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.
Almost all hair loss in guys results from male-pattern baldness, a genetic trait that comes from your parents. Other causes include certain medications, too much vitamin A, or not enough protein. Illness or stress can lead to sudden, heavy shedding called telogen effluvium. Good news, though: Hair loss that isn’t from male-pattern baldness often reverses itself.
A commonly prescribed treatment for women is hormone replacement therapy (HRT). HRT is only prescribed to women with AGA during menopause or women who have low estrogen and/or progesterone for other reasons. These female hormones suppress male hormone production and seem to keep hair loss at bay. Physicians, however, do not recommend long periods of HRT treatment because of the increased risk of breast cancer, heart disease and stroke.
First things first: If you're struggling with hair loss or thinning, you're far from alone. It's extremely common, with American women accounting for 40 percent of Americans struggling with hair thinning or loss. It also tends to be most prevalent in your 40s and 50s. This can occur for a laundry list of reasons, including hormonal changes, Alopecia, and stress, so it's always best to visit your doctor to determine what's going on. Regardless of the reason, losing your hair can be extremely devastating for some — make that most — people, seeing as hair is an external factor that can greatly impact a person's self-image and confidence. (Thanks for that, societal pressure.)

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.
Massaging the scalp can help to restore hair growth and can be used in conjunction with hair oils and masks. This stimulates the scalp and can improve hair thickness. Taking the time to massage your scalp each day can also help you relieve stress and tension. It’s thought that stretching forces during the massage encourage hair growth and thickness in the dermal papilla cells.
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.
“I think their effectiveness is not as significant as finasteride or minoxidil,” says Dr. Wolfeld, “however, it’s something that can be used quite easily by patients at home. If they use it two or three times a week, I tell them it can help to thicken their hair.” Results can take up to 18 months to show up, so Dr. Wolfeld stresses that patience is a virtue.

In the past few years, medicine has made tremendous strides in the treatment of men's hair loss. With the advent of 5-alpha-reductace inhibitors such as Propecia and the evolution of surgical hair restoration, living with noticeable hair loss is no longer inevitable. For the first time in the history it is now possible to stop or slow the progression of hair loss and to replace lost hair through surgery with completely natural results.
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.
"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.
Dr. Carlos Wesley, a hair restoration surgeon in Manhattan, said that women in his practice respond better to P.R.P. than men do, which may have something to do with the fact that women with genetic hair loss tend to have more inflammatory cells around the follicles. From 2013 to 2014, he said, he had an 83 percent increase in female patients, in part because of P.R.P.
Lemons are rich in vitamin C and vitamins B1, B2, B3, B5, B6, B12, folic acid, and other nutrients. Plus, they are loaded with antioxidants. In addition to hair growth, lemon juice promotes smooth, shiny, dandruff-free hair. When applied on the scalp, it stimulates circulation and hence prevents hair loss. Do not use lemon juice in excess though, as it can lighten your hair color over time.

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).
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).
This procedure can take several hours. First, surgeons remove an elliptical strip 3 to 4 inches long from the back of the scalp and trim the hairs short (A). The strip is then divided into 500 to 2,000 separate follicular units, each containing only a few hairs (). The units are then planted in an equivalent number of slits made in the scalp in the area of missing hair (C).
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.

