Hair Loss Treatment · Online Treatment
Hair Loss Treatment (Androgenetic Alopecia)
Adult care by secure video visit, self pay option starting at $79, MD-only, insurance is not required.
Yes — adults (18+) with androgenetic alopecia can get treatment online. A board-certified MD reviews your hair loss pattern by secure video and, per AAD and IADVL guidance, prescribes finasteride, topical minoxidil 5%, or a combination for the most effective results, sent to your pharmacy same day. Visit price: $79 flat, no insurance required. Treatment must continue indefinitely, since loss resumes within 12 months of stopping. Patchy, well-circumscribed bald spots need in-person evaluation for alopecia areata instead.
Male pattern hair loss, also called androgenetic alopecia, is the most common cause of hair loss in men. It is driven by dihydrotestosterone (DHT), which gradually miniaturizes hair follicles over the temples, crown, and mid-scalp. Approximately 50 percent of men are affected by age 50, and prevalence continues to rise with age. The AAD and IADVL guidelines support finasteride and minoxidil as first-line treatments, with combination therapy offering the best outcomes. TeleDirectMD uses a safety-first telehealth approach that screens for red flags including patchy hair loss, scarring alopecia, rapid diffuse shedding, scalp lesions, and systemic symptoms before determining whether treatment by video visit is appropriate. If the history and pattern are consistent with androgenetic alopecia without red flags, guideline-based treatment can be initiated by video visit. Adults with suspected alopecia areata, scarring alopecia, or hair loss with systemic signs are directed to in-person dermatology evaluation. This page is for adults located in one of our covered states, including communities nationwide.
Board-certified MD · 43 states · evenings & weekends · HSA/FSA accepted · 5.0★ (125 reviews)
Online MD-Only Hair Loss Care
flat self-pay · insurance not required
- Evaluation for androgenetic alopecia and common mimics
- Red-flag screening for scarring alopecia, alopecia areata, and systemic causes
- Guideline-based finasteride and minoxidil prescribing when appropriate
- Clear follow-up timeline and side effect counseling
What it costs
$79 flat. HSA/FSA accepted.
One fee covers the visit — no facility fees, no surprise billing. Here is how it compares to other care settings.
- MD evaluation and red-flag screening
- Assessment for androgenetic alopecia vs other causes of hair loss
- Finasteride and minoxidil counseling when appropriate
- Prescription sent if clinically appropriate
- Clear follow-up timeline and side effect guidance
How it works
How Online Hair Loss Treatment Works
Book your video visit
Insurance is not required. No referral needed. Many visits are available same day, depending on scheduling. Before your visit, note when you first noticed thinning, your family history of hair loss, any medications you take, and whether you have tried minoxidil or finasteride before.
See a licensed MD by video
We review your hair loss pattern, onset and progression, family history, prior treatments, medication list, and overall health. The evaluation screens for red flags including patchy loss, scalp scarring, rapid shedding, and systemic symptoms before determining if telehealth treatment is appropriate.
Get a treatment plan and, if appropriate, a prescription
If medication is clinically appropriate, we send an e-prescription to common pharmacies such as CVS, Walgreens, Walmart Pharmacy. You receive a clear timeline for expected results, side effect counseling, and follow-up guidance regardless of treatment choice.
Treatment
Common Medication Options
These are the primary medications for androgenetic alopecia. The actual treatment plan is determined by the MD after reviewing your hair loss pattern, medical history, current medications, and risk factors.
| Medication | Typical dose | Timeline | Key considerations |
|---|---|---|---|
| Finasteride (Propecia/generic) | 1 mg by mouth once daily | Results at 3-6 months, peak at 1-2 years | Blocks DHT by approximately 65 percent. Not a controlled substance. Sexual side effects in 1-2 percent, usually reversible. Teratogenic — women who are or may become pregnant must not handle crushed or broken tablets. Must continue indefinitely. |
| Minoxidil 5% topical (Rogaine/generic) | Apply to scalp twice daily | Results at 4-6 months | FDA-approved OTC, no prescription needed for topical form. Works independently of hormones. Initial shedding may occur in the first 2-4 weeks and is normal. Must continue indefinitely. |
| Combination (finasteride + minoxidil) | Finasteride 1 mg daily + minoxidil 5% twice daily | Results at 3-6 months | Most effective medical approach. Addresses both the hormonal driver and follicle stimulation through separate mechanisms. |
| Ketoconazole shampoo 2% (adjunctive) | Apply to scalp 2-3 times per week | Ongoing adjunctive use | Antifungal with mild anti-androgenic properties. May reduce scalp DHT locally. Used as an adjunct to finasteride and minoxidil, not as monotherapy. |
Treatment plans are individualized by the MD after reviewing your hair loss pattern, medical history, allergies, and goals. Finasteride is not a controlled substance. TeleDirectMD does not prescribe controlled substances.
