What Is The Hairy Pill?

Patches of circular hair loss on the scalp of a man with alopecia areata

The Hairy Pill® is a personalized, customizable, subscription-based hair loss treatment. This patented treatment was developed by Dr. Rodney Sinclair, a professor at the University of Melbourne who is a well-known dermatologist. There are two main options – one for men and one for women – which use various oral medications and nutraceuticals to promote hair growth. This hair loss treatment is currently only sold in Australia.

What Ingredients Are in The Hairy Pill®?

If you’ve been on The Hairy Pill® website, you’ll likely notice that there’s a repeated mention of the Therapeutic Goods Administration of Australia’s regulations. While the website’s pages link to Dr. Sinclair’s related research and patents (some of which include long lists of ingredients), none of the pages mention any of The Hairy Pill® ingredients. (1-4) 

When contacted directly, the customer service team from The Hairy Pill® said that each version of The Hairy Pill® differs from patient to patient. The customized compound has about nine or 10 oral ingredients. These include:

  • Minoxidil 
  • An anti-androgen (finasteride or dutasteride for men and spironolactone for women)
  • Vitamins
  • Elements (also known as minerals)
  • Amino acids

What Are The Hairy Pill® Active Ingredients?

The main Hairy Pill® active ingredient is oral minoxidil. While topical minoxidil is FDA-approved as a pattern hair loss treatment for both men and women, oral minoxidil is only FDA-approved as a blood pressure reducer. (5,6)

When used off-label as a hair loss treatment, oral minoxidil is prescribed in lower doses. It can help treat multiple types of hair loss, including male and female androgenic alopecia, alopecia areata (an autoimmune form of hair loss), chemotherapy-induced alopecia, and stress-related hair loss. (5,6)

Hairy Pill® patients can choose to incorporate another active ingredient (the anti-androgenic component) or have it removed from their medication. The anti-androgenic ingredients block a hormone called dihydrotestosterone (DHT). DHT is the primary hormone involved in the progression of androgenic alopecia. (7) You should also know that the customer service team mentioned that other ingredients can be added or removed from The Hairy Pill® on a case-by-case basis. 

Are the Ingredients in The Hairy Pill® the Same as Those in the Patents?

The Hairy Pill® website currently references Dr. Sinclair’s research and patents. Their customer service team also mentioned that The Hairy Pill® is the same treatment prescribed to patients at Dr. Sinclair’s clinic. Since The Hairy Pill® is patented, it seemed likely that the pill’s ingredients would simply be listed in the patents.

But it turns out that this isn’t the case. The Hairy Pill® customer service team said that there are a number of active and inactive ingredients listed in the patents. And while the patents list alternative anti-androgens (like apalutamide and nilutamide) and nutraceutical ingredients (like caffeine and licorice), none of these ingredients are incorporated into The Hairy Pill®.

The Hairy Pill® for Men vs. The Hairy Pill® for Women

The Hairy Pill® options for men and women contain most of the same ingredients. The main difference is the type of anti-androgenic medication that is incorporated into your prescription. Anti-androgenic medications – often referred to as DHT blockers – can help stop the progression of pattern hair loss. DHT blockers are also used for the treatment of benign prostatic hyperplasia (BPH), in order to control excessive prostate growth in men. (7,8,14)

Men are usually prescribed finasteride or dutasteride. Finasteride is an FDA-approved male pattern hair loss treatment that works as a dihydrotestosterone (DHT) blocker. (7) Dutasteride is a stronger DHT blocker that’s also used as a male pattern hair loss treatment – but it’s only approved for that purpose in certain parts of Asia. (8) Both finasteride and dutasteride are used for the treatment of benign prostatic hyperplasia (BPH). (7,8,14)

Finasteride and dutasteride have been explored in a number of clinical trials with both male and female patients. Unfortunately, neither drug has been approved as a hair loss treatment for women. But the negative effects of androgenic hormones on hair follicles occur in women, too.

Rather than prescribe finasteride or dutasteride, The Hairy Pill® offers women spironolactone. This medication is FDA-approved for the treatment of cardiovascular disorders, as well as fluid build-up and swelling caused by kidney or liver issues. It’s also used off-label to treat acne and hirsutism (excessive hair growth in women). (9)

In recent years, studies have explored the use of spironolactone as an anti-androgen for women with androgenic alopecia. It’s been used as both a stand-alone hair loss treatment and in combination with other hair loss treatments, like minoxidil and laser hair therapy. And in general, it seems to be pretty effective. (10) Some studies have even reported that this drug is more effective than finasteride for women. (11)

Who Can Take The Hairy Pill®?

The Hairy Pill® can be taken by most men and women as long as they’re 18 or older. Since this medication is personalized, the only health-related restriction is that individuals can’t be pregnant, trying to get pregnant, or breastfeeding. The customizable nature of The Hairy Pill® means that people with other medical issues can also use this treatment. (1)

However, the biggest restriction on The Hairy Pill® is that it’s currently only available to people residing in Australia. If you’re an Australian living abroad, you’re likely out of luck too. The Hairy Pill® subscription requires medication to be shipped to you on a regular basis. So unless you’re traveling to Australia every few months and still have an Australian address, you probably won’t be able to use this treatment.

