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?
Domen, I was reading some articles and also the links you’ve provided in your other comments above – they say both Finesteride and Minoxidil only check further hair loss and thicken existing hair – but both can’t re-generate hair that’s already gone from bald spots. I guess the effectiveness of these 2 medications are quite proportionate to age of the native! At 42, I guess, I am old 🙁 Atleast according to Indian standards!!
The most common kind of hair loss is pattern baldness. It happens when hair follicles shrink and stop working. The first sign is the appearance of strands that are thinner and more fragile. Then the scalp becomes more visible as fewer hairs grow to replace those that shed. That’s because the anagen phase becomes too short for the hair to grow out of the scalp. Plus, the hairs that remain aren’t securely anchored. And this condition happens to both men and women.

One common side effect of minoxidil is a red, itchy scalp, but users claim that merely switching brands can sometimes alleviate that symptom. Another possible side effect is excess hair growth in unwanted places, including the face. It is important to point out that unwanted hair growth and other side effects go away once treatment is discontinued.
One hard truth: Hair loss is mostly out of your control. “Baldness comes down to your genes,” says Frederick Joyce, M.D., founder of Rejuvenate! Med Spa and a member of the International Society for Hair Restoration Surgery. “If you have the baldness gene, there are some natural remedies that may make your hair stronger and healthier to slow your hair loss slightly—but they won’t prevent you from going bald. Still, maintaining hair health by eating well and using the right products—combined with medical-grade treatments—can really work all together to help you have a fuller, thicker head of hair.”
Just letting go is possibly the most challenging of the available options. It’s also the cheapest and ultimately the most effective in the struggle with hair loss. Given the imperfections of surgical, medical, and technological options, there are many who advocate simple acceptance. (BaldRUs.com is one of several sites devoted to embracing the scalp's natural fate.) What's more, the health benefits of happier mirror time -- and fewer years of harmful anxiety -- just might offset the loss of those Samson-like powers. 

Clearly, minoxidil is not a miracle drug. While it can produce some new growth of fine hair in some — not all — women, it can't restore the full density of the lost hair. It's not a quick fix, either. You won't see results until you use the drug for two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you'll need to keep using it to maintain those results. If you stop, you'll start to lose hair again.
Some women find that the minoxidil solution leaves a deposit that dries and irritates their scalp. This irritation, called contact dermatitis, is probably caused not by the minoxidil itself, but rather by the alcohol that is included to facilitate drying. A 5% solution (available only by prescription and approved only for men) is more effective than the 2% formulation and may be prescribed off-label for women. The 5% version comes in a foam, which appears to cause less irritation than the liquid.
2. High-tech regrowth therapies. Laser treatments ($200 and up) expose hair to low levels of laser light, which boosts hair growth by increasing the amount of adenosine triphosphate (ATP) in hair follicles. ATP provides energy to hair-follicle cells, so the more of it that’s around, the more energy hair follicles can use to grow your hair. Sadick says three months of weekly sessions are best when you’re kick-starting a hair-loss treatment.
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
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.

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.
George Cotserelis, MD, is director of the University of Pennsylvania's Hair and Scalp Clinic. He agrees that there's no evidence these alternative hair loss treatments have any effect. "If any of it did work," he says, "I'd be very worried about using that product. The fact that it’s working would mean it's doing something to the testosterone and could be having adverse effects."

There are several different types of medication you can buy to help treat hair loss. Procepia and Finasteride are currently the only approved drugs you can take that will effectively treat hair loss. The active ingredient in both treatments (finasteride) works by blocking DHT (the male hormone dihydrotestosterone) that causes hair loss by shrinking hair follicles on your scalp. It has been proven to lead to hair regrowth or to stop hair loss in around 9 out of 10 men in clinical trials. 
Both minoxidil and finasteride require a lifelong commitment, but for users looking for a treatment with permanent results, hair transplant surgery may be the solution. Over the years, surgeons have developed techniques to deliver natural-looking results that are a far cry from early hair transplants, which had a cornrow-like appearance. These procedures are costly and may require multiple sessions depending on the patient.

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.


Back in the 17th century, men were told that coating their balding heads with chicken faeces would help them regain a full head of long glossy locks. While we might have moved on somewhat since then, we still don’t fully understand the science behind hair loss and hair regrowth and, unfortunately, there are still some very common myths about hair remedies that we are far too quick to believe. 
Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid. When hair loss occurs quickly, the person may have tingling, burning, pain, or itching on the scalp. Treatment may help the hair re-grow if scarring has not occurred.
Thank you. This has been the most helpful article I have read! Very much appreciated! Last question (I won’t bug you with anymore after this) . . . I was tested by my doctor and came out perfectly healthy so it is either stress or MPB. My job is extremely stressful so it could be that but I have no way or knowing for sure. As such, do you think there is any harm on me taking finasteride even if it isn’t MPB and is just stress? I suppose if the medicine didn’t work, I would know it was stress and not MPB. Also, I assume this is something I would continue to take for life right?
Ketoconazole is another off-label treatment that stands out for treating hair loss. Ketoconazole is the active ingredient in Nizoral shampoo, and 2 percent strength is often prescribed to treat dandruff -- a 1 percent formula is sold over the counter, but reviewers say that it's not as effective. Many men choose to triple-treat their hair loss with minoxidil, Propecia and Nizoral shampoo. Studies show promising results with ketoconazole, though not any better than minoxidil or Propecia, but experts insist that further study is needed.

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.
When it comes to a hair growth shampoo, you have two options: prescriptions or over-the-counter treatments. Prescription shampoos like ketoconazole are anti-androgenetic, meaning they prevent testosterone and dihydrotestosterone (DHT), two hormones associated with hair loss by targeting hair growth at the site of the follicle and helping to interrupt the hormone cycle locally that causes thinning,” explains Dr. Schweiger. “Over-the-counter growth shampoos typically contain amino acids and antioxidants to provide the components to rebuild hair as well as reduce damage and inflammation.”

"This is an oral, prescription-only medication with the brand name Propecia that’s also FDA approved to treat hair loss," says Spencer. Male pattern hair loss occurs when a hormone called dihydrotestosterone (DHT) prevents hair follicles from getting the nutrients they need. Finasteride works by blocking the production of DHT, which protects the follicles.


In-office laser light treatments or at-home handheld devices, such as the HairMax LaserComb, supposedly grow new hair by stimulating blood flow to the area (think: an amped-up version of a scalp-stimulating shampoo). Just don’t expect the device to make your noggin go from looking like George Costanza’s to Jerry Seinfeld’s. “These lasers won’t grow any new hair. If anything, they may just help you hang on to some of the hair that you already have a bit longer,” says Dr. Joyce.
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