The Best Hair Loss Treatment
- February 26, 2018 - We’ve updated this review to provide additional information on hair transplants and other new treatments currently under development. We've also made some light changes to clarify our methodology. We remain confident that Rogaine’s 5% minoxidil foam is the best hair loss treatment for most people.
The Best Hair Loss Treatments
- Men’s Rogaine Unscented Foam
Best Overall for Men and Women
- Kirkland Signature Regrowth Treatment Minoxidil Foam for Men
- Equate Hair Regrowth Treatment for Men
- HairMax Ultima 12 LaserComb
A Pricey Add-on Treatment
There’s no cure for baldness, but there are ways to hold on to what you've got. The six dermatologists and the clinical studies point to three methods: minoxidil, laser treatments, and prescription finasteride. The key is finding the combination and hair loss regimen that works for you. A doctor is your best bet for that kind of guidance — but we found a few trustworthy products that will work for most people.
Our top pick is Men’s Rogaine Unscented Foam. It contains five percent minoxidil which has been clinically proven to slow hair loss and even regrow some hair. It’s also FDA-approved and non-prescription, which means it’s not only effective and safe for use but widely available. You can easily find a three-month supply on Amazon for about $35.
There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice.
Our other recommendation is the HairMax Ultima 12 LaserComb. The comb uses low-level lasers to stimulate hair follicles and modulate dihydrotestosterone (DHT) — a hormone that causes the most common type of hair loss. While it sounds like something from a sci-fi movie, the treatment works, and the dermatologists we consulted reported that their patients saw thicker and longer hair when combined with our top pick. The only catch: The comb isn’t as effective as minoxidil treatments, and at nearly $400, it’s a much bigger investment. Still, it’s the best option if you’re looking for a non-invasive, non-chemical treatment.
How We Found the Best Hair Loss Treatment
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
What about 'hair building fibers'?Products like Toppik use statically charged keratin fibers that bind to existing hair shafts, which may make hair look thicker, but does nothing to prevent hair loss. You might want to consider using one of these products in addition to an actual hair loss treatment, but don’t count on it alone.
Other medical conditions — most commonly telogen effluvium and seborrheic dermatitis — can also cause hair loss, but most people can trace their follicular woes back to androgenetic alopecia, so we focused our search there. We started with more than 200 products, including all-natural solutions and high-tech gadgets, while skipping treatments that focus only on volumizing or thickening hair. We also limited our scope to the scalp, and left out specialty products designed only for eyebrows or beards.
We dug into clinical studies and talked to experts in the field, who helped identify specific ingredients that have proven effective in combating hair loss and aren’t just snake oil.
The ugly truth: The vast majority of hair loss treatments boast exaggerated claims, and a startling number have absolutely no scientific backing whatsoever.
Our first step: eliminating those snake oils.
To us, that meant any product with zero proven ingredients, case studies, or FDA clearance — which shrunk our list by a whopping 180 contenders. That’s right, there are only three treatments that have actually been cleared by the FDA and supported with clinical studies: finasteride (commonly marketed as Propecia), minoxidil, and laser treatments. And, since finasteride is prescription-only, it left us with two.
If a product is cleared, that means the FDA has deemed it safe, effective, and substantially equivalent to another previously approved or cleared device on the market. In other words, FDA clearance is kind of like an insurance policies for consumers. Both ensure that a product will be safe and effective.
That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).
However, ketoconazole is still not FDA approved for hair loss treatment, which means it cannot be endorsed or marketed as such. Put simply, ketoconazole likely curbs hair loss, but additional research is needed for the FDA to give it approval. While it is safe to use as a supplement to our top picks, we wanted to recommend products with as much scientific backing as possible. So, we stuck with FDA approved minoxidil or FDA cleared laser treatments. But we’ll keep a close eye on products like ketoconazole shampoos and update as new research appears.
Beware online stores selling Propecia without a prescription.Finasteride is FDA approved, but buying it online without a prescription can be illegal and dangerous. Prescription-free online stores have a reputation for selling placebos or dangerous replacements. We recommend speaking with a doctor about prescriptions or sticking to save over-the-counter treatments.
