In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."
But you must start these medical therapies before you lose all your hair. McAndrews likens it to brushing your teeth, in that both are preventative measures. “The sooner you start doing it, the better at slowing down this aging process,” he explains, adding, “Is toothpaste perfect? No, you’re still getting tooth decay with toothpaste, but you’re slowing down tooth decay.”
1. Minoxidil. It’s the only FDA-approved topical nonprescription medication that can claim to regrow hair — and it should be part of any hair-loss plan if you have serious thinning, says Rogers. Minoxidil has loads of research to back it, but it requires commitment. If you quit using it, your hair will start to lose ground again. Use a 5 percent strength, like Women’s Rogaine 5% Minoxidil Foam ($30), once daily to see results in three to four months, says Rogers.
For those concerned that the existing treatments lack a certain sci-fi quality, behold the Laser Comb. The Laser Comb recently became only the third hair loss treatment to receive FDA approval. And it is the first that doesn’t use drugs or surgery. By stimulating follicles with a low-level laser, the hand-held device was shown in test trials to increase hair volume in a majority of patients.
These anti-androgenic effects can be used to help treat hair loss. Nizoral shampoo contains 2% ketoconazole and is prescribed not only for the treatment of scalp conditions, but also in combination with other treatments for androgenetic alopecia. A 1% version is now available over-the-counter, but it may not be as effective as the 2% prescription strength. There are no significant side effects.
in clinical studies of mostly white women aged 18-45 years with mild to moderate degrees of hair loss, the following response to minoxidil topical solution 2% was reported: 19% of women reported moderate hair regrowth after using minoxidil topical solution 2% for 8 months (19% had moderate regrowth; 40% had minimal regrowth). This compares with 7% of women reporting moderate hair regrowth after using the placebo, the liquid without minoxidil in it, for 8 months (7% had moderate regrowth; 33% had minimal regrowth).
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.
And though this treatment appears to be safe and somewhat effective, it’s hard to tell who will react well to this low-level light therapy, which is why the doctors I spoke with were hesitant to fully endorse it. “We’re not sure what the optimal power is, what the optimal wavelength is, we don’t even really know the mechanism of action of how this is working,” says Rieder. Plus, it doesn’t work on everyone. “There are subpopulations of patients who do respond to low-level laser light, but this is not easily predictable,” explains McMichael, though she adds that the risk of using the LaserComb is low.

Joseph Greco, Ms. Telford’s practitioner, who shares a patent for a process to remove growth factors from platelets, said he gets results in 80 percent of patients, more than half of whom are female. Roughly half of them fly in and out, often on the same day, he said, because the procedure doesn’t require downtime and has minimal side effects. (Small clinical studies suggest further research is necessary but acknowledge the procedure’s “excellent safety profile.”)
Thanks for the article with great info. I’ve been taking minoxidil 5% for the last 2 years. I’ve tried a generic minoxidil brand and also Kirkland to no effect. I’ve been hoping it’s maybe slowed the hair loss process. The hair around my crown just keeps getting thinner. Do you think changing to another “better quality” brand like Lipogaine or Rogaine could work? Or does it appear that any minoxidil brand is not going to work?
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