Hair loss can cause significant psychological stress and isn’t limited to the scalp, with some individuals experiencing thinning or loss of eyebrows and eyelashes. Identifying the underlying cause of hair loss is crucial for individualized, patient-specific treatment. Hair growth is a complex biological process. Each hair follicle is influenced by various hormonal, biochemical, and genetic factors as well as extrinsic factors, like stress. An individualized hair loss treatment plan might combine a variety of approaches, such as: 

• Stimulating follicular stem cells: Reactivating dormant hair follicles produces new hairs.
• Opening ion channels in cells: This can promote potassium ion influx into cells, which can help shorten the dormant phase and prolong the growth phase of hairs.
• Suppressing DHT (dihydrotestosterone): Reducing DHT’s effect on follicles is critical for treating androgenetic alopecia. 
• Providing antioxidant effects: Oxidative stress can damage hair follicles, and antioxidants can create a more favorable environment for hair growth.
• Extending the anagen (growth) phase: Several treatments keep hairs in the active growth phase longer, allowing them to grow thicker and longer before shedding.
• Increasing scalp circulation and growth factors: Enhancing blood flow improves oxygen and nutrient delivery to hair roots. 
• Blocking chronic inflammation: Inflammatory signals around hair follicles contribute to hair thinning, such as in androgenetic alopecia. Anti-inflammatory agents can promote a healthier scalp environment.

Patient-Specific Compounded Treatments for Hair Loss

Any single commercially available product is unlikely to address more than one of the factors above. For instance, minoxidil mainly improves blood flow and prolongs the growth phase of hair follicles, but it doesn’t suppress DHT, while finasteride lowers DHT but doesn’t directly stimulate follicles or help reduce inflammation. An individualized approach may be necessary to simultaneously address the multiple contributing factors to hair loss.

However, such customization isn’t available from one-size-fits-all commercial products. Compounding allows providers to prescribe a variety of APIs in a single formulation to create a treatment that addresses the unique combination of factors contributing to an individual’s hair loss. We work closely with prescribers to develop custom formulations to meet the specific needs of individual patients. Some of the ingredients we offer in compounded hair loss formulations include:

• Minoxidil (Topical or Oral): Minoxidil increases blood flow to the scalp and prolongs the anagen phase of hair follicles, thereby slowing hair loss and encouraging new growth in both men and women.¹ Compounded minoxidil can be made in higher strengths than the standard 5% if this strength isn’t providing desired results. For patients who cannot tolerate topical application, low-dose oral minoxidil can be used off-label.
  
  
• Finasteride: Finasteride blocks the conversion of testosterone to DHT. While often taken as a 1 mg daily oral tablet, it can be compounded into a topical formulation to deliver the drug directly to scalp follicles with minimal systemic absorption.² We can also combine finasteride with minoxidil and other ingredients in a single topical solution to treat hair loss.
  
  
• (New!) Dutasteride: Dutasteride is more potent than finasteride, resulting in over 90% suppression of DHT. Because dutasteride has a longer half-life and stronger DHT suppression, oral use can sometimes cause stronger side effects, such as lower libido. We offer topical sprays and drops of dutasteride 0.05%, which can help localize its effect to the scalp and reduce systemic absorption.
  
  
• Estradiol and Progesterone: In women, hormone fluctuations and declines, such as postpartum drop in estrogen or post-menopausal hormone changes, can cause hair thinning.³ Topical estradiol can help counteract androgens in the scalp and has shown some efficacy in slowing hair loss in women. We compound low-dose estradiol (or progesterone) scalp solutions to supplement female patients’ hormonal support, especially if lab tests show low levels that might be contributing to hair loss.
  
  
• Tretinoin: Tretinoin (retinoic acid) can increase minoxidil’s absorption and efficacy.⁷ A low concentration of tretinoin may be compounded with minoxidil to help convert minoxidil to its active form in the scalp, which can enhance minoxidil’s effects.⁸
  
  
• Topical Corticosteroids: Given the role of inflammation in many hair loss conditions, a mild corticosteroid such as fluocinolone acetonide can reduce scalp inflammation and irritation. Fluocinolone cream can be used for alopecia areata to help regrow hair in affected areas by calming the scalp.⁹ As with other steroids, it should be used for short periods. Other options include Hydrocortisone and Betamethasone.
  
