As a first step, it's important for you to read through this treatment plan. It provides valuable information on how to take the medication, potential side effects, and who should avoid it.

Now this is the initial step in your journey to tackle your hair loss, and we are going to support you through the whole process of what should be a 12 month journey. Any worries, concerns, questions just message us – we are here for you.

Is it possible to treat hair loss?

You know that old saying, "There's nothing you can do about it"? Well, when it comes to hair loss, science and medicine beg to differ! It turns out, about 90% of men with male pattern baldness have options for treatment. Here's what these treatments can do for you:

1. Slow down your hair loss significantly.
2. Put a stop to the hair loss and help you keep what you've got.
3. Even bring back some of that lost hair and prevent further loss.

So, there's hope yet! Let's tackle this together.

How does the All-in-One Spray work?

This triple combination product is loaded with hair loss-protecting goodness! Central to the leading cause of male pattern baldness is the activity of the hormone Dihydrotestosterone (DHT) at the hair follicular site. This treatment plan includes our unique topical finasteride, which works to suppress the activity of the enzyme 5-alpha reductase (5AR) at the scalp level. This in turn lowers hair loss and shredding and also promotes hair growth. By avoiding the oral tablet route it’s formulated specifically to minimise ‘widespread’ side effects. Hence is a really attractive solution (no pun intended!) for those wishing to pursue long-term treatment without having to maintain a daily pill-taking regimen. Its use results in less hair follicle ‘destruction’, which slows down and in some cases reverses hair loss. This is double whammied by the use of our maximum strength topical minoxidil; a powerful hair growth stimulant which works by increasing blood flow to your scalp, nicely nourishing and boosting hair follicles into their ‘ripe’ growth phase. Lastly, we have included topical azelaic acid a natural ingredient, perfectly designed to exfoliate the scalp; improving the skin quality and maximise the delivery of topical minoxidil to target where it works best. It has also been demonstrated to exert a similar inhibitory effect on that pesky 5AR enzyme, working in alliance with finasteride in reducing hair loss. This triple combined topical treatment is a full treatment plan for men wishing to pursue an ‘all in one’ product which will deliver local treatment avoiding the need to worry about taking tablets or using separate treatment products. We are offering you a specially formulated preparation, which our clinical team believes will be the most effective way to treat your hair loss. As such, it is classed as an unlicensed special treatment. This means it’s a specific medication which is made to serve a specific patient need. This is produced by our licensed manufacturer that specialises in the development and manufacture of such bespoke specials. If you have any questions you can contact our clinicians via your patient account messaging facility.

Will the All-in-One Spray work for me?

The amount of hair regrowth varies among men, and consistent use of the prescribed treatment directly to the scalp is crucial for optimal results. This tailored hair kit combines powerful triple therapy to effectively reduce hair loss. Oral finasteride has shown efficacy in about 90% of men with mild to moderate male pattern baldness, and studies suggest that topical finasteride may offer similar benefits, potentially with fewer side effects. However, the effectiveness of finasteride for receding hairlines at the temples or extensive hair loss remains unclear, although it may still help prevent further recession on the scalp.

Topical minoxidil is effective in approximately 60% of users, helping to stabilise hair loss and promote regrowth. The combination of 10% topical minoxidil and 5% azelaic acid works synergistically, providing a robust treatment option. With the increased strength of the 10% spray, only once-daily application is needed for optimal results. Together, topical minoxidil, azelaic acid, and finasteride work independently to deliver an enhanced approach to hair loss treatment.

How to use the All-in-One Spray?

It is important to use the spray regularly and as directed to ensure optimal results.

The treatment solution should be applied as follows:

1. Wash your hands before and after applying the solution.

2. Apply the solution to dry/towel-dried hair and scalp. Part the hair to allow delivery onto the scalp zones most impacted with baldness.

3. Apply 1 ml (7 sprays) of the solution ONCE daily to the most problematic ‘balding’ scalp areas, you can do this at a time which best suits you.

Tips: We suggest applying it a night so that you can sleep whilst it works its magic and not worry about it impacting your hair styling regime. Also remember, you are treating the scalp and not the hair.

4. Using more than 1 ml for each application, or more than once a day will not enhance results and will mean you will lose product unnecessarily

Extra tips:

• Allow the solution to dry for at least 20 mins before applying any hair styling products, or going to bed.
• If you forget to apply, no stress, just apply when the next dose is due. No need to double up.
• If you find it too oily, ensure you use it on clean hair and you can also gently use a hairdryer

Results will come to those who wait!

