HAIR
Understanding female-pattern thinning
Female-pattern hair loss usually shows as a widening part and thinning over the crown, often with the front hairline kept. Genetics and androgen activity play a role. Options support growth (minoxidil), reduce androgen effects (spironolactone), or combine approaches.
If pregnancy is possible. Spironolactone, finasteride and dutasteride can affect a male fetus and are avoided if pregnancy is possible. Oral minoxidil and topical tretinoin are also usually avoided during pregnancy, and hormone-containing formulas need a clinician conversation first. Tell your clinician about any pregnancy plans.
Topical vs oral hair treatment
| Topical | Oral |
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| How it's used | Applied to the scalp, usually daily | Taken by mouth, usually daily |
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| Whole-body exposure | Lower, though some is absorbed | Higher |
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| Evidence context | In a 2024 trial in men, 5% topical minoxidil improved hair density at 24 weeks | In the same trial, 5 mg oral minoxidil also improved density and was not superior to topical |
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| Common tradeoffs | Scalp irritation, residue, daily application | Unwanted body or facial hair with oral minoxidil; less often lightheadedness or fluid retention |
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| Who may prefer it | People who want to limit whole-body effects | People who find daily application hard to keep up |
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| Price at Avono | From $75 per month | From $59 per month |
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Compare your options
Topical or oral minoxidil? Topical minoxidil is FDA-approved over the counter for female-pattern hair loss. Low-dose oral minoxidil is used off-label; its most common side effect is unwanted facial or body hair (about 15% in a large safety study).
Why spironolactone? Spironolactone is an antiandrogen: it reduces the effect of androgens on hair follicles. A 2023 review found improvement in roughly 57% of patients studied, though studies varied widely. Its hair-loss use is off-label.
What about DHT blockers? Finasteride and dutasteride are mainly used by men. They can affect a male fetus, so they are not used by anyone who is or may become pregnant.
Hormone-containing formulas. Women’s Scalp Solution contains estradiol (an estrogen), progesterone and liothyronine (thyroid hormone). Evidence for these ingredients in topical hair treatment is limited, so discuss your history with your clinician.
What each ingredient is. Minoxidil: vasodilator. Spironolactone: antiandrogen. Tretinoin: retinoid. Fluocinolone: corticosteroid. Estradiol and progesterone: hormones. Liothyronine: thyroid hormone. Biotin: vitamin.
Sources: Penha 2024 (JAMA Dermatol); Vano-Galvan 2021 (JAAD); Spironolactone review (Cureus 2023); Propecia label.
For men & womenTopical
Hair Force One
Active ingredients: Vitamin C + Zinc + Biotin + Iron + Niacinamide + Methylcobalamin
A topical vitamin-and-mineral formula that does not contain minoxidil, finasteride, dutasteride or spironolactone.
Why choose it
For someone who specifically wants a topical, nutrient-focused formula and wants to avoid the main prescription hair-loss drug mechanisms.
$75 per month
No membership fee · No clinician fee · Free shipping
For womenTopical
Women's Scalp Solution
Active ingredients: Azelaic acid + Estradiol + Progesterone + Liothyronine
A highly customized topical containing azelaic acid plus three hormones: estradiol, progesterone and liothyronine (T3).
Why choose it
This is a clinician-guided hormone-containing topical for women. It is meaningfully different from standard minoxidil or spironolactone treatment.
$75 per month
No membership fee · No clinician fee · Free shipping
For men & womenTopical
Hair Revive
Active ingredients: Minoxidil + Tretinoin + Fluocinolone + Biotin + Vitamin E
A minoxidil-based topical with tretinoin, fluocinolone, biotin and vitamin E, but no finasteride or dutasteride.
Why choose it
For someone who wants a multi-ingredient topical built around minoxidil while avoiding DHT-blocking medications.
$85 per month
No membership fee · No clinician fee · Free shipping
For womenOral
Willow Oral
Active ingredients: Minoxidil + Spironolactone + Biotin
A women's oral combination of minoxidil + spironolactone + biotin.
Why choose it
For women who prefer an oral treatment and want both a hair-growth medication and an anti-androgen in one formula.
$79 per month
No membership fee · No clinician fee · Free shipping
For men & womenTablet
Minoxidil Tablet
Active ingredients: Minoxidil
A single-ingredient oral hair-loss option that avoids scalp application.
Why choose it
For people who want minoxidil but prefer a pill over a topical product.
$59 per month
No membership fee · No clinician fee · Free shipping
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