Hair · MPB Protocol

HAIR
PROTOCOL

Finasteride · Topical Minoxidil · 6-Month Decision

Free
Under $10
Invest later
Recommended Stack — When Budget Allows
Topical Minoxidil 5% — Kirkland
Growth stimulator · Apply BID to dry scalp
invest
Costco 6-month pack. Apply 1mL morning and night. Let absorb 4 hours before washing. Initial shed at weeks 4–8 is normal — do NOT stop. Hair regrowth weakest at temples, stronger at crown.
~$3 / mo
Costco
Scalp Massage — Free Adjunct
Improves minoxidil absorption and independently stimulates follicles
free
Moderate evidence: massage increases blood flow, enhances minoxidil distribution, and stimulates follicles via mechanical tension and growth factor release. Studies show better density outcomes combined with minoxidil vs minoxidil alone. Protocol: 4–10 min daily or 2–5 min twice daily after applying minoxidil, fingertips in circular motions across the scalp. Leave product on minimum 2–4 hours after. Apply before the lip routine so hands stay clean afterward.
4–10 min
daily
Finasteride 1mg — Generic oral
DHT blocker · Take daily, same time
invest
Via Keeps or Hims online — no in-person visit needed. Prescription via questionnaire. Reduces scalp DHT ~60–70%. Best at stabilizing recession; modest regrowth possible. Assess at 6 and 12 months.
~$18–25 / mo
Keeps / Hims
Finasteride — What to Know
Mechanism
Inhibits 5-alpha reductase type II. Reduces scalp DHT ~60–70%. Slows recession and enables modest regrowth — better at crown than hairline.
1mg / day
Side Effects — Sexual
~1–2% in trials. Real-world rates higher due to nocebo effect — men told about side effects report them 3× more than uncounseled men (Mondaini 2007). Monitor at 4–8 weeks. If persistent after 4 weeks: stop, switch to topical finasteride spray.
~1–2% rate
Post-Finasteride Syndrome
Real for a small minority, incidence unquantified. Persistent sexual side effects post-discontinuation. Looksmax communities overstate prevalence. Stop within 4 weeks of onset if side effects appear.
rare
Timeline
6 months minimum to assess. Full effect at 12 months. Must be taken indefinitely — stopping reverses gains within months.
6–12 mo
Topical Minoxidil — What to Know
Mechanism
Extends anagen (growth) phase, widens follicles. Works via sulfotransferase enzymes that vary across the scalp — explains why crown responds better than hairline.
5% solution
Initial Shed — Do Not Stop
Week 4–8 shed (telogen effluvium) means it's working. Hair follicles cycling into active growth phase. Stopping here is the most common mistake.
wks 4–8
Hairline vs Crown
Minoxidil (oral or topical) is weaker at temples than crown. Finasteride does more heavy lifting at the hairline. The Ramos 2024 RCT found oral minoxidil had no statistically significant advantage over topical at the frontal scalp (12%, p=0.24).
crown > hairline
Oral Minoxidil — Not Yet
Oral Minoxidil 1.25–2.5mg
Defer — only if topical fails at 6 months
cardiac flagdefer
No significant advantage over topical at the hairline (Ramos 2024). Looksmax community uses it mainly for eyelash/brow halo, not hairline rescue. Given grandfather stroke history, skip unless topical clearly fails. If pursued later: disclose family history, start at 1.25mg, not 2.5mg. Fluid retention and palpitations are real at higher doses.
~$10–25 / mo
after 6 mo
6-Month Decision Tree
Recession stabilized, no side effects
continue stack
indefinitely
Hairline still receding
consider
dutasteride
Sexual side effects persist >4 weeks
stop fin →
topical spray
Documentation
Monthly photos in identical lighting and angle. Same spot, same time of day. No progress photos are useless without a baseline.
monthly