MW For the first time in decades, new hair-loss treatments are in the works. Here's how they're different.

By Jaimy Lee

'Botox on steroids': Old hair-loss drugs are getting an upgrade, and new ones are on the way

People experiencing hair loss have had few treatment options.

People who are losing their hair face a frustrating struggle to stop or reverse it.

They can book a flight to Turkey for a hair transplant, spend hundreds of dollars on unproven remedies advertised online, or take one of only two medications that have actually been shown to work: minoxidil and finasteride.

"It's been decades since we've had a new treatment," said George Cotsarelis, chair of dermatology at the University of Pennsylvania Perelman School of Medicine in Philadelphia. "The suspense has been building and building, and now we have a few things that are either a variation on minoxidil or maybe something new, but they're still very, very early."

This includes work being done by companies like Veradermics $(MANE)$, Cosmo Pharmaceuticals (CH:COPN) and Pelage Pharmaceuticals, which are all studying different ways to treat male- and female-pattern hair loss. The experimental therapies, some of which have novel mechanisms of action, still must be proven to be safe and effective in clinical trials.

But physicians are eager for new treatments to offer their patients, who often show up at their offices upset to learn how few options there are for the most common form of hair loss, which affects 85% of men and 40% of women by age 50. Hair loss associated with COVID-19 infection and with the rapid weight loss resulting from GLP-1 drugs has further fueled patient demand for better treatments with fewer side effects.

Investors are paying close attention and are ready to back new approaches. "I've never had a raise go so fast," Pelage CEO Daniel Gil said about the $120 million in funding his company secured in October.

Veradermics, which is developing an oral extended-release version of minoxidil, went public earlier this month, and Cosmo's disclosure in early December of promising Phase 3 data for clascoterone prompted a rally for its stock, which has nearly doubled since then.

Will all of these new treatments or delivery systems work? The odds are against it, but the wave of innovation backed by investors is a signal that there is momentum behind new treatments for hair loss. It's a condition that can produce returns as patients flock to telehealth, as the stigma of seeking treatment for hair loss fades and as dermatologists emphasize treatment as crucial to a patient's emotional well-being.

Are more people losing their hair?

There are several forms of hair loss, the most common being androgenetic alopecia, or male- or female-pattern hair loss. For men, it's mostly caused by the body's hereditary response to the hormone dihydrotestosterone and can lead to balding. In women, it's also genetic and causes hair thinning primarily due to hormonal changes in menopause.

There are other types of hair loss, like the autoimmune condition alopecia areata, which is treated with JAK inhibitors, steroids or minoxidil.

It's unclear whether an increasing number of people are experiencing hair loss, although some researchers say lifestyle and dietary habits can bring on early onset androgenetic alopecia. COVID-19 can also cause temporary hair shedding during and after infection.

"We learned a lot about hair loss through [the pandemic], and then it highlighted how our body responds to inflammation," said Natasha Mesinkovska, a dermatologist at UCI Health in Irvine, Calif., who consults with several companies working on hair-loss treatments.

Then there are the GLP-1s like Eli Lilly's $(LLY)$ Zepbound or Novo Nordisk's (NVO) Wegovy, which can trigger temporary hair loss due to rapid weight loss in people who don't eat very much or very well while taking the medicines. In some cases, Mesinkovska encourages patients to slow down their weight loss by staying on a lower dose of the medicines.

"People are just losing huge amounts of weight, very, very fast," she said. "The people that have the most issues are the ones that lose 30 pounds in three months, which is a lot of them. I try to tell them to slow their roll, but it's tough."

There are two FDA-approved treatments for these patients - minoxidil and finasteride, both of which come in oral and topical forms. Minoxidil was initially approved for hypertension in 1979, and the company took it back to the FDA in the 1980s once it was clear it produced hair growth, and marketed it as Rogaine. Merck $(MRK)$ developed finasteride, which went by the brand name Propecia for hair loss after it was approved for men in 1997. Finasteride tends to work better in men than minoxidil.

Both drugs have to be taken chronically - if a patient stops taking them, the new hair will fall out within months - and the pills can have challenging side effects. The oral version of minoxidil can cause unwanted hair growth on the face and other areas of the body, while finasteride can dampen libido and lead to erectile dysfunction. It can also cause birth defects and isn't approved for women.

"People are giving it out like candy, and they're giving it out to children, teenagers and young women and older," Cotsarelis said. "I don't feel comfortable doing that, knowing that I'm just treating hair loss."

He's working on a process that administers minoxidil using microneedles on the scalp after early research in his lab showed that "wounding" can increase hair growth and sometimes form new hair follicles, similar to how fractional lasers are used to treat the skin.

"There's definite value in different types of minoxidil, delivering it differently, and thinking about how it might work better," Cotsarelis said. "How much value is a little hard to say."

Novel ways to treat hair loss

Cosmo and Veradermics both have important milestones this year. Cosmo has said it plans to submit clascoterone, a topical androgen receptor inhibitor, to the FDA for review this year once a safety study wraps up, and its stock is up 10% so far this year. Clascoterone was only tested in men, but Veradermics is working on a new form of minoxidil for both men and women, and it expects to have Phase 2/3 data this year. Its stock is up 16% since its market debut on Feb. 4.

'There's definite value in different types of minoxidil, delivering it differently, and thinking about how it might work better. How much value is a little hard to say.' George Cotsarelis, chair of dermatology, University of Pennsylvania Perelman School of Medicine

Pelage is planning to start Phase 3 studies this year for PP405, a topical "regenerative medicine approach" to hair loss that targets hair follicles stuck in the resting phase. The privately held startup was spun out of the University of California, Los Angeles, and is backed by investors like Google Ventures and ARCH Venture Partners. It is also being tested in both men and women.

"This is a real recognition that women to date really have been underserved by the current available drugs," said Gil, Pelage's CEO and a former executive at Allergan, the company behind Botox.

Even as the science around hair regrowth is evolving, the cultural and commercial changes may be what's driving investor interest. About 40 million people in the U.S. used minoxidil for hair loss in 2023, and hair-loss treatments aren't covered by health insurance in the U.S. But patients have demonstrated that they are willing to regularly spend hundreds of dollars on Botox and GLP-1s as well as on heavily marketed hair-loss products with no proven benefit. In its S-1 filing with the Securities and Exchange Commission, Veradermics said it's targeting a "cash-pay non-reimbursed product strategy."

"The GLP-1s have really mainstreamed aesthetics," Gil said. "I see this as Botox on steroids."

-Jaimy Lee

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February 25, 2026 15:36 ET (20:36 GMT)

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