Treatment

First sign to look for

Visible improvement

Peak / plateau

Notes

Topical minoxidil

Less shedding by 6–10 wks

3–6 mos

6–12 mos

Upfront shed is common; daily adherence matters.

Oral minoxidil (off-label)

4–8 wks

3–4 mos

6–12 mos

Often faster than topical; higher chance of systemic side effects.

Finasteride (oral)

Shedding reduction 1–3 mos

4–6+ mos

~12 mos

Most proven DHT-lowering option (men).

Topical finasteride

2–3 mos

4–6+ mos

~12 mos

Lower systemic exposure; consistent application required.

Dutasteride (off-label US)

1–2 mos

3–6 mos

~12 mos

Stronger DHT suppression; discuss risks.

Spironolactone (women)

2–3 mos

4–6 mos

6–12 mos

Anti-androgen; avoid in pregnancy.

Ketoconazole shampoo

Scalp comfort 2–6 wks

2–4 mos

4–6 mos

Anti-inflammatory/sebostatic; supportive role.

Latanoprost (topical) (off-label)

8–12 wks

3–6 mos

6–12 mos

Prostaglandin analog; mixed scalp data; avoid eye contact.

Thyroid replacement (T4/T3) for true hypothyroidism

8–12 wks

3–6 mos

variable

Only when clinically indicated; medical supervision.

Treating telogen effluvium

Shedding slows 6–8 wks

3–6 mos

6–9 mos

Remove trigger; support sleep/nutrition/stress.

Hair transplant

Grafts shed 0–4 wks

New growth 3–4 mos

12–18 mos

Final “maturation” ~18 mos; maintenance still needed.

Microneedling

6–10 wks

3–6 mos

6–12 mos

Weekly/biweekly typical; synergistic with minoxidil.