performed monthly for three months, followed by maintenance treatments every few months. Because PRP uses the patient’s own blood, side effects are minimal. Many patients experience impressive results, although response can be difficult to predict.  

What Is the Best Treatment for Hair Loss?

There is rarely a single “best” treatment for everyone. The most successful hair restoration plans are usually individualized and often combine multiple therapies. For example:

• Men with pattern hair loss may benefit from finasteride, minoxidil, PRP, or a combination of treatments.

• Women with pattern hair loss may benefit from minoxidil, spironolactone, oral minoxidil, PRP, or red light therapy.

• Patients with shedding disorders may respond well to minoxidil, nutritional optimization, and treatment of the underlying trigger.  

The Bottom Line

Hair loss is common, but it is also highly treatable. The key is identifying the type of hair loss and starting treatment early before significant follicle damage occurs. Today, patients have access to a wide range of evidence-based options—from topical and oral medications to PRP, red light therapy, and nutritional support. Working with a dermatologist can help determine the combination of treatments most likely to restore and preserve your hair for the long term.