Welcome to 2025! Antiandrogens, high dose minoxidil, topical finasteride – wondering where the future of hair loss therapy is headed? You’re in the right place!
Wondering what’s new on the medical hair loss therapy market for 2025? There are both some new and some familiar trends you should have in your peripheral view. Image by Freepik.
Since we’re still kicking off the new year, I thought it’d be a good time to weigh in on the medical hair loss therapy trends we’ll be seeing in 2025. Some (like minoxidil and finasteride) are new twists on the reliable while others (antiandrogens, prolactin, peptides) are brand new and cutting edge.
Wondering what treatments will be worth your time and money as 2025 marches on? Read on!
Trend 1: Higher Doses of Oral Minoxidil
Consider this a newer take on an always reliable medical therapy staple, oral minoxidil. We like minoxidil for treating hair loss because of its ability to encourage hair growth and reverse miniaturization. It won’t prevent future loss, however it is fantastic for improving hair caliber and density.
To that effect, some doctors have been experimenting with prescribing higher doses of oral minoxidil to patients – up from a standard starting dose of 2.5mg/day to 5 or 10mg/da – in the pursuit of boosting ‘hair growth gains’.
The trend didn’t arise out of thin air. Early studies do show that higher doses of oral minoxidil appear to be just as safe as the lower doses but with more effective gains.
However, before you run to your provider looking to ‘up your dose’, be aware that the concerns around side effects still increase with the higher doses, despite the medication’s relative safety. Originally discovered as a potential blood pressure medication in the late 1970s, cardiac and other circulatory complications (leg swelling, fluid build-up around the lungs and/ or heart) are associated with high doses (up to 40mg/day). That increased risk should be weighed carefully, especially if you aren’t already on a DHT blocker to protect the hair you still have and prevent future loss.
Tempted to try the new, higher doses of oral minoxidil to see if it ups your gains? Though medical hair loss therapy is incredibly safe, keep in mind that ‘new’ and ‘different’ usually carry some inherent risk. No aesthetic improvement is worth your health. Be aware, informed, and follow-up with your doctor. Image by cookie_studio for Freepik.
Trend 2: Topical Finasteride
If minoxidil is the cornerstone of medical hair loss therapy, then finasteride is the foundation. Chances are if you follow my channel, you’ve heard me talk about finasteride many a time before. If not, finasteride is an alpha-5 reductase inhibitor. That means it counters the activity of an enzyme called alpha-5 reductase, which is responsible for converting testosterone to dihydrotestosterone, the hormone that most influences hair loss. For those experiencing androgenic alopecia, minoxidil alone is really just a band aid solution. Yes, it will help with maturation, calibre, and growth of miniaturized hairs, but to preserve the hair you still have (or freshly transplanted hair) for the long term, a medication that blocks the deleterious effects of DHT is essential. It’s why minoxidil and finasteride are so often spoken in the same breath and why I so often prescribe them together.
However, there’s a catch. One of the rare potential side effects of using this antiandrogen is sexual dysfunction and, despite finasteride’s overall safety profile and effectiveness, many men don’t want to take even a small chance. That’s where topical finasteride comes in.
Because the side effects of this medication are dose dependent, and less finasteride reaches the blood system when applied topically, there’s been a surge of men exploring the topical form.
I have a Feel Confident version available for prescription, but – I’ll be honest – it’s not my first choice. Oral finasteride is generally very safe and easier to comply with, not to mention that topical finasteride can be messy, may not be as effective over the long term for reducing hair loss, and can be toxic during pregnancy (particularly for a male fetus). You’re also not completely out of the woods with regards to side effects with topical, which may defeat the purpose.
Finasteride and minoxidil – the dynamic duo of hair growth. Though Topical minoxidil and topical finasteride are options if you’re concerned about systemic effects, keep in mind that effectiveness and consistency of use can take a hit. Image by Freepik.
Trend 3: Synthetic Peptides
Peptides are long strings of amino acids (the building blocks of proteins) that have been getting attention for their potential to improve the appearance of skin, lose weight (Ozempic), and it turns out they might even help with hair growth too.
Peptides are a very large category of relatively new-ish drugs. Made in a lab, synthetic peptides have been shown in vitro to trigger a lot of different cellular pathways. In the case of hair, some peptides can increase growth factors that we know are involved in hair growth.
However, the few studies available are isolated to cell culture – meaning they haven’t been shown effective in animal models or people. It’s in the category of promising but early.
It’s also not FDA approved.
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However, there’s been a lot of excitement over peptides – they’re a ‘buzzy term’. Because of that, some providers are jumping the gun and offering to inject synthetic peptides (like with exosomes), but I’d strongly caution you away. The data just isn’t there and these aren’t FDA approved uses, which carries an extra risk in my mind.
I know new hair loss medical therapies are appealing, but it’s the wild west out there. Not everything that promises to deliver hair regrowth can, and not all trends are to be followed. Be informed and careful out there! Image by Kamranaydinov for Freepik.
Trend 4: Antiandrogens
Another trend we’re going to see in 2025 is the emergence of a new category of hair loss drug: antiandrogens – specifically, drugs that block the effects of male hormones (androgens), such as DHT.
These are designed to be used locally at the hair follicle and work one of two ways – by blocking the receptor for DHT (effectively shutting it off like you would a light switch), or by degrading it entirely.
Clascotorone (already in use as an acne therapy) and pyrilutamide (KX-826) outcompete DHT for the receptor binding spot in hair follicles, preventing the downstream pathway that leads to miniaturization and eventual loss. GT20029 on the other hand, leads to the degradation of the receptor entirely, meaning there’s nothing left for DHT to bind to.
Though these aren’t readily available (yet), the concept is exciting. There aren’t many ways to target DHT (the main culprit behind androgenic alopecia), and androgen receptor blockers will hopefully offer a more targeted, stronger option for patients in the future, with the potential for fewer side effects.
Trend 5: Newcomer Prolactin
I left the most experimental on my list for last, and that’s injection of a prolactin receptor inhibitor, HMI115. Prolactin is a hormone that’s important for lactation, however, the activation of the prolactin receptor and high levels of prolactin are associated with elevated hair loss.
We’re not really sure why prolactin and hair loss are affiliated, it’s just not intuitive where this hormone fits into the DHT/hair growth and loss cycles. Treatment is also systemic, which makes me wary when we’re not sure what the mechanism is. In my mind this one needs a lot more study, however, it’s worth being on your radar as an alternative way to address hair loss and potentially boost gains, outside of classic DHT inhibition.
So that’s my list of medical therapies that are worth keeping track of through 2025. And, while there are some exciting new therapies and options on the horizon, that’s no reason for you not to explore safe and effective medical therapy now.
Check out my Feel Confident hair care line for products with ingredients that really can help support growth and see if prescription medical hair loss therapy is right for you.
The content of this newsletter is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient’s needs. Results and particular outcomes are not guaranteed.