As with transplants, the word toupee conjures an outdated and disagreeable image. The 70s-style rugs have mostly been traded in for spiffier "hair replacement systems." But the basic concept -- a foreign object atop your head -- can only evolve so far. Of course, the effectiveness of hairpieces is tough to evaluate. You may spot an awful one now and then, but the ones you do spot are just the awful ones. Who knows how many masterpieces slip undetected under the radar?
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.
Like the long-suffering friend who inspired her to undergo the procedure, Ms. Telford quickly saw an improvement in her hair. New hair growth usually take at least four months, but at the two-month mark, she has already spotted some baby hairs. “Not a gazillion,” she said, “but it’s a start.” She’s planning to return for follow-up treatments every six months, and has high hopes of ditching the wigs and wearing her hair in a pixie.

It may seem a peculiar American vanity that men have in-boxes full of hair loss treatment offers and spend billions of dollars on hair loss treatments each year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's Historic Quest to End Baldness, chrome-dome anxiety has tormented us for ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says.

Warnings For external use only Flammable: Keep away from fire or flame Do not use if your degree of hair loss is different than that shown on the side of this carton, because this product may not work for you you have no family history of hair loss your hair loss is sudden and/or patchy your hair loss is associated with childbirth you do not know the reason for your hair loss you are under 18 years of age. Do not use on babies and children. your scalp is red, inflamed, infected, irritated, or painful. you use other medicines on the scalp.
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.”

Defy hair loss with ROGAINE®, the #1 dermatologist-recommended, FDA-approved brand with a clinically proven formula to regrow hair. Unlike thickening shampoos that temporarily coat the hair, ROGAINE® penetrates deep into your scalp to revive follicles and increase protein production so you can grow new, fuller, thicker hair. The revolutionary formula begins to work on contact with patented Tricho-Prime™ Technology, a proprietary combination of ingredients that primes your scalp for optimal hair regrowth.


Apply one mL 2 times a day directly onto the scalp in the hair loss area. See carton and enclosed leaflet for complete directions. Using more or more often will not improve results. Continued use is necessary or hair loss will begin again. When using this product do not apply on other parts of the body. Avoid contact with the eyes. In case of accidental contact, rinse eyes with large amounts of cool tap water. Some people have experienced changes in hair color and/or texture.
When men have hereditary hair loss, they often get a receding hairline. Many men see bald patches, especially on the top of the head. Women, on the other hand, tend to keep their hairline. They see noticeably thinning hair. The first sign of hair loss for many women is a widening part. In rare cases, men see noticeably thinning hair. And in rare cases, women can see a receding hairline or bald patches. The reasons for this are unknown.
NuNutrients Advanced is a potent serum that works at the root of hair loss. It revitalizes hair follicles, helps reduce hair loss, and reduces inflammation, while regrowing hair by reducing the level of DHT (which can degrade hair follicles and inflame the skin). Voted a #1 trusted brand in 2013 and 2014, this effective treatment uses Biochanin A (extracted from Red Clover) to produce results that can’t be achieved with other products. Biochanin A is a natural inhibitor of DHT, subdues hair loss, and modulates free radical damage to the skin and scalp. This helps the hair stay rooted much longer, while increasing the size of the hair follicle for better volume. It also uses Acetyl Tetrapeptide-3 Biomimetic peptides to stimulate the extracellular matrix proteins for stronger hair anchoring. It also prevents hair from falling out and improves the scalp’s health, while adding more volume and increasing the size of the hair follicle.
NuNutrients Advanced is a potent serum that works at the root of hair loss. It revitalizes hair follicles, helps reduce hair loss, and reduces inflammation, while regrowing hair by reducing the level of DHT (which can degrade hair follicles and inflame the skin). Voted a #1 trusted brand in 2013 and 2014, this effective treatment uses Biochanin A (extracted from Red Clover) to produce results that can’t be achieved with other products. Biochanin A is a natural inhibitor of DHT, subdues hair loss, and modulates free radical damage to the skin and scalp. This helps the hair stay rooted much longer, while increasing the size of the hair follicle for better volume. It also uses Acetyl Tetrapeptide-3 Biomimetic peptides to stimulate the extracellular matrix proteins for stronger hair anchoring. It also prevents hair from falling out and improves the scalp’s health, while adding more volume and increasing the size of the hair follicle.
3. Surgical hair replacement. If you opt for hair transplantation (which runs $5,000 and up), your dermatologist or hair-replacement surgeon will remove single hair follicles from the back of the head, near the nape of the neck, where your hair is fullest. Once those follicles are harvested, they are then dissected and reimplanted into an area of the scalp where hair is thinning. The procedure takes anywhere from three to six hours, and newly implanted hair will usually begin to grow on its own 3 to 12 months after the treatment session. Traditionally, hair transplantation required removal of an entire strip of scalp, Sadick says, but this new follicle-by-follicle technique looks more natural when it heals and allows patients to get heads of hair as dense-looking as before they started losing it.
Coming in at number 7 is the tablet formulation from Research Verified. This tablet formulation contains a mixture of multi-vitamin blends and trusted compounds known to promote hair growth and prevent future hair fall. The product is manufactured in US FDA certified labs ensuring high quality. Containing active ingredients such as Saw Palmetto and Ginkgo biloba, help promote natural and lustrous hair regrowth.
If you’re a lady and can remember the one difference in directions (or just scope out the instructions online) we recommend saving the cash. Similarly, you could go generic with Equate Hair Regrowth Treatment for Men or Costco’s Kirkland Signature Hair Regrowth Treatment Minoxidil Foam for Men. These alternatives offer the same percentage of active minoxidil and near-identical inactive ingredients for as little as half the price — a great option for both genders.
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. 
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.
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.
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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.
And though this treatment appears to be safe and somewhat effective, it’s hard to tell who will react well to this low-level light therapy, which is why the doctors I spoke with were hesitant to fully endorse it. “We’re not sure what the optimal power is, what the optimal wavelength is, we don’t even really know the mechanism of action of how this is working,” says Rieder. Plus, it doesn’t work on everyone. “There are subpopulations of patients who do respond to low-level laser light, but this is not easily predictable,” explains McMichael, though she adds that the risk of using the LaserComb is low.
Oral supplements can also be effective if the result of the problem that causes the hair loss in the first place. For example, women with a lack of iron or zinc in their diet may have thinning hair. Or persons taking certain medications may not absorb enough nutrients from food to support healthy hair growth. Also, remedies like saw palmetto and Fo-Ti appear to block the production of DHT.
In clinical testing, nearly nine out of 10 men noticed results. The solution is intended for men only and is easy to use on a daily basis. Simply dispense 1/2 capful of foam in your hands, part your hair, and apply in the area where your hair is thinning. Use your fingers to massage throughout the hair loss area twice a day and you should notice regrowth in as little as two months. Results last only as long as you use the medicine.

