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Guide · Step 1 of 5By Klineva · Updated on 4 October 2026 · 17 min read
Your hairline is receding or the crown of your head is thinning, and every month a headline announces “the end of baldness”: what should you believe? The honest answer comes down to three ideas. Two medicines, finasteride and minoxidil, slow hair loss for as long as you use them, and a hair transplant is the only solution where the hair has gone. The newest treatments getting the most attention, such as the clascoterone lotion (often called Breezula), are still in trials, with no authorisation in Europe as of October 2026. This guide separates the facts from the hype, and says whether you should wait before having a hair transplant.
Hereditary baldness (androgenetic alopecia, as doctors call it) is very common: it can affect up to one man in two by the age of 50. When it comes to treatment, the professional society for hair transplant surgeons, the ISHRS, points out that only two medical treatments are approved by the US FDA: finasteride is for men only, while minoxidil is the only one of the two also approved for women. For areas that are already bare, that leaves a hair transplant.
These treatments have one thing in common that you should know from the start: they slow hair loss, they do not cure it. On minoxidil, the ISHRS writes that, as with all medicines, the gains fade within a few months once you stop. You then return to where you would have been without treatment. However, medical treatment is far more effective at the start of hair loss, before baldness is complete.
Finasteride lowers the level of DHT, a hormone derived from testosterone that makes the follicles of predisposed people shrink. It is available on prescription only. As a tablet, it is authorised in several European countries for men aged 18 to 41. A spray, Fincrezo, has been sold in France since March 2025, also on prescription and not reimbursed by the French social security system.
Its risk profile is debated between authorities. In 2025, the European Medicines Agency confirmed that suicidal thoughts are among the possible side effects of the tablet. It nevertheless considers that the benefits of this tablet outweigh its risks. The ANSM, the French agency, takes the opposite view and considers the balance of benefits and risks of finasteride 1 mg for baldness to be unfavourable. In France, an annual information attestation, co-signed by the doctor and the patient, is required for finasteride 1 mg tablets. This has applied since 16 April 2026 for starting treatment, and since 16 June 2026 for treatment already under way. Without this attestation, the pharmacy cannot dispense the medicine. The Fincrezo spray is not affected.
Other effects have been described, notably sexual problems, and some can persist after stopping the treatment. If your mood changes during treatment, talk to your doctor without delay. In case of distress, 3114 is the French national suicide prevention number. Its close cousin, dutasteride, is authorised in Europe for benign prostatic hyperplasia. But using it for hair loss is an off-label medical decision.
Minoxidil is sold as a solution to apply to the scalp, without a prescription. In France, Alostil 5% is indicated for moderate hair loss in men, and it is not reimbursed by the French social security system.
Minoxidil also exists as a tablet, and that is a more delicate matter. Lonoten is authorised only for severe high blood pressure. Its official product sheet, published by the ANSM, states that lengthening and thickening of the fine downy hair are “common” in most people treated. Prescribing it for hair loss is therefore off-label use. In early 2025, a group of 43 hair-specialist dermatologists from 12 countries reached a consensus, published in JAMA Dermatology. It covers how to prescribe this off-label minoxidil. According to small studies, at low doses this minoxidil can be safe and effective in some patients. The consensus serves as a reference point for doctors while awaiting new data.
Medicines need follicles that are still present. Where they have disappeared, a hair transplant can, according to the American Academy of Dermatology, be an effective and lasting solution. It moves your own hair, taken from the back of the head, to the thinning areas. Our guide FUT, FUE or DHI compares the techniques.
To understand what the new treatments are aiming at, take a close look at a hair. It grows in a small sheath of skin, the follicle. At its base, a small structure, the papilla, gives the stem cells, housed in a bulge on the side, the signal to grow.
In hereditary baldness, DHT acts on the sensitive follicles. Bit by bit, the hair becomes finer and shorter, until it is no more than an almost invisible down. The follicle has not necessarily disappeared as a result: it is weakening. This is the margin that treatments, old and new, try to make use of. In areas of complete baldness, only surgery is effective. The approaches being tested follow four ideas:
Here is where things stand in October 2026. “Phase 3” is the last stage of the trials. The application is then examined by an agency: the FDA in the United States, the European Medicines Agency in Europe. None of these treatments is authorised for hair loss in Europe or in the United States.
| Treatment | Where does it stand? | What next? |
|---|---|---|
| Clascoterone 5% (lotion) | Phase 3 completed, 1,465 men | Filings planned for early 2027 (United States) and Q2 2027 (Europe) |
| Prolonged-release minoxidil tablet | Positive phase 2/3, 519 men | Second phase 3 trial: results in the second half of 2026 |
| Pyrilutamide (lotion) | Positive phase 3 in China, 666 patients | Application for authorisation in China, according to Kintor |
| PP405 (gel) | Small phase 2a trial, 78 people | Late-stage trials announced for 2026 |
Manufacturers’ press releases, June 2025 to August 2026. Compiled in October 2026.
This molecule is already used against acne, as a cream: it is Winlevi, authorised in the European Union in October 2025. The company Cosmo is testing it as a 5% lotion for hair, under the brand name Breezula. Its two large trials, in 1,465 men, met their objective. The results, announced in December 2025, show more hair in the measured area than with a placebo.
Beware of spectacular percentages: the +539% and +168% announced are improvements relative to placebo. They do not say how much hair you gain. The press release gives neither that number nor an explanation for the gap between the two trials. At one year, according to the company, the gain is 2.39 times higher in patients who stayed on treatment than in those switched to placebo after six months. According to the company, no significant general hormonal effect was observed. The company plans to file its applications in the first quarter of 2027 in the United States and in the second in Europe. Filing an application is not an authorisation, and no sale date has been announced.