With those pinned down, it wasn’t hard to determine which don’t actually work. Pretty much all the “active” ingredients listed in ineffective treatments — from biotin and zinc to emu oil and saw palmetto — have never been proven, and are instead marketed based on logical-seeming correlations. It would make sense that biotin, a B vitamin readily found in hair, skin, and nails, could help hair grow more quickly. And caffeine is a stimulant that works in coffee, so rubbing some on your scalp might wake some of those sleepy follicles… right?
Not so fast. Dr. Alex Khadavi, a board-certified dermatologist and associate professor of dermatology at the University of Southern California, says that it’s a good idea to approach all of these products with a skeptical eye.
“There’s people selling pills and creams and lotions and whatever else, and sometimes you can’t even trust what ingredients they have in there,” he warned us when we spoke to him over the phone. Key takeaway: The hair loss industry is crazy dishonest, so we eliminated any treatments (especially homeopathic methods) that aren’t based in concrete, peer-reviewed science.
Advecia Hair Loss Vitamins, Alter EGO Energizing/Prevention Shampoo for Hair Loss & Growth, Amazing Jasmine Hair Cream Shampoo/Conditioner, Amplixin Intensive Growth Serum, Amplixin Stimulating Hair Growth Shampoo, Apivita Propoline Tonic Shampoo for Thinning Hair for Women, Art Naturals Organic Argan Oil Hair Loss Prevention Shampoo, BeanStalk Hair Loss Treatment, Beauty Facial Extreme Maximum Strength Hair Regrowth Conditioner, Beauty Facial Extreme Maximum Strength Hair Regrowth Shampoo, Bio-Hair Advanced Hair Support Formula Vitamins, Biofusion 100% All Natural Hair Loss Shampoo, Biohair-Care Biotin Hair Loss Prevention, Biotopic Bald Spot Treatment, Biotopic FolliclePLUS 27+ for Men, Biotopic FolliclePLUS 27+ for Women, Biotopic Regrowth, Bloom Krans Anti Hair Loss Shampoo for Women, Bloom Krans Full Bloom Hair Growth Vitamins for Women, Bloom Krans Full Bloom Hair Rejuvenating Conditioner, Bloom Krans Hair Growth Vitamins for Women, Bosley Revive Starter Pack, By Natural Scalp & Hair Nourishing Oil-Based Shampoo, Codina Organic Pumpkin Shampoo for Hair Loss Prevention, Cosmo Service Energizing Anti-Hair Loss Lotion, CSCS Hair Loss Shampoo, DAELONG Hair Growth Conditioner, DasGro Ultimate Hair Growth Vitamins, Dead Sea Premier Anti Hair Loss Shampoo, Deity of Hair Plant Shampoo for Hair Loss, Deltacrin Hair Loss Prevention Shampoo, DermaChange Strengthful Hair Growth Shampoo, Doori Cosmetics Daeng Gi Meo Ri Ki Gold Energizing Shampoo, Ecrinal Anti Hair Loss Ampoules ANP2+, Ecrinal Hair Lotion for Men with ANP2, Ecrinal Hair Lotion with ANP2 for Men, Ecrinal Hair Lotion with ANP2 for Women, Ecrinal Hair Tonic Spray for Women, Ecrinal Women’s Shampoo with ANP for Hair Loss and Anemic Scalp, Erbecrin Anti Hair Loss Energizing Lotion with Plant Extracts, F&T Scalp Massager Comb, Flawless Botanics Hairsentials Hair Growth Accelerator, Flawless Botanics LuxTherapy Hair Loss Shampoo, Follicle Fuel for Hair Growth, Folliform DHT Blocker for Men and Women, Folligen Cream Copper Peptide Cream for Hair Loss or Thinning Hair, Glytone by Ducray Anacaps Dietary Supplement, Glytone by Ducray Anaphase Shampoo, Glytone by Ducray Anastim Hair Lotion Concentrate, Glytone by Ducray Neopeptide Hair Lotion, GoodOnYa Hair Loss Prevention Shampoo and