Hair Loss Treatments Compared: Medication, Laser and Surgery

Surgery is one option among several, and for a good number of people it is not the first one. This page sets out the main approaches, what each can realistically achieve, and where each falls short.

Nothing here is a recommendation for your situation. Prescription treatments require a doctor's assessment, and what suits one person is inappropriate for another. The purpose is to give you an accurate map before you have that conversation.

How to think about the options

Two things determine what is worth considering.

What is causing your hair loss. Pattern hair loss, driven by inherited sensitivity to dihydrotestosterone, responds to a specific set of approaches. Loss caused by iron deficiency, thyroid dysfunction, medication or traction responds to addressing that cause instead. Getting the diagnosis right comes first. See when hair loss isn't genetic.

How much is left to work with. Follicles that are miniaturising but still producing hair can sometimes be maintained or partially improved. Follicles that have been lost cannot be brought back, and the only remaining option is redistributing hair from elsewhere.

That second point explains the general logic: medical treatment aims to preserve what you have, surgery redistributes what remains, and the two are frequently used together rather than as alternatives.

Topical minoxidil

What it is. A topical solution or foam applied to the scalp, available without prescription in Australia.

How it is thought to work. The mechanism is not fully established. It appears to prolong the growth phase of the hair cycle and increase blood flow to the follicle. It does not act on DHT.

What it can achieve. In a proportion of users it slows progression and produces some regrowth of miniaturised hairs, generally most noticeable at the crown rather than the frontal hairline. It works better on hair that is thinning than on areas already bare.

Trade-offs. It requires twice-daily application indefinitely. Stopping generally results in loss of any gains within months, since the underlying process was never altered. Some users experience scalp irritation, dryness or flaking. Initial increased shedding in the first weeks is common and generally settles. It can cause unwanted hair growth if it transfers to the face.

Realistic view. Modest benefit for many, meaningful benefit for some, no benefit for others. Low barrier to trying. The main practical obstacle is adherence over years.

Oral finasteride

What it is. A prescription oral medication. It inhibits the enzyme 5-alpha reductase, reducing conversion of testosterone to DHT.

How it works. By lowering DHT, it addresses the driver of pattern hair loss directly rather than working around it.

What it can achieve. It is the most effective non-surgical option for slowing pattern hair loss in men, and produces partial regrowth in a proportion of users. Effects develop over months rather than weeks.

Trade-offs. It requires ongoing use, and gains are generally lost within a year of stopping. Reported adverse effects include sexual side effects such as reduced libido and erectile dysfunction, mood changes, and less commonly breast tenderness or enlargement. Reported rates in trials are low but the possibility is real, and there has been ongoing discussion in the literature about the persistence of side effects in a small subset of users after stopping.

It is not prescribed for women of childbearing potential due to risks in pregnancy.

Realistic view. The most effective medical option for men with pattern hair loss, with a side effect profile that requires an informed conversation with a prescribing doctor. This is not a decision to make from a website.

Topical finasteride and combination products

Topical formulations of finasteride, sometimes combined with minoxidil, are available through some prescribers and compounding pharmacies.

The rationale is to achieve local DHT reduction with lower systemic absorption, and therefore potentially fewer systemic side effects. Evidence is developing and less extensive than for the oral form. Systemic absorption still occurs.

Whether this is appropriate is a prescribing decision.

Low-level laser therapy

What it is. Devices delivering low-intensity light to the scalp, sold as combs, caps and helmets, or delivered in-clinic.

How it is thought to work. Proposed mechanisms involve stimulating cellular activity in the follicle. The mechanism is not well established.

What it can achieve. Some randomised trials have reported modest improvements in hair density. The evidence base is smaller and less consistent than for the medications above, study quality varies, and many trials have been industry funded.

Trade-offs. Devices are a significant upfront cost. Treatment requires regular sessions indefinitely. Benefit, where present, appears modest.

Realistic view. Not unreasonable as an adjunct for someone already using other approaches. Not a substitute for them, and the cost relative to demonstrated benefit deserves scrutiny.

Platelet-rich plasma

What it is. Blood is drawn, centrifuged to concentrate platelets, and the concentrate injected into the scalp.

How it is thought to work. Growth factors in the platelet concentrate are proposed to stimulate follicular activity.

