Thanks for your response and awesome article! Do you recommend sticking with minoxidil for a period of time (i.e. 6 months) before starting finasteride or do it all at once? I would be on finasteride now if I wasn’t nervous about the potential side effects so my plan was to wait to see if minoxidal does anything for me over the next 3 months or so (at that point I will have been on it ~ 6 months). My shedding has certainly reduced so hopefully it is starting to work. I’m in the very early stages of hair loss. No one would notice (except me and my wife). Just looks my hair part on the top of my head even though it really is thinning.
Minoxidil: This medicine is applied to the scalp. It can stop hairs from getting thinner and stimulate hair growth on the top of the scalp. The U.S. Food and Drug Administration (FDA) has approved minoxidil to treat hair loss. It is the only hair re-growth product approved for men and women. A dermatologist may combine minoxidil with another treatment.

Some doctors prescribe Avodart off-label (meaning to treat something other than illnesses or conditions listed on the drug's label) to patients suffering from male-pattern baldness. Dutasteride, the active ingredient in Avodart, like finasteride, is used to treat enlarged prostate glands, but it blocks both types of the enzyme that create DHT, instead of just one. Studies show that dutasteride is superior to finasteride in treating AGA, but it has yet to be approved by the FDA for that purpose.


Reality is, if finasterise is so safe, why doesn’t merk market this drug as a vaccine for hair loss? For every man north of 18 to take this drug to prevent the possibility of balding? It’s safe, so why not? Truth is the science isn’t clear that either AR inhibition or DHT reduction is safe. All we know is that merk did a study and were able to publish data that suits their agenda. 

Finally, if these tests come back normal, your dermatologist may suggest a scalp biopsy of a couple of two-millimeter sections taken from your scalp under local anesthesia ($400 and up). It can determine whether genetic hair loss, telogen effluvium (a condition in which hair falls out from stress or rapid weight gain), or a disease (such as lupus) is the cause of your shedding, and your dermatologist can treat you accordingly.
Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known.
Carrots contain a wide range of vitamins (C, K, E, B1, B2, and B6) and minerals (potassium, manganese, molybdenum, and phosphorus). They also contain carotenoids that act as antioxidants. All of these revitalize the hair follicles and make your hair longer and thicker (51). Apart from the topical application, add carrots to your diet in the form of juices or simply eat them raw.
Rosemary is one of the first essential oils people choose to promote hair growth and reduce hair loss. Rosemary oil stimulates new hair growth and can be used to treat androgenetic alopecia. Mix a few drops of rosemary oil into a carrier oil and massage it into your hair and scalp before rinsing. Do this a few times per week. Add a few drops of rosemary oil into your shampoo and conditioner on a daily basis. Do not use essential oils directly on the skin. Always mix them in a carrier oil or shampoo.

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.
Excessive hair loss led me to this product about six years ago, and having sought advice from physicians ("It's stress"), a vitamin guru ($150 later) and all the information I could glean from the internet, I was wisely advised by my dermatologist to try men's Rogaine. The price, however, was a major deterrent, so more sleuthing led me to Walmart, and their version of Rogaine -- just plain minoxidil, but at an affordable price. Equate did wonders! And has continued to work its volumizing wonders over the years. My hair's thick and shiny, and while it undergoes spells of temporary loss, it always returns in full volume. I couldn't live without this product -- and a three-months' supply for a little more than $18 (5% solution), it's not only a bargain, but a blessing!!
2. Pyrithione zinc shampoo. Traditional volumizing shampoos will give the hair you have a lift so it looks fuller (we like the sulfate-free L’Oréal Paris EverPure Volume Shampoo, $8). But some research suggests shampoos with the antidandruff ingredient zinc pyrithione can mitigate hair loss that’s caused by conditions like dandruff, says Mirmirani. Try Head & Shoulders Deep Moisture Shampoo ($6), and use a conditioner without silicones — they can make hair appear limper, especially if it's applied near the roots (we like Love Beauty and Planet Coconut Water & Mimosa Flower Conditioner, $9).
Minoxidil (Rogaine, generic versions). This drug was introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research confirmed that a 2% solution of minoxidil applied directly to the scalp could stimulate hair growth. How it works is still not clear. Two double-blind studies of women ages 18 to 45 demonstrated its effectiveness. In one study, 13% of female minoxidil users had moderate hair growth, and 50%, minimal growth (compared with 6% and 33%, respectively, in the placebo group). In the second study, 60% of women in the minoxidil group reported new hair growth, compared with 40% in the placebo group. As a result of these studies and others, over-the-counter 2% minoxidil is FDA-approved for treating androgenetic alopecia in women.
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.
Since birth control pills decrease the production of ovarian androgens, they can be used to treat women's androgenetic alopecia. Keep in mind, however, that the same cautions must be followed whether a woman takes contraceptive pills solely to prevent contraception or to treat female pattern baldness. For example, smokers age 35 and older who take the Pill are at higher risk for blood clots and other serious conditions.
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.

