Female Hair Loss: Guide to Finasteride, Minoxidil & Ketoconazole

Amy Brodsky

Medically reviewed by

Amy Brodsky

Amy Brodsky

About

Dr. Amy Brodsky is board certified in Dermatology and is a fellow of the American Academy of Dermatology. Dr. Brodsky completed her undergraduate studies with a Bachelor of Science in Biomedical Engineering at the University of Illinois, followed by her Medical Degree at The University of Chicago. She won the Women’s Dermatologic Society Fellowship to study clinical trials on Cosmeceuticals, and opened her own practice in 2007, which she subsequently grew to 3 offices and over 50 people. In 2012, Dr. Brodsky founded Sun Hero, a non-profit dedicated to sun protection awareness and in 2021 launched her own skin care line, Derma Made.

Credentials

Medical Advisory Board Member At:

• Nu Image Medical

Written by our editorial team.

Last Edited 1 year ago · 4 min read

With over 80 million Americans having hair loss, many people seek treatment. Many people associate hair loss with men, but it isn’t always men who lose their hair. Women can lose their hair, too.

Women are often surprised when they lose hair, because it usually affects males. However, when a woman loses hair, it is not expected. According to Southeastern Plastic Surgery, a Florida-based practice, 40 percent of American women experience hair loss. 

There are a number of hair loss medications on the market that promise to help you regrow hair. Hair growth is cyclical. Humans shed anywhere between 50 and 200 hairs per day. This is a natural process, and hairs regrow on a regular basis. 

Experts assert that there are key differences in how men and women handle hair loss. Women, as a rule, feel depressed and feel as if no one understands the problem they are facing. This is especially true with female pattern baldness. Female hair loss is more common than you think. In fact, experts have found that an estimated 50 percent of women will experience hair loss at some point in their lives. 

Many women decide to take hair loss drugs to restore their hair and promote regrowth. One such drug is Finasteride, and it is growing in popularity.

Finasteride 

What is Finasteride? According to Medline Plus, Finasteride is a prescription medication used to primarily treat benign prostatic hyperplasia (BPH) and male pattern baldness. While Finasteride is an effective treatment for men, many women take it for hair loss as well. Often taken off-label by women, Finasteride keeps testosterone from being converted into dihydrotestosterone (DHT). DHT is a hormone known to cause hair loss in both men and women. 

 When taken at a level of one milligram, 1.25 milligrams, or 2.5 milligrams per day, Finasteride works by inhibiting the production of the enzyme, 5-alpha-reductase. This particular enzyme converts testosterone into “another hormone” that causes the prostate to enlarge. This drug treats hair loss by increasing levels of testosterone in the body. These extra hormones decrease prostate size and encourage hair regrowth on the scalp. 

Finasteride begins working the moment you ingest it. However, it takes some time for women to begin regrowing hairs. According to data from clinical trials, it generally takes anywhere from three to six months for a woman’s hair to thicken from taking this medication. Seeing changes in your hairline is a gradual process with this medication, so you have to be patient.   

 A clinical study conducted in 2006 found that 62 percent of female participants taking Finasteride saw a regrowth of hair. However, researchers did not know if this was due to taking a higher dosage of the medication or simply the result of taking Finasteride.   

Minoxidil

Minoxidil, which is sold under the brand name, Rogaine, is a medication designed to treat high blood pressure. In addition to this, it is effective in the treatment of hair loss. For this reason, it is one of the most common hair loss drugs on the market. Designed in the 1950s to treat ulcers, Minoxidil enjoyed success, but experts eventually found it to be effective in treating hair loss as well.

Scientists soon found hair restoration to be a side effect of Minoxidil, making it an attractive option for those with hair loss. While Minoxidil boasts success in many people, it also comes with side effects to be aware of. Those who take this drug may experience scalp and skin irritation, an irregular heartbeat, headaches, and high blood pressure. Minoxidil may also affect fetal development in unborn babies.

Minoxidil is an over-the-counter medication, so there is no need to visit a doctor for a prescription. Although it is effective, Minoxidil is not the right fit for everyone. It doesn’t work for all cases of baldness. Additionally, you must apply Minoxidil as directed, if you want it to be effective. You can purchase this medication in different strengths. While you may not need a prescription for Minoxidil, you should speak with a doctor if you have concerns.

Minoxidil is effective for women, but it should not be taken if you are pregnant or breastfeeding. Those under the age of 18 should exercise caution when taking Minoxidil. This prescription has been associated with sudden and unexplained hair loss and an infected or itchy scalp. Those who have lost hair when taking other chemical products should not take this medication. Studies have found Finasteride to be better than Minoxidil. 

Studies have found Minoxidil to be effective in females when it is applied directly to the scalp. This stimulates hair growth. The FDA found two percent Minoxidil to be beneficial for women. 

