Hair-loss Medication Timeline: Here’s What to Expect, and When

Hair loss can happen for a handful of reasons. Age, medications, and health conditions are just a few.

Regardless of the cause, it’s natural to feel on edge if you experience hair loss or thinning. The good news is there are medications that can help, such as finasteride (Propecia), minoxidil (Rogaine), and more.

While the specific medication timeline for hair-loss medications can vary, it’s helpful to know when they should generally start working. We’ll break down what to expect by medication and answer some commonly asked questions.

Which hair-loss medications are available?

There are several prescription and over-the-counter (OTC) hair-loss medications for male-pattern baldness.

Good to know: This article focuses on some of the most common medications for male-pattern baldness. For those experiencing alopecia areata — an autoimmune condition causing severe hair loss — there are a few other FDA-approved treatment options. These include Olumiant (baricitinib), Litfulo (ritlecitinib), Leqselvi (deuruxolitinib), and more.

When do you start to see results from finasteride and other hair-loss drugs?

The timeline for seeing results depends on which hair-loss medication(s) you’re taking. We’ve got you covered for when to expect results from hair-loss medications.

Finasteride

Finasteride is a first-choice medication that’s FDA approved to treat male-pattern hair loss. It’s a 5-alpha reductase inhibitor (5-ARI) that works by lowering levels of dihydrotestosterone (DHT) — a hormone that contributes to hair loss. The recommended finasteride dosage for male-pattern hair loss is 1 mg by mouth once daily.

Finasteride starts working quickly after you take your first dose. In fact, it lowers DHT levels by about 65% in 24 hours (1 day). This helps prevent further hair loss. But it can take at least 3 months for hair regrowth to begin.

You should see more noticeable results, such as fuller hair, around the 6- to 12-month mark. Some people who participated in studies have reported continued hair growth within the first 2 years of taking it. These studies also showed that 8 out of 10 men maintained their existing hair 5 years into treatment.

Minoxidil

Sometimes a side effect works as an advantage. People taking oral minoxidil for managing hypertension (high blood pressure) noticed it was causing hair growth. That’s why topical minoxidil was created. It’s now an approved, go-to hair-loss medication that’s commonly found on the shelves of local pharmacies, big box retailers, and online. Minoxidil is thought to work by increasing blood flow to the hair follicles. 

EXPERT PICKS: WHAT TO READ NEXT

• Taking finasteride: Pharmacists talk about recommended finasteride (Propecia) dosages for adults.

• Finasteride stories: Real people share their experiences about taking finasteride for male-pattern baldness.

• Risk management: Like all medications, finasteride can cause side effects. Learn from pharmacists about which ones to watch for.

Although topical minoxidil starts working after you apply your first dose, noticeable hair growth will take some time. And you may potentially experience more hair loss within the first couple weeks of starting it. This is just a sign that your body is getting rid of old hairs to grow new ones. More hair loss can be discouraging, but remember that this is normal early on. But if you’re continuing to lose hair after the first 2 weeks, reach out to your healthcare professional.

You should start seeing topical minoxidil’s beneficial effects about 2 to 4 months after applying it twice daily. You’ll likely first notice soft, colorless hair that looks like peach fuzz. As you continue applying the medication, it should grow in the same color and thickness as your current hair. The 5% solution is generally more effective than the 2% solution. But higher doses may come with more side effects, such as scalp irritation, itching, and unwanted facial and body hair.

What’s more, while oral minoxidil isn’t approved for hair loss, research shows it can be an effective off-label treatment. A recommended starting dosage is 2.5 mg by mouth once daily. You can expect to see results about 3 to 6 months after starting oral minoxidil.

Studies show that combining finasteride with topical minoxidil may be more effective than using them on their own. They work as a team to manage hair loss. But it isn’t clear which strength of minoxidil would be best in this case. 

Keep in mind: Although combining two different hair-loss medications seems to work well, you shouldn’t combine topical minoxidil with oral minoxidil.