If you are living in Australia but have decided that The Hairy Pill® isn’t for you, you might still want to reach out to Dr. Sinclair’s clinic. They often run clinical trials and are currently recruiting men with pattern hair loss for Dermaliq’s DLQ01 study

The Hairy Pill® Side Effects

All hair loss drugs come with potential side effects. However, the side effects of The Hairy Pill® may have the potential to be reduced compared to the average standard medication. This is because their medical team says that they can customize the active ingredients and their doses for each patient. They may even offer the option of lower starting doses, increasing the doses over time. Additionally, it seems the team can leave out certain ingredients upon request if you’d prefer to avoid a certain product in your medication. 

Will I Experience Hairy Pill® Side Effects?

According to The Hairy Pill®  website, “less than 2% of patients” experience side effects”. The main side effect they mention in their order form is postural hypotension – which is essentially the feeling of lightheadedness and dizziness. (1) 

Their FAQ page also states that side effects like excessive hair growth (formally known as hypertrichosis) are an issue that the “vast majority (approx. 95%) of people will not experience”. (12) Both postural hypotension and hypertrichosis are side effects associated with oral minoxidil. Other side effects associated with low doses of oral minoxidil include (5,6):

  • Minoxidil shedding, a temporary period of hair shedding that occurs when you first start a hair loss treatment
  • A slight increase in heart rate
  • Fluid retention that can result in swelling of the lower legs, ankles, and feet

If you have spironolactone in your version of The Hairy Pill®, you may also be more likely to experience lightheadedness and dizziness. This is the most commonly reported side effect associated with the oral version of this medication. More rarely, people have reported experiencing low blood pressure, hyperkalemia (a build-up of potassium in the blood), and skin rashes or hives. (10) 

If you have finasteride or dutasteride in your version of The Hairy Pill®, you may experience a much wider range of side effects. When using dutasteride for hair loss, side effects are rare, but can include (8,14):

  • Decreased libido
  • Indigestion
  • Fatigue
  • Breast tissue growth
  • Impotence, ejaculation issues, and other problems related to sexual dysfunction

Side effects associated with finasteride include depression, dizziness, weakness, low blood pressure, shortness of breath, and breast tissue growth. Sexual dysfunction issues may also occur to finasteride users, which include but are not limited to issues like erectile dysfunction (5-19% of patients) ejaculatory dysfunction (1-7%), reduced sex drive (2-10%), and fertility issues, like decreased sperm count. (7,13,14) 

Finasteride’s side effects are considered to be dose-dependent. When taken in the 1-milligram daily doses that are generally prescribed for hair loss, these side effects are considered to be rare. People taking higher doses of finasteride (typically when it is prescribed for prostate issues) are more likely to experience side effects. However, in both cases – as well as for dutasteride users – it is possible that these side effects may persist after the medication is discontinued. (7,13,14) 

Although uncommon, psychological side effects including suicidal ideation, depression, and anxiety may also occur after finasteride is used. The exact rates of occurrence and reason this occurs is unknown, but it appears that younger men are more at risk. Further investigation is needed to understand this phenomenon, which is known as post-finasteride syndrome. (15) 

If you’re suddenly feeling a bit put off by this laundry list of side effects, you’re not alone. Many people stay away from finasteride and dutasteride for this reason. And topical versions of these products – which are less likely to cause these side effects – are becoming increasingly popular. Unfortunately, The Hairy Pill® is just an oral hair loss treatment. Subscribing to this service doesn’t seem to offer use of topical alternatives, like a finasteride lotion or dutasteride serum.

Remember that doses of The Hairy Pill® active ingredients can change from person to person, so it’s not possible to say how likely these side effects are. Your doctor will probably start you on a low dose to reduce the risk of side effects, especially if you’ve never taken an anti-androgenic drug before. If you’re particularly concerned about a particular side effect, just ask your doctor to remove that ingredient from your medication. 

How Does The Hairy Pill® Work?

The Hairy Pill® is a subscription-based hair loss treatment service that requires you to talk to both a doctor and pharmacist before you start taking the medication. According to The Hairy Pill® website (1), subscribing requires the following five-step process:

  1. You respond to a short online questionnaire on their website.
  2. The doctor writes a prescription based on the responses to your questions. If necessary, they’ll also talk to you about any allergies and pre-existing health conditions you have. They may also customize your medication based on any desires you have or medications you’re currently taking.
  3. The pharmacist sets up a call to talk you through your medication and prepares your treatment.
  4. Your treatment is shipped to you via express post.
  5. You have the option to talk to the doctor every 3 months to discuss results and side effects and modify your hair treatment medication as needed. 

According to The Hairy Pill® website, the price for this service – inclusive of doctor consults – is  $75 AUD per month. However, when you sign up, you’ll be asked to pay for the first 3 months upfront. 