How soon can I expect results?

The sooner you start treatment after noticing hair loss, the better your chances of success. Results may appear within 3-6 months, though it may take longer for some. Continued use helps hair follicles gain volume, promoting thicker, longer hair and preventing further loss. If treatment is stopped, new hair may disappear within 3-12 months.

How long should I take it for?

For as long as you'd like to keep your hair. Optimal results are seen at 12-24 months, though improvements may start within 3-6 months. This is a long-term hair loss management plan.

What are the side effects?

Topical minoxidil is generally safe for most people. Most patients do not experience serious side effects, so it can be a good option for treating hair loss. Systemic side effects from topical minoxidil are infrequent. Research suggests that when absorbed through the skin, topical minoxidil does not remain in the system for too long. As a result, the likelihood of systemic effects is very low, even with regular application. However, some users have reported rare systemic side effects, including lightheadedness, swelling in the hands and feet, and an increased heart rate. However all medications have side effects, so it’s important you understand the ones sometimes seen with minoxidil.

Minoxidil Side EffectsStop using this treatment plan and talk to a clinician, your own doctor or a pharmacist if you experience any of the following potential side effects include:

Hypertrichosis

Hypertrichosis is when you have more hair than usual in places where you normally don't have much hair, like your face, arms, or back.

• 0.5% of patients discontinued due to hypertrichosis
• Symptoms of hypertrichosis should reverse, typically once this treatment is stopped.
• Consider hair removal options, such as shaving, waxing, or laser treatment, if the hair growth is bothersome.

Contact Dermatitis

Skin irritation or rash that develops where the minoxidil solution is applied.

• The alcohol in the spray can may cause irritation. Avoid applying minoxidil to inflamed or irritated skin.
• Keep the scalp clean and avoid other hair products that may irritate the skin.
• Alcohol can dry out the scalp; use hydrating oils like coconut oil to maintain moisture.

Changes in hair colour

Minoxidil can cause changes in hair colour, often making hair darker or, less commonly, lighter. This may occur as the new hair grows back thicker and more pigmented, particularly in areas where hair was previously thinning and lighter.

• Managing unwanted colour changes, such as hair dye.

Gastrointestinal disorders

When taking minoxidil, you might feel sick or nauseous, feel like vomiting, or have belly pain

• Take minoxidil with food to help reduce stomach upset
• Stay hydrated and eat small meals
• If you have any worries about side effects, please book a call to speak with a clinician.

Palpitations

Palpitations are the sensation of feeling your heart beating rapidly, irregularly, or strongly. You might notice them as fluttering or pounding in your chest.

• Palpitations can be exacerbated by the following: strenuous exercise, lack of sleep, stress, alcohol and caffeine.
• Should you have palpitations, coupled with chest pain, feeling faint or shortness of breath it could be a serious condition. Seek immediate medical assistance by calling 999 or going to A&E.
• If you have any worries about side effects, please book a call to speak with a clinician.

Headaches

A type of pain or discomfort that you feel in your head, scalp or neck

• Use the medication as prescribed and avoid overuse, as excessive use can increase the risk of headaches
• Drink plenty of water to help prevent headaches, as they are a common side effect
• If you have any worries about side effects, please book a call to speak with a clinician.

Swelling

Fluid retention happens when your body holds onto more water than it needs, causing swelling in areas like your legs, feet, or hands. This can make you feel bloated or puffy.

• Low risk typically less than 1.3% of patients are at risk of suffering from fluid retention
• If you have any worries about side effects, please book a call to speak with a clinician
• If you experience any of the following symptoms—severe swelling, pain, redness, or heat in a specific area; a high fever; or swelling in one ankle, foot, or leg without an obvious cause of injury—please seek urgent medical help. Contact your GP for an emergency appointment or call 111. Please follow this link for more information.

Pericarditis

Pericarditis is inflammation of the lining around your heart, which causes chest pain. It's not usually serious, but it can sometimes cause serious health problems.

• If you have any of these symptoms: chest pain, shortness of breath, feeling faint, or fainting, call 999 or go to A&E immediately. For more information, see the symptoms listed here.
• If you have any worries about side effects, please book a call to speak with a clinician

Angina

Angina pectoris is when you feel chest pain or pressure because your heart isn't getting enough oxygen. It is caused by reduced blood flow to the heart muscles.