Hair: It’s a natural part of being a human. But when the temperature climbs, and skin is exposed, it’s one of those things that a good many of us want to control. This week, we’re tackling hairlessness, not just the process of hair removal (electric shavers and ingrown-hair treatments and aesthetician-approved tweezers) but also what to buy when you’re losing your hair, and even how to take care of a Sphynx cat. Here, we’re talking to dermatologists and hair-loss doctors about hair-loss treatments that actually work.


The other main hair-loss treatment that was recommended by all four dermatologists I interviewed is finasteride, often called by its brand name Propecia. This FDA-approved medication is only available with a prescription, but these days, it’s found as a generic and ordered online after a virtual consultation, through start-ups like Hims, Keeps, and Lemonaid.
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.
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration.

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.


While you won’t find a miracle shampoo on the market, nioxin and some other products can help keep your scalp in tip-top shape to improve the look of any hairs you do have left on your head. In fact, feeding your hair with the proper nutrients both inside and out can make it appear healthier, so you might consider using products with natural herbs, such as rosemary and mint.
"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.
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.
Well, there you have it, folks. Without legitimate clinical evidence, there's no way of telling whether castor oil is the hair-care cure-all some people claim it is. That being said, as long as you consult your doctor first, there should be no problem with you experimenting with it on your own to see how and if it works for you. At the end of the day, we're not calling anyone a liar, but facts are facts, so until there's more science-backed information on the subject, it's best to take any glowing tesimonials with a grain of salt.
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.
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
Stop use and ask a doctor if chest pain, rapid heartbeat, faintness, or dizziness occurs sudden, unexplained weight gain occurs your hands or feet swell scalp irritation or redness occurs unwanted facial hair growth occurs you do not see hair regrowth in 4 months May be harmful if used when pregnant or breast-feeding. Keep out of reach of children. If swallowed, get medical help or contact a Poison Control Center right away.
"Castor oil will not grow hair," says cosmetic chemist and author Perry Romanowski matter-of-factly. "There is no evidence for it and no scientific theory supporting that it would work, so yes, it's a total myth." In better news, he says that castor oil is not damaging to the hair and can provide some conditioning that improves the flexibility of the hair fiber.
Some treatments in development hold particular promise for women. Angela Christiano, a hair geneticist and Columbia University professor of dermatology, is hoping to begin clinical trials in a year or two on a procedure in which she dissects hair-follicle stem cells, grows them in the lab until she has several million, then injects them into the scalp, where, a very small study done with a human skin model has shown, they induce new hairs.
Coming in at the fourth position is the all-natural, plant based organic shampoo from PhytoWorx. The shampoo is formulated with plant stem cells to promote hair growth and tackle DHT. Rare plant cells from the plant Malus domestica, along with various essential oils, promote a healthy roots. The shampoo formulation is very easy to use and is completely hassle free. If you are looking for an all-natural formulation, this is one of the best.
While trauma can come on suddenly and unexpectedly, you may be able to help manage ongoing stress in your life with exercise, like yoga, or mindfulness techniques, like meditation. Some researchers are even exploring these alternative healing modalities in relation to reversing hair loss. The idea is that yoga and meditation may help regulate blood sugar and enhance circulation, promoting regrowth.
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.”
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.
During a hair transplant procedure, a dermatologist or cosmetic surgeon removes tiny patches of skin, each containing one to several hairs, from the back or side of your scalp. Sometimes a larger strip of skin containing multiple hair groupings is taken. He or she then implants the hair follicle by follicle into the bald sections. Some doctors recommend using minoxidil after the transplant, to help minimize hair loss. And you may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery.

1. Collagen powder. Preliminary studies suggest that marine-sourced collagen may stimulate hair growth, says New York City dermatologist Yoon-Soo Cindy Bae. Though more research is needed, participants in studies reported thicker hair after three to six months of daily use. Crushed Tonic Original Powder ($105) easily mixes into coffee, tea, and water.
Thank you for such a great article. I have just started notice of my hair fall and want to do something about it. I have seen the Reviews for REGAINE so far, that seem effective. Can you please tell me, are ROGAINE and REGAINE same products ? If not, which one will you recommend ? Also, is there any need to use anything beside with one of the above products ? Thanks for your time,
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?
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.
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.
Getting Rapunzel-like strands is no easy feat—ask any girl who’s gobbled down countless biotin pills and vitamin E supplements only to be greeted with the same lackluster strands. There are a lot of factors that contribute to hair growth (or lack thereof), but one of the most overlooked is physical stimulation—as in, massaging the heck out of your scalp. Turns out giving yourself a scalp massage using some key natural ingredients can help your hair grow faster and in turn make your strands look more Blake Lively–esque. Or there’s the whole egg-yolk-mask thing. Or why not try a hot oil castor oil treatment? There are plenty of natural treatments that will give you the hair of your dreams—all you have to do is look to your kitchen for the necessary supplies.
The trick about all of these hair-loss products and treatments is that they’ll stop working as soon as you stop using them. “They have to be ready for a lifetime commitment,” says Rieder. But, just like brushing your teeth, as long you keep on keeping on with the scientifically proven preventative treatments, those hairs on your head should be just fine.
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