Understanding it
What Is Androgenetic Alopecia (Male Pattern Hair Loss)?
Androgenetic alopecia, commonly called male pattern hair loss or male pattern baldness, is the most common cause of hair loss in men. It results from a genetic sensitivity of hair follicles to dihydrotestosterone (DHT), a hormone derived from testosterone by the enzyme 5-alpha reductase. Over time, DHT causes susceptible follicles to miniaturize, producing progressively thinner, shorter hairs until the follicle stops producing visible hair entirely.
The condition affects approximately 50 percent of men by age 50 and up to 70 percent by age 70. It typically follows a recognizable pattern: recession at the temples, thinning at the crown, and gradual progression that may eventually leave hair only along the sides and back of the scalp. The Hamilton-Norwood scale is used to classify the stages of male pattern hair loss.
Two FDA-approved treatments exist: finasteride, an oral medication that blocks DHT production, and minoxidil, a topical solution that stimulates hair growth. Combination therapy is the most effective approach. TeleDirectMD evaluates adults with typical pattern hair loss by video visit, with screening to identify cases that require in-person dermatology evaluation.
Causes & risk factors
Causes and Risk Factors
Androgenetic alopecia is driven by a combination of genetics and androgen hormones. Understanding the causes and risk factors helps determine whether a telehealth evaluation is appropriate or whether in-person testing is needed to rule out other conditions.
- Genetics: the strongest risk factor. Family history of male pattern baldness on either side increases risk significantly. Multiple genes influence follicle sensitivity to DHT.
- DHT (dihydrotestosterone): the primary hormonal driver. Testosterone is converted to DHT by 5-alpha reductase in the scalp. DHT binds to androgen receptors on susceptible follicles and triggers miniaturization over time.
- Age: prevalence increases with each decade. Onset can begin as early as the late teens or early twenties, with progression continuing throughout life.
- Thyroid disorders: hypothyroidism and hyperthyroidism can cause diffuse hair thinning that mimics or overlaps with androgenetic alopecia and may need in-person evaluation.
- Iron deficiency: low ferritin levels can contribute to hair shedding and may need laboratory testing when diffuse thinning is present.
- Stress and illness: telogen effluvium, a diffuse shedding triggered by physical or emotional stress, surgery, or illness, can be confused with progressive pattern hair loss and usually resolves on its own.
Not every hair loss pattern is androgenetic alopecia. Patchy loss may suggest alopecia areata, an autoimmune condition. Scarring alopecia causes permanent follicle destruction and requires biopsy. Rapid diffuse shedding with systemic symptoms needs laboratory workup. TeleDirectMD screens for these patterns and directs complex cases to in-person dermatology.
Symptoms & red flags
Symptoms and Red Flags for Hair Loss
Use this table to understand which patterns fit androgenetic alopecia and which patterns suggest a need for in-person dermatology evaluation.
| Pattern or situation | What it suggests | Telehealth appropriate? | Red flag requiring in-person evaluation |
|---|---|---|---|
| Gradual thinning at temples and crown over months to years | Androgenetic alopecia (male pattern hair loss) | Often yes | Not a red flag if pattern is typical and no scalp changes |
| Receding hairline with preserved hair density elsewhere | Early androgenetic alopecia | Often yes | If onset is sudden or associated with scalp symptoms, evaluate further |
| Diffuse thinning across entire scalp | May be androgenetic alopecia, telogen effluvium, thyroid disorder, or iron deficiency | Sometimes | If accompanied by fatigue, weight changes, or rapid onset, in-person evaluation with labs is often needed |
| Patchy, well-circumscribed round or oval bald spots | Alopecia areata (autoimmune, different condition) | No | Requires in-person dermatology evaluation and possible treatment with immunomodulators |
| Scalp scarring, smooth shiny patches, or permanent follicle loss | Scarring alopecia (cicatricial alopecia) | No | Requires scalp biopsy and in-person dermatology evaluation |
| Scalp redness, scaling, pustules, or itching with hair loss | Tinea capitis, folliculitis, seborrheic dermatitis, or other scalp condition | Sometimes | If severe, spreading, or not responding to initial treatment, in-person evaluation needed |
| Hair loss with joint pain, facial rash, weight changes, or other systemic symptoms | Possible autoimmune disease, thyroid disorder, or other systemic condition | No | In-person evaluation with laboratory workup is needed |
Not every symptom is the same
Differential Diagnosis: Androgenetic Alopecia vs Other Conditions
Several conditions can cause hair loss or mimic androgenetic alopecia. TeleDirectMD screens for these patterns during the video visit and directs cases that do not fit typical male pattern hair loss to appropriate in-person evaluation.