Dutasteride 

Dutasteride is another 5-ARI. It’s approved to treat an enlarged prostate. Even though dutasteride isn’t officially approved for hair loss, it’s still a top option that many people turn to. The typical dutasteride dosage for hair loss is 0.5 mg by mouth once daily.

Dutasteride can lower DHT levels by up to 90% in about 1 to 2 weeks. However, you likely won’t notice benefits with dutasteride until about 3 months after starting the medication. And don’t give up if it’s not working in that time — it may take as long as 6 months for some. One study showed that taking dutasteride for 6 months can triple the amount of hair on your head compared to taking nothing at all.

Dutasteride may even be more effective than finasteride for hair loss. One meta-analysis (a large study that combines the results of smaller studies) found that people taking dutasteride for 6 months had higher hair counts on the crown and front of the scalp than with finasteride. 

Ketoconazole shampoo

Ketoconazole shampoo is an antifungal that’s approved to treat dandruff and tinea versicolor, a fungal skin infection. But your healthcare professional may prescribe it as an off-label option for hair loss. It works in a similar way to finasteride and dutasteride; it blocks 5-alpha reductase to lower DHT levels.

Studies suggest that ketoconazole shampoo works well when used alone or alongside other hair-loss medications, such as finasteride. Ketoconazole shampoo was applied 2 to 3 times per week in most studies. Hair growth and thicker hair was typically seen 3 to 6 months after starting ketoconazole shampoo.

How long does it take for hair-loss medications to fully work?

It may seem like it’s taking a while to experience substantial hair growth after starting your medication. That’s because it takes some time to see the full benefits, often up to 12 months (1 year).

Once they do start working, their effects usually last for a while. People who take finasteride, dutasteride, or topical minoxidil see benefits for up to 5 years of regular use. Oral minoxidil has been studied for up to 1 year showing benefits. Limited research shows benefits with ketoconazole shampoo up to almost 2 years. 

When can you stop taking hair-loss medications?

It may be tempting to stop your hair-loss medication, especially if you’re seeing good results. But you’ll likely start experiencing hair loss if you do so.

Once you stop finasteride, DHT levels typically return back to normal within about 14 days (2 weeks). This means you’ll likely start losing hair. Any regrown hair will typically be lost within 1 year of stopping finasteride.

Dutasteride stays in your body longer than finasteride after you stop it. It could take up to 6 months to start losing hair after stopping dutasteride. 

Once you stop topical minoxidil, you can expect to lose regrown hair in 3 to 4 months. Oral minoxidil leaves your body within about 1 day after you stop it. You’ll gradually start to lose your hair. The data isn’t as clear with ketoconazole shampoo since it’s typically used with other hair-loss medications. 

If you aren’t seeing any benefits 6 months after starting a hair-loss medication, it may be time to switch to a different one. Side effects could be another reason to switch medications. For instance, if you experience erectile dysfunction with finasteride, your healthcare professional may recommend minoxidil. It’s rare for minoxidil to cause sexual side effects. 

How to save on hair-loss medications

There are ways to save on hair-loss medications:

• Save with GoodRx for Hair Loss: You can pay as low as $16 for finasteride and as low as $20 for minoxidil. That’s one clear price that includes the telehealth visit, medication, and delivery.

• Save with GoodRx at the pharmacy: Anyone with a valid prescription can use GoodRx to purchase generic finasteride for as low as $9.30 per month. Oral minoxidil may cost as low as $10.47 per month, and a can of topical minoxidil may cost as low as $9.93.

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Written by:

Rachel Feaster, PharmD, BCOP, BCPS

Rachel Feaster has over 10 years of professional experience in ambulatory, inpatient, pharmacogenomics, and oncology care. She is board certified in oncology and pharmacotherapy.

Reviewed by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Reviewed by:

Kathryn Cannaday, PharmD Candidate

Kathryn Cannaday is currently a pharmacy intern with Ascension St. Vincent Hospital in Indianapolis. She is also currently involved in a year-long experience with Butler University Community Outreach Pharmacy, serving as a medication therapy consultant for the underserved local community.

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