How Long Does The Hairy Pill® Take To Work?

According to The Hairy Pill® website, their hair loss treatment usually takes 3 to 6 months to work. This length of time is the same as the vast majority of hair loss treatments. In general, people start to see hair loss treatments start to work after about 3 months, and their results continue to improve between months 3 and 6. (1)

The 3-month delay in response time is due to the hair growth cycle. Essentially, hair loss treatments can immediately start to influence your hair follicles, but it takes time for those follicles to produce healthier hairs and new hair strands. 

The only exception to this general rule is if you’ve already been using a hair loss treatment. If you’re switching from one product to another, you may see results much faster. But if it’s your first time trying a treatment, whether you’re using FDA-approved topical minoxidil, oral finasteride, or The Hairy Pill®, you’ll likely need to wait at least 3 months to see results. 

Does The Hairy Pill® Really Work?

The Hairy Pill® reviews and testimonials imply that this hair loss treatment works well. However, it’s hard to say how well it works – or the percentage of people it works for – because there have been no studies published on The Hairy Pill®. 

This would usually be a red flag when it comes to many medications. But this isn’t particularly surprising in this case. Personalized medications and treatment plans aren’t the sort of thing that would usually be studied in clinical trials – though they could be reported in case studies. 

Dr. Sinclair, the creator of The Hairy Pill®, has published hundreds of papers related to hair loss. A number of these studies focus on the active ingredients incorporated into The Hairy Pill®  and in several cases, some of the individual ingredients were even assessed in clinical trials. 

Many studies have shown that oral minoxidil, spironolactone, finasteride, and dutasteride can improve hair regrowth – though their side effect profiles vary. (5-11) The Hairy Pill® prescribes combinations of these active ingredients, which can be a convenient, customizable option. Whether this combination pill is the most effective, affordable, or safe hair loss treatment for you is hard to say. A discussion with your physician can help point you toward the right hair loss solution for your needs.

References

  1. The Hairy PIll. (2022, December 21). The Hairy Pill® | Hair Loss Treatment – One Pill. One Solution. The Hairy Pill®.
  2. The Hairy PIll. (2022, December 21). Professor Rodney Sinclair. The Hairy Pill®.
  3. Google Scholar Search: “Professor Rodney Sinclair” “Hair Loss.” (n.d.). Google Scholar. Retrieved December 21, 2022
  4. Google Patents Search: “Rodney Sinclair Hair Loss” “Hair Loss” “Inventor: Rodney Sinclair” (n.d.). Google Scholar. Retrieved December 21, 2022
  5. ​​Villani, A., Fabbrocini, G., Ocampo‐Candiani, J., Ruggiero, A., & Ocampo‐Garza, S. S. (2021). Review of oral minoxidil as treatment of hair disorders: in search of the perfect dose. Journal of the European Academy of Dermatology and Venereology, 35(7), 1485-1492.
  6. Randolph, M., & Tosti, A. (2021). Oral minoxidil treatment for hair loss: A review of efficacy and safety. Journal of the American Academy of Dermatology, 84(3), 737-746.
  7. Zito, P. M., Bistas, K. G., & Syed, K. (2020). Finasteride. StatPearls [Internet].
  8. Choi, G. S., Kim, J. H., Oh, S. Y., Park, J. M., Hong, J. S., Lee, Y. S., & Lee, W. S. (2016). Safety and Tolerability of the Dual 5-Alpha Reductase Inhibitor Dutasteride in the Treatment of Androgenetic Alopecia. Annals of dermatology, 28(4), 444–450.
  9. Patibandla, S., Heaton, J., & Kyaw, H. (2021). Spironolactone. In StatPearls [Internet]. StatPearls Publishing.
  10. James, J. F., Jamerson, T. A., & Aguh, C. (2021). Efficacy and Safety Profile of Oral Spironolactone Use for Androgenic Alopecia—A Systematic Review. Journal of the American Academy of Dermatology.
  11. Ahmed, S. A., Ayman, E. Y., & Mousa, A. (2020). Topical Finasteride versus Topical Spironolactone in the Treatment of Androgenetic Alopecia. The Medical Journal of Cairo University, 88(June), 1017-1022.
  12. https://www.thehairypill.com.au/faqs/hair-loss-treatment/side-effects/
  13. Mysore V. (2012). Finasteride and sexual side effects. Indian dermatology online journal, 3(1), 62–65
  14. Nestor, M. S., Ablon, G., Gade, A., Han, H., & Fischer, D. L. (2021). Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of Cosmetic Dermatology, 20(12), 3759-3781.
  15. Nguyen DD, Marchese M, Cone EB, Paciotti M, Basaria S, Bhojani N, Trinh QD. Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride. JAMA Dermatol. 2021 Jan 1;157(1):35-42. doi: 10.1001/jamadermatol.2020.3385. PMID: 33175100; PMCID: PMC7658800.
Published on May 30, 2023

Last updated May 2023

Latest articles