Some 30 million women in the United States have hereditary hair loss (compared with 50 million men), according to the American Academy of Dermatology, though that figure does not include the millions more who struggle with thinning hair because of pregnancy, menopause, stress and other health conditions. Barely 5 percent of women are said to be good candidates for hair transplant surgery because women lose hair everywhere, meaning that, unlike with men, there is rarely a luxuriant spot on the back of the head from which to harvest hairs unobtrusively.

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.
The first robot designed to help surgeons perform a portion of the hair transplant procedure recently became FDA approved. Called the ARTAS Robotic-Assisted FUE System by Restoration Robotics, it’s an image-guided robot with micron-level precision that harvests up to 1,000 hair grafts per hour – which has made hair transplant surgery even more accurate and efficient.
Cyproterone acetate is not available in the U.S. Doctors consider it one of the last resorts for treating female pattern hair loss because of its possible toxicity and long-term side effects. As with any drug, side effects other than those listed on the package may occur. Contact your doctor if you notice a side effect that is unusual or particularly bothersome.
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Adam Friedman, a program director at The George Washington University School of Medicine & Health Sciences, is on the same page as Romanowski. "While it does have antimicrobial properties which may be useful in terms of fighting off bacterial or fungal overgrowth on the scalp that can lead to hair-damaging inflammation, there is zero evidence [showing] it is helpful for hair growth," he says, adding that some people can actually be allergic to castor oil and experience inflammation, ultimately doing more damage than good to the scalp. "To propose that castor oil accelerates hair growth, a tightly regulated process (one centimeter per month) for which FDA approved medications for hair loss do not impact, is ridiculous," he states.
Rogaine’s foam squirts out just like hair mousse and is applied with “cool, dry hands.” Applying means working the foam down to the scalp where you want to see thicker growth — for it to work, “it has to get into your scalp,” Dr. Wolfeld explains. “If it sits on your hair, it’s not really as effective.” Once massaged, it dissolves into a watery liquid that leaves a tingly sensation, “but no burning!” one of our balding testers was happy to discover.
If you’re a lady and can remember the one difference in directions (or just scope out the instructions online) we recommend saving the cash. Similarly, you could go generic with Equate Hair Regrowth Treatment for Men or Costco’s Kirkland Signature Hair Regrowth Treatment Minoxidil Foam for Men. These alternatives offer the same percentage of active minoxidil and near-identical inactive ingredients for as little as half the price — a great option for both genders.
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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.
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.
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.
"I recently started using your hair growth products, and now there is no looking back. My hair has always been really thin and fine and growth around the hairline at the temples has been poor. It almost looked like my hairline was receding. I didn't like putting my hair up as I looked like I was going bald. But, not any more. My hair feels thicker, and growth is improving at the temple area. My hair would never grow beyond my shoulders, that's going to be the next test, how long will it grow!! Thank you, after years of irritation with my fine hair things are looking up." 
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