Propecia alternatives: what works and what to try instead

Propecia (finasteride) helps many men keep hair by blocking DHT. But some avoid it because of sexual side effects, mood changes, or wanting a non-prescription route. If that sounds like you, this guide lists practical alternatives—what works, what risks to expect, and how to pick the right option.

Medical alternatives

Several prescription choices can replace or complement finasteride. Minoxidil is the most common: a topical solution or foam applied daily to the scalp. It doesn’t block DHT, but it stimulates hair growth and slows shedding for many users. Expect three to six months to see improvements and continued use to keep results.

Dutasteride blocks DHT more completely than finasteride and often shows stronger hair-thickening in studies. It’s more potent and carries similar sexual side effect risks, so discuss dose and monitoring with your doctor before starting.

Topical finasteride or topical dutasteride aims to reduce systemic exposure while delivering medicine to the scalp. Small trials report good results with lower blood levels, but long-term safety data are limited. Ask your clinician about compounding options and follow-up blood tests.

Oral or injectable medications for hormone-related hair loss may be used in specific cases under specialist care. For example, anti-androgens are sometimes used for women with androgen-driven hair loss. Always talk with an endocrinologist or dermatologist before trying hormone-based treatments.

Non-drug options and at-home steps

Minoxidil aside, several non-drug approaches help. Low-level laser therapy (LLLT) devices, like helmets or combs, can boost hair density for some people. Results take months and devices vary in quality, so choose ones with clinical backing.

Platelet-rich plasma (PRP) injections use your own blood to stimulate follicles. Many clinics report visible thickening after a series of treatments. PRP suits people with early hair thinning rather than advanced baldness.

Microneedling, sometimes combined with minoxidil, creates tiny scalp injuries that may boost growth factors and absorption. It’s a low-cost option but needs proper technique or professional sessions.

Ketoconazole shampoos reduce inflammation and may help hair health when used twice weekly. They’re not a stand-alone cure, but they support other treatments.

Supplements like saw palmetto, pumpkin seed oil, and biotin claim benefit. Evidence is mixed: saw palmetto shows modest anti-androgen effects in small trials but isn’t as reliable as prescription options. Only use supplements after checking for interactions and product quality.

How to choose: Start with your goals and tolerance for risk. If you want proven results with low maintenance, minoxidil plus a ketoconazole shampoo is a simple start. If you need stronger DHT suppression, discuss dutasteride with your doctor. For those avoiding drugs, try LLLT, PRP, or microneedling.

Ask these questions at your appointment: What are realistic results? What are the side effects and how likely are they? How long before I know it’s working? Will blood tests or follow-up be needed? Getting clear answers helps you decide.

This is practical guidance, not medical advice. Check with a dermatologist before changing or starting treatments so you get a plan tailored to your situation. Track progress with photos and notes monthly.