20 years old, doctor prescribed Minoxidil and Propecia for hair loss, afraid of side effects, would PRP injections be better?

Thank you for your question. You state you are 20-years-old, and saw a doctor about your hair loss. Your doctor prescribed you finasteride and minoxidil, but you’re scared of side effects, so you are asking if PRP injections would be better.
I can certainly give you some guidance about this. I’m a Board Certified Cosmetic Surgeon and Fellowship-trained Oculoplastic Surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. I’ve been performing hair transplants since I started my practice, and have been prescribing finasteride to male pattern hair loss patients since 1997. I’m also the founder of TrichoStem Hair Regeneration Centers, based on a system we developed that uses extracellular matrix and PRP for non-surgical treatment of pattern hair loss for men and women. We have patients from around the world who come to see us for this treatment.
If you have already seen a doctor who prescribed you finasteride and minoxidil, then the doctor confirmed you have have male pattern hair loss. Male pattern hair loss is largely due to scalp sensitivity of the hormone dihydrotestosterone, or DHT. If you have pattern hair loss as young as 20, then you have very high DHT-sensitivity in your scalp. Having high scalp DHT-sensitivity means your scalp hair will thin very rapidly, so your doctor prescribed you finasteride as it’s a DHT-blocker. You will need to take finasteride to block DHT as PRP or minoxidil will not block DHT-formation. Taking finasteride to block DHT will slow your hair thinning.
You are concerned about the side effects of finasteride, but the chances of side effects are very low at about 2%. Side effects from finasteride as generally rare, as many men around the world are taking the drug to treat pattern hair loss.
Minoxidil is not as effective as finasteride as it does not treat DHT, nor does it treat thinning hair. Minoxidil appears to extend the hair growth cycle, and delays the hair shedding cycle so you have more on your head. However, if you stop using minoxidil daily, these effects will disappear, and you will have a sudden shed. The effects of minoxidil can also diminish with time, even if you use it daily.
PRP alone for hair loss does not block DHT, nor will it treat hair loss long-term. PRP is limited to stimulating short-term hair growth, and it will take several treatments to get to this point. Many people are frustrated with PRP alone as even after multiple treatments, they don’t see a difference in hair coverage. Injection treatments of PRP alone are indefinite, and they will not treat the genetic causes of pattern hair loss. I find PRP alone to have the same effect along the lines of minoxidil.
In our practice, for someone young like yourself with early onset of male pattern hair loss and high DHT-sensitivity, I would treat with a combination of finasteride and the Hair Regeneration treatment. Finasteride would block DHT-formation, and the Hair Regeneration treatment would be used to stimulate hair growth, thicken thinning hair, and renew hair growth from dormant hair follicles. Hair Regeneration uses PRP, but its main ingredient is extracellular matrix by ACell, using PRP as the activator. This treatment appears to renew a healthy hair growth cycle, so thinning hair sheds, and grows back thicker. It also stimulates hair growth from follicles that are still viable, but have not been growing. Hair Regeneration is also administered far less often than PRP. We’ve had older patients with later onset of pattern hair loss and less DHT-sensitivity who had one treatment session last over 5 years without taking finasteride. However, for younger man with high DHT-sensitivity, finasteride would be a definite part of the treatment plan, and one injection treatment may last 1-3 years, and second booster treatment within that time would be included with treatment. Hair Regeneration patients can either stop minoxidil, or be weaned off minoxidil to prevent sudden hair shedding.
I suggest you consider finasteride if you want to treat hair loss as DHT-sensitivity is a problem for you. Additional treatments like Hair Regeneration can thicken thinning hair and increase hair density, but this effect cannot be achieved with PRP injections alone, and the longevity of these effects are much shorter if you don’t take finasteride as well. Research similar treatments, as well as what people are saying about PRP alone for hair loss treatment,  as well as the rarity of side effects of finasteride before dismissing the need for the drug. I hope you found this information helpful. Thank you for your question.