Treatment	Dosing	Strength of evidence	Comments
Alopecia areata
Topical steroids	Applied twice daily to scalp	B	Evidence for short-term growth, but none for long-term growth5
Topical minoxidil (Rogaine)	Applied twice daily	B	Evidence for short-term growth; one study showed more hair regrowth with 5% than 1% formulation5,6
Topical immunotherapy with diphenylcyclopropenone or squaric acid	Treatment applied by dermatologist every few weeks	B	Unlicensed treatment; may cause severe dermatitis7
Oral steroids	Six-week tapering course of prednisone starting at 40 mg per day	B	Continued treatment is needed to maintain hair growth; risks of prolonged steroid use outweighs the benefits6
Intralesional corticosteroids	Triamcinolone acetonide (Kenalog) 5 to 10 mg per mL; 0.1 mL injected with a 30-gauge needle into the dermis 1 cm apart to a maximum of 3 mL; can be repeated every four to six weeks	C	Hair regrowth lasts a few months; effect on long-term outcome is unknown6
Anthralin cream (Dritho-Creme HP)	0.5% to 1% cream once daily for 20 to 30 minutes, increasing by 10 to 15 minutes every two weeks	C	Hair staining prevents use in fair-haired patients6
Female pattern hair loss
Minoxidil 2%	Apply twice daily to dry scalp	B	20 percent of women using the drug versus 7 percent of women taking a placebo reported moderate new hair growth after 32 weeks; number needed to treat = 88; 7 percent of women using minoxidil experience undesirable hypertrichosis9
Spironolactone (Aldactone)	100 to 200 mg orally daily	C	88 percent of women had a modest decrease in hair loss with treatment10
Flutamide (formerly Eulexin)	250 mg orally daily	C	Treatment for one year resulted in a modest improvement in alopecia; 32 percent of participants experienced elevated liver function tests while taking the medication, resulting in some safety concerns11
Male pattern hair loss
Finasteride (Propecia)	1 mg orally daily	A	Promotes hair growth for more than two years, with the effect waning by year three12,13; does not significantly affect sperm production and poses no risk to a female sex partner; when screening men on finasteride for prostate cancer, the upper limit of normal prostate specific antigen levels should be doubled to ensure appropriate interpretation14,15
Minoxidil (2%)	1 mL to scalp twice daily	A	Consistent evidence showing moderate to dense regrowth of hair16
Minoxidil (5%)	1 mL to scalp twice daily	A	Consistent evidence showing moderate to dense regrowth of hair16
Ketoconazole (2%) shampoo (Nizoral)	Daily	C	Increased hair density, size, and proportion of anagen follicles after shampooing two to four times per week for 21 weeks17
Pyrithione zinc (1%) shampoo (Head and Shoulders)	Daily	C	Increased total visible hair count, but 5 percent less than treatment with minoxidil 5%18