If you are looking into hair loss treatment, you will see two broad routes: over-the-counter (OTC) products you can buy yourself, and prescription treatment, which sometimes includes compounded formulas made for an individual patient. This guide explains the differences so you can decide what questions to bring to a provider.
Over-the-counter options
- Topical minoxidil is the main OTC medication for hair loss and is FDA-approved for hereditary hair loss in men and women.
- Shampoos, serums and supplements make up most other OTC products. Many have limited evidence for treating hair loss, and supplements are most likely to help when there is a confirmed deficiency.
OTC products are convenient and do not require a consultation. The trade-off is that there is no medical review of the cause of your hair loss, which matters because different causes need different care.
Prescription options
Prescription treatment starts with a licensed provider reviewing your history and deciding what, if anything, is appropriate. Options include FDA-approved medications such as oral finasteride for men, off-label medications such as oral minoxidil or spironolactone, and compounded formulas.
What compounding adds
A compounded formula is prepared by a licensed pharmacy for one patient, based on a prescription. It can:
- Combine more than one prescribed ingredient in a single product
- Use a different base for people irritated by standard formulas
- Use a form or strength not available off the shelf
Compounded medications are not FDA-approved. The FDA does not review them for safety, effectiveness or quality before they are dispensed the way it reviews approved drugs. Compounded treatment is not automatically better than an OTC or FDA-approved product. It is a way to tailor treatment when there is a reason to. See how compounded treatment works.
Side by side
| OTC | Compounded prescription | |
|---|---|---|
| Medical review | None required | Required |
| FDA approval | Topical minoxidil approved; many other products not evaluated for hair loss | Not FDA-approved as compounded products |
| Personalization | Fixed formulas | Prepared for the individual |
| Ingredients | Usually one active ingredient | Can combine prescribed ingredients |
| Cost | Generally lower | Generally higher, includes provider review |
How to decide
If you have mild, gradual thinning, an OTC product may be a reasonable first step. A provider's review is worth considering if you are unsure of the cause, have tried OTC options, cannot tolerate them, or want to discuss prescription options. See treatments with the strongest evidence.
Next step
If you want a licensed provider to review your options, start your online consultation.
Prescription required for prescription treatment. A licensed provider decides whether treatment is appropriate. Compounded medications are prepared by a licensed pharmacy for an individual patient and are not FDA-approved. Individual results vary. Prescribed Essence currently serves patients in California, Colorado, Florida and New York.
