That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).
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.
Instead, you may want to add vitamin D (about $15) to your shopping cart. A vitamin D deficiency can exacerbate hair thinning and make it almost impossible for any over-the-counter product to reverse hair loss, says Dhaval Bhanusali, a dermatologist in New York City, who recommends taking 5,000 international units of D3 a day (and it’s generally beneficial for bone health in women over 40). “There’s also a link between low iron and zinc levels and temporary hair shedding, called [telogen] effluvium,” says Rogers.

4. Tinted dry shampoo. Camouflage spots where you’re seeing more scalp than you want to (your hairline, a widening part, a thinning crown) and add volume with a colored dry shampoo (try Orlando Pita Color Boost Dry Shampoo in Light or Dark Tones, $22). But be sure to give your scalp a vigorous shampoo during your next shower — dermatologists recommend keeping your scalp free of styling products so you’re not clogging already taxed pores.
Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic, said that Rogaine works better on the top and crown (for reasons not fully understood, the frontal hairline tends to be more resistant to treatment) and ideally should be started as soon as women notice thinning. “Any regrowth you get is a minimal amount,” Dr. Piliang said. “So the more density when you start, the better results you get.”
Side effects and concerns: Minoxidil is safe, but it can have unpleasant side effects even apart from the alcohol-related skin irritation. Sometimes the new hair differs in color and texture from surrounding hair. Another risk is hypertrichosis — excessive hair growth in the wrong places, such as the cheeks or forehead. (This problem is more likely with the stronger 5% solution.) Because the patent on Rogaine (the brand-name version of minoxidil) has expired, many generic products are available. They all contain the same amount of minoxidil, but some include additional ingredients, such as herbal extracts, which might trigger allergic reactions.
Some companies market special hair growth vitamins and supplements that you can buy to make it easier for you to stay healthy and help prevent hair loss. In general, however, all you need to do is make sure that you are getting enough protein in your diet (eating lots of protein-rich foods like dark green leafy vegetables, fish, eggs and beans), and the right levels of iron, zinc and vitamin A. B, C and folic acid. 

Oral supplements like Viviscal Extra Strength dietary supplements (Est. $50 per month) have also been proven to have a measurable effect on hair regrowth; a double-blind, placebo-controlled study in the Journal of Clinical and Aesthetic Dermatology found that the nutritional supplement significantly increased hair growth among women with thinning hair.
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.
hey am 22.. i used alot of hair dyes and relaxers on my hair when i was younger like two years ago that’s when i started going bald. i decided to cut every hair on my head , now am very shy to walk around bald so i wore a cap or hat on my head everyday even in hot weather. the shape of my head is very bad i feel frustrated like am really young for all this. i started using rogaine early this December but am not seeing any improvement or whatever is because i always cover my head with a cap or what? please i need an advice on what to do cos i don’t think i can go anywhere without covering my ugly head.

The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”

The main type of hair loss in both sexes — and the subject of this article — is androgenetic alopecia, or female (or male) pattern hair loss. In men, hair loss usually begins above the temples, and the receding hairline eventually forms a characteristic "M" shape; hair at the top of the head also thins, often progressing to baldness. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman's hairline rarely recedes, and women rarely become bald.
Many physicians recommend that patients engage in a combination therapy that includes minoxidil and Propecia (Est. $75 per 1-month supply) with prescription. Propecia is an oral medication with finasteride being the active ingredient. Finasteride was originally developed by Merck to treat enlarged prostate glands. Excess hair growth was a surprise side effect of the drug and led to the development of Propecia, which was approved by the FDA for treatment of male-pattern baldness in 1997. It has not been approved for women.
While minoxidil has been clinically proven to slow the progression of hair loss and regrow some hair, most experts see it as a relatively marginally effective drug in the fight against hair loss. Since minoxidil has no effect on the hormonal process of hair loss, its positive effects are at best temporary and usually yield somewhat disappointing 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?

Folic acid is also known as vitamin B9. Folic acid supplements are often recommended to improve hair growth and treat hair fall. It plays an important role in the formation and function of red blood cells in the body. These cells are responsible for transporting various nutrients, enzymes, and hormones to different parts of the body, including the scalp and hair (18, 19). Supplements can be taken for this on a daily basis to help in hair growth.
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.
Her hope is that the procedure (she has helped start a company named Rapunzel to develop it) will eventually become another lunchtime cosmetic treatment. Once a patient has had her cells harvested and cultured, they could be stored indefinitely; then, after giving her doctor a month’s notice (the time it takes to grow the million needed), she could pop in for injections. Costs would likely be on par with hair transplants, roughly $10,000 and up.
Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic, said that Rogaine works better on the top and crown (for reasons not fully understood, the frontal hairline tends to be more resistant to treatment) and ideally should be started as soon as women notice thinning. “Any regrowth you get is a minimal amount,” Dr. Piliang said. “So the more density when you start, the better results you get.”
“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?”
The most unique ingredient in this tablet formulation is solubilized keratin. It is a breakthrough supplement proven to help reduce hair loss and promote regrowth. The tablets also contains a blend of 23 essential vitamins essential for micro-circulation of blood within the roots of the hair. The product is suitable for both men and women and has been shown to effectively combat the balding.
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.
Side effects and concerns: Around the time new hair growth starts, some women experience folliculitis (inflammation of the follicle). This minor complication can be treated with compresses and antibiotics. A more serious hazard is shock loss, the sudden loss of hair that normally grows in the area of the transplant. Shock loss affects 30% to 50% of female hair-transplant recipients; fortunately, the loss is usually temporary, and the hair will regrow. One drawback is that there's a finite amount of donor hair, and it may not be enough to fill in the transplant site as densely as before, especially if the area of thinning hair is large. A transplant procedure can cost from $4,000 to $15,000 and is rarely covered by insurance.
Keranique's Hair Regrowth Treatment features the only FDA-approved ingredient clinically proven to help women regrow hair. Perfect for women with thinning hair looking for serious and long-term solutions to maintain their hair's fullness. Use twice a day, everyday, for healthy and fuller-looking hair. The Keranique Hair Regrowth Treatment’s active ingredient is clinically proven to reactivate dormant hair follicles and help re-grow hair.
SOURCES: George Cotsarelis, MD, director, Hair and Scalp Clinic, University of Pennsylvania School of Medicine, Philadelphia. Andrew Kaufman, MD, assistant professor, department of dermatology, University of California, Los Angeles; medical director, Center for Dermatology Care, Thousand Oaks, Calif. Tom Barrows, PhD, director of product development, Aderans Research Institute Inc., Atlanta. Cotsarelis, G. and Millar, S.E. Trends in Molecular Medicine, July 2001; vol 7: pp 293-301. American Society for Dermatologic Surgery web site. American Academy of Facial and Reconstructive Plastic Surgery web site. American Hair Loss Council web site. Springer, K. American Family Physician, July 1, 2003; vol 68: pp 93-102. Hair Loss Help web site, "Interview with Dr. Ken Washenik from Bosley." Fuchs, E. Developmental Cell, July 2001: vol 1: pp 13-25.
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.
"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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