Finasteride tablets are often the go-to recommendation for men starting to go a little thin on top due to male pattern baldness. While it is one of only two treatments licensed to treat androgenetic alopecia, and shown in clinical trials and decades of real-world use to be safe and effective – that doesn’t mean it’s suitable for everybody. As with any medication, Finasteride tablets come with a risk of potential side effects, commonly sexual in nature, which mean they are not suitable for everybody.
If using Finasteride isn’t up your street, there are plenty of effective treatments which can help prevent or stop hair loss, which don’t need a prescription.
Does Minoxidil Spray work by itself?
Minoxidil Spray is the only over-the-counter (OTC), licensed treatment for male pattern baldness.
Just like Finasteride tablets, it’s proven to be effective at stopping hair loss in men with mild to moderate hair loss. Unlike Finasteride, it:
- Doesn’t require a prescription
- The most common side effects are local, rather than systemic
- Doesn’t impact hormones
Minoxidil is a vasodilator, which means when applied to the scalp, it promotes blood flow to the hair follicles which creates an optimal environment for healthy hair growth. It can help support hair growth in weakened hair follicles through bringing a rich supply of blood, lengthening the anagen (growth) phase of the hair follicle, and encouraging the expression of growth factors which regulate the hair growth cycle.
While Minoxidil Spray is usually combined with Finasteride tablets for best results, it has still been shown in clinical trials to be effective by itself. In one study, using Minoxidil 5% Spray for one year was shown to be effective at stopping hair loss in 84% of participants.
What else can you use?
DHT blockers
Male pattern hair loss is mainly driven by a hormone called DHT. Over time, it attaches to your hair follicles and gradually shrinks them. As this happens, the hairs they produce get thinner and weaker, and eventually they can stop growing new hair altogether. That’s what leads to more shedding, thinning, and visible bald spots.
Finasteride works by lowering DHT levels, which helps slow or even stop this process.
You might have heard of saw palmetto, a natural plant extract that’s been studied for a similar role. Some research suggests it can block the enzyme (5-alpha-reductase) that turns testosterone into DHT, and may help stop DHT from binding to hair follicles in the first place.
That said, it doesn’t seem to be quite as effective as finasteride. In one study, 38% of people taking saw palmetto saw hair regrowth after 24 months, compared to 68% of those on finasteride. Saw palmetto also seemed to work mainly on the crown, whereas finasteride showed results across both the crown and front of the scalp.
There’s also some research into topical saw palmetto (meaning applied to the scalp directly). In one study, men used a saw palmetto lotion daily, with a stronger serum applied to thinning areas at the start. The results showed modest improvements—slight increases in overall hair count and more noticeable increases in thicker hairs, along with fewer thin, weaker strands. People also reported being more satisfied with their hair over time.
Overall, saw palmetto might be worth considering, especially if you're looking for a more natural option, but keep in mind its results tend to be milder compared to proven medical grade treatments like finasteride. For that reason, it’s usually wisebest to combine it with other hair loss treatments.
Derma roller
A derma roller, a hand-held tool covered in tiny needles you can use at home for microneedling, may help stop hair loss in two ways: boosting the absorption of topical treatments like Minoxidil Spray, and stimulating hair follicles.
Using a derma roller creates micro-injuries in the scalp, which is thought to improve blood flow, activate wound-healing pathways which may upregulate the expression of growth factors like VEGF, β-catenin, and Wnt3a to extend the anagen phase, as well as creating micro-channels which help active ingredients like minoxidil reach the hair follicles.
Adding a derma roller to your existing routine, if you use a topical hair treatment, can give your results a helping hand. We have a blog dedicated to using a derma roller properly to make sure you’re getting the most out of it, which you can read here.
Shampoo and Conditioner
Shampoos and conditioners are not a standalone treatment for male pattern baldness, but you’ve got to wash your hair anyways, so might as well use a shampoo which can help your hair be stronger and healthier. Look out for shampoos which contain ingredients which are anti hair-loss and support a healthy scalp environment, like caffeine, saw palmetto and anti-dandruff ingredients like ketoconazole.
Supplements
Unless your hair loss is driven by a nutritional deficiency, such as low iron or biotin, food supplements are unlikely to correct hair loss by themselves. If you’re already getting enough nutrients from your diet, taking extra is unlikely to improve hair growth or reverse hair loss.
However, research into various natural ingredients such as marine collagen, Anagain and saw palmetto (as mentioned above) have shown they can improve hair quality and thickness.
Anagain
A natural plant extract made from pea shoots, shown in a study that applying a gel containing 4% Anagain to their scalp for three months reduced the number of hairs in telogen (shedding phase) and increased the number in anagen by 78%. Another trial showed that participants taking 100 mg of Anagain as an oral supplement saw hair shedding reduce by 33.9% after only 4 weeks.
Collagen
Collagen peptides (CPs) could help support hair in a few different ways. They act as antioxidants, which means they help protect your follicles from the kind of stress that can contribute to thinning and greying. Marine collagen in particular looks promising, with some studies suggesting it can boost key growth signals (like IGF-1) while dialling down the ones that slow hair growth.
There’s also some encouraging research showing CPs can stimulate follicle activity and support the growth phase of the hair cycle. That said, most of this comes from lab and animal studies, so it doesn’t always translate perfectly to real life.
Human evidence is still early, but it’s moving in the right direction. One study, for example, found an increase in hair count after taking a collagen-based supplement. So while it’s not a guaranteed fix, collagen does look like it could play a supportive role, especially as part of a broader routine focused on overall hair and scalp health.
If you’re looking for hair loss treatments without prescription ingredients, our free consultation will take your stage of hair loss and your preferences into account to recommend a treatment plan for you.
All of our blog articles are reviewed by our Medical Director before publication.