  
• Bimatoprost: Bimatoprost is the active ingredient in Latisse®, the treatment for growing longer, fuller eyelashes. In compounded form, bimatoprost 0.03% can be added to hair loss formulas to promote dormant hair follicles into the growth phase. We offer compounded bimatoprost for treating scalp alopecia in patients who aren’t responding to first-line treatments.
  
  
• Biotin: A compounded formulation may also include vitamins or botanical extracts to support hair health, such as biotin (vitamin B7). While severe biotin deficiency is rare and not a common cause of hair loss, ensuring adequate biotin may improve hair quality in patients experiencing hair loss due to other factors.¹⁰
  
  
• Saw Palmetto: Saw palmetto is a botanical 5-alpha-reductase inhibitor that may act as a natural DHT-blocker to improve hair density in men with mild to moderate hair loss.¹¹
  
  
• Peptide Blends: We have developed a proprietary biopeptide blend that contains copper tripeptide GHK-Cu, which has been shown to increase hair follicle size and prolong the growth phase of hair to help reverse hair thinning.¹² Our blend also includes peptides like palmitoyl tetrapeptide-20, which may help prevent premature graying of hair.¹³
  
  
• (New!) Cetirizine: When applied topically at a 1% concentration, cetirizine modulates inflammatory prostaglandins in the scalp to promote hair growth.⁴ Clinical studies have demonstrated that daily use of topical 1% cetirizine can significantly increase hair density in as little as 3–6 months,⁵ making it a useful addition to a formulation that includes finasteride or minoxidil.⁶ Cetirizine can be incorporated into our topical hair loss formulas as an anti-inflammatory agent to enhance overall results in both men and women. The photos below show the results of compounded formulations containing cetirizine 1% in both male and female patients. 

Male patient, age 53, struggled with age-related hair loss. The compounded solution used included Minoxidil 10%/Cetirizine 1%/Finasteride 0.1%.

Female patient, age 42, with a bald spot. The compounded solution used included Minoxidil 10%/Cetirizine 1%/Estradiol 0.025%/Fluocinolone 0.025%.

Propylene Glycol-Free Formulations to Improve the Patient Experience 

Commercial topical products and many compounds containing topical minoxidil, often contain propylene glycol as a solvent or penetration enhancer, which can irritate patients’ scalps and cause redness, itching, flaking, or dryness.¹⁴ Compounding a stable propylene glycol-free hair solution requires specialized knowledge of alternative solvents and formulation techniques to maintain solubility and formulation stability to prevent residue buildup. We use vehicles to avoid propylene glycol entirely, while still delivering active ingredients to the scalp. 

Pioneers in Hair Loss Compounding Since 2011

VLS Pharmacy & New Drug Loft began dermatological compounding with a focus on hair loss treatments in 2011. Since then, we have been pioneers in the field of compounded hair loss medications and have developed many formulas to address alopecia. Over a decade of refining formulations and protocols and listening to physician and patient feedback results in unmatched expertise in formulating hair loss solutions. 

Our long history in this area means we have collaborated closely with various prescribers, from dermatologists to hair restoration specialists. Whether it’s optimizing a formula for a specific patient, or reformulating a medication for someone who can’t tolerate its commercial form, we can work with you to develop compounded formulations tailored to address the specific needs of individual patients.

Partner with VLS Pharmacy & New Drug Loft

As licensed 503A compounding pharmacies, we follow stringent quality standards for all preparations. We source high-quality, pharmaceutical-grade APIs directly from PCCA (the leader of superior-quality APIs) to ensure purity and consistency. This means our formulations are reliable. All medications are prepared in our state-of-the-art facilities by compounding pharmacists and technicians who understand the science behind hair growth. 

Choosing VLS Pharmacy & New Drug Loft means partnering with a team that is passionate about hair restoration and has a proven track record of success.

 

As part of our efforts to ensure patient satisfaction, we compound all of our formulations using high-quality pharmaceutical-grade APIs sourced directly from PCCA, the leader of superior-quality APIs. Our pharmacists and technicians tailor each formulation to meet a patient’s specific needs, including the dose and administration route. As a 503A pharmacy specializing in sterile and non-sterile compounding, we will support you and your patients by creating individualized and effective pharmaceutical therapies. 