• If you have any of these symptoms: chest pain, shortness of breath, feeling faint, or fainting, call 999 or go to A&E immediately. For more information, see the symptoms listed here.
• If you have any worries about side effects, please book a call to speak with a clinician

Breast tenderness

Using minoxidil might cause your breasts to feel sore or tender to the touch.

• Breast tenderness is a rare side effect, but if you experience any soreness or tenderness in your breasts, please book a call to speak with a clinician.

Pericardial effusion

Palpitations refer to the feeling that your heart is beating too hard, too fast, fluttering, or skipping a beat.

• It’s not very common, occurring in approximately 3% of cases. However, if you experience symptoms such as chest pain, difficulty breathing, dizziness, or feeling faint, please call 999 or seek urgent medical attention at A&E.

Cardiac Tamponade

This is a condition where fluid builds up in the space around the heart. This fluid puts pressure on the heart, preventing it from pumping blood effectively.

• A rare side effect, occurring in approximately 3% of cases. However, if you experience symptoms such as chest pain, difficulty breathing, dizziness, or feeling faint or a fever, please call 999 or seek urgent medical attention at A&E.

Leucopenia

Leucopenia is a condition where the number of white blood cells is low.

• If you experience symptoms such as high fever, persistent infections, unexplained bruising or bleeding, mouth sores or red patches in the mouth, or a severe cough, please call 999 or seek urgent medical attention at A&E.

Thrombocytopenia

Thrombocytopenia is a condition characterized by a low number of platelet cells.

• Although it's a rare side effect, if you notice symptoms such as easy bruising, abnormal bleeding, blood in your urine, gums, or stool, or tiny red or purple dots on your lower legs, please call 999 or seek urgent medical attention at A&E.

More information about potential side effects

Similarly, finasteride is highly effective, backed by years of clinical data supporting its safety. In clinical trials, 98.6% of men who took oral finasteride continued treatment without experiencing adverse effects. However, like all medications, finasteride can cause side effects, so it's important to be aware of the potential ones. If you experience any of the following side effects, stop using this treatment and consult with a clinician, your doctor, or a pharmacist:

Finasteride Side EffectsStop using this treatment plan and talk to a clinician, your own doctor or a pharmacist if you experience any of the following potential side effects include:

Decreased libido

This may involve a decrease in sexual desire, which is typically temporary, but there have been some rare cases of long-term effects, including a lack of sexual fantasies or a persistent low sex drive that may not resolve.

• Typically less than 1.8% of patients are at risk of suffering from a drop in libido
• Exercising and implementing a balanced diet may help to improve the effects on sex life. It also helps to cut down on cigarettes and alcohol
• If you have any worries about side effects, please book a call to speak with a clinician

Erectile Dysfunction

This is when a man struggles to get or keep an erection firm enough for sex.

• Typically less than 1.8% of patients are at risk of suffering from erectile dysfunction
• Exercising and implementing a balanced diet may help to improve the effects on sex life. It also helps to cut down on cigarettes and alcohol
• If you have any worries about side effects, please book a call to speak with a clinician

Testicular Pain

The feeling of pain, aching or discomfort in one or both testicles.

• It’s not very common, and it usually goes away, but if you notice it, let your clinician know.
• Should you have sudden, severe testicular pain that doesn’t go away or any of the symptoms listed here, it could be a serious condition. Seek immediate medical assistance by calling 999 or going to A&E.
• If you have any worries about side effects, please book a call to speak with a clinician.

Ejaculation disorders

Ejaculation disorder is where you may have persistent trouble ejaculating, either too quickly, too slowly, or not at all, causing distress and impacting sexual satisfaction. This also may also involve low sperm/ejaculate volume, which can potentially impact fertility.

• Low risk typically less than 2% of patients are at risk of suffering from sexual side effects
• If you have any worries about side effects, please book a call to speak with a clinician

Depression

Depression is more than feeling sad or down. It's a serious mood disorder that causes persistent sadness, loss of interest, and affects how you feel, think, and handle daily activities for at least two weeks.

• 281 reports of mood disorders, including depression and suicidal behaviour, associated with finasteride since 1993
• This represents a very small fraction of the large number of people who have used finasteride over the years, indicating that the risk of depression is quite low
• You may not notice some changes in your mood and behaviour, so it is very important to tell your friends and family that you are taking this medicine and that it can have effects on psychological well-being
• If you have these symptoms, support and help are available. Please follow this link for more information.
• If you have any worries about side effects, please book a call to speak with a clinician

Suicidal Ideation

Suicidal thoughts involve thinking about ending your own life. These thoughts can range from fleeting to detailed plans..