Conditioner, GQ Hair Biotin Scalp Serum for Hair Loss, Groveda Fast Hair Growth Serum, Hair Again Supplement, Hair Covet Women Hair Growth Vitamin Supplement, Hair Dance Hair Growth Stimulator, Hair Genesis Maximum Strength Hair Loss Serum, Hair Growth Botanical Revolution Anti-Hair Loss Elixir for Scalp, Hair Growth Botanical Revolution Anti-Hair Loss Extra Strong Scalp Treatment, Hair Growth Botanical Revolution Anti-Hair Loss Scalp Treatment, Hair Growth X, Hair Joy Anti-Hair Loss Care Shampoo, Hair Joy Anti-Hair Loss Care Tonic, Hair Regain Hair Loss Treatment & Hair Thickening Shampoo, Hair Rite Hair Growth Vitamin Supplements, HairAnew Unique Hair Formula, HairChi Hair Regrowth Foam, Hairomega 3-in-1 DHT Blocker Supplement for Hair Loss, Hairomega Serum 2% Minoxidil Foam, HairXT100 Premier Hair Supplement, Har Vokse Natural Hair Loss and Regrowth Treatment, Herbal Hair Regrowth Treatment for Women, HF14 DHT Blocker Hair Growth Vitamins, Hoffman MD Natural Hair Growth Serum with Biotin, Honeydew Hair Loss Shampoo, Infinite Growth, Inhairit Hair Loss Conditioner, Inhairit Hair Regrowth Solution for Men and Women, Jade Bloom PREVENT Hair Loss Blend, Jaowyng Beauty Advanced Hair Regrowth Serum, JAS Emergiscalp Hair Loss Prevention Shampoo, Conditioner and Leave-In Treatment, JustNatural Bald Spot Treatment, JustNatural Grow New Hair Treatment, JustNatural Hair Loss Shampoo, JustNaturals Adult Women’s Hair Loss Treatment, JustNaturals Alopecia Hair Loss Treatment, Keraplant Hair Loss and Hair Thinning Prevention Conditioner, Keraplant Hair Loss and Hair Thinning Prevention Shampoo, Keraplex Organica Shampoo for Hair Loss Prevention, Kroning Signature Black Bottle Anti Hair Loss Shampoo for Men, Kroning Signature Black Bottle Hair Growth Support Vitamins, L’emarie Dandruff Shampoo Hair Loss Prevention, L’emarie Scalp Re-Energize Treatment, Laritelle Organic Hair Loss Prevention Conditioner, Laritelle Organic Hair Loss Prevention Oil, Laritelle Organic Hair Loss Prevention Shampoo, Latin Botanicals Volume & Loss Treatment Shampoo, Lee Stafford Hair Growth Treatment, LineaSkinCare Deep Revitalizing Hair Loss Prevention Shampoo, Lipogaine Big 3 Premium Hair Loss Prevention Shampoo, Mega Life HairtoStay Shampoo, MinoxiBoost Hair Loss Shampoo for Men and Women, Natte Hair Tonic Gel, Nature Lush Fight Hair Loss Shampoo, Neugaine Premium Organic Hair Loss Shampoo, Newopure Natural Hair Growth Vitamins, Nourish Beaute Burst Hair Growth Accelerating Serum, Nourish Beaute Nourish Hair Growth Support Vitamins, NuCell Hair Anti-Hair Loss Serum, NuGene Anti-Hair Loss Serum, NuHair Hair Regrowth Tablets for Men, NuHair Thinning Hair Serum for Men and Women, NuHair Thinning Hair Vitamins for Women, NuNutrients Advanced Hair Regrowth Treatment for Men, NuNutrients Advanced Hair Regrowth Treatment for Women, Nutrafol Men Advanced Thinning Hair & Hair Loss Supplement, Nutrafol Women Advanced Thinning Hair & Hair Loss Supplement, Nutrifolica Hair Loss Volumizing Conditioner, Nutrifolica Hair Regrowth Shampoo, Nutrine Garlic Shampoo for Excessive Hair Loss, Omiera Labs Natural Treatment for Hair Loss, Only Natural for Hair Only, PhytoWorx Hair Recovery and Regrowth Supplement, PhytoWorx Organic Hair Loss Shampoo, Pilo-Genic Mini Emulsion Hair Loss Treatment Lotion, Piping Rock DHT Blocker for Men & Women, Planet Ayurveda Hair Growth Formula for Men, Premium TS Hair Loss