Sometimes Appropriate for Telehealth
- Classic male pattern thinning at temples and crown without red flags
- Early androgenetic alopecia with family history and gradual onset
- Initiation or continuation of finasteride and minoxidil therapy
- Side effect counseling and treatment adjustment for current medications
- Lifestyle and adjunctive therapy discussion
Often Requires In-Person Evaluation
- Patchy hair loss suggesting alopecia areata (autoimmune)
- Scarring alopecia with permanent follicle destruction requiring biopsy
- Rapid diffuse shedding suggesting telogen effluvium, thyroid disorder, or iron deficiency
- Female pattern hair loss requiring different diagnostic workup
- Scalp inflammation, infection, or lesions needing direct examination
Androgenetic Alopecia vs Alopecia Areata
Androgenetic alopecia is gradual, follows a predictable pattern at the temples and crown, and is driven by DHT. Alopecia areata is an autoimmune condition that causes sudden, well-circumscribed round or oval patches of hair loss anywhere on the scalp, and requires in-person dermatology evaluation and different treatment including immunomodulators.
Androgenetic Alopecia vs Telogen Effluvium
Androgenetic alopecia is chronic and progressive, affecting specific areas of the scalp in a recognizable pattern. Telogen effluvium is diffuse shedding across the entire scalp, usually triggered by stress, illness, surgery, or nutritional deficiency, and typically resolves on its own within 6 to 12 months once the trigger is addressed.
Androgenetic Alopecia vs Scarring Alopecia
Androgenetic alopecia miniaturizes follicles but does not destroy them permanently, which is why treatment can regrow hair. Scarring alopecia (cicatricial alopecia) destroys hair follicles permanently, often presenting with smooth shiny patches, scalp pain, or inflammation. Scarring alopecia requires scalp biopsy for diagnosis and cannot be treated with finasteride or minoxidil.
If your hair loss pattern does not match typical androgenetic alopecia or any red flags are present, TeleDirectMD will direct you to in-person dermatology evaluation.
Treatment approach
Treatment Options
Androgenetic alopecia is treated with medications that either block DHT or stimulate hair growth directly. The AAD and IADVL guidelines support finasteride and minoxidil as first-line treatments, with combination therapy offering the most effective results. Treatment must be continued indefinitely because hair loss resumes within 12 months of stopping.
Finasteride (oral, prescription)
Finasteride 1 mg daily is a selective 5-alpha reductase type II inhibitor that blocks the conversion of testosterone to DHT, reducing scalp DHT levels by approximately 65 percent. Results are typically visible at 3 to 6 months, with peak effect at 1 to 2 years. Finasteride is not a controlled substance. It is generally well tolerated, but patients must be counseled about sexual side effects (decreased libido, erectile dysfunction, decreased ejaculate volume) that occur in 1 to 2 percent of users and are usually reversible upon discontinuation. Finasteride is teratogenic and must not be handled by women who are or may become pregnant.
Minoxidil (topical, over the counter)
Minoxidil 5 percent topical solution or foam is applied twice daily to affected areas of the scalp. It is FDA-approved and available over the counter without a prescription. Minoxidil works independently of hormones by prolonging the growth phase of hair follicles and increasing blood flow to the scalp. Results are typically visible at 4 to 6 months. It must be continued indefinitely to maintain benefits.
Combination therapy (finasteride plus minoxidil)
Using finasteride and minoxidil together is the most effective medical approach. Finasteride addresses the hormonal driver of hair loss while minoxidil directly stimulates follicle growth through a separate mechanism. Studies consistently show superior results with combination therapy compared to either agent alone.
