"There's never been a single study to show they work," Bernstein says of the alternative remedies. "It's conceivable that some might have some minor impact. But the real problem is that people waste valuable time experimenting with them when they'd be much better off spending their money on something proven to work. The window for Propecia passes, and if you've spent two years with this herbal thing instead, that can make a big difference in the results you ultimately get."
The test involves plucking about 50 hairs from the head, typically at the back of the scalp, so your dermatologist can look at them under a microscope and determine how much of the hair is in the resting, growth, and fall-out phases. Next, a vial of blood is sent to a lab to check hormone and nutrient levels ($100 and up, depending on insurance). If low levels of iron, or high levels of male hormones, like androgens, are contributing to your hair loss, for example, both can be treated through oral supplements or medication.
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.
When it comes to prescriptions, Propecia (finasteride) stands as the strongest oral option for treating balding. If used consistently, this hair-loss treatment stops the progression of pattern hair loss, caused by genetics, for most users -- no messy application necessary. Although the drug has yet to earn FDA approval for treatment of women, recent studies have shown that it is both safe and effective for female users. See our full review »
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.
What is your opinion on laser combs? I went to the Men’s Club yesterday and they recommended I spend ~$800 to buy a laser band, comb or hat. What is your opinion on how those work? Sounds like snake oil to me. They also recommended I go to my dermatologist to get a prescription to reduce sebum in my hair. I have been on Fin for 11 months, Minox foam 1x/day yet hair shed hasn’t stopped. I do have a prescription for Ketoconazole shampoo but rarely use it. I read in your article that this shampoo does help with Sebum build up so I will try that. Any other recommendations for sebum reduction?
2. A strategic cut. Long, layer-free haircuts divert volume from the roots, making your part seem wider than it is, Scrivo says. Going shorter (than your current length — no need for a major chop) helps take weight off so hair can look fuller and bouncier. And layers that angle inward on the sides will build height and body at the crown. If you’re game to try bangs, Scrivo says, they lessen the amount of scalp that shows at the hairline.
You can maximize your results from minoxidil by dying your hair after two to three months of treatment. Minoxidil tends to create very fine hairs at first, and dying the hair increases the contrast between the hairs and the scalp, making the new hair growth area look denser. This is one common technique in before/after photos for hair loss treatments.
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.

Physicians are reluctant to prescribe systemic treatments (pills or other form of treatment that affects your entire system) because they can tamper with your body's own androgen levels (see Causes for an explanation of androgens). The doctor will first want to confirm that the hair loss is due to an excess of androgen (another name for male hormones) in the system or a sensitized "over-response" to normal amounts of androgen. Therefore, physicians often choose topical treatments, which are applied directly to the scalp.
"I recommend that everyone [with any hair loss] take finasteride," says Robert M. Bernstein, MD. Bernstein is associate clinical professor of dermatology at Columbia University and founder of the Bernstein Medical Center for Hair Restoration. "To patients who are younger,” he says, “I also recommend minoxidil. But the mainstay is finasteride. The data show that, over five years, it significantly retards hair loss in 85% of users."
I’m 33 and I still have quite a full hair line. I was facing mild hair loss until recently I’m noticing a lot of shedding, I’ve been on Propecia for the past year though. I’m not sure if Propecia is not effective on me anymore or it was kind of limiting hair fall until now. I’m even doubting that it could be MPB but do you think The Big Three would also help even if it wasn’t an MPB case?

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.


I’m 33 years old. I’ve been using Finasteride (1mg) for over 3+ years now, and it really stopped my hair loss. I say I’m a living proof of the effectiveness of this drug. And yes it really lowered my libido. But then in these past days, I felt this pain around my testicles. Then my leg became partly numb. I tried to experiment on how to stop the pain and numbness by stopping Finasteride for a while. Sequentially, the pain and the numbness went away after stopping it. I’m afraid of coming back on drinking Finasteride again.

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.


Yes. Hyperandrogenism, a medical condition characterized by excessive production of male hormones called androgens, can cause hair loss in affected women. The most common cause of hyperandrogenism in women is functional ovarian hyperandrogenism, also known as polycystic ovary syndrome. In addition to hair loss, other signs include obesity, acne, and irregular menstruation, and it is one of the most common causes of infertility.
Viviscal is a natural hair-growth supplement that promotes hair growth in people with thinning hair. It contains a marine complex known as AminoMar C. This is made of minerals, vitamins, and shark and mollusk powder. These ingredients help to regenerate new cells and strengthen existing cells. You have to take the pills twice a day for at least six months in order to see results. Viviscal also makes a shampoo and conditioner.
×