Prevention Shampoo, PRI Advanced 4-in-1 Hair Regrowth Treatment, PRI Formula 500 Hair Growth Conditioner, PRI Formula 500 Hair Rejuvenation System, ProBliva Hair Growth Serum, Procerin Male Hair Loss Shampoo, Procerin Tablets for Men, Procerin XT Hair Loss Foam, Prominox 4 Hair Loss Vitamins, Prominox 5 Topical Hair Loss Solution, PURA D’OR Anti-Hair Loss Premium Organic Argan Oil Shampoo, PURA D’OR Organic Argan Oil Conditioner, Regenepure DR Shampoo, Research Verified Hair Growth Support, RidgeCrest Herbals Hair Revive, Rx 4 Hair Loss Conditioner, Rx 4 Hair Loss Scalp Cream, Rx 4 Hair Loss Shampoo, Shen Min Hair Growth Vitamins for Men, Shen Min Hair Growth Vitamins for Women, Shen Min Hair Strengthening Formula, Shen Min Topical Solution for Thinning Hair, SHOWSA Organic Argan Oil Hair Loss Prevention Shampoo, Silettum Hair Loss Prevention Supplements, Simone Trichology Prevention Hair Loss Shampoo, SojournEarth Hair Loss Prevention Shampoo, Spare My Hair Premium Hair Growth Conditioner, Spare My Hair Premium Hair Growth Shampoo, Spare My Hair Scalp Solution, Surethik Hair Thickening Foam, Thai Bsc Falles Kaffir Lime Hair Loss Prevention Natural Tonic, Time Machine Hair Regrowth Tonic, Tricomin Solution Follicle Therapy Spray, Tropic Isle Jamaican Black Castor Oil, Ultrax Labs Hair Rush DHT Blocking Hair Loss Maxx Hair Growth Nutrient Solubilized Keratin Supplement, Ultrax Labs Hair Solace Conditioner, Ultrax Labs Hair Surge Caffeine Hair Loss Hair Growth Stimulating Shampoo, UNA Oxygenating Treatment, Vie Naturelle Hair Loss Treatment Shampoo, Vie Naturelle Pro-T Select Hair Growth Vitamins, Vitagrowth Premium Hair Regrowth Serum, VITAMINS Organic Hair Loss Conditioner, VITAMINS Shampoo for Hair Loss, Viviscal Extra Strength Hair Nutrient Tablets, Viviscal Hair Growth Program Extra Strength, Viviscal Man Hair Dietary Supplements, Viviscal Professional, VLCC Hair Defense Conditioner, VLCC Hair Defense Oil, VLCC Hair Defense Shampoo, Watermans Grow Me Hair Loss Shampoo, Wick & Strom Hair Loss Vitamins, Wick & Strom Premium Anti Hair Loss Shampoo
We favored minoxidil over laser treatments.
Double your efforts.Even if you’re taking finasteride or applying minoxidil daily, you can still use a laser treatment. In fact, every doctor we asked recommended combining treatments.
Laser treatments are the latest frontier in staving off hair loss, and they’ll be the first choice for fans of sci-fi. As silly as they may sound, these treatments do work — the American Journal of Clinical Dermatology in 2014 reported a “statistically significant difference” in hair density with no “serious adverse events” or side effects.The bad news: Laser treatments tend to be expensive, progress is slow, and they don’t always produce stellar results.
Dr. Cheri Ong, dermatologist for American Dermatology Associates, Inc., confirmed and explained “Low-level laser treatments (LLLT) are popular non-invasive and non-chemical options for hair loss that work by activating energy production in the hair follicle and modulating DHT.”
“I think their effectiveness is not as significant as finasteride or minoxidil,” says Dr. Wolfeld, “however, it’s something that can be used quite easily by patients at home. If they use it two or three times a week, I tell them it can help to thicken their hair.” Results can take up to 18 months to show up, so Dr. Wolfeld stresses that patience is a virtue.
