Where should I get AGA/FAGA treatment? The diagnosis and explanation to see before medication

When choosing a clinic for AGA/FAGA, first confirm whether they examine for other causes of hair loss before prescribing medication[1][2]. Next, the key indicators are whether they properly explain side effects and effects on pregnancy, and whether they show you the timeline for judging effectiveness[3][4][5]. In women, there are strict restrictions on oral medications designed for men, so it is also important whether they provide explanations separated by gender[5][6].

Do they investigate other causes before medication?

Hair loss causes are not limited to AGA/FAGA. Before diagnosing AGA, a medical examination to rule out other causes is recommended[1].

For example, in female hair loss, it is recommended to check for telogen effluvium—temporary hair shedding—and to confirm whether there is excess androgenic hormone[2]. Special attention is needed if there are changes such as increased body hair, hard-to-treat acne, or a deepening voice[2].

Medications can also be the cause. Thyroid medications, blood thinners, and oral contraceptives are listed as drugs associated with hair loss[7]. Also, alopecia in which hair roots are destroyed (scarring alopecia) cannot be reversed by AGA medications[7]. At the first appointment, pay attention to whether they ask about medications you are taking and the progression of hair loss.

Do they explain side effects and pregnancy concerns properly?

AGA medications have different side effects depending on the drug. With finasteride or dutasteride, sexual dysfunction and mood decline are more likely to occur in a dose-dependent manner; with minoxidil oral medication, increased body hair and palpitations become more likely[3].

Extra caution is needed for women who may become pregnant. Finasteride may affect male fetuses in the womb, so reliable contraception is essential[5][4]. Whether they discuss these matters before prescribing is an important clue when comparing clinics.

Do they show you the timeline for assessing effectiveness in advance?

AGA medications are not a treatment whose effects are immediately apparent. For topical minoxidil, a guideline of 6–12 months of use before judging effectiveness is shown[4]. Finasteride is a medication used on the premise of continued treatment for at least 2 years[4].

It is known that temporary increased hair shedding can occur when starting treatment, and that minoxidil may be ineffective in some people[8]. Medication is a treatment that works while you continue taking it, and hair loss is said to progress again if you stop[7]. What can be expected is mainly halting progression and, in some people, increased hair growth[1].

Do they differentiate medication selection by gender?

The range of available medications differs between men and women. In men, 1 mg finasteride oral medication is approved by the U.S. FDA[2]. In Japan and Korea, 0.5 mg dutasteride is also approved for male AGA[3].

The only medication approved by the U.S. FDA for women is topical minoxidil[6]. For postmenopausal women, 1 mg finasteride is not recommended[5]. Whether to use androgen-suppressing medication in women is decided based on age, signs of high androgen levels, and need for contraception[6].

Are additional treatments explained alongside the evidence for them?

For additional treatments such as injections, it is reassuring to hear both the strength and limitations of the evidence. In five trials of PRP made from a patient's own blood added to minoxidil, all reported an added benefit[9]. However, three of them were evaluated as having designs prone to bias in results[9].

How to compare? Clinic selection checklist

At the consultation, verify the following points:

Diagnosis: Do they check for other causes of hair loss before prescribing?[1][2]

Explanation: Do they discuss side effects and precautions for people who may become pregnant?[3][5]

Timeline: Do they indicate a guideline for assessing effectiveness (6–12 months for topical medication)?[4]

Gender: Do they avoid prescribing male oral medications as-is to women?[5][6]

Additional treatments: Do they convey both the strengths and limitations of the evidence?[9]

Whether hair loss is due to AGA/FAGA or another underlying condition cannot be determined without examining the scalp and listening to your history. At the appointment, share information about the pattern and progression of thinning, medications you are taking, and—if you are a woman—your plans for pregnancy before choosing medication.