The US company Veradermics is developing a prolonged-release minoxidil, designed to avoid peaks of minoxidil in the blood. One trial involved 519 men with mild to moderate baldness. After 6 months, the average gain was 30 to 33 hairs per cm², depending on the dosing schedule, compared with 7 with a placebo. Side effects were close to those of the placebo. These results come from a company press release. A second phase 3 trial is due to deliver its own results in the second half of 2026.
Pyrilutamide, from the Chinese company Kintor, is another lotion of this type. Its phase 3 trial, with results dating from March 2026, was conducted in China in 666 patients over 24 weeks. According to the company, it produced a gain of 15.33 hairs per cm² with the 1% concentration applied twice a day, compared with 4.68 on placebo. Kintor says it is moving its application for authorisation in China forward (press release of June 2026).
PP405, a gel from the company Pelage, has so far delivered only the results of a small trial. It involved 78 men and women, with one application a day for only 4 weeks. The manufacturer reports a gain in density in some of the most affected men, and announces late-stage trials for 2026.
Other leads are younger still. Absci’s injectable antibody, which blocks the prolactin receptor, had delivered only first safety data in 32 healthy volunteers as of June 2026. These say nothing about hair growth. According to the company, first efficacy data are expected in the second half of 2026, and complete data in early 2027. As for the techniques that would multiply follicle cells in the laboratory (“cloning”), one company announced first tests on volunteers in March 2026. To our knowledge, no results have been published.
No, not to date. These medicines treat a different condition, alopecia areata, and they are not harmless.
Alopecia areata shows up as patches without hair. It is an autoimmune disease: the body’s defence system attacks healthy tissue, here the follicles. JAK inhibitors slow this reaction. In Europe, baricitinib (Olumiant) and ritlecitinib (Litfulo, since September 2023) are authorised for severe alopecia areata from the age of 12. In the United States, the FDA authorised baricitinib in 2022 for adults and extended it to those aged 12 and over at the end of September 2026.
Hereditary baldness has a different origin: the sensitivity of the follicles to male hormones, with no attack by the immune system. In Europe, neither Olumiant nor Litfulo is authorised for it.
These medicines also carry serious risks. In 2023, the European Medicines Agency reviewed several JAK inhibitors, including Olumiant. It concluded that, in chronic inflammatory diseases (alopecia areata included), they increase the risk of serious cardiovascular problems, cancers, blood clots, serious infections and death. This risk is higher than with anti-TNF medicines, another family of treatments. In people at risk, the Agency restricts their use to cases where there is no alternative. These are people aged 65 and over, smokers or former heavy smokers, and those with a cardiovascular or cancer risk.
If you have patches without hair rather than a receding hairline or a thinning crown, see a dermatologist. According to the American Academy of Dermatology, effective treatment starts with finding the cause.
The more a product is presented as miraculous, the more wary you should be. Here are the most common traps.
Not as a matter of principle, and the decision is made with a doctor. Three reasons explain this.
The two approaches complement each other rather than compete. The ISHRS gives a telling example: the crown is thinning while the front half of the scalp is already bare. In that case, medical treatment can be used to restore the crown, and surgery to rebuild the frontal hairline. Any treatment before or after a hair transplant is decided case by case with the doctor.
That leaves the real question: when to have a transplant? It depends on your age, how fast you are losing hair and your stage. Our guide When should I have a hair transplant? helps you answer it.
Whatever the news, the way forward stays the same.
And when a headline announces the end of baldness, ask yourself three questions: is this product authorised, by which agency, and who prescribes it?
real patients, with the number of grafts and the time elapsed since surgery
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No: medicines slow hair loss for as long as you use them. The official product sheet for the finasteride spray states that things return to the starting point 9 to 12 months after stopping. For areas that are already bare, a hair transplant can be a lasting solution. Hair taken from the back of the head does indeed resist the hormone responsible for baldness (DHT), even once moved.
Several months. According to the American Academy of Dermatology, it takes about 4 months to notice an improvement with finasteride. With minoxidil, it is most often 6 to 12 months. These timescales are guidelines: your doctor will tell you when to review progress.
It is the finasteride spray (Fincrezo), sold since March 2025 on prescription to men aged 18 to 41 with mild to moderate baldness. French social security does not reimburse it. In its 24-week trial, an area of 1 cm² gained 16.3 hairs with the spray, 18.7 with the tablet and 6.3 with a placebo. The genuinely new treatments (clascoterone, prolonged-release minoxidil) are not authorised in France as of October 2026.
No one can say yet. The company Cosmo plans to file its applications in the first quarter of 2027 in the United States and in the second quarter of 2027 in Europe; the agencies will then have to review them. As of October 2026, no sale date has been announced.
There is no evidence that they do. In May 2025, the French health research institute Inserm pointed out that no major scientific discovery proves their effectiveness against baldness. It also pointed out that there are no clinical trials of these products in aesthetic medicine. In the United States, the FDA states (warning of April 2024) that no exosome-based product is approved.
Not as a matter of principle: even for the most advanced, clascoterone, applications are only planned for 2027. The trials involved mild to moderate baldness, and only a hair transplant can bring back hair where the follicles have disappeared. Treatment and hair transplant can complement each other; the free diagnosis from photos offered by Klineva helps you choose the right time.
The results of the treatments in trials come from their manufacturers’ press releases (June 2025 to August 2026), compiled in October 2026.
step 1 of 5: before the transplant
Guide · Step 1
When should I have a hair transplant?
The right time to get started, from the season to the stage of hair loss.
Read the guide
Guide · Step 1
FUT, FUE or DHI: which technique should you choose?
The three techniques compared, without the jargon.
Read the guide
Guide · Step 1
The stages of baldness: the Norwood scale
Find out where you stand and what a transplant can cover.
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