Hair loss in young women: Which one to start vs which one to use?

Combination therapies often best in young women with genetic hair loss

As many know, I'm a big believer in starting treatments one at a time in order to get a sense of how well a given treatment works. if one starts treatment A, B, C and D all at the same time and finds they have better hair in one year, it will be difficult to determine which one really is the one helping. 

4 main options for genetic hair loss in women

There are four main options for treating genetic hair loss in women: minoxidil, hormone blocking medications (spironolactone, birth control pills, cyproterone, etc), low level laser and platelet rich plasma therapy. 

Which one to start? 

My goal is to help patients choose the treatment which best suits their lifestyle, their safety and risk tolerance, and of course recommend treatments with the highest chances of success. For some women, minoxidil might be the best starting treatment; for others it might be spironolactone. For others yet, it's the laser devices. 

For many patients with genetic hair loss, the decision is that - which one should I use? Many women can maintain results with one treatment. For young women however, it's more of a question of which one to start. Many women with early onset genetic hair loss (i.e. before 25) are at high risk for significant hair loss as they age. For these women, I strongly recommend considering 2 or 3 treatments added one after the other 6 months apart. For young women, it's more of a decision which treatment to start off with rather than a decision which treatment to pick.