If you are a woman with hair loss, it helps to understand the different types of hair loss. Type I hair loss is hair loss that involves only a small amount of thinning hair. This type of hair loss can be covered up when you use the proper styling techniques. Type II hair loss is a bit more advanced, as hair volume is slowly lost. With type II hair loss, the midline part gradually grows wider, as more hair is lost. 

Type III hair loss involves a lot more thinning of the hair. As more hair falls out, the scalp becomes more visible. At this point, you can see through the remaining hair, as the skin is more exposed.

Ketoconazole

Ketoconazole is yet another treatment for female hair loss. According to GoodRX Health, Ketoconazole is effective in treating hair loss, although it was not created for that purpose alone. Ketoconazole comes in cream and shampoo form. The cream must be rubbed onto the areas where you wish to regrow hair. 

Use Ketoconazole until your hair loss treatment is complete. Of course, some people may opt for the shampoo form of Ketoconazole. Ketoconazole is an antifungal treatment. According to Everyday Health, Ketoconazole is “an antifungal drug used to manage scalp conditions like dandruff.” This includes treating conditions such as genetic alopecia.   

Be aware that this medication should be avoided if you have damaged or burned skin, are pregnant or trying to get pregnant, or if you have an allergic reaction to ketoconazole. Ketoconazole is intended for external use only. 

Wash your hands thoroughly before and after using this medication. Avoid contact with your eyes. If ketoconazole does get into your eyes, wash them thoroughly with cool tap water. This medication should be taken at the same time each day and as directed. Moisten your skin with water before using Ketoconazole. Lather it into your hair, and let it sit for five minutes. Then, rinse out the shampoo, and dry your skin with a towel until the area treated dries completely. If you are applying Ketoconazole directly to your scalp, it is not necessary to shampoo your hair every time you apply the medication. 

According to PubMed, Ketoconazole has some drug interactions. Ketoconazole interacts negatively with fluconazole. There is the potential for overdose with Ketoconazole. 

Of course, you may be wondering how female hair loss begins. Female hair loss is genetic, and is typically passed down through families. It can begin when you are a teenager. When hair loss starts early like that, hair loss is usually worse. While men with hair loss typically lose hair at the top of the scalp, such is not often the case with women. With women, hair begins to gradually thin in the crown area. 

Hairs usually become shorter, and the cycle of hair growth becomes shorter as well. There may come a point when hairs become very short, because the cycle of hair growth has grown shorter. It’s important to be aware of how different products affect women. Minoxidil regrows female hair 81 percent of the time. 

Minoxidil prolongs your hair’s growth cycle, allowing more time for hair to grow back to its full thickness. While it takes time for these products to regrow hair, they work better if started earlier in the hair loss process. 

Effectiveness is a concern for many people with hair loss, so it helps to know which product will work best for you. Hair growth products come in different forms. Finasteride is a pill, and Ketoconazole comes in a cream and shampoo form. Minoxidil comes in a foam, a liquid, and a pill that you apply to your head with a dropper. While effective, experts don’t know exactly how Minoxidil works to regrow hair. 

You may need to continue taking Minoxidil to see sustained hair restoration. There is a possibility that hair regrowth could stop after you stop taking this medication. 

16 Sources

Nu Image Medical has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

https://www.se-plasticsurgery.com/blog/hair-loss-affects-over-80-million-americans/

https://my.clevelandclinic.org/health/diseases/16921-hair-loss-in-women

https://www.nebraskamed.com/dermatology/hair-loss-in-women-what-causes-it-and-how-to-stop-it

https://medlineplus.gov/druginfo/meds/a698016.html

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https://www.goodrx.com/finasteride/finasteride-works-for-hair-loss-in-women

https://www.fda.gov/drugs/information-drug-class/5-alpha-reductase-inhibitor-information

https://jamanetwork.com/journals/jamadermatology/fullarticle/403800

https://en.wikipedia.org/wiki/Minoxidil

https://www.mayoclinic.org/diseases-conditions/hair-loss/diagnosis-treatment/drc-20372932

https://www.mayoclinic.org/drugs-supplements/minoxidil-topical-route/side-effects/drg-20068750?p=1

https://www.healthline.com/health/does-rogaine-work#rogaine-vs-competitors

https://www.goodrx.com/conditions/hair-loss/ketoconazole-hair-loss

https://www.mayoclinic.org/drugs-supplements/ketoconazole-topical-route/proper-use/drg-20067739

https://pubmed.ncbi.nlm.nih.gov/8357281/

https://www.everydayhealth.com/hair-loss/hair-loss-treatment-nizoral.aspx

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your physician about the risks and benefits of any treatment. Nu Image Medical may not offer the medications or services mentioned in this article.