Please comment below with any thoughts or questions.

Reach out to our team to learn about best practices and to partner with our experts on custom compounded medications for your patients. All medications from VLS Pharmacy and New Drug Loft are prepared in a lab that follows quality standards per our status as a 503A pharmacy.

 

References

1. Goren A, Naccarato T. Minoxidil in the treatment of androgenetic alopecia. Dermatol Ther. 2018;31(5):e12686. doi:10.1111/dth.12686
2. Lee SW, Juhasz M, Mobasher P, Ekelem C, Mesinkovska NA. A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women. J Drugs Dermatol JDD. 2018;17(4):457-463.
3. Grymowicz M, Rudnicka E, Podfigurna A, et al. Hormonal Effects on Hair Follicles. Int J Mol Sci. 2020;21(15):5342. doi:10.3390/ijms21155342
4. Hossein Mostafa D, Samadi A, Niknam S, Nasrollahi SA, Guishard A, Firooz A. Efficacy of Cetirizine 1% Versus Minoxidil 5% Topical Solution in the Treatment of Male Alopecia: A Randomized, Single-blind Controlled Study. J Pharm Pharm Sci Publ Can Soc Pharm Sci Soc Can Sci Pharm. 2021;24:191-199. doi:10.18433/jpps31456
5. Hossein Mostafa D, Samadi A, Niknam S, Nasrollahi SA, Guishard A, Firooz A. Efficacy of Cetirizine 1% Versus Minoxidil 5% Topical Solution in the Treatment of Male Alopecia: A Randomized, Single-blind Controlled Study. J Pharm Pharm Sci Publ Can Soc Pharm Sci Soc Can Sci Pharm. 2021;24:191-199. doi:10.18433/jpps31456
6. Alavi SMK, Layegh P, Vahabi-Amlashi S, Sabeti V, Forouzanfar M, Darchini-Maragheh E. Therapeutic effects of topical cetirizine in the treatment of female pattern hair loss: a randomized controlled noninferiority trial. Expert Rev Clin Pharmacol. 2023;16(10):1009-1015. doi:10.1080/17512433.2023.2243813
7. Kwon OS, Pyo HK, Oh YJ, et al. Promotive Effect of Minoxidil Combined with All-trans Retinoic Acid (tretinoin) on Human Hair Growth in Vitro. J Korean Med Sci. 2007;22(2):283-289. doi:10.3346/jkms.2007.22.2.283
8. Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes – Sharma – 2019 – Dermatologic Therapy – Wiley Online Library. Accessed November 3, 2025. https://onlinelibrary.wiley.com/doi/10.1111/dth.12915
9. Assay of 0.2 % Fluocinolone Acetonide Cream for Alopecia Areata and Totalis | Dermatology | Karger Publishers. Accessed October 29, 2025. https://karger.com/drm/article-abstract/141/3/193/343408/Assay-of-0-2-Fluocinolone-Acetonide-Cream-for?redirectedFrom=fulltext
10. Patel DP, Swink SM, Castelo-Soccio L. A Review of the Use of Biotin for Hair Loss. Skin Appendage Disord. 2017;3(3):166-169. doi:10.1159/000462981
11. Evron E, Juhasz M, Babadjouni A, Mesinkovska NA. Natural Hair Supplement: Friend or Foe? Saw Palmetto, a Systematic Review in Alopecia. Skin Appendage Disord. 2020;6(6):329-337. doi:10.1159/000509905
12. Pickart L. The human tri-peptide GHK and tissue remodeling. J Biomater Sci Polym Ed. 2008;19(8):969-988. doi:10.1163/156856208784909435
13. Almeida Scalvino S, Chapelle A, Hajem N, et al. Efficacy of an agonist of α-MSH, the palmitoyl tetrapeptide-20, in hair pigmentation. Int J Cosmet Sci. 2018;40(5):516-524. doi:10.1111/ics.12494
14. Singh S, Patil A, Kianfar N, et al. Does topical minoxidil at concentrations higher than 5% provide additional clinical benefit? Clin Exp Dermatol. 2022;47(11):1951-1955. doi:10.1111/ced.15338
    
    
    
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