You've noticed it. Maybe it's the widening part, the thinning crown, or the temples that aren't quite what they used to be. Here's the good news: with the right routine, most men can maintain and often improve what they have. This isn't about fear—it's about optimization. Think of it as a fitness routine for your hair.
This guide gives you a complete, tiered protocol. Start with the essentials, add enhancements as you dial in, and optimize your lifestyle for best results. No miracle cures, no BS—just what actually works.
What the Research Shows
Tier 1: The Essential Foundation
If you do nothing else, do these. This is the 80/20—the treatments with the most evidence and the biggest impact.
DHT Protection
For most men experiencing thinning, DHT (dihydrotestosterone) is the culprit. Your follicles are genetically sensitive to it, causing them to miniaturize over time. The solution: block DHT production.
Finasteride (1mg daily)
Blocks 70% of DHT by inhibiting 5-alpha reductase. The gold standard for maintenance and regrowth. 86% of men maintain or improve over 10 years.
Prescription RequiredWorried about side effects? The data shows 2-4% experience sexual side effects (vs 2% on placebo). Most resolve when stopping or adjusting. The nocebo effect is real—men told about side effects are 3x more likely to report them.
Growth Stimulation
Minoxidil (5% or Oral)
Extends the growth phase of hair follicles and improves blood flow. 40% of users see moderate to dense regrowth. Works best when combined with DHT protection.
OTC or PrescriptionTopical 5% is the standard. Oral minoxidil (low-dose) is gaining popularity for convenience and potentially better results, but requires prescription monitoring.
The "Big 2" baseline: Finasteride + Minoxidil together are more effective than either alone. If you're serious about results, start with both.
Your Daily Schedule: Tier 1
Morning
Take finasteride 1mg with breakfast (consistency matters more than timing). If using topical minoxidil, apply 1ml to dry scalp in thinning areas.
Evening
Apply second minoxidil dose (if using topical 2x daily). Leave at least 4 hours before washing. Oral users skip this—once daily dosing is sufficient.
Tier 2: Enhanced Protocol
Once you've established your foundation, these additions can boost results and optimize your scalp environment.
Scalp Health
Ketoconazole Shampoo (2%)
Anti-fungal with potential anti-androgenic properties at the scalp. Reduces inflammation and dandruff. Use 2-3x per week, leaving on for 3-5 minutes.
OTC (1%) or Rx (2%)Weekly Scalp Oil Treatment
Rosemary oil (shown comparable to 2% minoxidil) or castor oil for moisturization. Massage into scalp, leave overnight, wash out. The massage alone may boost thickness.
Natural SupportMechanical Stimulation
Microneedling (1-1.5mm)
Creates controlled micro-injuries that trigger growth factors. Studies show significant enhancement when combined with minoxidil. Weekly sessions, 10-15 minutes.
DIY or ProfessionalYour Weekly Schedule: Tier 2
Monday / Thursday
Use ketoconazole shampoo instead of regular shampoo. Lather, leave for 3-5 minutes, rinse thoroughly.
Sunday Evening
Microneedling session (if using). Skip minoxidil for 24 hours post-needling. Can do scalp oil treatment on a different night.
Tier 3: Lifestyle Optimization
These factors don't replace treatment, but they create optimal conditions for your hair to thrive.
Sleep
Growth hormone is released primarily during deep sleep. Chronic sleep deprivation impairs hair growth cycles. Target 7-9 hours consistently.
Nutrition
Ensure adequate protein (hair is keratin), iron, zinc, biotin, and vitamin D. Deficiencies can cause or worsen hair loss independent of DHT. A blood panel can identify gaps.
Stress Management
Chronic stress elevates cortisol, which can push follicles into telogen (resting/shedding phase). This is called telogen effluvium and is reversible—but only if you address the stress.
Exercise
Regular exercise improves circulation, reduces stress hormones, and supports overall hormonal balance. There's no evidence that exercise increases hair loss (despite the bro-science about increased testosterone).
The Complete Weekly Routine
Here's how it all comes together:
Every Morning: Finasteride with breakfast. Topical minoxidil (if using) to dry scalp.
Every Evening: Second minoxidil application OR oral minoxidil users take their dose here.
2-3x Per Week: Ketoconazole shampoo (Mon/Thu recommended).
1x Per Week: Microneedling session (Sunday) or scalp oil treatment (separate from needling day).
Daily: 7+ hours sleep, balanced nutrition, stress management, exercise.
Timeline: What to Expect
Weeks 1-4: No visible changes. Finasteride begins working systemically to reduce DHT. You may experience initial shedding with minoxidil—this is normal and indicates it's working (pushing out old hairs to make room for new growth).
Months 2-3: Shedding stops. Hair loss stabilizes. Some men notice less hair in the drain, on the pillow.
Months 4-6: First visible improvements. New vellus (fine, light) hairs may appear. Existing hairs may look thicker.
Months 6-12: Significant results for responders. Vellus hairs mature into terminal hairs. Density visibly improved.
Year 1+: Continued improvement possible for 2+ years. Maintenance mode thereafter.
Critical: This is a marathon, not a sprint. Men who quit at month 3 never see results. Commit to at least 12 months before judging effectiveness.
Getting Started: The Easy Way
You don't need to piece this together yourself. Telehealth providers specialize in hair loss protocols—they'll evaluate your situation, prescribe what's appropriate, and ship it to your door. Most consultations are free, and monthly costs run $30-75 depending on the protocol.
Ready to Build Your Protocol?
Get a personalized treatment plan from licensed providers. Most men start seeing results in 3-6 months.
Get Your Free Consultation →Common Questions
Do I need all three tiers?
No. Tier 1 alone (finasteride + minoxidil) works for most men. Tiers 2 and 3 optimize results but aren't required. Start simple, add as needed.
What if I can't take finasteride?
Options include topical finasteride (lower systemic absorption), topical dutasteride, or natural DHT blockers like saw palmetto (less effective but an option). Discuss alternatives with a provider.
Is this forever?
Hair loss is progressive. Stop treatment, and it resumes. Most men on maintenance protocols are happy with the trade-off—a few minutes daily for continued results.
What about natural alternatives?
Rosemary oil, castor oil, pumpkin seed oil, and saw palmetto have some evidence. They're not as effective as pharmaceuticals for most men, but can be good supporting players or options for those who can't/won't use medication.
The Bottom Line
A routine for thinning hair doesn't have to be complicated. Start with the proven foundation (finasteride + minoxidil), add scalp health optimizations as you dial in, and support with lifestyle factors. Consistency beats intensity—showing up daily for 12 months beats a perfect routine you quit after 6 weeks.
You've got this. The tools exist, the science is solid, and results are achievable for the vast majority of men who commit to the process. Time to build your protocol.