Topical OTC minoxidil can promote hair regrowth in over 80% of users by improving scalp blood flow. Men can use 2–5% topical solution or foam twice daily, while women should apply it once daily. For advanced cases, prescription options like oral finasteride or off-label oral minoxidil may provide additional benefits.
January 10, 2025

Hair Loss: At-Home Regrowth

Evidence-Based Over-the-Counter Guide

William Shen

William Shen

Co-founder & CPO

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Progressive, nonscarring pattern badness in men and women is typically related to hormone-dependent shortening of hair growth phases. It can be slowed or reversed with over-the-counter medications in many patients.

First-line recommendations:

Prescription medications:

  • Finasteride: Medication that inhibits DHT, used for androgenetic alopecia in men. Available in oral or topical form.

  • Oral minoxidil: More convenient than oral minoxidil and comparable efficacy, though used off-label as minoxidil is only FDA-approved in its topical form. 

Citations

Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. 2021; 20(12): p.3759-3781. doi: 10.1111/jocd.14537


What OTC evidence is reviewed?

  • For each condition, we performed a literature review to find a recent widely cited expert group guideline published in the leading specialty-specific peer-reviewed journal or top general medical journal.

  • Based on the recommendations in the publication, we identify recommended active ingredients and devices that are available over-the-counter per FDA regulations.

What evidence is prioritized?

Levels of evidence considered:

  • Tier 1 (Safe and Definitely Effective): Professional field consensus or multiple randomized controlled clinical trials showing the same conclusion. Wherever possible, we use Tier 1 evidence for "first-line" recommendations.

  • Tier 2 (Safe and Probably Effective): Individual clinical trials which may be discordant or large-scale observational experience. Tier 2 evidence may inform "first-line", "second-line", or "supplement" recommendations.

  • Tier 3 (Safe and Maybe Effective): Mechanistic plausibility without high-quality clinical evidence of efficacy but high-quality evidence of safety. Tier 3 evidence may inform "second-line" or "supplement" recommendations.

How does MDandMe select recommended products?

  • Based on the top clinical recommendation, we evaluate products containing the recommended active agent with FDA-approved dosage based on price, average customer reviews, how often it is purchased, and how quickly it will ship to home. 

  • We provide public documentation of the active ingredients in our recommendations, using all 32 FDA monographs, Prescription-to-Nonprescription (Rx-to-OTC) Switches, as well as New Drug Application (NDA) approvals.

How does MDandMe select recommended devices?

  • Based on the top clinical recommendation, we evaluate devices that are FDA-cleared or comply with other medical guidelines (if not a FDA-regulated category) by reputability, price, and average customer reviews.

  • We provide public documentation of supporting evidence for each device.  

Where do I view other OTC guides?

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You can view all of our published OTC guides here.

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