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Hi, great article. I have an aggressive form of MPB. I am 23 year old with a NW2 hairline, diffuse thinning over the top and crown. Been on 5% Minoxidil and 2% Keto for about 9 months. Went through a period of shedding which has reduced somewhat in the last couple of months. I don’t see any appreciable increase in density anywhere but I do see plenty of thin vellus hair at my hairline. I am waiting for the 1 year mark to see the full effect of this regime. Is there like a test you can do to assess hairfall? Or do we just have to count the hair lost in the shower? Do you reckon I should start the Fin to hold on the the hair I have? Like most guys (actually a bit more than most guys seeing that I am young) I worry a lot about being in the 2% who experience disastrous sides from Fin. I do plan to check my DHT levels before I start, if I do at all, to see if I naturally have high/low DHT. That should tell me what to expect, to an extent.
Results from clinical studies of mostly white women ages 18 to 45 years with mild to moderate degrees of hair loss report that after using minoxidil for eight months, 19% of users had moderate regrowth and 40% had minimal regrowth. Of those using a liquid without active minoxidil (a placebo) during the same time period, 7% reported moderate hair regrowth while 33% had minimal regrowth.
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.
A commonly prescribed treatment for women is hormone replacement therapy (HRT). HRT is only prescribed to women with AGA during menopause or women who have low estrogen and/or progesterone for other reasons. These female hormones suppress male hormone production and seem to keep hair loss at bay. Physicians, however, do not recommend long periods of HRT treatment because of the increased risk of breast cancer, heart disease and stroke.
Cyproterone acetate is not available in the U.S. Doctors consider it one of the last resorts for treating female pattern hair loss because of its possible toxicity and long-term side effects. As with any drug, side effects other than those listed on the package may occur. Contact your doctor if you notice a side effect that is unusual or particularly bothersome.
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.
Spironolactone, brand name Aldactone, is in a class of drugs called potassium-sparing diuretics (often called water pills). Spironolactone is typically used to reduce fluid in your body without causing the loss of potassium. It is also used to treat potassium deficiency, high blood pressure (hypertension), swelling (edema), and a hormonal disorder called hyperaldosteronism.
Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.
Castor oil, as some might already know, is one of the most popular all-natural "panaceas." Go ahead, Google it: What you'll find is article after article about how the viscous oil can help with shedding, breakage, and regrowth. But unlike rosemary oil and vitamin B5, both of which have studies that back up their aid in hair growth, scientific evidence surrounding castor oil is lacking. (Any testimonials about castor oil for hair growth are anecdotal, coming mostly from blogs, Reddit, and YouTube.)
Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks.
Unfortunately, there has been little research into female-pattern baldness. The AHLA says, "While many drugs may work to some degree for women, doctors are reluctant to prescribe them, and drug companies aren't exactly falling over themselves to test existing or new drugs specifically for their ability to prevent and treat female-pattern baldness." The only FDA-approved treatment for hair loss in women is 2 percent minoxidil, although some doctors will prescribe other drugs off-label.
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.
Beginning treatment as soon as possible after the hair loss begins gives the best results, because prolonged androgenetic alopecia may destroy many of the hair follicles. The use of anti-androgens after prolonged hair loss will help prevent further damage and encourage some hair regrowth from follicles that have been dormant but are still viable. Stopping treatment will result in the hair loss resuming if the androgens aren't kept in check in some other way. Maintaining your vitamin and mineral levels helps while you're on anti-androgen medications.
What worked for me was doing nothing about losing my hair and just letting nature take its course. My hair started receding in my early 20s, but only a little, then it stopped for about 30 years. Then in my early 50s my hair started receding and thinning very rapidly again. I panicked until my wife told me she loves bald men and had been wishing I would go bald. She talked me into just letting myself go bald. In less than two years I went from norwood 2 or 3 to norwood 6. I don’t regret my decision to go bald and have no desire to regrow my hair. My wife and I really enjoyed watching my hair recede and thin away. I love being bald and you couldn’t pay me to regrow my hair. In retrospect, I wish I had kept on balding in my 20s all the way to norwood 7.
The good news: Hair transplants don't look like dolls' hair anymore. The bad news: You won't be able to go anywhere to show off your new 'do because you'll be broke. The average recipient of a follicle transplant receives several thousand grafts -- strips of hair removed from bushier parts of the head -- at a cost of several thousand dollars. The cost continues to mount when patients come back for added thickness over the years.
Dr. Carlos Wesley, a hair restoration surgeon in Manhattan, said that women in his practice respond better to P.R.P. than men do, which may have something to do with the fact that women with genetic hair loss tend to have more inflammatory cells around the follicles. From 2013 to 2014, he said, he had an 83 percent increase in female patients, in part because of P.R.P.

Thinning hair in women is worth investigating for more than its impact on physical appearance. While many conditions that lead to temporary hair loss will go away without treatment or with simple lifestyle measures, others may be signs of potentially irreversible loss or health conditions. Others yet may respond well to treatments to promote regrowth, so starting sooner rather than later is key.
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.
“I’m 43 years old and my hair has started to thin out a little bit. I started looking into a lot of these different products on the market that claim they can slow down balding in men and some of them even claim they can regrow your actual hair. As I went on the internet and started looking around, I kind of went down a rabbit hole into these different reviews and all sorts of different products from vitamins to topical solutions. Do any of these things do what they claim they can do?”
Coconut oil contains fatty acids that penetrate inside the hair shaft and reduce protein loss from hair. Coconut oil can be used either before or after you wash your hair depending on your hair type. If your hair tends to be oily, you can do a leave-in treatment overnight or for a few hours before you wash it. Massage coconut oil into your scalp and all of your hair. If your hair is dry, you can also use it as a leave-in treatment. There needs to be more research on coconut oil as a promoter of hair growth, but it’s been shown to improve the health and luster of hair and has been used for centuries.
Hair loss can be devastating for both men and women, even more so when there are loads of products on the market that don't work. According to the American Hair Loss Association (AHLA), two thirds of American men experience some degree of hair loss by the age of 35. By the age of 50, approximately 85 percent experience significantly thinning hair. Balding is commonly associated with aging, but for 25 percent of men the process begins before the age of 21. What's more, hair loss is not limited to men: The American Hair Loss Association reports that women make up about 40 percent of hair-loss sufferers in the United States.
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards.
“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.
The easy-to-use spray bottle allows you to apply the serum directly to your scalp, or you can spray it onto your hands to rub into parts of your scalp. Each bottle offers a three month supply and should be used twice daily. It has outstanding reviews online, partly because it does not leave a sticky residue or cause preliminary hair shedding like most other regrowth treatments.
"Despite some of the claims, a shampoo or conditioner won’t be able to stop or slow hair loss, nor help with a receding hairline or thicken hair that’s becoming thinner," says trichologist Anabel Kingsley from The Philip Kingsley Trichology Clinic in London. "At best, a thickening shampoo will make hair temporarily thicker for a short period of time, but they certainly won’t help with hair loss or thinning."
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