The Evidence-Based Hair Loss Protocol Checklist

Step 1: Confirm the diagnosis

• See a dermatologist or telehealth provider to confirm androgenetic alopecia (pattern hair loss)
• Rule out thyroid issues, iron deficiency, and telogen effluvium with basic blood work
• Take baseline photos: hairline, crown, and top-down, in consistent lighting

Step 2: Tier 1, the proven core

• Ask your doctor about finasteride 1 mg daily (men) — the foundation that addresses the cause (DHT)
• Start minoxidil 5% once or twice daily on the scalp (men and women)
• Commit to at least 6 months before judging results — shedding in weeks 2–8 is normal and temporary

Step 3: Tier 2, the multipliers

• Add weekly microneedling (0.5–1.5 mm derma stamp) — shown to roughly double minoxidil response in studies
• Disinfect the stamp with 70% isopropyl alcohol before and after every session
• Skip minoxidil for 24 hours after needling; never needle irritated or broken skin
• Use ketoconazole (Nizoral) shampoo 2–3 times per week, left on the scalp for 3–5 minutes

For women

• Use 5% minoxidil foam once daily or 2% solution twice daily (both FDA-approved for women)
• Do not use finasteride if pregnant or planning pregnancy — discuss anti-androgen options with your doctor
• Ask about spironolactone if minoxidil alone is not enough after 6–12 months

Track and adjust

• Repeat photos every 30 days in the same lighting and angles
• Judge progress at month 6 and month 12 — not week 6
• If a treatment causes side effects, talk to your doctor about dose or alternatives instead of quitting everything

This checklist is for information only and is not medical advice. Finasteride, dutasteride, and spironolactone are prescription medications — always consult a licensed clinician before starting or changing treatment.