1995 · Robert M. Bernstein, William R. Rassman
FUT (strip harvesting)
Type. Surgery: one strip of scalp from the donor zone
A single strip of hair-bearing skin is cut from the back of the scalp and the wound is closed in one line. The strip is split into individual follicular units under a stereo microscope, and the units are placed in the thinning area.[1][2][3]
Suits. Patients who keep their hair long enough to cover a linear scar. In 751 women with female pattern hair loss treated by FUT over 31 years, the recipient area was not shaved and average operating time was 3 hours 21 minutes.
Trade-offs. Leaves a linear scar that widens as strip width increases. Hypertrophic or keloid scarring after FUT reached 15.1% in a 2025 scoping review. In a 30-patient study, a double trichophytic closure gave the best-looking scar.
2002 · William R. Rassman, Robert M. Bernstein
FUE (follicular unit excision)
Type. Surgery: units punched out one at a time
Each follicular unit is cut free with a punch about 1 mm wide down to the mid dermis and lifted out with forceps. There is no linear incision. In 2017 an ISHRS nomenclature committee renamed it follicular unit excision.[1][2][3]
Suits. ASPS calls FUE the newer, more common method, with quicker recovery and less scarring. It suits people who wear short or buzz-cut hair. In the 2002 paper a test on 200 patients rated 25% ideal and 35% good candidates.
Trade-offs. Takes longer than strip harvesting. Each punch heals as a small white dot, more visible in darker skin or short hair. Cutting through follicles (transection) is a known drawback.
2011 · Restoration Robotics
Robotic FUE (ARTAS)
Type. Surgery: FUE harvest by an image-guided robot
FDA cleared the ARTAS System on April 4, 2011 (510(k) K103428). Cameras map the donor area, and a robotic arm with a sharp inner needle and a blunt outer punch cuts and lifts each unit into a storage container. The physician or technician implants the grafts by hand.[1][2][3]
Suits. Cleared for men with male pattern hair loss who have black or brown straight hair. The learning curve is shorter than for manual FUE, and the robot does repetitive harvesting without fatigue.
Trade-offs. The clearance does not cover women or light or curly hair. The robot picks units by an algorithm in a random pattern. Implanting is still manual.
1997 · Propecia
Finasteride 1 mg
Type. Medicine: tablet once a day, men only
Blocks type II 5-alpha reductase and lowers scalp DHT. FDA approved Propecia on December 19, 1997. In two 1-year trials of 1,553 men aged 18 to 41, hair count in a 5.1 cm2 crown area rose 107 hairs over placebo at 1 year and 138 at 2 years. Men on placebo kept losing hair.[1][2][3]
Suits. Men with mild to moderate pattern loss. Daily use for 3 months or more is needed before benefit shows. Hair loss starts again after stopping.
Trade-offs. In year-1 trials: decreased libido 1.8% vs 1.3% on placebo, erectile dysfunction 1.3% vs 0.7%, ejaculation disorder 1.2% vs 0.7%. Postmarketing reports include sexual dysfunction that continued after stopping, depression and suicidal ideation. Not for women; pregnant women should not handle broken tablets.
1988 · Rogaine
Topical minoxidil
Type. Medicine: 2% or 5% solution or 5% foam on the scalp, over the counter
FDA approved 2% minoxidil solution on August 17, 1988. Solution and foam are sold over the counter for men and women. In a 48-week trial of 393 men, 5% solution gave 45% more regrowth than 2%. In women, pooled trials found more regrowth than placebo.[1][2][3]
Suits. Thinning on top of the scalp. It is the only FDA-approved drug for female pattern hair loss. Men's labels say it is not for frontal baldness or a receding hairline. Results take 2 to 4 months; the label says stop if none show by 4 months.
Trade-offs. Scalp itching and irritation, more with 5%. Unwanted facial hair. Shedding can rise for up to 2 weeks at the start. Regrowth is lost when use stops. In women, 30% to 60% do not improve.
2021 · Off-label
Low-dose oral minoxidil
Type. Medicine: low-dose tablet once a day, off-label
Minoxidil tablets are not FDA-approved for hair loss; doses of 0.25 to 5 mg a day are used off-label. In a 24-week trial of 90 men, 5 mg oral was not superior to 5% topical overall but did better on the crown in photo review. A 2025 Delphi consensus of 43 hair specialists from 12 countries set dosing and monitoring.[1][2][3]
Suits. Patients who find twice-daily topical use hard or get scalp irritation from it. In 52 women with female pattern hair loss, 1 mg a day matched 5% topical minoxidil.
Trade-offs. In 1,404 patients, hypertrichosis affected 15.1%, lightheadedness 1.7%, fluid retention 1.3% and tachycardia 0.9%; 1.7% stopped for side effects and none had life-threatening events. In the 90-man trial, 49% on 5 mg had hypertrichosis.
2001 · Avodart, off-label for hair
Dutasteride
Type. Medicine: 0.5 mg capsule, off-label
Blocks type 1 and type 2 5-alpha reductase; finasteride blocks type 2 only. Its FDA approval (2001) covers an enlarged prostate, not hair loss. In a 24-week trial of 917 men, 0.5 mg grew more hair than finasteride 1 mg.[1][2]
Suits. Men with pattern hair loss. In the 917-man trial, hair count and hair width rose with dose.
Trade-offs. In the 917-man trial, the number and severity of side effects were similar across groups. The trial lasted 24 weeks. Half-life is about 5 weeks, and it stays in the blood for 4 to 6 months after stopping.
· Injected from the patient's own blood
Platelet-rich plasma (PRP)
Type. In-office injection: concentrated platelets into the scalp
Blood is drawn, spun to separate it, and the platelet-rich plasma is injected into the thinning scalp. Platelets release growth factors such as PDGF, VEGF and IGF-1. The procedure takes about 10 minutes.[1][2][3]
Suits. Pattern hair loss as an add-on or alternative to medicine. A meta-analysis of 9 trials and 238 patients found higher hair density than placebo at 3 and 6 months. AAD describes monthly sessions for 3 months, then every 3 to 6 months.
Trade-offs. Hair count and hair diameter did not differ from placebo in that meta-analysis. Only 2 of 7 studies reported side effects, none serious.
2007 · HairMax LaserComb
Low-level laser (light) therapy
Type. Device: red light from a comb, cap or helmet at home
FDA cleared the HairMax LaserComb on January 18, 2007 (510(k) K060305) to promote hair growth in men at Norwood-Hamilton IIa to V with Fitzpatrick skin types I to IV. In its trial, users treated 3 times a week for 26 weeks. A meta-analysis of 11 sham-controlled trials found higher hair density in men and women.[1][2][3]
Suits. Patients who want a home treatment without drugs. Comb- and helmet-type devices both worked in the meta-analysis.
Trade-offs. AAD says it takes several sessions a week for many months. In the Cochrane review of women, laser comb users did not rate it better than sham, though hair counts rose.
· Off-label
Spironolactone (women)
Type. Medicine: antiandrogen tablet for women, off-label
A diuretic used as an antiandrogen for female pattern hair loss. It is not FDA-approved for hair loss. Doses range from 25 to 200 mg a day. In one study of 166 women, 42% reported mild improvement and 31% increased thickness.[1][2][3]
Suits. Women with female pattern hair loss, often combined with topical minoxidil. It takes 6 to 12 months to know whether it works.
Trade-offs. It can cause birth defects, so women who can get pregnant also take birth control. Side effects include fatigue, breast tenderness, irregular periods and low blood pressure. Hair gained is lost 3 to 4 months after stopping.