The efficacy of minoxidil, finasteride and dutasteride for the treatment of androgenic alopecia (AGA) has been validated and is considered the standard of care. However, the incidence of sexual function 5-alpha reductase inhibitor side effects reported in males has contributed to poor compliance. Surprisingly, long-term sexual dysfunction has been reported after discontinuing both oral and topical formulations of finasteride and dutasteride. Serious sexual dysfunction side effects have not been reported for minoxidil, or spironolactone and decent hair growth improvements are reported for spironolactone. 

Peptide based therapies including GHK-Cu, IGF-1, TB4 and PTD-DBM have all shown hair growth improvements in small studies. Sirolimus, an immune modulator and mTORC1 inhibitor has also shown some improvements in hair follicle growth, however its use is limited due to systemic immunosuppression.

Up and coming hair growth therapies include low level laser therapy and plasma replacement. FDA approval for both options provide validity, however, the costs can be prohibitive. In summary, the clinician should document that the client has been counseled regarding the risks and minimal data available to support the efficacy of most hair restorative treatments.