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Androgenetic alopecia is the most common form of hair loss in men and women, caused by the action of dihydrotestosterone (DHT) on genetically susceptible hair follicles. A licensed doctor reviews the case through a questionnaire and decides, case by case, whether a medical treatment is appropriate — and if so, which one.

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Treatments a doctor considers

A licensed doctor decides case by case. Hi Doctor never prescribes without an evaluation.

Oral finasteride

A 5-alpha-reductase inhibitor taken daily. A doctor may prescribe it after reviewing history and ruling out contraindications.

Oral minoxidil

Low-dose oral minoxidil, used off-label by some dermatologists. Requires close medical supervision for potential cardiovascular effects.

Topical minoxidil

Solution or foam applied directly to the scalp. Can be combined with other actives in a compounded formulation.

Dutasteride 0.5mg

A more potent 5-alpha-reductase inhibitor. Reserved for specific cases, always under medical evaluation.
A personalised compounded formulation — combining finasteride, minoxidil, tretinoin or other actives — can also be prepared by a pharmacy after a medical prescription. Medication is paid for separately at the pharmacy of the patient’s choice — Hi Doctor does not sell medications. See pricing for what the consultation covers.

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Your path to treatment

1

Start the online visit

Answer a questionnaire about health and goal. No in-person appointment, no travel — an eligibility answer arrives within 24 hours.
2

A doctor reviews the case

A licensed doctor reviews the answers personally. If they need clarification, they message through the private chat in the account. If treatment is appropriate, they sign an electronic prescription.
3

Review and payment

If the doctor does not approve treatment, the consultation fee is refunded in full within 48 hours.
4

Ongoing support

Private chat with the doctor for questions, a 4-week check-in, and renewal before the prescription expires.

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Who it is not suitable for

A doctor reviews your pattern and history to assess whether androgenetic alopecia is the likely diagnosis and to rule out other causes of hair loss such as telogen effluvium, traction alopecia or alopecia areata. Treatment is an individual medical decision — not every case needs it, and the doctor may recommend against medication depending on your history and the pattern of loss.

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Common questions

The doctor reviews the questionnaire answers about your hair-loss pattern, duration, family history, medical history and current medicines. They assess whether the pattern matches androgenetic alopecia and rule out other causes. If they need clarification, they message you through the private chat in your account.
Yes. Hi Doctor operates across the European Union. If a doctor approves treatment, they issue an electronic prescription valid under EU Directive 2011/24/EU, which you can take to any pharmacy in the EU.
If the doctor decides treatment is not appropriate for your case, the consultation fee is refunded in full within 48 hours.
Results vary by person and by medicine. Finasteride and minoxidil typically require several months of consistent use before changes are noticeable. The doctor reviews your progress at the 4-week check-in and during renewals to assess whether the treatment is working.
Androgenetic alopecia is driven by the action of dihydrotestosterone (DHT) on genetically susceptible hair follicles. DHT is made from testosterone by the enzyme 5-alpha-reductase, and in people with a genetic predisposition it shortens the hair growth cycle and shrinks follicles over time.
Yes. Minoxidil stimulates the follicle while finasteride blocks the hormonal cause. The combination is frequently used and a doctor may consider it based on your history and pattern of loss.
An electronic prescription is a digital document signed by a licensed doctor. Under EU Directive 2011/24/EU, a prescription issued in one member state can be dispensed by a pharmacy in any other member state, so you can collect your medicine wherever you are in the EU.
Hi Doctor also reviews female hair loss, telogen effluvium, traction alopecia, alopecia areata and postpartum hair loss. Each condition has a separate evaluation pathway. See the conditions overview.

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Molecular mechanism

Androgenetic alopecia is driven by the binding of dihydrotestosterone (DHT) to the androgen receptor (AR) in dermal papilla cells (DPCs) of the scalp. DHT is formed from testosterone by 5α-reductase, of which the type 2 isoenzyme is constitutively expressed in the mesenchymal portion of the hair follicle at higher levels in predisposed scalp than in non-balding areas (PMID 21167691). AR expression itself is also elevated in DPCs from balding scalp, and the AR coactivator Hic-5/ARA55 is enriched in these cells, collectively amplifying androgen sensitivity. Once DHT–AR complexes translocate to the nucleus, they alter transcription of paracrine mediators. In balding DPCs, androgens upregulate transforming growth factor-β1 (TGF-β1), TGF-β2, dickkopf-1 (DKK-1) and IL-6, each of which suppresses keratinocyte proliferation and promotes follicular miniaturisation. TGF-β1 inhibits hair matrix keratinocyte growth in a paracrine fashion, DKK-1 blocks Wnt/β-catenin signalling which is required for hair follicle cycling, and IL-6 contributes to the catagen-promoting milieu. The net effect is progressive shortening of the anagen (growth) phase, reduction of the hair shaft diameter, and eventual vellus transformation of terminal hairs. The frontal and vertex scalp are susceptible while the occipital scalp is typically spared, a pattern thought to reflect differences in AR density and 5α-reductase activity across regions.

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Diagnostic classification

The Norwood–Hamilton classification grades male pattern hair loss from type I (minimal frontotemporal recession) to type VII (a wide horseshoe-shaped band of terminal hair). The frontal–vertex distinction matters because vertex thinning progresses faster and responds differently to medical treatment than bitemporal recession, which is less androgen-sensitive. In women, the Ludwig classification describes three grades of diffuse central thinning with frontal hairline preservation, and the Sinclair scale offers a simpler four-grade visual analogue for clinical monitoring. These classifications help the reviewing doctor assess severity, track progression, and set realistic expectations for treatment response.

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Start a consultation

Hair-growth consultation

Answer the hair-growth questionnaire and a registered doctor reviews it. They decide whether treatment is appropriate, which one, and at what dose — and declining is a normal outcome. See what it costs and how the review works.
This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.