Dr. Frank Agullo was the lead expert in Mochi Health’s explainer on finasteride for women. That version ends at the prescription. This is the in-clinic half, in his words.
What the Medication Does
What does finasteride actually do for a woman losing hair?
Dr. Agullo: “It slows down that signal driving the follicle to shrink. It is not a hair-growing medication. It is a mechanism to slow down hair-loss activity and maintain hair growth.”
Dr. Agullo: “In women, finasteride is a stabilizer first and a regrower second. The win is the hair you keep. Any new density over the following year is a bonus.”
A stabilizer first.
Who He Puts On It
How often do you prescribe finasteride to women, and which group is most of them?
Dr. Agullo: “It is actually very common in women with female pattern hair loss. I offer it to all postmenopausal women as one of the main preventative means to stop further hair loss. We use it sparingly and with a lot of care in premenopausal women due to pregnancy risks.”
| Patient | Finasteride at Southwest Plastic Surgery |
|---|---|
| Postmenopausal, female pattern hair loss | Offered as a main preventative |
| Premenopausal | Sparingly, with care, because of pregnancy risk |
| Hair loss from PCOS | Often paired with an androgen blocker such as spironolactone |
The Off-Label Conversation, Once
Off-label and pregnancy warnings, in your own words.
Dr. Agullo: “Finasteride is not FDA approved for the treatment of alopecia in women. Yet we know that it works, because it has the same mechanism of action in women who have hair loss due to androgenic alopecia. We use it off-label, and we advise patients that we’re using finasteride off-label, and they understand this use. When we use it in premenopausal women, we do so with a lot of patient education, as this is important, as the medication can cause birth defects if used during pregnancy.”
That conversation happens every time.
The One-Year Wait
When does a patient see growth?
Dr. Agullo: “Phase two consists of hair growth. There is a slight, if minimal, growth boost in phase two, but the effects on hair thickness or receding hairline are not fully seen until around 12 months down the road.”
Twelve months. Slight, if minimal.
Not Every Hair Loss Is Hormonal
From a consultation this month, conducted in Spanish and rendered in English:
Dr. Agullo: “Did you pull your hair back a lot before, in a ponytail or a bun? Sometimes when you do that for many years, the hair suffers and falls out.”
Traction alopecia. Finasteride will not fix a pulled-out hairline.
What Else the Med Spa Adds
What helps the hair that is still there?
Dr. Agullo, on exosome treatments: “Exosomes are little particles that the body itself forms, but inside they have all the growth factors that signal the hair to grow. Like when you cut yourself, all the growth factors go there to fix it, but now we’re doing it artificially, we put them here so the body concentrates on the hair. And it’s giving us very good results. Usually you can do four treatments, one a month, or you can do one a little stronger and then another at four months. It’s done here in this chair, one of the nurses does it, and you can go to work a few hours later. There’s really no restriction.”
Dr. Agullo, on PRP at the time of a transplant: “The only other thing I recommend doing at the same time is using a little bit of your platelet-rich plasma, where we draw some blood from your vein and we get the growth factors, and I mix that into where I’m putting in the grafts, and we get a higher take rate. Our take rate is almost ninety-eight, ninety-nine percent of the grafts actually survive and grow.”
Both are offered on the med spa side.
When to Talk Transplant
What about a woman who wants more than holding the line?
Dr. Agullo: “So we would take hair from the back, we take it in a strip, so it leaves a scar, but your hair will hide it, and we place the hairs one by one.”
Dr. Agullo: “There is a technique where we take the hair one by one, but to do that we have to shave, and in women that doesn’t make sense, right?”
Strip for long hair. FUE when shaving is acceptable. The FUE hair transplant post covers the rest.
FAQ
Is finasteride approved for women?
No. “Finasteride is not FDA approved for the treatment of alopecia in women. Yet we know that it works, because it has the same mechanism of action in women who have hair loss due to androgenic alopecia.”
Can a premenopausal woman take it?
Carefully. “We use it sparingly and with a lot of care in premenopausal women due to pregnancy risks.”
Will it regrow my hair?
“It is not a hair-growing medication.” The win is the hair you keep.
How long before I see a change?
The effects are “not fully seen until around 12 months down the road.”
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026, is a member of the International Society of Hair Restoration Surgery, and was the lead expert in Mochi Health’s explainer on finasteride for women.
Ready to Talk?
The first visit is a scalp exam and a plan. Medication, exosomes, PRP, or a transplant, in that order of conversation.
Call (915) 590-7900, text 1-866-814-0038, or contact Southwest Plastic Surgery. #StayBeautiful
Find Dr. Agullo at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