• 281 reports of mood disorders, including depression and suicidal behaviour, associated with finasteride since 1993
• This represents a very small fraction of the large number of people who have used finasteride over the years, indicating that the risk of depression is quite low
• You may not notice some changes in your mood and behaviour, so it is very important to tell your friends and family that you are taking this medicine and that it can have effects on psychological well-being
• If you're feeling like you want to end your life, it's important to tell someone. Please call NHS - 111 for more measures for support please follow this link for more information.
• If you have any worries about side effects, please book a call to speak with a clinician

Breast tenderness/enlarged breast tissue

This is the development of larger than usual breast tissue, making breasts appear bigger around the nipple area, possible symptoms can include increased nipple sensitivity, breast pain..

• Gynecomastia from finasteride is very rare, with some reports suggesting a 0.4% incidence rate. However, this figure is uncertain and more studies are needed.
• Finasteride induced gynecomastia is often one-sided but can be both sides
• If you have any worries about side effects, please book a call to speak with a clinician

Palpitations

Palpitations refer to the feeling that your heart is beating too hard, too fast, fluttering, or skipping a beat.

• It’s not very common, and it usually goes away, but if you notice it, let your clinician know.
• If you have any symptoms of or currently have heart palpitations with any of these symptoms: chest pain, shortness of breath, feeling faint, or fainting, call 999 or go to A&E immediately. For more information, see the symptoms listed here.
• If you have any worries about side effects, please book a call to speak with a clinician

Anxiety

A feeling of worry, nervousness, or unease, which can be accompanied by physical changes such as an increase in heart rate and restlessness.

• It’s not very common, and it usually goes away, but if you notice it, let your clinician know.
• Although feelings of anxiety at certain times are completely normal, see a GP if anxiety is affecting your daily life or causing you distress.
• If you have any worries about side effects, please book a call to speak with a clinician

Increased Hepatic Enzymes

That the levels of certain enzymes produced by your liver. are higher than normal in your blood. This can indicate liver damage or inflammation

• This is typically a rare side effect, and its frequency is not well known
• If you experience any of the following symptoms: fatigue, jaundice (yellowing of the skin and eyes), dark urine, abdominal pain, or nausea, stop your treatment and see your GP.

More information about potential side effects

Stop using this treatment plan and talk to a clinician, your own doctor or a pharmacist if you experience any of the above side effects.

If you are allergic to finasteride, minoxidil, or any of the excipients in the All-in-One Spray, you may experience anaphylaxis or a severe generalised allergic reaction. Symptoms can include fainting, shortness of breath, sudden drop in blood pressure and swelling of the lips, tongue, throat, face and neck. If you feel very unwell or experience serious, severe or persistent side effects please go to your local Accident & Emergency department immediately or in an emergency call 999.

We want the best for you and your health. It is important that you don’t feel alone, so please voice your concerns and get in touch with one of our team members for more help if you need it. You can message a clinician via the messaging function on your patient account, and we will typically reply within 24 hours.

We are committed to continually improving our understanding of the medications we prescribe, including their side effects, to provide the highest level of care, guided by the latest medical insights. If you experience any side effects, please discuss them with your clinician or coach. Additionally, you can report side effects, no matter how minor, through the government-run Yellow Card reporting scheme at https://yellowcard.mhra.gov.uk/. Your feedback helps to improve medication safety for everyone.”

Why am I Shedding?

Temporary hair loss may occur within the first 2-8 weeks of starting your treatment plan. While this might seem concerning, it's actually a sign that the Minoxidil component in your treatment is working! This is evidence that the Minoxidil is working its magic on the natural hair growth cycle causing the old hair to fall out to make way for the newer stronger hairs.

When will I see the Results?

The moment you've been anticipating: When will you start noticing changes? It's natural to be eager for results, but it's crucial to understand that success takes time. The All-in-One Spray gets to work as soon as you begin treatment, yet visible results might not appear immediately. While some early signs can surface within six months, we recommend committing to the treatment plan for at least a year to fully appreciate its effects. Keep in mind, restoring hair isn't a quick fix—it's a journey that requires patience and persistence.

