I’m just a Phd in a different field but I usually work on stuff related to medical problems. You are therefore obviously better qualified to talk about this but here’s how I understand it. Please correct me if I’m wrong since this is a very fascinating topic to me and there’s no experts like you around where I live :-)
Your genes build a “backdoor” into your hair follicles by making them vulnerable to DHT. Slowly over your lifetime more and more follicles become vulnerable, depending on your individual genetic coding.
There’s then a war going on in your body: DHT attacks the follicles, slowly makes them smaller until they completely disappear. Two proven ways to tilt the odds into your favor:
- Finasteride works by decimating the enemy – it indirectly reduces the amount of DHT – less attackers for your hair – balding slows down.
- Minoxidil works by strengthening your follicles and giving them a better defense against the attacker (DHT) – attacks are less effective – balding slows down.
Effectively both slow the balding down, only that Finasteride is much more effective. If you’re serious about winning this battle you should try to take both but if you can’t take Finasteride for whatever reasons, not all is lost and minoxidil might at least give you a few more years with nice hair.
Here’s three studies I read:
- Olsen, Elise A., et al. “A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men.” journal of the american academy of dermatology 47.3 (2002): 377-385.: “The mechanism by which topical minoxidil induces hair growth in AGA has not been fully characterized. Topical minoxidil increases hair density either by induction of anagen or an increase in anagen duration. Hair diameter is also increased by topical minoxidil.9,10 The net result is reversal of the miniaturization process of AGA and/or slowing the progression of hair loss.”
- Price, Vera H., Emory Menefee, and Paul C. Strauss. “Changes in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 2% topical minoxidil, placebo, or no treatment.” Journal of the American Academy of Dermatology 41.5 (1999): 717-721.: “This study demonstrates that 5% and 2% topical minoxidil promote hair growth and retard the hair loss process over 96 weeks, with 5% topical minoxidil having the greater efficacy. Although the interval hair weight eventually began to decrease with time, the minoxidil treatment maintained an increased rate of hair weight (protein) production, over that of placebo or untreated subjects, of about 25% more for the 2% minoxidil treatment and about 35% more for the 5% minoxidil treatment and averaging about 30% during the 96-week treatment period.”
- Arca, Ercan, et al. “An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia.” Dermatology 209.2 (2004): 117-125. “In this comparative study of topical minoxidil and systemic finasteride, it was concluded that both drugs were effective and safe in the treatment of mild to severe AGA, although oral finasteride treatment was more effective (p < 0.05).”