My hair is thinning in my twenties. What actually works to stop it?

Short answer: the best-proven, widely used treatments are topical minoxidil and (for people with male-pattern hair loss) oral finasteride. Other options that can help for some people are ketoconazole shampoo, low-level laser therapy, PRP injections, and hair transplant surgery. Which is right for you depends on the cause of thinning — so see a dermatologist to get a diagnosis and basic blood tests first.

What actually works (brief, evidence-based)

• Topical minoxidil (brand: Rogaine; generic: minoxidil 5% foam/solution, Kirkland is a cheaper option). Proven to slow hair loss and regrow hair for many people; must be used continuously. Expect 3–6 months to see results.
• Oral finasteride (brand: Propecia; generic finasteride). Very effective for androgenetic (male-pattern) hair loss in men. Prescription only. Works in months but must be continued. Has possible sexual side effects in a minority of users — discuss risks with a clinician.
• Ketoconazole shampoo (brand: Nizoral 1–2%). Not a primary treatment but can reduce scalp inflammation and may have mild anti-androgen effects; use as adjunct 2–3×/week.
• Low-level laser therapy (LLLT) devices (brand: HairMax). Some clinical evidence of modest benefit; convenient home devices exist.
• Platelet-rich plasma (PRP) injections at a qualified clinic/dermatologist. Growing evidence of benefit for some people; results vary and usually require multiple sessions.
• Hair transplant (FUE/FUT) — permanent restoration for people with stable hair loss and sufficient donor hair. Clinics: established practices like Bosley or reputable local FUE specialists/board-certified hair surgeons. This is a surgical option after medical treatments are optimized.

Things to check first (important)

• See a dermatologist (or a trichologist as adjunct). They’ll examine your pattern of loss and order tests if indicated: TSH, free T4, ferritin, CBC, vitamin D, possibly testosterone/androgens if female.
• Women: evaluate for conditions like polycystic ovary syndrome (PCOS) or iron deficiency. Treatments differ — finasteride is usually not appropriate for women of childbearing potential; spironolactone (Aldactone) is sometimes used off-label.

Practical next steps (recommended plan)

1. Book a dermatologist visit (in-person or tele-derm). Tele-medicine services that provide hair-loss care and prescriptions include Keeps, Hims (for men), and Roman — convenient for starting finasteride or minoxidil after a consultation. For women, many dermatologists will advise appropriate alternatives.
2. Get basic blood tests (TSH, ferritin, CBC, vitamin D; others if recommended).
3. Start topical minoxidil (Rogaine or generic) daily. Consider ketoconazole shampoo 1–2× weekly as an adjunct.
4. If you’re a man with androgenetic pattern thinning, discuss finasteride with the dermatologist. If you’re a woman, discuss spironolactone or other options if appropriate.
5. If you want additional options after medical therapy, ask about PRP or LLLT (HairMax), or consult a hair transplant surgeon when hair loss has stabilized.

Notes on expectations and safety

• Most medical treatments must be continued indefinitely; stopping them usually leads to return of prior hair loss.
• Minoxidil can cause early shedding before improvement, and some scalp irritation.
• Finasteride can cause sexual side effects in a small percentage of men and is contraindicated in pregnancy (women who can become pregnant should not handle crushed tablets and should not use it).
• Supplements (Nutrafol, Viviscal) have mixed but some supportive evidence for certain people, especially when deficiencies are present; they’re generally adjuncts rather than primary therapies.

If you want, tell me:

• Your sex, pattern of thinning, and whether you’ve tried anything already — I can suggest a tailored starting plan and what to ask your dermatologist.