2 years of topical treatments, zero results — what are my next options?

General Basic Questions
,
1

Hey everyone, sharing my journey and hoping for some inputs.

Background: Male, 31 years.

Timeline:

Sep 2023 – Jan 2025:
Topical minoxidil 5% (2x daily). Consistent use, zero results. Hair loss continued throughout.

Jan 2025 – present:
Switched to Hims topical spray (finasteride 0.3% / minoxidil 6%)

Aug 2025 – present:
Added tretinoin gel 0.025% to the routine to help with absorption

Still losing hair. No regrowth or stabilization at any point.

I’ve consulted multiple dermatologists at every stage - they all said it was AGA and recommended oral meds if topicals haven’t worked and then PRP/Keralase if oral min/fin don’t work.

Recent bloodwork:

Got a DHT blood test — came back at 9.4 ng/dL, which is on the lower end.

Considering moving to oral meds. Debating between:

- Oral minoxidil (1.25–2.5 mg)

- Oral finasteride (1 mg)

- Both

Has anyone made the switch from topical to oral with good results? Is the low DHT reading a sign that the topical fin is actually working systemically, and I should just stay the course?

2

If topicals haven’t worked, switching to oral fin or min is a reasonable next step. Oral min is potent for increasing blood flow to hair follicles, while oral fin further lowers systemic DHT levels. Taking both could give the best chance for regrowth. A low DHT level might mean the topical fin effects are systemic, but if there’s no visible improvement, trying oral may be worth it. Consider continuing treatment as AGA treatments can take time to show results.