HairMax LaserComb Advanced 7, HairMax Professional 12 Laser Comb, iGrow Hands-Free Laser LED Light Therapy Hair Regrowth Rejuvenation System, iRestore Laser Hair Growth System
And then ditched 2 percent minoxidil treatments for 5 percent.
Not surprisingly, treatments with 5 percent minoxidil work better than treatments with 2 percent minoxidil. A randomized clinical trial published in the American Journal of Clinical Dermatology in 2002 found that, in men with androgenetic alopecia, “5 percent topical minoxidil was clearly superior to 2 percent topical minoxidil and placebo in increasing hair growth.” The difference was actually pretty astounding — after 48 weeks, the men who used 5 percent minoxidil experienced 45 percent more hair growth than the men who used the 2 percent treatment.
A separate study, published in Skin Therapy Letter — a professional reference site for dermatologists — found that women also benefit from using the more potent 5 percent minoxidil treatment. “Patient-reported improvement in hair volume and coverage appears to be greater with 5 percent minoxidil foam,” reads the report. Plus, because the 5 percent treatment is stronger, women only have to apply it once a day to get the same results as they would with the 2 percent treatment applied twice daily.
Keranique Hair Regrowth 3-Piece Treatment Set for Women, Lipogaine for Women, Pantene Minoxidil 2% Hair Regrowth Treatment for Women, Prominox 1 Hair Loss Shampoo, Prominox 2 Hair Loss Conditioner, Prominox 3 Hair Growth Stimulator, Prominox 6 Leave-In Hair Loss Conditioner, REDKEN Cerafil Retaliate 2% Hair Regrowth Treatment for Women, Rogaine for Women Hair Regrowth Treatment
We cut anything including propylene glycol.
While there are no overtly harmful ingredients in over-the-counter minoxidil, liquid solutions contain propylene glycol, which may cause itching, redness, and irritation. The topic is a contentious one — researchers point out documented cases of irritation while others point to studies that show small amounts are harmless and even safe to eat.
That meant new products like Hims and Keeps were out.Hims and Keeps are relatively new companies that allow you to set up a subscription for hair loss treatments. Both offer finasteride (after an online consultation with a doctor) or 5 percent minoxidil. However, their minoxidil solutions contain propylene glycol, so we cut them from consideration.
The truth is, the amount of propylene glycol in hair loss treatments is not likely to cause any real harm and the FDA has given the chemical approval for many uses. But even though it is safe, we wanted to ensure that our top picks would be as comfortable to use as possible. So when Dr. Khadavi told us that “a third of my patients get irritated from minoxidil products because of propylene glycol,” we decided to cut any treatments with it. In any case, it’s the minoxidil that helps curb hair loss and not the propylene glycol.
Fortunately, most minoxidil foams don’t use propylene glycol and thus stand a much lower chance of irritating your scalp than their liquid counterparts — all our top picks are foams.
Avacor Physicians Formulation® for Men, Bosley Professional Strength Hair Regrowth Treatment for Men, Follinox-5 Hair Loss Treatment, Kirkland Minoxidil Extra Strength for Men 5% Topical Solution, Leminox for Men, Lipogaine for Men, Lipogaine for Men Sensitive, Men’s Rogaine Extra Strength, Nioxin Minoxidil 5% Hair Regrowth Treatment Extra Strength for Men, Perfect Hair 5% Minoxidil for Men, REDKEN Cerafil Retaliate 5% Hair Regrowth Treatment for Men
Our Top Picks for Men and Women
In our research and our conversations with experts, one name kept popping up repeatedly: Rogaine. As the first topical brand FDA-approved to help regrow hair (all the way back in 1988), Rogaine benefits from more than 20 years of clinical trials and consumer feedback. Rogaine was the first brand to offer a 5 percent minoxidil foam solution when it debuted Men’s Rogaine Unscented Foam in 2006, and virtually every treatment developed since (for both men and women) has been an imitation or derivation of that formula.
And that’s why Men’s Rogaine Unscented Foam is our top pick — it’s the exact same product as the women’s formula, and much cheaper.
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”
The only real difference between the men’s and women’s directions (beyond different diagrams of hair loss patterns): Men are instructed to use Rogaine twice daily; women only once.
Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives?
The simple answer is that hair loss and growth is tied to genetics, so how responses will differ from person to person. This is all to say you should really work with your doctor to figure out what treatment plan will work best for you.
If you’re a lady and can remember the one difference in directions (or just scope out the instructions online) we recommend saving the cash. Similarly, you could go generic with Equate Hair Regrowth Treatment for Men or Costco’s Kirkland Signature Hair Regrowth Treatment Minoxidil Foam for Men. These alternatives offer the same percentage of active minoxidil and near-identical inactive ingredients for as little as half the price — a great option for both genders.
We gave preference to Rogaine, because it has a longer history on the market and a greater number of customer testimonials online, but both the Equate and Kirkland versions are solid options.
Rogaine’s foam squirts out just like hair mousse and is applied with “cool, dry hands.” Applying means working the foam down to the scalp where you want to see thicker growth — for it to work, “it has to get into your scalp,” Dr. Wolfeld explains. “If it sits on your hair, it’s not really as effective.” Once massaged, it dissolves into a watery liquid that leaves a tingly sensation, “but no burning!” one of our balding testers was happy to discover.
Other Hair Loss Treatments to Consider
Men’s Rogaine Extra Strength Solution is the liquid version of our top pick. It didn’t make our final cut because it includes propylene glycol, which causes irritation in roughly one-third of its users. With that said, Dr. Wolfeld finds that it can be even more effective in practical daily use. In his experience, “the solution can penetrate and get into your scalp a little bit better” than the foam — especially if you’re not taking the time and effort to apply the foam correctly. This seems crazy to us since the foam so quickly dissolved into a liquid in our tests, but if you’re worried, try a one-month supply of the liquid and make the switch to foam if you notice any irritation.
The HairMax Ultima 12 LaserComb ($395) makes for a great addition to any hair loss regimen — provided you can afford it. Dr. Wolfeld notes that it’s a popular option in his practice. “Some people like the action of combing something through their hair,” he says. “They find that to be a little bit easier to do as part of their routine in the morning.” Dr. Khadavi also recommends using a laser treatment of some kind in conjunction with other treatments. “Lasers do help in stimulating the hair into the growth phase. We don’t know the exact mechanism of how it works, but it definitely helps.”
The general medical consensus around laser treatments — caps and combs alike — is that low-level laser light therapy stimulates the cells within the hair follicle. These devices may also increase cell metabolism to promote thicker and more durable hair shafts, something that neither minoxidil or finasteride can do. To use the HairMax Ultima, all you have to do is glide the device over your scalp slowly. Treatments should take about eight minutes, and you should do it three days per week for the best results.
Hair Loss 101
Some of the most commonly cited “causes” of hair loss have no scientific backing.
- Wearing a hat won't make you go bald. As Dr. Bernstein notes, hair follicles get their oxygen from the bloodstream as opposed to the air, so go ahead and rock your favorite team’s cap every day.
- Bald guys don't have more testosterone. But they do have a higher percentage of hair follicles genetically susceptible to DHT. It sounds a lot less sexy when you put it that way. BBC Future did a whole investigation into this myth, proving once and for all that Bruce Willis is no more virile than Fabio.
- Hair loss isn't just passed down from your mother’s side. Actually, both parents may contribute genes that may make you more susceptible to hair loss, as this video from AsapScience illustrates.
- Using too much hairspray or gel won't cause hair loss. This was just one of several myths debunked in an entertaining 2011 report by US News.
- It's not just men that lose hair on their scalp. As our research makes abundantly clear, plenty of women suffer from hair loss, too. The American Academy of Dermatology estimates that as many as 30 million women in the U.S. suffer from hereditary hair loss.
Let's take a closer look at what works:
Because there’s no cure for baldness (yet), there’s no hair loss treatment that’s going to leave you totally satisfied. That said, there are three FDA-approved treatments — minoxidil, finasteride, and lasers — that can stave off hair loss for the foreseeable future. Use them together for best results.
Prescription finasteride is usually the first line of defense against hair loss — for men.
“In men, the most effective treatment for thinning hair is finasteride,” says Dr. Wolfeld, who routinely prescribes the pill to his patients.
