Asklemmy

I'm male and have done the whole gamut of hair regrowth options (graft + Finestride + Minoxidil both topical and pill forms). I'm pushing 40 and my hair is basically back to where it was in my early 20s.

In terms of how well each worked i'd rate them like this:

#1 Graft #2 Finestride #3 Topical Minoxidil #4 Pill Minoxidil

Obviously grafts are expensive but holy-cow do they work! Grafts are your only option to restore hair after a follicle has died (you can tell if an area of the scalp has dead follicles if the skin is smooth and shiny). You can cut the high cost by over 2/3s with some research and a trip to Turkey and I know several people that have done this with great results. There are entire flights of people just getting graft procedures there from the US and Europe. I opted for staying in the US and take the wallet hit for logistic reasons since I have small kids.

Finestride probably won't be an option for you since it attacks DHT which is what causes follicles to go dormant in men. I take 1mg per day and technically this is all I need to take to stop most of my scalp follicles from going dormant. Combining this and Minoxidil is what got me the best results since they work by different mechanisms.

Topical Minoxidil (Rogaine) is likely your best option. It's just a vasodilator so there's little worry about hormonal reactions. My wife has been using it though it's only been a few weeks and it takes months to really see results. It's kind of a pain to use, since you have to apply it twice per day forever basically. This is why I opted for the pill version. (Bonus fact: you can buy topical Minoxidil in bulk at Costco! A six-month supply is $50 at mine)

Pill Minoxidil is a bit of a mixed-bag. As I mentioned before I use it for convenience as I got tired of the topical. It puts significantly more of the substance in your bloodstream so side effects are more likely (though I haven't experienced any) and it's not as targeted to the scalp. It's basically a blood-pressure medication though the levels needed for hair regrowth are lower than for blood pressure. If I wasn't already taking Finestride I would opt for topical Minoxidil instead

I'm a male. I eventually gave up and shaved the whole thing. Not really interested in taking meds the rest of my life or doing some uber expansive surgery to try and fix it. I do have a nice beard I take good care of though.

I am not a doctor, but have had some results using minoxidil and Foligain’s Minox&Triox spray. As was pointed out in the other comment, hair follicles will start to die as you age (assuming you’re male) this is caused by DHT which is a result of testosterone breaking down. First the follicle goes dormant, and then dies. Depending on how advanced your thinning is, you can likely reactivate and save between few and most of the follicles. I hate recommending Reddit, but r/tressless is a good resource, but they pass around a lot of lingo so be prepared for that.

What about a hat?

My wife and I are both taking the Nutrafol supplements and topical minoxidil. It's working, expensive, but it's working. Nutrafol has saw palmetto, which is basically herbal finsteride. Ymmv.

I’m not a doctor, but isn’t the issue that the hair follicle dies? So to get more hair you would need to have more follicles implanted or something?

I’ve been on both Finasteride (prevents hair loss) and Minoxidil (grows hair) for decades, without noticeable ill effects. Very effective combo. 👍

I'm a trans man (FTM) and while I've gone for the "shave head and let nature take its course" option, a lot of trans men seem to really like finasteride because it doesn't have as many hormonal side effects as some other treatments. It's not an at-home method but I believe you can get it from a GP/PCP, you shouldn't need to go to a specialist. A lot of guys also seem to like minoxadil/Rogaine but you need to watch out if you have cats, because it's really toxic to cats.

I will preface this by saying its not for everyone. I know some ladies that went with wigs when their hair started thinning. One just does a topper, more or less like extensions but clips on the top of your head. The other full on accepted it and just buys cheap wigs off Amazon. They are better than Halloween wigs but cheaper than real human hair. There is a learning curve to picking out ones that aren't obviously fake and trimming and wearing them so that don't look like they are wearing a wig. There are videos on YouTube to help with all that. Also some hair stylists will trim them for you. It works well for her. Except for wanting to buy all the wigs in addition to all the shoes.

As an aside, if you are one to want to have vibrant unnatural colored hair it can be a better route to go than dying because the wigs don't fade or grow out. You can spend $20-40 on a fun colored wig that you just replace when it wears out or $100+ on getting your hair dyed and touched up.

Maybe try to get into a Moogene Medi trial to try some CRISPR gene editing?