Hair Loss Treatments Available in Canada: Finasteride, Minoxidil and What Works

Two treatments have serious evidence. The rest do not.

For androgenetic alopecia — the pattern hair loss that accounts for the overwhelming majority of cases in both men and women — Health Canada has authorized two treatments with substantial clinical evidence: oral finasteride and topical minoxidil. Everything else marketed for hair loss ranges from adjunctive to unsupported.

Finasteride

Finasteride inhibits 5-alpha reductase, reducing conversion of testosterone to dihydrotestosterone, the androgen that miniaturises susceptible follicles. It requires a prescription in Canada. Most men see stabilisation before regrowth, and the treatment is more reliable at preventing further loss than at recovering what is already gone — which is why starting earlier produces better outcomes.

Sexual side effects are the most discussed concern. They occur in a minority of users and typically resolve on discontinuation, but they are worth an explicit conversation with the prescribing clinician rather than a line in a questionnaire. Finasteride is contraindicated in women who are or may become pregnant.

Minoxidil

Topical minoxidil is available over the counter in Canada and works through a different mechanism, prolonging the growth phase of the hair cycle and increasing follicle size. It is effective for both men and women. Because the mechanisms differ, the two are frequently used together, and combination therapy generally outperforms either alone.

Timelines, honestly

Expect three to six months of consistent daily use before visible change, and up to twelve months for the fuller result. Increased shedding in the first weeks is common and is not evidence that treatment is failing — it reflects follicles cycling into a new growth phase. The most common reason treatment “doesn't work” is stopping at week eight.

What happens when you stop

This is maintenance therapy. Gains achieved on finasteride or minoxidil typically reverse within about twelve months of stopping, returning you roughly to the trajectory you would have been on. Anyone starting should plan for ongoing treatment rather than a course with an endpoint.

Why online clinics suit this well

Pattern hair loss is diagnosed visually and historically, which photographs handle adequately, and the treatment is a daily routine that benefits enormously from automatic refills. A missed month is a real setback. That combination — straightforward diagnosis, adherence-critical treatment — is why Canadian telehealth platforms have taken so much of this category.

When to see someone in person

Patchy or circular loss, loss with scalp inflammation or scarring, sudden diffuse shedding, or hair loss alongside other systemic symptoms all point away from androgenetic alopecia and need in-person assessment. Thyroid disease and iron deficiency are common reversible contributors, particularly in women.