Did you know the average woman is born with about 100,000 hair follicles on her head--and she keeps them for the rest of her life? Most women lose between 50 and 100 hairs a day. If your hair is healthy, it will grow back on its own. But if you're one of the 30 million women in America who experience hereditary hair loss, you may be losing 150 hairs or more a day--hair that doesn't grow back as thick and healthy as it once was.
According to Men’s Fitness, Minoxidil will help slow the hair loss process, preserve the hair you have, and regrow hair more quickly. The six month supply of unscented topical solution is clinically proven to help regrow hair and revitalize hair follicles. The easy-to-use application can be used once daily. Simply apply the solution along the scalp using the dropper.
Great article thx!! I’m 38 and still have a full head of hair but I started to shed about 3 months ago. Typically ~15 hairs on my pillow when I wake up and 20 or so hairs on my hand after I shower. I also notice hairs on my desk during the day. I never noticed any hair loss before 3 months ago. I started to use rogaine 5% twice a day about a month and a half ago and the shedding accelerated. I read that is normal but should it still be doing this after 1.5 months? I haven’t tried propecia yet as I want to see if Rogaine will do the trick but will if the shedding doesn’t stop. Also, do you think stress can play a part in hair loss? I started a super stressful job about 6 months ago so thinking my hair loss could be related to that.
This study claims laser therapy does have some sort of effect, but I’ve never found any people who swear by it, like for minoxidil, finasteride, and keto. I wouldn’t waste my money on it. To be honest with you, I’m on minox, fin and keto for about 3 years now and still experience sheds every once in a while. I wouldn’t worry about it. While my hair is shedding my hairline is staying intact. How often do you use the keto shampoo?
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.
You can also get a hair-loss kit from Hims, which comes with both minoxidil and finasteride. Keeps has one, as well. And though it might seem like overkill to take two different hair-loss treatments at once, this is one of those rare instances where more is actually better. McAndrews calls the combination of orally administered finasteride and topically applied minoxidil a “full-court press” against hair loss. “That’s doing the most you can for preventative medicine.” Rieder notes that taking both drugs together is more effective than taking either one alone.
Hair loss is part of the natural aging process but can also be genetic or caused by a medical condition. It’s crucial to choose a treatment that won’t dry out your hair, will give it volume, and will keep your scalp healthy. If hair loss is caused by hereditary baldness, the FDA has approved minoxidil (Rogaine) at 5%, which is available over the counter. Other hair loss treatments for women contain natural ingredients like tea tree oil and flower extracts. Some products need to be used daily, but others can be used less often. Some take weeks to show results while others help hair growth within days. Some hair loss treatments are more suitable for certain types of hair (dry, oily, combination, or colored).
The big three are still the best anti-hair loss regime for most men who just started losing their hair. They are safe, inexpensive, take little time to apply, and best of all, they work. However, If your hair is beyond the Norwood 3 scale, you might want to be looking into other solutions, like a hair transplant. The big three are much more effective at keeping your hair, not regrowing it.
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.
Using ROGAINE doesn't mean giving up your favorite styling products. So spray away. Gel it up and/or mousse around. Just make sure your styling aids don't interfere with letting ROGAINE become absorbed into your scalp. Always remember to wait until ROGAINE dries before you use your styling aids, and be sure to apply styling aids to your hair--not to your scalp.

Other options include microneedling ($1,200 and up per treatment) and platelet-replacement therapy (also $1,200 and up per treatment), which are usually offered in conjunction. Your scalp will be numbed first so you don’t feel the pinpricks involved in microneedling. They promote hair regeneration by spurring wound healing, and platelet-replacement therapy involves injecting growth factors into those wounds. “Combination therapy typically works better than monotherapy and usually yields results after three monthly treatments,” says Sadick, and should be teamed with an at-home minoxidil treatment.
While diet alone won’t save your hair, there may be some truth to the old adage that you are what you eat. “You’re not going to have the healthiest hair if you’re living off doughnuts, because being nutrient-deficient weakens strands and makes them more prone to breakage,” says Denise Kernan, owner of DK Hair Techs, Inc., a member of the International Society for Hair Restoration Surgery, and a hair transplant technician who has worked on everyone from senators to sports stars to actors to mafia guys (she won’t name names to protect the privacy of her clients).

About one-third of women experience hair loss (alopecia) at some time in their lives; among postmenopausal women, as many as two-thirds suffer hair thinning or bald spots. Hair loss often has a greater impact on women than on men, because it's less socially acceptable for them. Alopecia can severely affect a woman's emotional well-being and quality of life.
Men may also experience some sexual and emotional side effects while taking it: In a study published in the June 2011 issue of The Journal of Sexual Medicine, Dr. Michael Irwig of George Washington University found as many as 92 percent of test subjects reporting problems in the bedroom. The study also reported that “the mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months,” meaning that side effects lingered long after subjects stopped taking the pill.
Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.

3. Hair fibers. The best (and easiest) way to hide a widening part or sparse patch is with hair fibers. They’re tiny, charged fibers that adhere to your scalp (until your next shampoo). Toppik Hair Building Fibers ($25) come in a range of colors so you can easily find one that matches your own hair. (In a pinch, you can also brush a powdered eye shadow that matches your hair color along your part.)
1. Hair color. Anytime you dye your hair, you’re increasing the diameter of each strand, which can help add volume when your hair is sparse and fine. As a general rule, ask your colorist to make sure highlights are finer at the top of the head, where hair is the thinnest, and more intense at the bottom, where it’s thickest, says Eva Scrivo, a hairstylist and the owner of the Eva Scrivo Salon in New York City. And beware: A color that contrasts with your scalp (blonde tones if your scalp is dark, deep brunettes if your scalp is light) will make any visible scalp more obvious.
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.
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