Get the diagnosis first
Androgenetic alopecia, telogen effluvium after illness or a large weight loss, iron deficiency, thyroid disease, and scarring alopecias are different problems with different treatments, and one of them is urgent because scarring is permanent if it is not treated early. Pattern, speed of onset, whether there is itching or pain, and whether the scalp looks inflamed all matter. A photograph and a ferritin and thyroid check often change the plan.
What has randomised evidence
For androgenetic alopecia, topical minoxidil and oral 5-alpha-reductase inhibitors have the strongest randomised data, and both work better at maintaining what you have than at recovering what has gone. That framing matters: starting earlier genuinely produces a better outcome than starting later. Finasteride has recognised potential side effects, including sexual side effects and mood changes, which belong in the conversation before the first prescription rather than after.
Where the evidence is thinner
Low-level light therapy has some supportive randomised data of modest size. Platelet-rich plasma has a growing but heterogeneous literature with inconsistent protocols. Copper peptide and exosome-based topicals are supported largely by mechanism and small series. Microneedling shows promise mainly as an adjunct. These are reasonable things to discuss and unreasonable things to be promised.
Why bloodwork appears on a hair page
Because iron deficiency and thyroid disease are common, treatable causes of diffuse shedding that no topical will fix, and because vitamin D and androgen status inform the picture. Treating the scalp while missing a ferritin of 8 is a waste of everyone's time.
Key points
- Diagnose first — scarring alopecia is urgent and permanent.
- Minoxidil and 5-ARIs have the strongest randomised data.
- Maintenance beats recovery — starting earlier genuinely matters.
- Check ferritin and thyroid before treating the scalp.
AZZA Medical is not a medical provider and does not practice medicine. Medical services are provided exclusively by independently licensed physicians of our partner physician network and their affiliated professional entities.
Compounded drugs are not FDA-approved and have not been evaluated by FDA for safety or effectiveness.
This is not emergency care. AZZA Medical does not provide urgent or emergency medical services. If you are experiencing a medical emergency, call 911 or go to your nearest emergency room.