Lifestyle and adjunctive measures
General scalp health, adequate nutrition, stress management, and treating underlying conditions such as thyroid disorders or iron deficiency can support hair health. Avoiding harsh chemical treatments, excessive heat styling, and tight hairstyles that cause traction may help preserve existing hair. Smoking cessation may also benefit hair health by improving blood flow to the scalp.
Advanced options (not managed by TeleDirectMD)
Hair transplant surgery, platelet-rich plasma (PRP) injections, low-level laser therapy, and scalp micropigmentation are additional options for patients who do not respond adequately to medical therapy or who desire cosmetic restoration. These require in-person evaluation with a dermatologist or hair transplant surgeon.
What we do not manage by video
- Alopecia areata (autoimmune patchy hair loss requiring immunomodulators)
- Scarring alopecia requiring scalp biopsy and specialized treatment
- Female pattern hair loss requiring hormonal evaluation
- Hair transplant evaluation or procedural treatments such as PRP
Decision guide
Should I Use TeleDirectMD for Hair Loss? Decision Guide
Do you have any red-flag signs?
- Patchy, well-circumscribed areas of hair loss (possible alopecia areata)
- Scalp scarring, smooth shiny patches, or scalp pain (possible scarring alopecia)
- Rapid diffuse shedding with fatigue, weight changes, or fever
- Scalp redness, pustules, or open lesions
- Hair loss with joint pain, rash, or other systemic symptoms
Yes: seek in-person dermatology evaluation
No: continue to Step 2
Are you 18+ and currently in one of our covered states?
Yes: continue to Step 3
No: use in-person care as appropriate
Does your hair loss fit a typical male pattern?
- Gradual thinning at the temples, crown, or mid-scalp
- Receding hairline over months to years
- Family history of male pattern baldness
- No patchy loss, scalp pain, or scalp scarring
Yes: continue to Step 4
No: or the pattern is atypical, seek in-person dermatology evaluation
You are likely appropriate for a TeleDirectMD video visit
Recovery & prevention
Home Care, Timeline, and Follow-up
Timeline and What to Expect
- Hair loss treatment requires patience. Results from finasteride and minoxidil are typically visible at 3 to 6 months, with peak improvement at 1 to 2 years
- An initial shedding phase during the first 2 to 4 weeks of minoxidil use is normal and does not mean the treatment is failing
- Treatment must be continued indefinitely. Hair loss resumes within approximately 12 months of stopping finasteride
- Take finasteride at the same time each day. Apply minoxidil to a dry scalp and allow it to dry fully before lying down
- Avoid using hair dryers on high heat directly after applying minoxidil
What to Watch For After Starting Treatment
- Sexual side effects from finasteride (decreased libido, erectile changes, decreased ejaculate volume) occur in 1 to 2 percent and are usually reversible upon stopping
- Scalp irritation, itching, or flaking from topical minoxidil. If persistent, try switching from solution to foam or reducing frequency
- If you develop new patchy hair loss, scalp scarring, or scalp lesions while on treatment, seek in-person dermatology evaluation
Follow-up and Long-term Management
- Follow up at 3 to 6 months to assess initial response and adjust treatment if needed
- Photographic documentation at baseline and follow-up helps track progress objectively
- If finasteride is not tolerated due to side effects, discontinue and discuss alternatives with your MD
- For patients who do not respond adequately to medical therapy after 12 months, referral to dermatology for advanced options may be appropriate
- Continue treatment indefinitely for maintained results. Discuss any concerns about long-term use with your MD
Safety first
When Not to Use TeleDirectMD for Hair Loss
TeleDirectMD is designed for typical androgenetic alopecia in adults. We are direct about when telehealth is not appropriate.
You Should Not Use TeleDirectMD If
- You are under 18 years old
- You have patchy, well-circumscribed bald spots (possible alopecia areata requiring in-person evaluation)
- You have scalp scarring, smooth shiny patches, or scalp pain (possible scarring alopecia requiring biopsy)
- You have rapid diffuse shedding with fatigue, weight changes, or other systemic symptoms
- You have scalp redness, pustules, or open lesions
- You are a woman who is or may become pregnant (finasteride is teratogenic)
- You want a hair transplant consultation or procedural treatment
- You are not physically in one of our covered states at the time of visit
Alternative Care Options
- Dermatology: patchy hair loss, scarring alopecia, scalp biopsy, advanced or atypical cases, and female pattern hair loss
- Primary care: hair loss with suspected thyroid disorder, iron deficiency, or other systemic contributing factors requiring laboratory workup
- Hair transplant surgeon: advanced hair loss unresponsive to medical therapy, cosmetic restoration goals
- Endocrinology: suspected hormonal imbalance, polycystic ovary syndrome, or adrenal disorder contributing to hair loss
Common questions
Hair Loss Treatment FAQs
Can I get a prescription for hair loss online?
