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A number of happy milestones happened when I turned 30 last year. I got married. I started a new job and traveled the world. But then there was this: “You have androgenic alopecia,” my dermatologist said as he finished a clinical assessment of my scalp. I sat back in the rigid chair, dumbfounded. I’m balding. This wasn’t the diagnosis I expected to hear when I walked into the appointment. I thought maybe I had dandruff or light thinning due to stress, but alopecia? Never in a million years did I think that’s what was happening to my hair.
I first noticed my hair thinning in May 2024. I remember looking through photos from my honeymoon earlier that month obsessing over the way my hair looked: In addition to appearing thinner overall, I noticed a bald patch near the front of my part. Often, my scalp showed through when I wore ponytails. I would wait almost six more months before mentioning anything to my husband, almost ashamed that my hair might be thinning. How could it be? I just turned 30 and I work in beauty. I use all the best shampoos and most expensive hair masks. I get to visit celebrity hairstylists and test out new tools all the time. Surely, someone would have said something if they thought I was balding, right?
What is Androgenic Alopecia?
“Androgenic alopecia is genetic, hormone-influenced gradual thinning of the hair,” says Kunal Malik, MD, a board-certified dermatologist based in New York City. He adds that it tends to appear in a particular pattern: Men will typically notice a receding hairline and crown thinning while women tend to see thinning across the top of the scalp, though the front hairline is usually unaffected.
In women, androgenic alopecia (AGA) is also known as female pattern hair loss (FPHL). Predisposed individuals have genetic imbalances of androgens, the sex hormones responsible for male characteristics (the most well-known androgen being testosterone). Dr. Malik explains that these male hormones bind to the hair follicle receptors, causing them to shrink before they eventually stop producing visible hair altogether. Hormonal imbalances and conditions like polycystic ovary syndrome (PCOS) can increase the likelihood of this diagnosis. By the age of 50, 40% of females will be diagnosed with FPHL, according to a study out of the University of California, Los Angeles.
But AGA isn’t something that happens overnight. I may have been slowly losing my hair for a few years and not noticed since I see myself every day. To non-derms, my part may appear normal, if not a bit wide by typical beauty standards. I didn’t have any redness, itchiness, or discomfort in any way. In fact, if it hadn't been for a season of stubborn dandruff, I might never have made an appointment to get my hair checked. Within seconds of walking into my appointment and examining my hairline, my derm diagnosed me with AGA. He pointed to the thinning along my part, extending to the back of my head, as being a main indicator.
Androgenic alopecia is one of four forms of alopecia. The others can be autoimmune (alopecia areata), stress or illness related (telegenic effluvium), or related to physical pulling or tugging (traction alopecia). AGA can begin as early as your late teens or early twenties in men, but women typically don’t see thinning until after age 40 or post-menopause, explains Dr. Malik.
How to Treat Androgenic Alopecia
The same day I received my diagnosis, I went home with three prescriptions: for spironolactone, which is an anti-androgen to block hormones like testosterone and dihydrotestosterone (DHT) that can cause FPHL, ketoconazole shampoo, which helps reduce inflammation and may help block DHT, and oral minoxidil, which can increase new hair growth. Topical minoxidil is more effective at targeting the hair on your head, but it’s poisonous to cats, so I had to opt for the oral version, which can stimulate hair growth everywhere, not just on your head.
The last thing I wanted to do was start taking medicines for my hair loss, but I did so knowing it increased the likelihood that I could preserve and regrow as much of my hair as possible. I started taking 2.5mg of oral minoxidil and 100mg of spironolactone daily. I used the ketoconazole shampoo once a week as directed.
After about six weeks of taking the oral medications, I noticed a ton of facial swelling, which would later be identified as facial edema. Dr. Malik notes that this reaction is uncommon but can sometimes occur in the first few weeks of treatment or with higher doses of spironolactone. “Most patients who experience this find it resolves as their body adjusts to the medication,” he says. He adds that facial swelling is very rare with topical minoxidil but can happen with oral minoxidil due to the medications vasodilatory (as in, widening of the blood vessels) effect.
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I also noticed more gastrointestinal upset, which Dr. Malik says is not very common with spironolactone or minoxidil. He notes that if you do notice this symptom to take your medication with food to help reduce feelings of nausea. As someone with IBS, I’m not surprised that this was a side effect I noticed. I also saw hair growth on my upper lip, jaw, cheeks, and arms while taking oral minoxidil, which wasn’t a total surprise since, like I said, it creates overall hair growth as opposed to targeted hair growth that topical minoxidil can offer.
The spirolactone also messed with my period which Dr. Malik says can happen in 15 to 20% of women. “This occurs because spironolactone blocks androgrens, which can disrupt hormonal balance. The effect is dose-dependent,” he explains. While on vacation, I opted to stop taking both oral medications as they were significantly affecting both my physical appearance and my mental health. I continued to use the ketoconazole shampoo without any issues.
While I did see an increase in hair growth while I was taking these medications, the cons outweighed the pros for me. Instead, I spoke with my doctor about alternatives that might help stimulate hair growth without intense side effects. He recommended trying Nutrafol supplements, rosemary oil, and a low-level red light cap. I’ve yet to spring for the supplements or red light hat, but I made my own rosemary water (boil water, add a few sprigs of rosemary and turn off heat, stir well and let cool before pouring into a clean spray bottle) to use in the shower, purchased a scalp massager to help stimulate blood flow to my hair follicles, and invested in the $200 Mason Pearson hairbrush that my hairdresser said is worth every penny.
