Among the dozens of products marketed for hair loss, only two have the kind of repeated, randomized clinical evidence that justifies confidence, and they work in complementary ways.
Two drugs, two different mechanisms
Minoxidil, applied to the scalp as a liquid or foam, does not lower DHT. Instead it appears to prolong the growth phase of the hair cycle and improve blood flow to the follicle, nudging miniaturized follicles back toward producing thicker hairs.
Finasteride, taken as a daily oral tablet, attacks the root cause by inhibiting the 5-alpha-reductase enzyme, which lowers the amount of DHT in the scalp and slows or halts miniaturization. Because one stimulates growth and the other removes the hormonal driver, they are often used together for an additive effect.
Evidence Check: Both are FDA-approved with multiple randomized trials behind them. They work best in combination but only while usage continues; stopping will cause benefits to fade.
What the trials actually show
The majority of men who use finasteride consistently stop losing hair, and a substantial fraction see some regrowth, particularly at the crown. Minoxidil similarly helps many users maintain and modestly increase density. What neither drug does reliably is restore a full youthful head of hair from advanced baldness — their strength is in defending existing follicles and reviving recently miniaturized ones.
The catch: benefits depend on continued use
These are ongoing treatments, not cures. The underlying genetic and hormonal tendency does not go away. Stopping finasteride allows DHT to rise again and miniaturization to resume. Stopping minoxidil ends its stimulating effect. Within months of discontinuation, the hair the treatment was protecting is typically lost.
Side effects in proportion
Minoxidil is generally well tolerated; the most common issues are scalp irritation and a temporary increase in shedding in the first weeks. Finasteride is well tolerated by most users, but a small percentage of men report sexual side effects such as reduced libido or erectile difficulty. Large trials place the incidence at a low single-digit percentage. This decision is best made in conversation with a physician.
Setting expectations and timelines
A fair trial is at least six months, and the fuller picture emerges over a year. Photographs taken under consistent lighting are far more reliable than the daily mirror for judging progress. The men who do best are those who start early, use the treatment consistently, and measure results over seasons rather than days.
Disclaimer: These are medical treatments with possible side effects. Always consult a doctor before starting.