Yes, if you are an adult 18+ located in one of our covered states and your hair loss pattern is consistent with androgenetic alopecia after red-flag screening. TeleDirectMD can prescribe finasteride when clinically appropriate. Minoxidil 5 percent topical is available over the counter without a prescription.
How much does online hair loss treatment cost?
TeleDirectMD offers a transparent self pay option starting at $79 for an adult video visit. Insurance is not required. Prescription costs at your pharmacy are separate. Generic finasteride is typically $10 to $15 per month.
How long does it take for finasteride to work?
Results from finasteride are typically visible at 3 to 6 months, with peak improvement at 1 to 2 years of consistent daily use. Hair loss treatment requires patience, and early discontinuation is the most common reason for perceived treatment failure.
What are the side effects of finasteride?
Sexual side effects including decreased libido, erectile dysfunction, and decreased ejaculate volume occur in approximately 1 to 2 percent of users. These are usually reversible upon discontinuation. The FDA has also added warnings about depression and suicidal ideation. Patients are fully counseled before starting. Finasteride is not a controlled substance.
Is finasteride safe for long-term use?
Finasteride has been studied extensively since its approval. Most men tolerate it well long term. If side effects develop, they typically resolve after stopping the medication. Post-finasteride syndrome, in which symptoms persist after discontinuation, has been reported rarely but remains controversial and poorly understood. Discuss any concerns with your MD.
Can women take finasteride?
Finasteride is teratogenic and must not be taken by or handled by women who are or may become pregnant, as it can cause birth defects in a male fetus. Female pattern hair loss requires a different diagnostic and treatment approach, typically through in-person dermatology evaluation.
Do I need both finasteride and minoxidil?
Combination therapy with finasteride and minoxidil is the most effective medical approach for androgenetic alopecia. Finasteride blocks the hormonal driver of hair loss while minoxidil stimulates hair growth through a separate mechanism. Your MD will discuss which approach is best for your situation.
What happens if I stop taking finasteride?
Hair loss resumes within approximately 12 months of stopping finasteride. The hair that was maintained or regrown during treatment will gradually miniaturize and thin again. Treatment must be continued indefinitely to maintain results.
Is minoxidil shedding normal?
Yes. An initial shedding phase during the first 2 to 4 weeks of starting minoxidil is common and expected. This occurs because minoxidil pushes resting follicles into a new growth cycle. The shedding is temporary and is actually a sign that the medication is working.
How is male pattern hair loss different from alopecia areata?
Male pattern hair loss (androgenetic alopecia) is gradual, follows a predictable pattern at the temples and crown, and is driven by DHT. Alopecia areata is an autoimmune condition that causes sudden, well-circumscribed round or oval patches of complete hair loss. Alopecia areata requires in-person dermatology evaluation and different treatment.
Does TeleDirectMD treat hair loss in other states?
Yes. TeleDirectMD offers adult evaluations via video visits across multiple states where our physicians are licensed. You must be physically located in the state where you are requesting care at the time of your video visit.
Can I use my insurance for a TeleDirectMD visit?
Insurance is not required. If your plan is eligible, you may be able to use insurance. A self pay option is also available.
Does your state allow telemedicine for this kind of visit?
Yes. Your state allows licensed professionals to provide telemedicine within their scope when appropriate and according to accepted standards of care.
Can TeleDirectMD provide hair loss care in other states?
Yes. TeleDirectMD offers adult evaluations via video visits across multiple states. You must be physically located in the state where you are requesting care at the time of the visit.
How much does hair loss treatment cost online per month without insurance?
The first visit is $79 flat with no insurance required, and ongoing generic finasteride typically costs $10 to $15 per month at the pharmacy — minoxidil is available over the counter for a similar modest monthly cost.
Can women get finasteride prescribed for hair loss online?
Finasteride is generally reserved for men due to pregnancy-related risks and limited evidence in women; the MD will discuss appropriate alternatives, such as topical minoxidil, for women experiencing hair thinning after reviewing your history.
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