Approach to treatment of female pattern hair loss

Treatment choice is based on patient preference, adverse effects, cost and likely adherence to therapy. See Topical minoxidil and Oral spironolactone for information on each drug.

For mild to moderate female pattern hair loss in a patient who requests treatment, either topical minoxidil or oral spironolactone are suitable. It is also reasonable to start with a combination of both treatments.

For severe female pattern hair loss, use topical minoxidil and oral spironolactone as combination therapy.

If treatment has no clear benefit after 6 to 12 months, and the patient remains concerned, refer the patient to a dermatologist. Other anti-androgen options and oral minoxidil may be prescribed by a dermatologist.