Who should not take it?

Our hair treatment plans are not suitable for:

• Women and males under 18 or over 65.
• Those with unexplained, sudden hair loss or total baldness.
• Individuals with untreated or uncontrolled high/low blood pressure.
• Scalp conditions (e.g., psoriasis, sunburn, damaged skin).
• Those allergic to minoxidil, azelaic acid, propylene glycol, alcohol, or purified water.
• Women, especially pregnant or breastfeeding, must avoid handling broken tablets due to potential harm to unborn babies.
• Traces of finasteride in semen may pose minimal risk, but men planning pregnancy should avoid it or use condoms.
• Benign prostate enlargement under treatment.
• Male breast/prostate cancer, galactose intolerance, liver/kidney disease.
• It’s not effective for men with total hair loss.

Fertility or Pregnancy information

Men who take finasteride-containing products can have traces of the medication in their semen. Available evidence suggests this is unlikely to pose a risk to an unborn child and there is no known risk to the foetus as the amount of finasteride excreted following a 1mg dose is too small to be harmful. Having said this, foetus abnormalities can develop without an obvious reason. From an emotional point of view, if that were to happen, you may agonise and go back and try to see if ‘you did anything wrong’. This may sound illogical or unscientific but that is human nature. Given this, the conservative advice is that when taking finasteride-containing treatments (such as our All-in-One Spray), you should use a condom if having intercourse with a woman who is known or possibly pregnant. This is conservative advice, and you have the discretion to decide how to apply this advice given your own risk appetite.

In relation to fertility, long-term data from the use of finasteride and/or minoxidil-containing products impacting human fertility is lacking, and specific studies in subfertile men have not been conducted. The male patients who were planning to father a child were initially excluded from clinical trials. Animal studies do not show relevant negative effects on fertility, however, some spontaneous reports of infertility and/or poor seminal quality have been reported with finasteride. In some of these reports, patients had other risk factors that might have contributed to infertility. Normalisation or improvement of seminal quality was reported after discontinuation of finasteride. We would like our patients to be as well informed as possible, before deciding on treatment. We do not want to be seen to be omitting any pieces of information. It is important to note that most of the studies deem finasteride 1mg to be safe and effective, and that is our overwhelming experience from thousands of customers. We also understand concerns that new or potential users of finasteride treatment may face when deciding whether or not to take finasteride. We advise if you are actively trying to conceive then you should consider the above information and make an informed decision on whether you wish to proceed with treatment based on your personal fertility circumstances. If you are undergoing fertility treatment or have a known low sperm count and are trying to conceive, we advise you to not take finasteride-containing treatments so that you are not worrying about any theoretical impact they could have.

Mental Health

While finasteride can increase the risk of depressive symptoms in a small percentage of users, it is considered an uncommon side effect. Some studies suggest a link between finasteride and low mood, while others find no difference. Most men tolerate finasteride well, but those with a history of depression should consider the potential risks and benefits.

When starting your treatment, monitor your mood and inform friends and family that you are taking this medication, as they can help identify any changes. If you experience depressive symptoms or suicidal thoughts, stop taking finasteride 1mg (Propecia) immediately and contact your doctor as soon as possible.

Sexual Health

In clinical trials, less than 2% of men experienced sexual side effects from taking finasteride. Specifically, about 1.3% reported erectile dysfunction, 1.8% noted a reduced interest in sex, and 1.2% experienced ejaculation issues, including lower semen volume. If you encounter any sexual function issues, such as difficulty maintaining an erection or a decrease in sex drive, please discuss this with your prescriber or doctor. If you experience any problems with sexual function such as inability to get and maintain an erection or decrease in sex drive, please discuss this with your prescriber or doctor

What if my medical status changes?

If your medical status does change during the course of your hair plan subscription, please do let us know via the clinician messaging thread so we can determine whether ongoing treatment is suitable.

Please inform our clinicians via your patient account messaging facility: if you start taking any new medicines or if there are any significant changes to your medical history. Also if you experience any significant side-effects or want further advice on your treatment.

You must inform your GP about the medicines you take to ensure they have an accurate medication history. If you do not share this information with your GP it could result in the healthcare professional not having enough information to make informed clinical decisions about your care, increasing your risk of injuries or side effects. On your account page, you can download a letter to share with your GP that contains all the relevant information about your treatment plan.

The Men's Manual Podcast

Episode 02: Demystifying Hair Loss