What it can achieve. Studies have reported improvements in hair density in some patients with pattern hair loss. The evidence is mixed, protocols vary considerably between providers, and there is no standardised preparation method, which makes results difficult to compare.

Trade-offs. Requires repeated sessions, typically an initial series followed by maintenance. Involves injections into the scalp. Ongoing cost. Benefit is not reliably predictable.

Realistic view. Some evidence of benefit, considerable variability in how it is delivered, and it is not a replacement for either medical management or surgery. Whether it is offered here is a question for consultation.

Hairpieces, systems and concealers

Worth including because they are legitimate options that get dismissed.

Concealers including fibres, powders and sprays reduce the contrast between scalp and hair, making thinning less apparent. They are immediate, inexpensive and non-invasive. They wash out, and they do nothing for the underlying loss.

Hair systems and wigs have improved considerably. They offer immediate coverage regardless of donor supply, which matters for people who are not surgical candidates. They require maintenance, ongoing cost, and some tolerate them better than others.

Scalp micropigmentation deposits pigment into the scalp to create the appearance of closely shaved hair or to reduce the contrast in thinning areas. It suits some situations well, particularly alongside surgery or to reduce the visibility of donor scarring. It is permanent, which makes the quality of the work important.

Realistic view. For someone who is not a surgical candidate, or who does not want surgery, these are reasonable rather than second-rate. Nobody should be talked out of them.

Hair transplant surgery

What it is. Follicles are moved from the back and sides of the scalp, where they are largely resistant to DHT, to areas of loss. Two harvesting techniques are used: individual extraction, or removal of a strip that is then dissected.

How it works. Transplanted follicles retain the resistance they had in their original location. This is called donor dominance and it is why the hair persists.

What it can achieve. It creates coverage in areas where follicles have been lost, which no medical treatment can do. It is the only approach that addresses established loss rather than slowing further loss.

Trade-offs. It is surgery, with the risks that entails: bleeding, infection, swelling, altered sensation, poor graft survival, scarring, and an aesthetic result that may not meet expectations. Donor supply is finite and cannot be replenished. It does not stop ongoing loss in untransplanted areas, which is why medical management is often continued alongside it. Results take twelve to eighteen months. Not everyone is suitable.

Realistic view. The most substantial intervention available, and the only one that addresses areas already lost. Appropriate for a defined group of people rather than everyone losing hair.

At our Bankstown clinic, FUE starts from $4,990 plus GST for approximately 2,000 grafts, which is in the order of 4,000 hairs. FUT pricing is confirmed in writing after consultation.

See hair transplant surgery in Sydney: the complete guide, FUE vs FUT and our risks and complications page.

Why combining approaches is common

Surgery and medical treatment address different problems.

Surgery covers areas where follicles have been lost. Medical treatment slows loss in the areas that have not yet been transplanted. Someone who has surgery and stops medical treatment may find the surrounding areas continue to thin around the transplanted hair, which affects how the result ages.

For that reason patients already on medical treatment are usually advised to continue rather than stop.

What none of these do

Worth stating plainly.

None of them changes your genetics. Pattern hair loss is inherited follicular sensitivity, and nothing here alters that.

None of them restores lost follicles. Surgery moves surviving follicles. Medical treatment can improve miniaturised ones. Neither creates new ones.

None of them works without ongoing commitment. Medical treatments require indefinite use. Surgery requires a year or more before the result is apparent, and often ongoing medical management alongside.

None of them is guaranteed. Response to medication varies. Graft survival varies. Outcomes differ between individuals for reasons including genetics and general health.

Doing nothing

A legitimate option that deserves stating.

Pattern hair loss is a common, natural process. Not intervening is a reasonable choice, and a considerable number of men make it without regret. Nothing on this page should read as an argument that you ought to do something.

What to do next

If you want to understand your options properly, the sequence that makes sense is establishing what is causing the loss, understanding how much viable hair remains, and then discussing which approaches are appropriate.

Prescription options require a doctor. Surgery requires assessment of your donor area and an honest conversation about suitability, which for some people concludes that surgery is not the right answer.

A GP referral is required before a cosmetic surgery consultation. Get in touch.

Related reading: are you a suitable candidate, male pattern baldness and the Norwood Scale, age and hair transplants.