“Finasteride is a great medication that goes to the root cause of hair loss. You always have to address the root cause of the hair loss or they’re going to continue to lose more hair.”
Indeed, finasteride (also known as Propecia) works by lowering the body’s levels of the hormone DHT, which binds to receptors in hair follicles at the top of the scalp, causing them to gradually shrink and lose the ability to grow thick hair.
The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
Men may also experience some sexual and emotional side effects while taking it: In a study published in the June 2011 issue of The Journal of Sexual Medicine, Dr. Michael Irwig of George Washington University found as many as 92 percent of test subjects reporting problems in the bedroom. The study also reported that “the mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months,” meaning that side effects lingered long after subjects stopped taking the pill.
How worried should men be about the sexual side effects of finasteride? “What I tell men is that it’s not something they should stress about,” says Dr. Wolfeld, “but it is something they should be aware of.” In his experience, he notes only a roughly 5 percent incidence of sexual dysfunction reported by patients who take the medication.
A hair transplant is currently the best long-term solution, but it’s an investment.
Aside from medication and lasers, some opt for hair transplants — a procedure where hairs are removed from another part of your body and then transplanted to the thinning or balding areas. Does it work? In a word, yes. Research suggests that most hair transplant recipients report are "very satisfied" with their results. While successful, transplants are also far more expensive than medications, foams, or lasers with costs averaging anywhere from $4,000 or $15,000.
Hair transplants will likely lead to better results in the long run (you are introducing new hairs to the balding areas), but you’ll still need to use minoxidil or finasteride after surgery to maintain the results. Like all hair loss treatments, hair transplants are best when combined with other methods, and you’ll want to speak with your doctor to see what combination is best for you.
New hair loss treatments are on the way, and the early signs are promising.
Research for hair loss treatments is ongoing, and new companies are sprouting up to take on the issue. Many of these companies are developing products and services that are still undergoing clinical trials, but for many the results have been promising.
Though, it is important to point out that a lot of these companies are developing procedures that involve implanting hair, which means there is a chance they will be expensive — as we mentioned before, traditional hair transplants are costly. But a few companies and products such as Follicum’s FOL-S-005 and Fidia Pharma’s Brotzu Lotion are being designed as topical treatments.
We won’t know for sure if these products and services are effective until clinical trials finish. In addition, it is a good idea to wait for results from separate clinical studies that support the claims made by each company. But we’ll keep an ear to the ground as new research or treatments emerge.
The Bottom Line
The earlier you begin treating hair loss, the more effective the treatment will be. Androgenetic alopecia is a condition that gradually worsens over time, so the general rule is that the earlier you seek treatment, the better. “If you’re losing your hair and you have genetic hair loss, using medication such as Propecia or minoxidil is most effective when started early,” says Dr. Robert M. Bernstein, Dr. Wolfeld’s colleague at Bernstein Medical – Center for Hair Restoration. Because not everyone loses hair on the same timeline, you can’t rely on statistics to tell you when you should start treatment. Some men start to notice thinning in their early 20s, while others maintain a thick head of hair well into their 50s. If you suspect that you’re starting to lose your hair and want it to stop, act quickly.
Our Hair Loss Treatment Review: Summed Up
- Gupta A.K., & Foley K. A. (2014). 5% Minoxidil: Treatment for Female Pattern Hair Loss. Skin Therapy Letter, 19(6).
- Irwig, M. S. and Kolukula, S. (2011), Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss. Journal of Sexual Medicine, 8: 1747–1753.
- Jimenez, J. J., Wikramanayake, T. C., Bergfeld, W., Hordinsky, M., Hickman, J. G., Hamblin, M. R., & Schachner, L. A. (2014). Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study. American Journal of Clinical Dermatology, 15(2), 115–127.
- Olsen E.A., Dunlap F.E., Funicella T., Koperski J.A., Swinehart J.M., Tschen E.H., & Trancik R.J. (2002). A Randomized Clinical Trial of 5% Topical Minoxidil Versus 2% Topical Minoxidil and Placebo in the Treatment of Androgenetic Alopecia in Men. Journal of the American Academy of Dermatology, 47(3), 377-85.