George Cotserelis, MD, is director of the University of Pennsylvania's Hair and Scalp Clinic. He agrees that there's no evidence these alternative hair loss treatments have any effect. "If any of it did work," he says, "I'd be very worried about using that product. The fact that it’s working would mean it's doing something to the testosterone and could be having adverse effects."

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.
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2. Volumizing shampoos and treatments. Typically, these work by depositing ingredients, like wheat protein and keratin, that adhere to the hair shaft to a) thicken it and b) create spaces between hairs so you look like you have more of it. Try Kiehl’s Rice & Wheat Volumizing Shampoo ($18) with hydrolyzed wheat protein; Rogers likes Redken Cerafill Defy Shampoo and Conditioner ($20 each) with ceramides that bulk up hair.
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Hey man this was life saving article for me thank you so much… but I’ve still a doubt on finasteride. I saw many articles on finasteride all were negative about side affects.. My doctor advised me to take finasteride of 2.5mg daily for 90days.. what do you think is it good advice to take finasteride of 2.5mg daily??? I’m too young to lose my sex drive
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.
Although unwanted hair growth has been reported on the face and on other parts of the body, such reports have been infrequent. The unwanted hair growth may be caused by the transfer of minoxidil topical solution 2% to areas other than the scalp, or by absorption into the circulatory system of low levels of the active ingredient, or by a medical condition not related to the use of minoxidil topical solution 2%.
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.

Most women with pattern hair loss don't get a receding hairline or bald spot on top of the scalp as is common in men. Instead, there is visible thinning over the crown. In men and women, hairs are miniaturized because of a shortened growth cycle where the hair stays on the head for a shorter period of time. These wispy hairs, which resemble forearm hairs, do not achieve their usual length.

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The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
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.
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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.
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For the past two decades, scientists have made strides in developing hair loss treatments that are both safe and effective. However, the market is inundated with ineffective products; "99 percent of all products being marketed in the less than ethical hair loss treatment industry are completely ineffective for the majority of those who use them," according to the AHLA.
Propecia is no joke. Fair enough, you’ve been fine on it, but I can assure you that there are more people than you think whose lives have been completely destroyed by this drug. Shrinking penis’ and testicles, just 2 of the documented side effects are not nocebo. Many people have not able to reverse the many effects of propecia for years, after only taking the drug in some cases for just a few days !
The use of PRP “enhancements” such as Extracellular Matrix (ECMs) as well as Stem Cells/Signaling Cells can be added to the PRP to enhance it’s hair growth properties and prolong its effects. When PRP is performed without these enhancements, multiple repeat treatments are needed as often as every other month. Research has shown that the use of ECMs like ACell–derived from porcine/pig bladder, BioD–derived from donated healthy human placenta, Adipose-Derived Stem/Signalling Cells–harvested and separated from the patient’s own fat, and even special exosome preparations can help strengthen the effectiveness and lengthen the duration of the results from a single PRP treatment.  
Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid. When hair loss occurs quickly, the person may have tingling, burning, pain, or itching on the scalp. Treatment may help the hair re-grow if scarring has not occurred.
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.
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
Aside from medication and lasers, some opt for hair transplants — a procedure where hairs are removed from another part of your body and then transplanted to the thinning or balding areas. Does it work? In a word, yes. Research suggests that most hair transplant recipients report are "very satisfied" with their results. While successful, transplants are also far more expensive than medications, foams, or lasers with costs averaging anywhere from $4,000 or $15,000.
But in November, after 10 years of research, Rogaine introduced a new 5 percent minoxidil formulation for women. It’s a mousse (instead of a liquid) that needs to be applied only once a day instead of twice, which means that it can be more easily incorporated into a woman’s evening skin-care routine. Teal replaces the blue and silver palette of the men’s Rogaine, and the packaging bears a lotus flower. (Also last year, Pantene introduced its Hair Regrowth Treatment for Women, which is 2 percent minoxidil.)
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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