Dr. Malik adds that some natural alternatives that are supported scientifically to help hair growth include pumpkin seed oil and daily scalp massages. “While these approaches generally have fewer side effects than medications, they typically produce more modest results and work best for mild to moderate hair loss caught early,” he notes. “Combination therapy often produces better results in my experience compared to single treatments. Not all natural supplements have evidence for their use for hair growth, so consult with your dermatologist about the supplements and medications you're taking.”
How Do Platelet-Rich Plasma Treatments Help With Hair Loss?
With that in mind—and with the side effects of the medications I’d tried being too much to bear—I then set up an appointment for my first platelet-rich plasma (PRP) treatment, which uses your own processed blood to help hair regrowth. It would cost me $850 a session with a minimum of three sessions to start. Compared to supplements and medications, PRP may have a quicker and longer-lasting effect and can be used with or without medication or supplements to see results. My derm recommended that I take the medications in conjunction with PRP for better results, but given my sensitivity to the prescriptions, I opted out. Of course, everyone is different, so what may have worked (or not worked) for me, might work (or not work) for you.
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“PRP involves injecting concentrated platelets from your own blood into the scalp,” Dr. Malik further explains. “[It] releases growth factors that stimulate follicle health and prolongs the growth phase [of hair].” A course of treatment typically requires three or four initial sessions spaced four to six weeks apart, then maintenance every four to six months, he adds. While there’s evidence of PRP being effective for both men and women, one study evaluated hundreds of cases with female participants with FPHL and found that PRP showed “positive efficacy in treating FPHL in hair density compared to control groups.”
With results typically visible after three to six months of your last injection, I decided it was vital for me to start right away.
What Is Getting PRP For Hair Loss Actually Like?
I had my first PRP appointment on February 24, 2025, and nothing could have prepared me for what was in store for my scalp. I showed up to the doctor’s office 30 minutes early so the derm could draw a vial of blood. The “liquid gold” PRP serum is created using your own platelets, which is extracted from the blood as its spun in a centrifuge.
The next thing I knew, my derm—who I’m keeping anonymous for my own privacy—handed me a stress ball and began to shoot freezing cold air onto my scalp (to help numb) while injecting the serum repeatedly down my part. “You need to breathe,” he said, pausing halfway through the treatment. It’d been less than a minute, but my body was completely clenched. I wasn’t expecting the intense pain that now radiated across my head.
“You’re handling this like a champ,” the doctor said when he was finished two minutes later. He shared that he’d gotten PRP done himself and was screaming, even though he had opted for anesthetic. I was not offered anesthetic, but I highly recommend you ask for it if it’s available.
My scalp immediately following that first PRP treatment.
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I typically have a pretty high pain tolerance. As someone who has experienced periods that have sent me to the emergency room (multiple times, might I add) and had kidney stones in the past, I’d rank this pain a 9/10. It’s absolutely no joke. You need to be mentally prepared before entering the injection room.
With tears in my eyes, I tried to catch my breath as I went into the bathroom and saw splotches of red dotting my scalp. I considered cleaning it with paper towels, before thinking twice; in addition to not washing your hair for at least 24 hours, it’s recommended to not touch or disturb the area at all for the best results… which is how I ended up walking around New York City with dried patches of blood blotted in my hair. Surprisingly, no one noticed or commented on this, except my husband who eventually used a sanitized Q-tip to gently clean the remainder of the blood off my scalp. Ah, true love.
The healing process took almost a week. Sleeping for the first few nights was incredibly painful. I had to sleep without a pillow and make sure nothing was touching the top of my head. I was also told to avoid exercise for one to two days.
My second PRP appointment was even more nerve-wracking than the first. On March 26, 2025, I followed the same process. I showed up 30 minutes early, got my blood drawn, and waited for the serum to be prepared. I’m not sure if it’s because I knew how painful these injections were going to be this time around or if my scalp was more sensitive from all the treatments, but I swear this PRP session was 100 times worse than the first. I forgot to see if anesthetic was available for this appointment, which truly is my biggest regret. The healing process, however, seemed to be a bit quicker. My head didn’t hurt as badly that night and the pain was nearly gone two days later.
After two PRP treatments: progress!
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My last required PRP appointment was May 13, 2025, almost one year since I first noticed my hair thinning. “There’s less scalp already,” my derm said as he entered the room, noting the increased thickness in my hair. The injections took less than a minute, but they still hurt the same as they did the first time, once again sans anesthetic because at this point, why was I going to pay more for something I’ve already suffered through and lived? Aside from nearly tearing the stress ball in half, I had tears in my eyes and had to take several breaks to get through all of the shots.
My Final Thoughts on PRP
Aside from the pain of the injections, I didn’t notice any other side effects of PRP other than one or two ingrown hairs on my scalp. While I still have to wait three to six months to see the full effect of the treatment, I already have tons of baby hairs on my head and have had to invest in a very good hair wax to keep them tame.
While I’m still waiting to see what my final results will look like in a few months, I'm pretty encouraged by the growth I’ve seen so far. Not only am I getting great feedback from my friends and family. Best of all, I feel more confident when I take photos and, even more importantly, when I hang out with people in real life.
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